“I had tears in my eyes but I just left without looking back”. A qualitative study of migration-related stressors amongst Nepali male labour migrants

Abstract

Labour migration has become a crucial livelihood strategy in settings where employment options are limited. Such opportunities come with potential benefits but also introduce stressors. This study explores migration-related stressors amongst returnee male Nepali international labour migrants. We conducted a qualitative study in Kathmandu amongst 42 returnee male international labour migrants. We explored migration decisions, processes, experiences in destination and on return. The participants worked in low- and semi-skilled jobs in Malaysia, Qatar, and Saudi Arabia. Men reported stressors representing five broad areas: workplace/employer, family, recruitment, environment and legal. Most belonged to the workplace/employer category such as exploitative practices of document confiscation, contract discrepancies and poor working conditions. Family stressors were often due to disagreements about whether to migrate, and once in destination, being absent during illness and death in the family. Recruitment stressors were linked to the migration process and costs. Environmental stressors included over-crowdedness and poor hygiene, and poor security at the accommodation and in the wider town. Legal stressors were related to the lack of documentation, and negative encounters with the local police. Multiple stressors were often experienced simultaneously or in succession. Male labour migrants from Nepal who had worked in various countries and job-sectors reported multiple types of stress. The majority of stressors belong to the workplace category, where migrants may have limited power to challenge problems with their employers. The cumulative effect of such experiences may negatively impact on migrants’ wellbeing. Future research should explore migrants’ ability to cope with the many stressors encountered.

1. Introduction

Labour migration has become a crucial livelihood strategy in settings where decently paid employment opportunities are limited. Under these circumstances, migration is often circular, where workers migrate repeatedly between their home country and work destination (Wickramasekara, 2011). Many benefits have been attributed to labour migration particularly through the remittances sent home, such as improved household well-being, better access to education and healthcare (Adhikari and Hobley, 2011; McLeman and Smit, 2006). There are simultaneously numerous challenges, starting with the difficulties of securing employment to fulfilling various procedural requirements for migration in the country of origin. In many settings, migrants have to take out loans to fund their migration and make use of informal recruitment agents who are often neighbours, community members or even relatives making it difficult to report and pursue them if the situation in country is not as previously agreed (Hynes et al., 2018). Further, once in a destination, many migrants encounter stressful, and sometimes hazardous living and working conditions, frequently related to poor occupational protection, overcrowded living space and limited access to healthcare. Numerous reports have documented labour exploitative practices including: document confiscation; contract breaches; restrictions of movement; and non-payment of wages (Mak et al., 2017; Amnesty International, 2011; Verité, 2014; Environmental Justice Foundation, 2013; McCormack et al., 2015; IOM Kuwait, 2017; Asia Foundation, 2013; Government of Nepal, 2012; World Bank, 2016). For those in low-wage sectors, occupational hazards are exacerbated by the limited enforcement of regulations and policies (Kortum and Leka, 2014; Kaur, 2010). Some sources of stress are directly due to being international migrants, and their potential precarious legal and job status which are often controlled by their employer and are affected by their financial burdens to fund the migration (Datta et al., 2007; Lenard and Straehle, 2010; Asia Foundation, 2013; Environmental Justice Foundation, 2013; Government of Nepal, 2012).

Research on acculturation has been traditionally conducted amongst immigrant populations who have moved to locations that are culturally, socially, and politically different to their home country, with the intention to permanently resettle. The acculturation process is often described using Berry's concepts of integration, assimilation, separation and marginalisation (Berry et al., 1987; Esses, 2018). Labour migrants, whose stays are usually temporary, nevertheless have similar cross-culture experience. These can be exacerbated for those that spend substantial parts of their working life outside their own country. Combined, these stressors shape the experiences of labour migrants, and may contribute to poor wellbeing, including physical and mental health (Selenko and Batinic, 2011; Kesornsri et al., 2014; Sonnentag and Fritz, 2014; Tsutsumi et al., 2001).

In Nepal, international labour migration is common, especially for men (Government of Nepal, 2020). The main destinations for Nepali men migrating for work are Malaysia and the Gulf Cooperation Council (GCC), particularly Qatar, the United Arab Emirates, Saudi Arabia and Kuwait. Additionally, new destinations have been emerging in recent years due to changes in demographic trends in Asia and Europe. Since 2017, countries ranging from Poland, the Maldives, Jordan, Turkey, Cyprus, and Malta have all been issued between two and four thousand labour approvals annually, representing approximately 1.0% of total permits issued (Government of Nepal, 2020). Many reports have suggested labour migrants in low-skilled, low-waged, irregular or precarious work are more vulnerable to exploitation, including work-related accidents and fatalities (Rosano et al., 2012; Amnesty International, 2011; Government of Nepal, 2020; Wright, 2008). Few studies have explored migrants’ own perceptions of the types of stressors experienced throughout their migrations. This study, therefore, explores male Nepali labour migrants’ experiences of migration-related stressors to understand how these differ between employments, destinations, and how they affect men's life.

2. Methods

Qualitative life histories were conducted amongst a sample of male Nepali returnee migrants. Men were asked to talk about their life, beginning with their childhood, upbringing and family life leading up to their first migration, followed by migration experiences including decisions, family reactions, processes, experiences in destination, and their return to Nepal, as well as subsequent migrations.

Participants were recruited from low-cost hotels in the vicinity of Nepal's international airport and main bus stations in Kathmandu. These areas were selected as most returnee migrants need to spend the night in Kathmandu after arrival to connect with onward journey back to their villages. Prior to data collection, the lodges were visited by the first author and an interpreter to introduce the study and to seek permission to recruit participants on their premises. Those that granted permission were visited several times per week during data collection to seek participants. The early interviews comprised of migrants on holiday who intended to return to the destination to continue their employment. Local migrant organisations were later contacted to expand the range of potential participants.

Fieldwork took place between February and May 2016, concluding when saturation was reached with the final interviews reflecting very similar experiences to earlier ones. Interviews were conducted in English with the assistance of an interpreter and were audio-recorded with permission., The recordings were then translated into English for analysis. Two male assistants were involved in supporting the research by providing interpretation and later transcribing and translating some of the interview scripts. Four scripts from each interpreter were sent to an independent transcriber/translator to cross check for quality and accuracy.

Ethical approvals were obtained from the institution removed in anonymous version and the Nepal Health Research Council. Participants were given study information verbally and in writing, and provided written consent in a language of their choice, before interviews began. Additionally, each participant was given 500 NPR (approximately $5.00 USD) as compensation for their time.

2.1. Data analysis

Identification numbers were assigned to each interview to maintain the anonymity of the participants. The translated interview scripts were first read in their entirety and then open-coded in NVivo 11.0 by the first author to develop a coding scheme. The codes related to stressors were refined, expanded or collapsed to arrive at a final overall scheme.

To categorise the stressors, we adapted elements of existing workplace and acculturative frameworks. Workplace stress was based on Luthans’ work on macro-levels of organisational stress (Luthans, 2002) and an adaptation of Cooper and Marshall's job-stress model (cited in Lai et al., 2015). Acculturation elements were based on Berry's framework on integration, assimilation, separation and marginalisation (Berry et al., 1987). Specific migrant worker stressors drew on instruments Wong and Song's developed for and tested amongst migrant workers in China (Wong and Song, 2008) and the Migrant Farmworker Stress Inventory developed for Spanish-speaking farmworkers in the United States (Hovey, 2011). Additionally, a category relating to the recruitment agent/agency was added as this is a known source of stress for labour migrants. Once combined, the stressors represented seven categories: workplace, family, recruitment agent/agency, environment, legal, socio-cultural, and health, summarised in

Table 1. A matrix was developed with the coded data in the stressor categories and thematic analysis conducted to explore relationships across and within themes and sub-themes.

Table 1.

Stressor categories and description.

Stressor category	Description
Family†	concerns about illness or death in the family; relationships; children's needs; lack of appreciation by family
Recruitment agent/agency	application; fees; advice; job-search; travel arrangements.
Legal†	migration process and regulations; discrepancy between documents and employment; conflicts with authorities, potential deportation risks
Workplace (employer)*†	company policies; contract discrepancies; delayed, non-payment of wages; poor wages; poor working conditions; unequal treatment of workers; documentation confiscations; restricted freedom of movement; financial penalties for early termination of contract; work overload; job insecurity; occupational hazards
Environmental†,ⱡ	physical environment; security; housing; over-crowded; sanitary facilities; conflicts with those sharing accommodation and facilities
Socio-cultural†,ⱡ	political; economic; linguistic; religious; social issues.
Health†	non-occupational-related illness and accidents

Stressor category source: *workplace stress models

^†migrant worker stress.

^ⱡacculturative stress model.

Family stressors may stem from extended absences contributing to the deterioration of relationships, particularly with spouse and children. Recruitment agent/agency stressors pertain to the job-seeking and application process, including fees and logistical arrangements. Legal stressors include negative encounters with the police or other authorities, or due to migrants’ status and deportation risks. Workplace stressors refer to those imposed by the employer, such as the terms and conditions of employment, job security, occupational hazards, workplace conflicts, as well as exploitative labour practices. Environmental stressors include the housing, sanitation, climate and non-work-related conflicts and discrimination, such as those in the wider town, with host population and within the living environment. While political, economic, social, linguistic and religious issues either in the country of origin or destination form the socio-cultural stressors. Finally, migrants’ own physical, mental and emotional health may also be sources of stress which may arise from having to live and work in very different circumstances, away from family and friends.

3. Results

3.1. Study sample

Forty-two returnee men aged between 21 and 53 were interviewed and their characteristics are presented in Table 2. Most of the men (57%) received some secondary education, represented a range of caste/ethnic groups and were mostly from the Terai area of Nepal. Over half, n = 25, had migrated between two and five times. In their most recent migration, most men worked in Qatar, Saudi Arabia, and Malaysia as general labourers, factory workers, security guards or in semi-skilled work including drivers and carpenters. The men stayed in the destination country for between two months and 14 years during their most recent migration, and seven were on leave in Nepal.

Table 2.

Demographic and migration characteristics of study sample.

Age-groups:	n (%)
<25	10 (23.8)
25–34	20 (47.6)
35–44	9 (21.4)
≥45	3 (7.1)
Caste/ethnicity:
Brahman/Chhetree	12 (28.6)
Janajati	15 (35.7)
Dalit	5 (11.9)
Other	10 (23.8)
Area of origin:
Terai (lowland)	33 (78.6)
Hill	8 (19.0)
Mountain	1 (2.4)
Highest level of education attended*:
None/Informal/Primary	10 (23.8)
Secondary	24 (57.1)
Higher secondary/vocational/tertiary	8 (19.0)
No. previous labour migrations:
Once	17 (40.5)
More than once	25 (59.5)
Most recent migration destination:
Malaysia	12 (28.6)
Qatar	12 (28.6)
Saudi Arabia	11 (26.2)
United Arab Emirates	5 (11.9)
Kuwait	1 (2.4)
Afghanistan	1 (2.4)
Most recent migration work:
General labourer/porter	16 (38.1)
Driver / carpenter / plumber / mason	10 (23.8)
Factory worker	6 (14.3)
Kitchen /food-related work	4 (9.5)
Security	4 (9.5)
Retail/office boy	2 (4.8)
Duration of most recent migration*:
< 1 year	6 (14.3)
1 - <3 years	18 (42.9)
3 - <5 years	7 (16.7)
5 - <10 years	8 (19.0)
≥10 years	3 (7.1)
Next plans:
Return to the same job and employer	7 (16.7)
Re-migrate to different destination/job/company	22 (52.4)
Stay in Nepal	8 (19.0)
Undecided	5 (11.9)

3.2. Workplace stressors

Workplace stressors are those controlled and imposed by the employer. Twenty-seven men in this study described exploitative practices in at least one of their previous migration experiences. These included contract discrepancies, document confiscation, restrictions of movement particularly in relation to participant's desire to return to Nepal. Another five described workplace stressors that do not amount to exploitation but involved interpersonal conflicts with colleagues and foremen which impacted on their working life. Other workplace stressors encountered included poor or hazardous working conditions, and at the onset, not being picked up on arrival at the airport.

3.2.1. Stranded at the airport

For many men, the stress began immediately upon arrival in the destination country. Six men (three in Malaysia and three in Saudi Arabia) reported not being collected at the airport, or having to wait for up to two days, during which time some encountered problems with the security staff at the airport. Often, the small amount of local currency participants had was spent on phone calls to the recruitment agent/agency in Nepal or the employer at destination. One participant described his uncertainty and feelings of helplessness during this time:

When we went to Malaysia for the first time. … we stayed there for 2 days at airport. Nobody came to receive us. We were kept like dogs. We kept waiting. We were told that someone will come when we arrived and we would be picked up. We phoned him many times. We just kept waiting, we didn't know anything else. Then, they came after 2 days. … when I slept [at the airport], police came and beat us up. It was really difficult. (ID 21, age-group <25)

3.2.2. Document confiscation

Documents, such as passports and contracts signed in Nepal, were nearly always collected by the employer shortly after arrival at the company. Employment identification cards were sometimes also kept by the employer. Some migrants received a photocopy of their passport, while others received their official identification card only after working for several months. An official form of identification is often required if migrants were stopped by the police. Not having it, or having only a photocopy can be problematic, as explained by one participant:

I was not given ID, I didn't have visa so I didn't go outside because of fear of the police. … I asked many times for it but they [employer] did not give it to me. (ID 10, age-group <25)

Passports would only be returned when participants completed their contract. Some men explained that employers used these tactics to prevent them from running away or seeking work elsewhere. Some employers exerted further control on migrants’ movements even on their days off, as one participant described:

Yes [we could] if we wanted [to go out]. But we couldn't go far. We couldn't go towards KL [Kuala Lumpur]. The copy of passport would only allow us to move inside Johor Bahru. The company did not let us leave Johor Bahru… They gave permission to go to some specific place. We could go there if given permission. But not everyone could go together. (ID 21, age-group <25)

3.2.3. Contract discrepancies and substitutions

The most common stressors were by far discrepancies between the agreements signed in Nepal and the actual situation in destination country. Men reported being given new contracts to sign with worse terms and conditions in relation to the job, wages, deductions, working hours, and contract duration. Those who questioned the differences were told that only the contract signed at the destination country was valid. As one participant noted:

They came with new agreement papers and asked us to sign it. There it [the salary] was written as 700 plus 200 and I said that I had signed for 900 plus 200 in Nepal and why is the amount changed here. Then I asked for my passport to come back. They said that it is the normal process that the actual agreement will be signed at the work site. As I was there for first time, I believed them and signed it. (ID 10, age-group <25)

In another case, the new contract came after the participant had been working for several months. Although the participant could not read the new contract, he saw a figure that matched the salary in the agreement he had signed in Nepal and queried why the amount he was being paid was lower than what was written in the document.

Employers were also reported to have threatened those who refused to sign the new agreement:

And when we reached the company, our boss took all our documents and brought a new agreement paper of 5-years [instead of the 3-years signed in Nepal]. We did not sign it for 5,6 days but the company had our passport and they said that if you don't sign it, we won't give you accommodation, food, passport. We had no money and no passport and we also feared the police so we signed it. (ID 15, age-group <25)

Problems with wages continued during their employment in the form of delayed, withheld, or non-payment of wages or overtime hours. Those who wanted to terminate their contract early were told to pay fines representing several months’ salary, as well as their flight costs, and sometimes, an additional charge to get the required exit permit and their passports back.

3.2.4. Work environment & occupational hazards

Men reported heavy workloads including difficult work, long hours, and no days off. For example, five reported not having had a single day off during their entire contract while three reported working for between 16 and 18 h each working day. These practices can also continue until the day participants were due to leave the country.

The day we were returning [to Nepal], the day of the flight, we were made to work till about 6 or 7 o'clock in the evening. Then we went to our room. Two hours after that, we were dropped by a bus. (ID 21, age-group <25)

Working outdoors, digging roads and other construction work, particularly in the Gulf States exposed migrants to immense heat. Those who worked as labourers did not have fixed roles but would be called upon for any number of tasks. Others were actually employed by supply companies that act as middlemen, providing labour to other companies. One participant reported working for over 20 companies in a two-month period, sometimes two companies in the same day. Time pressures to complete tasks and lack of support from supervisors were highlighted by one participant who worked as a security guard:

…the company was very big and being a security guard, I had to patrol in the night. To complete the patrol, it used to take me one hour… I had to sign papers that were at different patrolling locations … if I didn't complete the patrol on time then my supervisor would scold me and called me a dog. Friends never supported me because if they did they might face problems. At that moment you really feel so helpless. (ID 38, age-group 35–44)

Working in factories can be dangerous and several participants reported exposures to chemicals or dust from production of cotton and paper products, due to insufficient or poor-quality protective gear, to machine malfunctions that resulted in injuries. Several men who worked as machine operators had occupational accidents, such as one who was operating a packing machine:

…the product comes on the line of the machine. There is a light that turns on and the decoration is filled and the product is cut. That light was not working and the machine was on and it cut my hand…this [showing where he was injured] was broken, it was cut till here, in x-ray everything was seen. (ID 13, age-group <25)

Initially, his medical expenses, including hospital stay, treatment, and follow-up consultations were paid for by the employer but these were later deducted from his salary. Another participant who experienced a similar accident had his medical expenses in the destination covered but was later sent back to Nepal with no compensation or further support for his on-going healthcare needs.

3.2.5. Return to Nepal

Employers often imposed restrictions on whether and under what terms men could return to Nepal, even on completion of their contract. One security guard who worked in Malaysia described:

The company didn't allow me to return back even after completing my three-year contract. I was staying there illegally for six months and I asked them to give us our tickets, so we could go home but still they didn't listen. (ID 38, age-group 35–44)

Another participant who wanted to return to Nepal was told to pay a large deposit to ensure his return:

So, I said to company either send me for holidays or finish my contract. The company agreed to send me on holiday but I had to deposit 7000 ringgits, which takes 7 months to earn. I was not sure I will be alive or dead in those 7 months… (ID 8, age-group <25)

Several participants were sent back to Nepal prematurely. One described the large sum of money he had paid in recruitment fees to get the job in the first place, which was seen as an investment to several years of decent earning, only to find it lasted only months when the company closed down and he was sent back to Nepal:

It was a two-year contract. They sent us back in between. That is also a problem. As it was a two-year contract, the agent took 95,000 NRP. That money was wasted. (ID 17, age-group 25–34)

3.3. Family stressors

Men's families often disagreed with their decision to migrate or the specific details of their migration, such as the destination. Men also explained their concerns about their family's wellbeing in their absence; and once in destination, their inability to be with their family during times illness and death were sources of stress for many.

3.3.1. Disagreements with migration

Parents of younger men did not always support men's decision to migrate, preferring them to continue with their studies, despite their household financial needs. Family members were also concerned about the young men's wellbeing working in a foreign country as many had never worked outside the home, and often had never even been outside their village. As explained by the participant below, family members were often conflicted on the decision to migrate:

Everybody loved me at home so didn't want me to go. Then I organised a passport by myself and brought it home. My brother told me to go to Qatar and stay with him. My other brothers told me not to go to Malaysia and said nobody is asking money from you. I reminded them about the situation, that we didn't have a house to live in. I had a lot of stress. So, because of that I went abroad… At first, they were very angry. They said they won't even give me money for the fees, and that I could go anywhere I want. I said that I'll manage it from somewhere by myself, but I'll go to Malaysia. But later, when the time came for me to leave, they agreed and gave money for the fees. (ID 21, age-group <25)

3.3.2. Illness and death

Men expressed their concerns about their ageing parents and agonised over who would care for them in their absence. Married men with young children described their distress at having to leave them behind for years on end:

It was really one of the toughest times when I was going to Malaysia, leaving behind my eldest son and wife who was pregnant. I had tears in my eyes but I just left without looking back. (ID 38, age-group 35–44)

In times of illness and death in the family, some participants returned to Nepal on leave to support their families, which in one case resulted in losing the job as he had to extend his stay to seek continued medical treatment for his mother. More often though, men were not granted leave, with their requests simply ignored or rejected: my father passed away due to cancer, I wanted to go home and requested leave from my company but it was rejected. After one year one of my brothers died and I was also not able to come back to Nepal. (ID 38, age-group 35–44)

3.4. Recruitment agents/agency stressors

Recruitment agent/agency stressors are connected to the job-seeking, application and navigating the migration process, including obtaining the required paperwork, as well as finding ways to pay for the fees charged. At various points during this process, stressors may occur due to unethical recruitment practices and the practicalities of obtaining and carrying debt to fund their migration.

3.4.1. Application and fees

Agents and agencies are often the main source of information and advice for aspiring migrants. Agents advise on the types of jobs available, key destinations, and ‘good’ employers. The entire process is usually managed by agencies, often via formal and informal agents, at a cost. Long processing times, sometimes up to one-year between submitting their passports and actually receiving a visa, despite being told by the agents that the process would be quick, was not uncommon. On the advice of the agents, participants also obtained medical clearance which was sometimes no longer valid by the time the visa arrived, resulting in their needing to reapply and pay for a second check. During the wait, participants described not receiving any information or updates until the documents have arrived, when they would be called and told to travel sometimes within days.

Although the job was usually agreed before proceeding with the visa application, sometimes the visa that eventually arrives is for a different job. Migrants may question this but ultimately trust the agents’ explanations that the visa obtained is the cheapest or easiest one to get, or that they need not be concern with what the visa says as the work at destination will be what has been agreed. Similarly, when agents/agencies charged fees that are higher than legally permitted by the Government of Nepal (GoN), they simply provided receipts for the legal allowed amount, rather than what was actually paid or not to provide receipts at all. Participants did not feel they could challenge these situations. One migrant who paid 120,000 NPR (approximately USD $1200) was given a receipt for 80,000 NRS, which was the legal amount chargeable, explained:

…they [agency] said that they have pay to immigration department, insurance, and they also have to cut the cost of staying them in hotel and food so all together it cost that amount but due to legal laws they cannot charge them more than 80,000. (ID 8, age-group <25)

Additionally, men reported receiving and signing their contract only hours before their flight and were often not able to read over them properly, as one noted:

We were in a hurry so we didn't read the contract. They explained it and then we all signed. There were about 15 to 16 people there. We all had to sign… They made us do it on the same day as our flight. After that they took us to the airport. (ID 17, age-group 25–34)

This participant further explained that the agency made them sign another document agreeing to deduct 1200 Saudi Arabian Riyals from their salary over the first six months, which would be returned on completion of the contract. But the company closed down unexpectedly and he was sent back early. He described the difficult of losing that money:

They [agency] made us sign. It was a 2-year contract… There were many people who left the company and ran away… Because of that, they hold 1200 Riyal by deducting some of the salary for a few months, like 6 months. And when you return after 2 years, when the contract is over, they will give it back to you. But we came back after 9 months… I asked for it but the manpower [recruitment agency] made a fool of us. They did not give us our money. (ID 17, age-group 25–34)

3.5. Environmental stressors

Environmental stressors concern the physical environment such as housing or the wider town where migrants live and work. Overcrowded accommodation, poor or inadequate cooking and sanitation facilities, and high levels of insecurity or crime impacted where and how men can move and their feelings of safety in their day-to-day life.

3.5.1. Accommodation & facilities

Poor and overcrowded accommodation and facilities such as rooms with more workers than beds or mattresses were common. One participant described his living situation as akin to “a goat's shed” (ID 35). Insufficient cooking and sanitation facilities compounded by the overcrowded accommodation meant migrants were sometimes unable to use the bathroom facilities in the mornings before work:

There was a hall and 35 people used to stay there with just one toilet and one bathroom. We had to bathe and eat and cook right there and sleep as well… If we didn't go early in the morning, there would be a line. Half of us went to toilet in the company. They [the other workers] would join the line in the morning, but when it was time to go to the company, they had to leave. (ID 21, age-group <25)

Many participants described not having anywhere in the accommodation to keep their personal belongings, resorting to storing them in their suitcase. In some rooms there were cupboards that could be used, but again, there were fewer than the number of migrants. One participant was able to access one after five-months when some migrants left the accommodation.

3.5.2. Security

Security of both the accommodation and the wider town in which men lived and worked were highlighted in a number of interviews. Many reported thefts in the accommodation, ranging from losing personal belongings such as cash and mobile phones, to communal items such as gas canisters for cooking, as well as physical conflicts within the accommodation. Additionally, many described encounters with locals in town as discriminatory, hostile and unsafe. This resulted in some reportedly not going out on their days off, or not going out alone, for fear of being robbed. Those who had to travel to and from work without company transportation were fearful of attacks even during the day:

…when we needed to walk then that would be very frightening. People would come from behind and hit us and take our money, mobile and then run away. … they would come on bikes and threaten us with knives and ask for money. If they get our money, then it is ok or else they would hit us and take it by force. (ID 11, age-group 25–34)

3.6. Legal stressors

Men with discrepancies in their official paperwork, such as work permit and visa, and those who were irregular, feared being caught, arrested and deported. Even amongst those with regular status, many reported being asked for bribes by the police, or the police being unsupportive when men were the victims of crime.

3.6.1. Documents

Official identification documents sometimes did not match migrants’ actual situation. For example, some had to increase their ages to meet the regulations for migration; others travelled on the wrong visa (as tourist), or had a visa for a different job than that which they actually did. Although none of the participants reported ever having had their documents checked against their actual work, there are occupations that are more at risk than others, such as drivers:

It [the job listed on the visa] was written fork lift. But the one I wanted was for driver. They told me they would change it after I got there… It was stressful to drive without a license, right? If I was stopped by police, I could go to jail, or worse if I hit and kill someone. They don't settle for money, even in Nepal. (ID 20, age-group 25–34)

3.6.2. Encounters with police and authorities

The most common interactions with the local police occurred when migrants were out on their day off work. As previously mentioned, few were given identification documents and passports were always held by the employers. Those who worked in Malaysia, in particular, reported that police would stop them on the streets, demanding to see original passports. They would then ask for bribes regardless of whether migrants had identification. For those without identification, the situation was more stressful and some reported paying multiple times:

…if we have ID the police also take money …they say I have to pay or they won't let me go. Not all police are like that, but some are. (ID 6, age-group <25)

Six men (four in Malaysia and two in Qatar) also reported having been victims of crime, mainly theft of mobile phones and cash. Those in Malaysia that had reported these to the police found them to be unsupportive. While others explained that they would not go to the police for anything. Two participants were detained and incarcerated due to physical confrontations in the accommodation in one case and following complaints of the persistent non-payment of salary in the other. In the latter case, the participant, along with other workers, filed a case against the employer and was told the police would help but they were arrested instead and were not told why. Both men reported not being able to contact anyone while in detention. Their personal belongings, including mobile phones and cash were confiscated and not returned when they were released several weeks later.

4. Discussion

This paper explored migration-related stressors encountered by male Nepali labour migrants. Stressors were categorised based on models of workplace stress, labour migrant stress, and acculturative stress, using those components relevant to this study's population. The men interviewed worked primarily in Malaysia and the Gulf States, but the range of stressors reported were similar, apart from security issues such as petty crime and corrupt police which were reported more amongst those who had worked in Malaysia. These findings are also similar to those experienced by other migrants in low- or semi-skilled work working in low- and middle-income countries (LMICs) as well as high-income ones including the UK, the US, and Australia (Potter and Hamilton, 2014; Ramos et al., 2016; Asia Foundation, 2013; Amnesty International, 2011; Environmental Justice Foundation, 2013).

Workplace stressors were by far the most commonly reported which included contract discrepancies, job insecurity, poor working conditions, non-payment of wages, occupational hazards, and restrictions of movement, many of which are indicative of forced labour (ILO, 2012). Some of these stressors have also been linked to occupational accidents, illness and poor physical and mental health (Benach and Muntaner, 2007). For example, studies amongst migrant farmworkers in the US found high-levels of stress, depressive symptoms and occupational injuries, and that stressful working conditions were associated with depression, and isolation with anxiety (Hiott et al., 2008). While occupational injuries were associated with depressive symptoms, and depression itself was also associated with stress, making it a vicious cycle (Ramos et al., 2016). Excessive job demands, high-levels of interpersonal conflict and low job control were also independently associated with depressive symptoms amongst labour migrants in Korea (Lee et al., 2012). Further, labour migrants also experience higher incidences of occupational injuries compared to the host population (Rubiales-Gutiérrez et al., 2010; Guendelman and Perez-Itriago, 1987) which may be due occupational health being somewhat neglected in the informal work sectors and particularly in LMICs (Kortum and Leka, 2014) meaning migrants themselves may not recognise such risks. It may also be due to the increased use of technology in destination countries compared to migrants’ country of origin, in addition to the inadequate provision of training (Guendelman and Perez-Itriago, 1987; Kaur, 2010). However, the relationship is not always clear-cut. An analysis comparing migrant and native Spanish and Italian workers found that health conditions such as musculoskeletal and respiratory problems were more common amongst immigrant groups, while the reverse was true for stress and cardiovascular diseases (Rosano et al., 2012). Further, study amongst Filipina domestic workers in Singapore found that the high-levels of stress reported did not correspond to poor well-being, suggesting perhaps their strong social and spiritual network may have had a protective effect (Anjara et al., 2017).

Although this study did not assess participants’ mental health, the types of workplace stressors associated with poor health were commonly described by the participants. Further, some men reported being unable to return to Nepal during illness and death of family members, which would have contributed to emotional distress as negative life events, both one's own or those of someone close, or chronic financial pressures have been noted to impact on stress (Aneshensel et al., 1991). Indeed, other studies have found that migrant workers returning from the Middle East had a prevalence 29% of common mental health disorders (Tilahun et al., 2020). Some participants who reported restrictions to their movements by their employer explained that these were due to their employer's fear that workers would run away. Such practices would be unnecessary if employers honour the agreement signed in Nepal.

In many cases, workplace stressors were compounded. For example, the experience of occupational injuries followed by being sent back to Nepal with no compensation or support for ongoing healthcare needs led to further financial and practical burdens both for migrants themselves and their family. Employers need to provide sufficient protective equipment against occupational hazards, and when injuries occur, employers should bear the full cost of treatment and compensation, even if workers opt to return home for treatment. In this study, only one participant reported being appropriately cared for by his employer following his workplace accident, when he was provided with all the treatments required and given extended leave to recover in Nepal with an open offer to return to his job at a later date.

Recruitment agent/agency-related stressors included the excessive fees charged, frequently beyond the legally permitted amount with no provision of itemised bill or receipt. Many migrants also reported being given contract agreements only hours before their flight. Men were therefore unable to challenge any discrepancies as it would be too late to make any changes, and costly to abandon or postpone the journey, given the lengthy process and the fees already paid. In a study conducted by the International Labour Organisation (ILO) on recruitment practices, agents admitted to fabricating the receipts for submission to the government to match the allowable legal maximum amount (ILO, 2017). Corrupt recruitment practices are frequently associated with the country of origin but they may in fact begin in the destination countries when companies do not pay the recruitment costs to remain competitive. This means the costs are absorbed by the source country agencies, which ultimately means they are born by migrants themselves (Jureidini, 2017; ILO, 2017). Further, aspiring migrants do not generally question the fees they are told to pay even if they are aware of the legal maximum amount, nor would they cross-check with their employers once in destination, making it easy for corrupt recruitment practices to persist (Jureidini, 2017). The constant flow of aspiring migrants, high profit margins and limited risks and consequences for recruitment agents and agencies mean these unethical practices are likely to continue. Like many other key labour source countries, the GoN has introduced many policies and signed bilateral agreements with key destination countries to protect Nepali labour migrants, including, for example, the ‘Free Visa Free Ticket’, making employers responsible for visa, round trip travel cost, publishing lists of and capping the costs manpower agencies can charge to prospective migrants (National Planning Commission and UNDP, 2014; ILO, 2017). These initiatives may offer some protection against exploitative practices although implementation and enforcement remain limited, while additional approaches to ethical recruitment practices should be encouraged (Jureidini, 2017). Fair recruitment is a goal for many international dialogues and agreements, including an important branch of the ILO's work, or the International Organisation of Migration's International Recruitment Integrity System, and the Global Compact for Safe, Orderly and Regular Migration (United Nations, 2018). In the meantime, the GoN should also require agents and agencies to supply all documents to migrants for a minimum period before the scheduled departure from Nepal, so they can be reviewed, explained by trusted individuals and still have the possibility to change their mind without being penalised financially or otherwise.

Acculturative stress arises due to the social and cultural changes migrants face as they temporarily live in a new country. Studies that measured acculturative stress are inconclusive. Amongst internal and international migrants in Asia, similar associations as those highlighted previously were found: an increased risk for poor mental health compared to the native populations (Kesornsri et al., 2014; Lee et al., 2012). In contrast, a study amongst Mexican migrant farmworkers in the US found mixed effects between acculturative stress and various health outcomes (Finch et al., 2004). Even ethnic similarities may not be protective of such stress as Korean-Chinese migrant workers in Korea still found high-levels of acculturative stress which may be due to migrants’ own expectations of being treated as Koreans but instead experienced prejudices from native Koreans (Lee et al., 2012).

For low-skilled and low-waged international labour migrants, such as those in this study, these stressors are more pronounced given their limited resources, including access to safety equipment, healthcare, compensation for occupational injuries, and legal recourse against employers. Additionally, stressors are almost never experienced in isolation, but are multiple and often cumulative. For example, workplace stressors such as document confiscation led to legal stressors where men feared being stopped by the police who may demand bribe payments. While other studies have found that migrants detained in destination countries for immigration offences were often put in that position by their employers who had confiscated their documents (Kaur, 2010). Precarious legal status was also found to exacerbate exploitative conditions amongst migrants from the new European Union states, where restrictions on residency and employment apply (Potter and Hamilton, 2014).

In settings where labour migration is a livelihood strategy, such as Nepal, individuals spend many of their productive years working in other countries, there is a greater likelihood of experiencing many of these stressors through repeat migrations. Despite many studies pointing to both exploitation and other stressors labour migrants face, there are still limited successful approaches to address, prevent, minimise or to better support labour migrants. The complexity of the migration process means that many of the stressors can only be managed through greater cooperation and collaboration between origin and destination countries, adopting and adhering to international guidelines and best practice approaches.

Data for this study were collected in 2016, after a period of major disruption following the earthquake in 2015 and the subsequent disputes between Nepal and India. According to GoN data, the number of labour permits approved for men was 477,690 in 2014/2015 after which it began to fall year on year to one of the lowest figures in the past 10 years at 215,630 in 2018/19. However, this reduction also reflected a change in migration scheme. In the same period, the permits issued under the Employment Permit Scheme (EPS) between Nepal and the Republic of Korea, which are recorded separately from the general labour permits, rose annually from 5460 in 2015 to 8107 in 2018. Additionally, despite this reduction in official numbers, the remittances sent back to Nepal continued to rise in the same period (Government of Nepal, 2020). In this study, several participants expressed a desire to go via the EPS due to its perceived safety. Indeed, according to an ILO report, the EPS has been recognised by the UN Public Service Award for its role in ensuring transparency and reducing corruption through its direct government-to-government model (Kim, 2015). However, the requirements, including passing a language proficiency test, mean it is only available to aspiring migrants with some minimal literacy and can invest time and money to study. Despite the EPS's achievements, it does not completely eliminate the risk for exploitation as have been reported elsewhere (Amnesty International, 2009). Although there may be changing trends to labour migration amongst Nepalis, such as destinations or schemes, the high levels of unemployment in Nepal will mean that labour migration will continue to be an important livelihood strategy for many. Additionally, the complex migration process will necessitate the use of intermediaries, which as demonstrated in this study, were able to bypass some of the regulations put in place to protect migrants. Therefore, the findings in this study, particularly as they cut through different destinations and capture the experiences beyond the working and living conditions, but also issues related to being away from their families, particularly ageing parents and young children, are likely to continue to be applicable.

The landscape of destination countries for Nepali migrants are beginning to diversify. This can prove to be an opportune time to (re)negotiate agreements and (re)develop new policies that address stressors documented in this and other studies. While for those returning to Nepal to resettle, there is an urgent need to support and address their wellbeing, particularly given the wide range of stressors associated with their migration experiences and the impact on migrants and their families. Although the GoN has introduced a range of re-integration support, there appears to be little that addresses their wellbeing. Given that the remittances sent by migrants back to Nepal represent approximately one-quarter of the country's GDP (Government of Nepal, 2020), it seems reasonable to invest in support and services to protect and support migrants before, during and after their migration.

5. Limitations

This study uses workplace, acculturative, and migrant worker stress to categorise stressors. However, the categories are not always mutually exclusive and in some cases the source of the stressor was ambiguous. For example, in the cases of visa issues or contract discrepancies, it is not clear from migrants’ perspectives whether the deceptions had come from the recruitment agent/agency in Nepal or from the employers at destination. Nevertheless, this is likely an accurate representation of the realities of migrants’ experiences and is a useful way of organising a myriad of types and sources of stress, although further work at refinement specifically for low-waged labour migrants would be useful in future studies.

The study sample only included men who had returned to Nepal. Those who have experienced the worst forms of exploitation and could not make it back would not be included. Conversely, those who are doing well and choose to extend their stay would also not be captured in this study. Nevertheless, men who participated included those who returned on vacation and were planning to go back to their job and employer at destination, as well as those returning on completion of their contract, those who had asked for leave with no intention to return, and those who terminated their contracts early. Data saturation was reached before data collection ended. Thus, the study was able to capture a wide diversity of experiences.

Lastly, our data were collected in 2016, after a period of major disruption following the earthquake in 2015 and the subsequent disputes between Nepal and India. According to GoN data, the number of labour permits approved for men was 477,690 in 2014/2015 after which it began to fall year on year to one of the lowest figures in the past 10 years to 215,630 in 2018/19. However, this reduction also reflected a change in the types of migration men engaged. In the same period, the permits issued under the Employment Permit Scheme (EPS) between Nepal and the Republic of Korea, which are recorded separately from the general labour permits, rose steadily from 5460 in 2015 rising annually to 8107 in 2018. Despite this reduction in official numbers, the remittances sent back to Nepal continued to rise in the same period (Government of Nepal, 2020). In this study, several participants expressed a desire to go via the EPS due to its perceived safety. Indeed, according to an ILO report, the EPS has been recognised by the UN Public Service Award for its role in ensuring transparency and reducing corruption through its direct government-to-government model (Kim, 2015). However, the requirements, including passing a language proficiency test, mean it is only available to aspiring migrants with some minimal literacy and can invest time and money to study. Despite the EPS's achievements, it does not completely eliminate the risk for exploitation as have been reported elsewhere (Amnesty International, 2009). Additionally, government-to-government schemes have not been able to meet with the demand generated (Wickramasekara, 2016). Although there may be changing trends to labour migration amongst Nepalis, such as destinations or schemes, the high levels of unemployment in Nepal will mean that labour migration will continue to be an important livelihood strategy for many. Additionally, the complex migration process will necessitate the use of intermediaries, which as demonstrated in this study, were able to bypass some of the regulations put in place to protect migrants. Therefore, the findings in this study, particularly as they cut through different destinations and capture the experiences beyond the working and living conditions, but also issues related to being away from their families, particularly ageing parents and young children, are likely to continue to be applicable.

6. Conclusion

Large numbers of men from Nepal migrate internationally for work and many reported stressors related to their migration experience. Although the stressors occurred throughout the migration cycle, sources of stress were overwhelmingly related to the workplace, which were generally under the control of employers. Further research should examine potential mechanisms to navigate the unequal power relationships between workers and employers and authorities. As labour migration from Nepal is likely to continue to be a livelihood strategy for many, government and civil society organisations need to identify more effective ways to reduce many of the common sources of stress faced by workers who are seeking to safely earn a decent living.

Funding

This work was supported by the UK Department for International Development to CZ, PO5732. The first author was a visiting scholar at the Foundation Brocher, where analysis and drafting of this manuscript took place.

The funders had no involvement in the design; collection, analysis and interpretation of data; in the writing of the manuscript; and in the decision to submit the article for publication.

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.