The precarious situation of migrant workers engaged in building the football stadiums in Qatar has been well documented. It was brought to the fore during the FIFA Men’s Football World Cup. Their working conditions as well as their living conditions are often very poor. During the games the Qatar World Cup’s chief executive, Nasser al-Khater reportedly made the rather flippant comment: “Death is a natural part of life, whether it’s at work, whether it’s in your sleep.” Begum and Worden see this as part of Qatar’s shameful government attitude towards the often preventable deaths of migrant workers, which in their view is reflected in the authorities’ failure to investigate the thousands of migrant worker deaths since 2010. 
Today Dr. Pramod Regmi, Dr. Nirmal Aryal, Prof. Edwin van Teijlingen, and BU Visiting Professor Padam Simkhada published ‘Excessive Mortalities among Migrant Workers: the Case of the 2022 FIFA World Cup’ appeared in print . At the time of submission to the Europasian Journal of Medical Science we wrote “The men’s FIFA Football World Cup 2022 is in full flow in Qatar” , but, of course, it has finished with a very exciting final between Argentina and France. Even with a fast review and acceptance process there was no chance that our ‘Brief Communication’ was going to be published during the World Cup. The delay, however, gives us the opportunity today to remind our readers of the need to keep the plight of migrant workers in the Middle East on the world’s agenda.
The FIFA World Cup brought these poor conditions and exploitation of foreign workers in the Middle East to the world’s attention. However, there is a great risk that the attention of the world, including that of campaigners, pressure groups, the media, politicians, and so on moves on to the next ‘hot’ topic. 
Regmi, P., Simkhada, P., Aryal, N., van Teijlingen, E. (2022) Excessive mortalities among migrant workers: the case of the 2022 FIFA World Cup. Europasian Journal of Medical Sciences,4:31-32. https://doi.org/10.46405/ejms.v4i0.455
This week the network ResearchGate alerted us that our paper ‘Identifying the gaps in Nepalese migrant workers’ health and well-being: a review of the literature’ has been quoted fifty times. An interesting achievement, but not particularly special, where it not for the FIFA men’s football World Cup. With the final weekend starting tomorrow and the winner being decided on Sunday in the match between Argentina and France, the timing of this announcement is impeccable. Since the health and well-being of many Nepalese migrant workers is determined by their working and living conditions in the Middle East, including Qatar.
All four authors of this review published five years ago are associated with BU, Dr. Pramod Regmi is Senior Lecturer in International Health, Dr. Nirmal Aryal recently returned to BU as researcher on a study into kidney disease among Nepalese migrant workers (funded by the Colt Foundation), and Prof. Padam Simkhada from the University of Huddersfield, who is also Visiting Professor in BU’s Faculty of Health & Social Sciences (FHSS). In addition, further research on Nepalese migrant workers is conducted in FHSS by BU PhD student Yagya Adhikari, whose thesis addresses the question of the forgotten health and social care needs of left-behind families of Nepalese migrant workers.
Football has been referred to as ‘the beautiful game’. And to be fair, there has been some brilliant football at the men’s FIFA World Cup in Qatar. Qatar’s records on human rights have been widely criticised in the run up to this global event. The global media have spent a lot of time on commenting on several social and economic issues in Qatar, such as LGBT (lesbian, gay, bisexual, and transgender) rights, the role and status of women, and the exploitation of migrant workers. Migrant workers from South Asia, including those from Nepal, have helped build the stadiums and roads leading up to it, provide the security at venues, take the suitcases of the conveyor belts at the airport, and serve fans and visitors food and drink at the venues. Many of these migrant workers are exploited not just by employers in Qatar, but also by labour agencies in their home countries. The risks are high, especially for those migrant workers who do the dirty, dangerous and difficult jobs (i.e. the 3Ds).
As researchers conducting research in the area of migration and health, we are worried that when the world cup finishes next weekend the world’s media will move on from Qatar and the attention will disappear from the exploitation of migrant workers in the Middle East (and elsewhere). We all know that the media’s focus will shift to on another global event, next week or next month. We want to make sure that spotlight stays on this global problem.
Dr. Pramod Regmi, Dr. Nirmal Aryal & Prof. Edwin van Teijlingen
With the men’s FIFA football world cup starting on Sunday in Qatar it important to remember the human costs of those who build the infrastructure. The media coverage on the number of workers dying during the building of the football stadiums has highlighted the plight of foreign workers in the Middle East more generally. For example, BU’s researcher Dr. Nirmal Aryal was cited in The Sunday Times in an article with the title ‘Qatar 2022: Dying for the World Cup”, see the BU Research Blog published this time last year.
Here at BU we have conducted several studies into Nepali migrant workers, including those working in Qatar and elsewhere in the Middle East [1-13]. In the Middle East working conditions for foreign labourers are often Dirty, Dangerous and Difficult (commonly referred at as the 3Ds). Migrant workers often perform physically demanding work in a hot unprotected environment, suffer dehydration and/or exposure to chemical, excessive use of pain killers, and unhealthy lifestyle factors (such as restricted water intake and a high intake of alcohol/sugary drinks) which may precipitate them to acute kidney injuries and subsequent chronic kidney disease . Dr. Regmi and colleagues in the Faculty of Health & Social Sciences are currently conducting a study into the kidney health of Nepalese migrant workers. This study is funded by the Colt Foundation.
From our work, we can say that in addition to the 3Ds, migrant workers are likely to experience a series of other challenges ranging from language and other cultural barriers, socio-economic problems and issues to do with their legal status, to a lack of health and safety training, difficulties in gaining access
to health services. If you have limited injury compensation in your line of work, a work injury attorney can answer commonly asked questions like “can employer make employee pay for accident?”
Aryal, N., Sedhain, A., Regmi, P., KC, R. K.,van Teijlingen, E. (2021). Risk of kidney health among returnee Nepali migrant workers: A survey of nephrologists. Asian Journal of Medical Sciences 12(12), 126–132.
Aryal, N., Regmi, P.R., van Teijlingen, E., Trenoweth, S., Adhikary, P., Simkhada, P. (2020) The Impact of Spousal Migration on the Mental Health of Nepali Women: A Cross-Sectional Study, International Journal of Environmental Research & Public Health 17(4), 1292; https://doi.org/10.3390/ijerph1704129
Regmi, P., Aryal, N., van Teijlingen, E., Adhikary, P. (2020) Nepali migrant workers and the need for pre-departure training on mental health: a qualitative study, Journal of Immigrant & Minority Health 22, 973–981.
Adhikary, P. van Teijlingen, E. (2020) Support networks in the Middle East & Malaysia: A qualitative study of Nepali returnee migrants’ experiences, International Journal of Occupational Safety & Health (IJOSH), 9(2): 31-35.
Aryal, N., Regmi, P.R., Faller, E.M,, van Teijlingen, E., Khoon, C.C., Pereira, A., Simkhada, P. (2019) ‘Sudden cardiac death and kidney health related problems among Nepali migrant workers in Malaysia’ Nepal Journal of Epidemiology9(3): 755-758. https://www.nepjol.info/index.php/NJE/article/view/25805
Adhikary P, van Teijlingen E., Keen S. (2019) Workplace accidents among Nepali male workers in the Middle East and Malaysia: A qualitative study, Journal of Immigrant & Minority Health 21(5): 1115–1122. https://link.springer.com/article/10.1007/s10903-018-0801-y
Simkhada, P.P., van Teijlingen, E.R., Gurung, M., Wasti, S. (2018) A survey of health problems of Nepalese female migrants workers in the Middle-East & Malaysia, BMC International Health & Human Rights 18(4): 1-7. http://rdcu.be/E3Ro
Adhikary P, Sheppard, Z., Keen S., van Teijlingen E. (2018) Health and well-being of Nepalese migrant workers abroad, International Journal of Migration, Health & Social Care 14(1): 96-105. https://doi.org/10.1108/IJMHSC-12-2015-0052
Adhikary, P, Sheppard, Z., Keen, S., van Teijlingen, E. (2017) Risky work: accidents among Nepalese migrant workers in Malaysia, Qatar & Saudi Arabia, Health Prospect 16(2): 3-10.
Simkhada, P.P., Regmi, P.R., van Teijlingen, E., Aryal, N. (2017) Identifying the gaps in Nepalese migrant workers’ health and well-being: A review of the literature, Journal of Travel Medicine 24 (4): 1-9.
Aryal, N., Regmi, P.R., van Teijlingen, E., Simkhada, P., Adhikary, P., Bhatta, Y.K.D., Mann, S. (2016) Injury and Mortality in Young Nepalese Migrant Workers: A Call for Public Health Action. Asian-Pacific Journal of Public Health28(8): 703-705.
Adhikary P, Keen S and van Teijlingen E (2011). Health Issues among Nepalese migrant workers in the Middle East. Health Science Journal.5 (3):169-i75 DOI: 2-s2.0-79960420128.
Daniels, aged 17, described the move as a “relief”, and was met with support and praise from key figures in men’s football and beyond, including Gary Lineker, Harry Kane and Sir Ian McKellen. He was also praised by national figureheads Prime Minister Boris Johnson and Prince William, who said Daniels coming out will “help break down barriers”.
The first UK professional footballer to come out was Justin Fashanu in 1990. The support for Daniels has been a stark contrast to the homophobic responses to Fashanu, who killed himself in 1998 at the age of 37.
Sport in the UK has long been rife with homophobia and considered an unsafe place for LGBT+ players. In 2017, a House of Commons report concluded that “despite the significant change in society’s attitudes to homosexuality in the last 30 years, there is little reflection of this progress being seen in football.”
Men’s professional football is the last of the UK’s three most popular sports, following rugby and cricket, to have an active, elite professional player come out. Rugby player Gareth Thomas came out in 2009 and cricketer Steven Davies came out in 2011.
This lagging behind is no surprise given the vile homophobic chanting at some of England’s best players such as Sol Campbell, and the reaction to Fashanu in the 1990s. Indeed, there are some early signs of homophobic hate in response to Daniels that have been condemned by LGBTQ+ rights group Stonewall.
Still, over the last couple of decades, changing cultural attitudes and campaigning efforts by organisations and fans have raised awareness of LGBTQ+ participation in sport.
The Justin Campaign, established in 2008 by a Brighton-based grassroots organisation, was one of the first official campaigns to raise awareness of homophobia in men’s football. The campaign had a local reach and targeted young people, mainly school and university students who entered tournaments as team “Tackle Homophobia”.
From the Justin Campaign came Football v Homophobia, developed by PrideSports, which now has a significant presence in the game worldwide. Alongside this grassroots activism, in 2013 betting company Paddy Power, working with Stonewall, initiated the Rainbow Laces campaign.
The FA, football’s governing body in England and Wales, introduced its first anti-homophobia initiative in 2012, Opening Doors and Joining In. Since then, the FA has endorsed both Football v Homophobia and the Rainbow Laces campaigns. However, research indicates that efforts by sport governing bodies can fall short and can be ineffective at actually implementing change.
While I don’t know how aware Daniels and his peers were of these campaigns as they were growing up, there is evidence from a 2017 study at a boy’s football academy that revealed “progressive attitudes towards homosexuality” among a small group of 14-15 year olds. This suggests that attitudes are becoming more inclusive – although the boys in the study felt unable to individually challenge homophobia when they observed it.
Homophobic chanting at men’s professional games can be a common occurrence. This chanting, often deemed as “banter” by the perpetrators, can be outright blatant homophobia, or what we now call a “micro-aggression”. Micro-aggressions are the everyday speech and actions directed at marginalised members of communities that reflect prejudice and discrimination, and can be damaging to minority individuals in sport.
Obviously, not all football fans make homophobic remarks and gestures at a game or on social media. Many formal LGBTQ+ fan groups, such as the Kop Outs (Liverpool), Gay Gooners (Arsenal) and Proud Canaries (Norwich City), have also been set up in recent years, creating a visible community within the oft-discriminatory world of football fandom.
Despite these efforts by fans, football’s governing bodies continue to ignore or forget homophobia. A case in point is Qatar, host country for FIFA’s men’s World Cup later this year, which has anti-gay laws.
At 17, Daniels has grown up with a popular culture that is more diverse than ever when it comes to gender and sexuality. There are more visible stories of LGBTQ+ people and communities generally, and within the world of sport. Thanks to decades of activism, LGBTQ+ culture has a place in the mainstream, and football is benefiting from this movement.
The women’s game is further along in celebrating out lesbian and bisexual players internationally. The 2019 FIFA women’s World Cup alone had 40 out women – players, coaches and managers – offering further evidence that the women’s game is a safer environment than the men’s. This might be because women in sport have had to deal with sexist and homophobic stereotypes for a very long time.
The impact of Jake Daniels’ decision to come out cannot be underestimated. Not only will it allow him to be fully himself – and perhaps an even better player – it is set to shift the culture of men’s elite professional football.
Sports betting is worth up to £625 billion per year, with 70% of that trade reckoned to come from football. During big sporting competitions, such as the World Cup, even more money is spent gambling than usual. Over the 2018 World Cup, bookmakers are estimated to make a profit of US$36.4 billion (£41.3 billion). And in the UK, the amount of money spent on gambling during the World Cup is expected to more than double from £1 billion in 2014 to £2.5 billion this year.
Sports gambling is being driven by the unlimited availability of online betting and the fact that no physical money is exchanged, making financial transactions seem less real. The vast amount of data that online gambling sites collect also enables them to personalise offers to individual gamblers. Instead, this data should be used to help people gamble responsibly by warning users in real-time that they are exhibiting problematic gambling behaviours.
High profile but infrequent betting events such as the Word Cup exacerbate the issues that problem gamblers face. Seeing others engage in betting, coupled with the advertisements from betting firms, leads problem gamblers to attempt to convince themselves that they do not have a problem. Environmental cues can also trigger the urge to gamble in those who have a gambling problem. So, the intensive advertising used by betting firms during the World Cup, along with media coverage of the World Cup in general, may further push problem gamblers towards making harmful decisions.
Watching your habit
Online gambling sites have an infinite memory for bets – when made, for how much, regarding what, and so on. This data is a rich source that websites use for tailoring offers and marketing material to fit a gambler’s potential interests. But this personalisation exploits cognitive biases in gamblers and encourages them to increase risk-taking and by extension, gambling.
There is only a fine line between the legitimate marketing and personalisation of content and offers on the one hand and exploitation and manipulation on the other. For example, the tracking of a gambler’s betting pattern means the gambler can be targeted with offers following heavy losses, encouraging them to chase losses even further.
But this same data could also be used to support reductions in problem gambling, either led by gamblers themselves or with the support of a counsellor or software. Such transparency could enhance the image of the gambling industry and make responsible gambling a shared responsibility between gamblers and bookmakers.
This data would provide an unprecedented opportunity to tackle problem gambling. For example, the data could lead to the app informing gamblers that they are exhibiting problematic gambling patterns. The real-time collection of information such as “the gambler has reached the monthly spending limit” could trigger a message visualising their past betting behaviour and a reminder of a commitment already made.
In our studies, digital addicts, including online gambling addicts, have indicated that having access to such data would act as a wake-up call, raising awareness. Digital media users, in general, like to be in control of their usage through labels and awareness tools.
Similar facilities have started to exist in mainstream digital media. For example, on Google, it is now possible to download your data and on Facebook to download your profile data history of interaction, but not currently as real-time streaming of data as actions happen.
We understand the barriers to implementing this vision. Gambling operators may not have such data readily available and may even rely on third parties to offer certain games. Some also fear that gamblers might share the data with competitor gambling sites, giving away information about marketing practices. But the General Data Protection Regulation(GDPR) right to data portability holds that gamblers shall not be prevented from accessing and sharing their data.
Given the advantages, and also the increased demand for transparency, this would eventually become the recommended practice for demonstrating advanced corporate social responsibility and inspiring the trust of the public and clients in the gambling industry. We are preparing a charter for the gambling industry towards a commitment for that.
The rise of online gambling, combined with the record amount of money being spent on gambling at this year’s World Cup makes this the perfect time to discuss what we can do to prevent and combat gambling addiction. Simply by using data to help people be better aware of their gambling habits, rather than hooking them back into their next bet, gambling sites could make a massive difference.
More evidence-based articles related to the World Cup:
The globalisation of football means it can now be found in most parts of the world. It is celebrated as the national sport in many countries. But, we forget that “football” actually means “men’s football”. It’s the same with other popular sports – our habit is to refer to basketball and women’s basketball, cricket and women’s cricket, ice hockey and women’s ice hockey. This naming places men’s football as the dominant universal and natural norm, while women’s football becomes the “other” version.
If we want a level football playing field, then “football” should be redefined by changing our reference to tournaments, championships and leagues to “men’s football” if that is what is being played. It’s time we started referring to the men’s football World Cup, just as we refer to the women’s football World Cup.
Women and girls have long been treated as second-class citizens in the many worlds of football, including playing, officiating, governing and spectating. And indeed, in the build up to the 2018 men’s World Cup, there was much discussion about racism and homophobia – but practically none about football, gender, sexism and misogyny.
The histories of the development of football in most countries around the world show that women and girls have been denied access to pitches, equipment, coaches, training, stadiums and financial support. These material opportunities are important because they enable and validate participation – and full football citizenship.
Finland takes on Austria in a qualifier for the 2019 Women’s World Cup. EPA
Media sport pages cover men’s sport. During the football season, the coverage is dominated by stories of men’s football. Women footballers seem to not exist. The sport press obliterates them.
But women and girls are playing, officiating, spectating and commentating on the game in ever increasing numbers around the world. The England women’s team outperforms the men’s team on the European and world stage. They are currently ranked ten places higher, in second position. And yet, the gender pay gap in football is atrocious.
While Russia, as host of the men’s football World Cup 2018, has been criticised for its poor record in dealing with homophobic and racist abuse, nothing has been said about gender-based abuse or discrimination.
Instead, ahead of the men’s World Cup, Russian MPs have been arguing over whether Russian women should or should not have sex with visiting (presumably male) football fans. The UK Foreign Office released advice on race and LGBT concerns, but there’s nothing on how sexist chanting can make men’s football a hostile environment for women. You only need to look at the sexism experienced by doctor Eva Carneiro and assistant referee Helen Byrne in the men’s premier league to see how this plays out.
What’s more, many of the concerns about homophobia and racism at the men’s World Cup stem from wider cultural issues in Russia. The same problems are evident with sexism and misogyny, yet they are curiously absent from the discussion when it comes to football. Cultural problems that affect men extend into the sporting arena, but not those that affect women.
In 2017, the Russian parliament passed legislation loosening laws on domestic violence. Russian women who support the #MeToo movement have come up against draconian assembly laws that say only one person is permitted to make a public protest.
There are no campaigns in international men’s football that aim to stop sexism, or call for anti-sexism and an end to gender-based violence.
Meanwhile, the women and girls who have fought hard to play football often encounter negative responses from the general public and from the media. Sport sociologists have found that sportswomen are trivialised, sexualised and experience symbolic annihilation – they simply don’t exist in images of the sport. A recent poster depicting Iranian fans is a prime example. Not a single female face features.
Women’s and girls’ sporting achievements are reduced as a result of ridicule. Their bodies are considered sexual objects rather than for playing sport. Former FIFA president Sepp Blatter’s comment that women should play in tighter shorts to attract more fans to the game is a classic example of this. More recently, feminist author Laura Bates challenged FIFA for describing player Alex Morgan as “easy on the eye and good looks to match” as well as the FA for tweeting about “lionesses go back to being mothers, partners and daughters” after playing in the women’s World Cup.
It’s easy to imagine that this men’s World Cup in Russia will continue to disregard gender, sexism and misogyny. And yet, sport, specifically football, has potential to incite change, and reform.
Renaming to men’s football is an easy and simple step in the direction towards equality. We may as well start with the men’s World Cup 2018.
Our BU briefing papers are designed to make our research outputs accessible and easily digestible so that our research findings can quickly be applied – whether to society, culture, public policy, services, the environment or to improve quality of life. They have been created to highlight research findings and their potential impact within their field.
Sports concussion has been the subject of much discourse in the scientific literature and mainstream media for many years. Major national and international sporting events are extensively covered by the media, with vast numbers of column inches and webpages dedicated to summarising these events. The frequency of concussion in some of the world’s biggest sports such as soccer, football, and rugby means that many of these concussive events which occur in high-profile competitions are also the focus of this reporting.
This paper analyses the descriptions of online sports concussion news on a global scale, using a search engine to retrieve news stories, and evaluates the media’s role in shaping public perception and misconception regarding concussion in sport. Further analysis sought to identify geographical patterns associated with different descriptions of sports concussion.
The interest in football goes well beyond the boundaries of it’s academic field. Such are the financial incentives and rewards in the modern game, professional football clubs now leave no stone unturned in their attempts to increase their performances on the field, win matches and increase their league position. This is the wider context for a recent submission to eBU: Online Journal, BU’s internal working paper journal designed around immediate publication and open peer review.
Based on an analysis of all 1,053 goals scored in the 2009/10 season, Jamie Osman, Andrew Callaway and Shelley Broomfield consider, ‘Just how important are set plays to teams competing in the Barclays Premier League?’.