Young Nepalese migrant workers returning from Saudi Arabia with chronic kidney disease (CKD) highlight a “silent epidemic” linked to extreme heat and poor labour conditions, raising alarms about Saudi Arabia’s compliance with FIFA’s human rights and labour standards for the 2034 World Cup. A University of Gothenburg study reveals one-third of young male dialysis patients in Kathmandu worked in the Gulf, starting treatment 17 years early, as preparations for World Cup venues amplify risks in 50°C+ temperatures.
Migrant Worker Health Crisis in Saudi Arabia
Nepalese migrant workers are returning home with failed kidneys after years of grueling labour in Saudi Arabia’s scorching heat, fueling fresh concerns over the kingdom’s hosting of the FIFA 2034 World Cup. Health experts at Nepal’s National Kidney Center report that over 20% of recent dialysis admissions involve Gulf returnees, many in their early 30s, who endured minimal protections like infrequent water breaks during construction and desert work. This “silent epidemic” of chronic kidney disease (CKD), tied directly to heat stress, intersects with Saudi Arabia’s massive infrastructure buildout for 15+ stadiums and Vision 2030 projects, prompting human rights groups to question FIFA’s oversight.
The plight of workers like Buddhi Bahadur Kami and Kul Bahadur Dulal underscores the human cost of Saudi labour. Buddhi Bahadur Kami, 41, spent 11 years painting large diesel storage tanks in Saudi Arabia’s relentless heat, sweating through thick uniforms and protective masks with water provided only every few hours, before returning to Nepal with failed kidneys. Kul Bahadur Dulal, 46, drove trucks across Saudi deserts for a decade, living in overcrowded camps, and now requires lifelong dialysis after his kidneys collapsed. Dr Rishi Kumar Kafle, nephrologist and founder of the National Kidney Center in Kathmandu, noted:
“A young boy who was healthy goes there and in two, three years he comes back with kidney failure.”
Nurse Deepa Adhikari at the center described the emotional toll, saying patients are
“financially, physically, and emotionally stressed,”
with families burdened by the cycle of poverty that drives more relatives abroad. Of the 138 patients admitted in the past six months, more than 20% had worked in the Gulf, including Saudi Arabia.
University of Gothenburg Study Reveals Stark Patterns
A forthcoming technical report by researchers from the University of Gothenburg analyzed 404 patients across five Kathmandu dialysis clinics. The study found that one out of three male patients on dialysis had worked abroad in hot climates, predominantly Saudi Arabia, Dubai, Qatar, Kuwait, Malaysia, and India. These workers began dialysis in their early 30s, an average of 17 years earlier than non-migrants, with half diagnosed in the host country. Senior researcher Kristina Jakobsson explained the mechanism: exposure to sun during straining tasks causes dehydration and heat stress, straining kidneys’ ability to regulate fluids and waste.
This aligns with global trends, as a 2022 study linked high temperatures and demanding work to surging CKD, projected to become the fifth largest cause of premature death by 2050.
FIFA 2034 World Cup Preparations Amplify Risks
Saudi Arabia’s solo bid for the 2034 men’s FIFA World Cup, confirmed in December 2024, promises 15 stadiums, fan zones, and transport upgrades amid temperatures exceeding 50°C and worsening dust storms. Human rights organizations warn of migrant worker deaths and exploitation in these builds, echoing Qatar 2022 failures.
In a New York Times Athletic article, FIFA faces accusations of “utter negligence” over Saudi’s 2034 hosting, with migrant worker risks central. Author Tariq Panja reported on 14 May 2025 that campaigners highlight the kafala system enabling passport confiscation and wage withholding. BBC News, in a piece by Sima Kotecha on 14 May 2025, detailed human rights groups warning of migrant worker deaths from heat and falls. The article cited unreported fatalities labeled “natural,” denying families compensation.
Human Rights Watch (HRW), in a 8 November 2024 report by Rothna Osman, warned:
“Saudi Arabia: 2034 World Cup Risks Widespread Labor Abuse.”
It flagged dangers in stadium construction, including heat exposure for South Asian migrants. Amnesty International, on 11 December 2024, stated the confirmation “puts many lives at risk,” urging binding reforms.
Mixed Migration Centre’s 1 July 2025 analysis, “Behind the scenes of Saudi Arabia’s labour engine,” exposed overcrowded housing and debt bondage fueling the crisis. A Human Rights Research Portal post on 22 May 2025 noted “migrant workers face danger, exploitation in preparation for the 2034 FIFA World Cup.”
Labour Rights and FIFA Standards Under Scrutiny
FIFA’s human rights policy requires hosts to uphold labour rights, yet Saudi’s midday work bans are deemed inadequate by experts. Dr Barrak Alahmad, director of Harvard’s Occupational Health and Climate Change Program, criticised bans assuming no heat stroke before 11:00 a.m., despite 125°F peaks in May. Qatar’s 2021 order mandates halts at wet bulb globe temperature over 32.1°C, but lacks continuous monitoring, per ILO’s Michail Kandarakis. HRW’s Michael Page, quoted in the In These Times article, called for pressure on companies and states.
CBC Sports, in a 13 December 2024 article by Anjani Patel, reported Saudi’s plans “harmful for the climate,” tying emissions to worker heat exposure. A Fair Square NGO piece on 9 February 2025 urged India to act on the “human cost” for its migrants.
Climate and Health Dimensions Challenge Ethical Hosting
CKD affects 674 million globally, with 90% in low-income areas lacking care; heat waves spike renal hospitalizations by 1-3%, per studies in Brazil and New York. A PMC article on 20 August 2025, “The 2034 FIFA World Cup in Saudi Arabia,” linked Gulf warming—twice the global average—to occupational hazards. YouTube’s HRW video from 14 May 2025 warned of migrant deaths.
La Isla Network’s Nicaragua model cut kidney injuries 70% via shaded breaks, proving prevention viability, yet Gulf states lag.
Governance and Transparency Gaps
Saudi offloads costs: $57 billion health spend vs Nepal’s $605 million, leaving clinics unpaid. FIFA’s transparency is questioned amid “sportswashing” accusations, where oil wealth masks abuses. HRW and Amnesty demand data on heat-related illnesses, absent in Saudi.
Implications for Stakeholders and Global Debates
Fans, civil society, and rights groups raise legitimate concerns: does 2034 hosting align with FIFA’s standards? Broader debates on accountability intensify, with calls for mandated insurance, screenings, and reforms to curb sportswashing. Prevention—frequent breaks, hydration, monitoring—could save lives, as Dr Kafle insists:
“Treatment is not the answer. Prevention is.”