From ... in Health — Oct 10, 2019

Qatar: Urgently Investigate Migrant Worker Deaths

A foreign worker climbs scaffolding at the Al-Wakra Stadium that is under construction for the 2022 World Cup, in Doha, Qatar.

Research published in the Cardiology Journal in July by a group of climatologists and cardiologists explored the relationship between the deaths of more than 1,300 Nepali workers between 2009 and 2017 and heat exposure.

They found a strong correlation between heat stress and young workers dying of cardiovascular problems in the summer months. An October Guardian analysis of official weather data over a nine-year period also emphasized that workers laboring outside of the times prohibited by a summer working hours ban in Qatar are still regularly being exposed to potentially fatal levels of heat stress. “The sudden and unexpected deaths of often young and healthy migrant workers in Qatar have gone uninvestigated by Qatari authorities, in apparent disregard for workers’ lives,” said Sarah Leah Whitson, Middle East director at Human Rights Watch. “Qatar cannot claim to uphold migrant workers’ rights as long as it ignores urgent and repeated calls for lifesaving reforms that protect workers from the heat.” According to a second Guardian investigation published on October 7 that relied on data obtained from official Nepali and Indian sources, the cause of death of 676 of at least 1,025 Nepalis who died in Qatar between 2012 and 2017 and 1,345 of 1,678 Indians who died in Qatar between 2012 and August 2018 was attributed to “natural causes.” Using data largely derived from death certificates issued in Qatar, the causes listed included cardiac arrest, heart attack, respiratory failure, and “sickness,” terms that obscure the underlying cause of deaths and make it impossible to determine whether they may be related to working conditions, such as heat stress. Human Rights Watch did not independently verify this data. When such deaths are attributed to “natural causes” and categorized as non-work-related, Qatar’s labor law denies families compensation, leaving many of them destitute in the absence of their often-sole income provider. In 2014, a report the Qatari government commissioned by the international law firm DLA Piper noted that the number of worker deaths in Qatar attributed to cardiac arrest, a general term that does not specify cause of death, was “seemingly high.” The report presented two key recommendations in that regard that authorities have not carried out. One recommendation was to reform laws to mandate autopsies or post-mortem examinations into “unexpected or sudden deaths.” The second was for an independent study into the “seemingly high” number of deaths vaguely attributed to cardiac arrest. Guidance by other countries on the completion of death certificates shows that a cause of death reported only as “cardiac arrest” is highly problematic. For instance, the United States Center for Disease Control and Prevention (CDC) offers guidance to doctors that “The mechanism of death (for example, cardiac or respiratory arrest) should not be reported as the immediate cause of death as it is a statement not specifically related to the disease process, and it merely attests to the fact of death.” In 2017, a Human Rights Watch report further demonstrated the inadequacy of Qatar’s time-and date-bound heat mitigation strategy in addressing the very real heat-related risks that outdoor workers face due to very high temperatures in Qatar outside these hours and times of year. It also found that the Qatari authorities’ failure to perform autopsies or post-mortems on deceased foreign workers when the cause of death was unclear was a significant problem. Yet, two years on, Qatar continues to enforce a demonstrably rudimentary summer working hours ban that only prohibits outdoor work between 11:30 a.m. and 3 p.m. from June 15 to August 31. Moreover, Qatar has not made public meaningful data on migrant worker deaths for six years that would allow an assessment of the extent to which heat stress is a factor. In contrast, Qatar’s 2022 FIFA World Cup organizers, the quasi-governmental Supreme Committee for Delivery Legacy, in 2016 mandated work-to-rest ratios, commensurate with the risk posed by heat and humidity, for the small percentage of workers exclusively building stadiums for the tournament.

These measures are an improvement over the general government regulations. But they don’t take into account the effect of sunlight, which, according to the Wet Bulb Globe Temperature (WBGT) heat stress index, significantly increases the risk of heat stress.

The WBGT measures the combined effect of temperature, humidity, wind speed, and solar radiation on humans.

The Supreme Committee has also been more transparent about reporting worker deaths for projects under its purview. But the data falls short of providing an accurate assessment of the causes of worker deaths: out of a total of 10 worker deaths on World Cup projects between October 2015 and July 2017, it listed 7 of these deaths as non-work-related deaths resulting from “cardiac arrest” and “acute respiratory failure.” Of the 10 worker deaths recorded between February 2018 and January 2019 and labeled as non-work-related, it attributed 9 to acute heart failure or acute respiratory failure. Qatari authorities should immediately replace the limited midday summer work ban with a legally binding requirement based on actual weather conditions consistent with international best practice standards. This should include rest-to-work ratios commensurate with the risk from heat and humidity exposure, access to shade, plentiful hydration, and the prohibition of work during all times of unacceptable heat risk.

The authorities should engage heat stress specialists in drafting legislation, which should include meaningful sanctions for noncompliance. Authorities should also release data on migrant worker deaths from the past six years, broken down by age, gender, occupation, and cause of death, amend its law on autopsies to require medical examinations and allow forensic investigations into all sudden or unexplained deaths, and pass legislation to require that all death certificates include reference to a medically meaningful cause of death. India, Nepal, Bangladesh, and other labor-sending countries should insist that Qatar carry out investigations into worker deaths, make comprehensive data publicly available, and put in place reforms to protect workers from heat, Human Rights Watch said. “There are no excuses for Qatar to drag its feet on an issue as important as why migrant workers are dying,” Whitson said. “Instead of turning a blind eye, FIFA, as well as other sporting associations choosing to stage international sporting events in Qatar, should be insisting that all workers toiling away in intense weather conditions to build the infrastructure necessary to host such mega events are adequately p.

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