Qatari authorities have failed to investigate the deaths of thousands of migrant workers over the past decade, despite evidence of links between premature deaths and unsafe working conditions, Amnesty International said today. The organization’s new report, In the Prime of their Lives, documents how Qatar routinely issues death certificates for migrant workers without conducting adequate investigations, instead attributing deaths to “natural causes” or vaguely defined cardiac failures. These certifications – described by one leading pathologist as “meaningless” – rule out the possibility of compensation for bereaved families, many of whom are already facing financial difficulties after losing their main breadwinner.
Amnesty International highlighted the risks posed to workers by Qatar’s extreme climate, especially when combined with excessive and physically strenuous working hours. Qatar recently introduced some new protections for workers, but major risks remain and authorities have done little to investigate the scale of heat-related deaths. As well as consulting leading medical experts and reviewing government data relating to thousands of deaths, Amnesty analysed 18 death certificates and interviewed the families of six men, all of whom were between 30 and 40 when they died.
“When relatively young and healthy men die suddenly after working long hours in extreme heat, it raises serious questions about the safety of working conditions in Qatar. In failing to investigate the underlying causes of migrant workers’ deaths, the Qatari authorities are ignoring warning signs which could, if addressed, save lives. This is a violation of the right to life. They are also denying bereaved families their right to remedy, and leaving them with painful unanswered questions,” said Steve Cockburn, Amnesty International’s Head of Economic and Social Justice.
“We are urging the Qatari authorities to fully investigate all deaths of migrant workers. If workers have been exposed to dangerous conditions such as extreme heat, and no other cause of death can be established, Qatar must provide families with adequate compensation, and take immediate action to strengthen protections for other workers. The failure to investigate, remedy and prevent the deaths of migrant workers is a breach of Qatar’s obligation to uphold and protect the right to life.”
Epidemiological experts said that in a well-resourced health system, it should be possible to identify the exact cause of death in all but 1% of cases, but Amnesty’s review of data from major labour-sending countries found that the rate of unexplained migrant worker deaths in Qatar may be close to 70%.
The scale of unexplained deaths
Amnesty International reviewed 18 death certificates for migrant workers issued by Qatar between 2017 and 2021. Fifteen provided no information about underlying causes, instead using terms such as “acute heart failure natural causes”, “heart failure unspecified” and “acute respiratory failure due to natural causes”.
Similar phrases were used in reports for more than half of the 35 deaths which have been recorded as “non-work related” on World Cup facilities since 2015 – suggesting meaningful investigations were unlikely to have been carried out in these cases.
Dr David Bailey, a leading pathologist and member of the WHO Working Group on death certification, told Amnesty International:
“These are phrases that should not be included on a death certificate without a further qualification explaining the underlying cause. Essentially, everyone dies of respiratory or cardiac failure in the end and the phrases are meaningless without an explanation of the reason why.”
Amnesty’s analysis of deaths data from multiple sources indicates that migrant worker deaths are going unexplained on a large scale. Official Qatari statistics show that over 15,021 non-Qataris – of all ages and occupations – died between 2010 and 2019, but data on cause of death is unreliable, due to the lack of investigations which Amnesty documented.
The fact that a high number of deaths are categorized as ‘cardiovascular diseases’ in Qatar’s statistics may be obscuring a high number of deaths that are, in reality, unexplained. This is also indicated by deaths data from South Asian countries, where a large majority of migrant workers come from.
For example, Bangladeshi government records show that 71% of deaths of Bangladeshi nationals in Qatar between November 2016 and October 2020 were attributed by Qatari authorities to “natural causes.”
An investigation by the Guardian also found that 69% of deaths among Indian, Nepali and Bangladeshi workers, between 2010 and 2020, were attributed to natural causes.
Sudden deaths
Amnesty investigated the deaths of six migrant workers in detail – four construction workers, one security guard and one truck driver. None of the men had any known underlying health conditions, and all had passed mandatory medical tests before traveling to Qatar. None of their families have received compensation.
Manjur Kha Pathan, 40, worked 12 to 13 hours a day as a truck driver. He had complained that the air conditioning in his cabin was faulty. Manjur collapsed in his accommodation on 9 February 2021 and died before the ambulance arrived.
Sujan Miah, 32, worked as a pipe fitter on a project in the desert. His workmates found him dead in his bed on the morning of 24 September 2020. On the four days leading up to Sujan Miah’s death, temperatures had exceeded 40°C.
Tul Bahadur Gharti, 34, worked in construction. He died in his sleep on 28 May 2020, after working around ten hours in temperatures that had reached 39°C.
Suman Miah, 34, worked in construction. He died on 29 April 2020, after completing a long shift in temperatures that reached 38°C.
Yam Bahadur Rana, 34, worked as an airport security guard, a job which involved long hours sitting outside in the sun. He died at work on 22 February 2020.
Mohammad Kaochar Khan, 34, worked as a plasterer. He was found dead in his bed on 15 November 2017.
Amnesty International interviewed the men’s families in Nepal and Bangladesh. Family members emphasized their shock at the deaths, stressing that they had believed their relatives to be in in good health. Several described the extreme heat and difficult conditions their relatives had regularly been exposed to at work.
Yam Bahadur Rana’s wife Bhumisara said:
“[My husband] had to sit in the sun for a long time. I feel like he had a heart attack due to dryness and heat because I never knew he was sick.”
Tul Bahadur Gharti’s wife Bipana said:
“I had never heard him mention a single illness… it was hard to believe when I heard the news of his sudden death… My husband was set on fire. I feel like I’m burning in oil.”
Health risks of extreme heat
A state’s duty to protect the right to life, as well as its obligations to ensure healthy working and environmental conditions, includes adopting laws or other measures to protect life from reasonably foreseeable threats. One of the most well-documented and foreseeable risks to workers’ life and health in Qatar is exposure to extreme heat and humidity, which has been the subject of numerous reports.
In 2019 the Qatari government commissioned a study into the issue by the Greece-base FAME Laboratory. It found that workers provided with only the minimal protections required by Qatari law at that time were at significantly higher risk of heat stroke than a group on a World Cup project, where workers generally have higher standards of protection.
A 2019 study in the journal Cardiology found a correlation between heat and deaths of Nepali workers in Qatar, concluding that “as many as 200 of the 571 cardiovascular deaths [of Nepali migrant workers] during 2009-2017 could have been prevented” with effective heat protection measures.
Until recently, the main protection against occupational heat stress in Qatar was a ban on outdoor working at certain hours, between 15 June and 31 August. There were no restrictions for the rest of the year. In May 2021, Qatar extended the summer working hours ban from 1 June to 15 September, and introduced other requirements including a prohibition on outdoor work when an index measuring heat and humidity reaches 32 degrees. The new legislation also gives workers the right to stop working and submit a complaint to the Ministry of Administrative Development, Labour and Social Affairs if they are concerned about heat stress.
Professor David Wegman, an expert on health and safety in the construction industry, told Amnesty that though the new law is an improvement, it “falls far short of what is necessary for the protection of labourers who are subject to heat stress exposures of all types”.
While the new regulations do provide some greater protections, critically they do not include mandatory rest periods proportionate to the climate conditions and nature of work undertaken. Instead, they grant workers the right to ‘self-pace’ in hot weather.
Given the extremely unequal power relations between workers and employers in Qatar, experts consulted by Amnesty highlighted that relying on ‘self-pacing’ is unlikely to be feasible for many workers, and that workers’ safety is “critically dependant” on mandatory breaks.
“All our dreams vanished”
None of the families Amnesty interviewed were offered any form of post-mortem examination to identify the underlying cause of death of their loved ones. This meant it could not be determined whether working conditions had contributed, thereby precluding the possibility of compensation from either employers or Qatari authorities.
Amnesty met Suman Miah’s family, including his two young children, at their home in Bangladesh. They heard about Suman’s death from his co-workers, and were not contacted by Qatari authorities or offered an autopsy.
“I could not believe the news at first. I had talked to him a few hours earlier”, Suman’s wife, Sumi Akter, said.
The Bangladeshi Welfare Board gave Suman’s family 300,000 Bangladeshi taka (approximately US$3,500), but this was used to pay off debts Suman had incurred from recruitment fees paid during his migration to Qatar.
Mohammad Kaochar Khan had also paid recruitment fees to get his job in Qatar. His family had partly funded the 350,000 Bangladeshi taka (approximately US$4,130) fee by selling land and taking out loans. They were also provided with financial assistance by the Bangladeshi government, which they used to pay off Mohammad’s recruitment debt.
Mohammad’s brother Didarul Islam told Amnesty:
“All our dreams vanished when my brother passed away. He hoped to improve all of our living standards but we were never able to save any money, because most of his wages were used to repay the cost of migration.”
The struggles these families are now facing illustrate the cycle of exploitation which continues to ensnare so many migrant workers in Qatar. Since being awarded the 2022 FIFA World Cup in 2010, Qatar has made several significant positive reforms to its labour laws. But weak implementation and enforcement mean that progress on the ground has been slow, and exploitation remains commonplace. Many migrant workers remain at the mercy of unscrupulous employers, who are allowed to commit abuses with impunity.
Amnesty International is calling on Qatar to strengthen its laws to protect workers from extreme heat, by introducing mandatory rest breaks in line with the risks they face, and to improve the investigation, certification and compensation of migrant workers’ deaths.
“Qatar must establish a specialist team to properly investigate the death of every worker and ensure that compensation is paid in any case where working conditions such as exposure to extreme heat cannot be ruled out as a contributing factor,” said Steve Cockburn.
“Qatar is one of the richest countries in the world – not only can it afford to do far better, it has an obligation to do so.”
Background
Experts outlined a range of techniques that are used to diagnose the cause of deaths in cases where exposure to extreme heat may be a factor. These include investigations into workplace conditions, workers’ medical history, and various medical examinations to rule out alternative causes of death.
Official statistics show that 15,021 non-Qataris have died in the country between 2010 and 2019. This does not equate to the number of migrant workers who have died because of working conditions, as it includes people of all ages, occupations and causes.
The government data also does not indicate how many workers have died in preparation for the World Cup. Qatar’s Supreme Committee on Delivery and Legacy says that 35 workers on World Cup projects they oversee have died since 2015, but there is no estimate of how many workers have died on other infrastructure projects linked to the delivery of the tournament.