KATHMANDU, MARCH 17 On Saturday, March 14, a quiet gathering built around a deeply personal book turned into something far larger, as stories of migration, illness and survival took centre stage during a recent event around 'I Had To Break Me'. The event opened with author Nisha reflecting on her own journey over the past few months. She spoke about spending long periods in isolation, confronting difficult emotions and allowing herself to be vulnerable in ways she had previously resisted. What began as private journaling, she said, slowly transformed into a body of work rooted in pain, healing and self-awareness. 'I never intended to publish,' she shared. 'Writing was just my way of processing pain.' With a background in science and healthcare, Nisha described how her experiences working with patients exposed her to different forms of suffering. Over time, she began questioning what healing truly meant beyond textbooks and prescriptions. Writing became an outlet when other methods fell short. But the event did not remain centered on the book alone. It gradually shifted toward a pressing issue that Nisha and her team have been working on: the health crisis faced by Nepali migrant workers. That transition brought forward the stories of Sagar Tamang, 31, and Surendra Tamang, 33, whose lives have been shaped by kidney failure after years of working abroad. Both originally from Sankhuwasabha, the two men had travelled to countries like Malaysia, Qatar and Saudi Arabia for work. What began as an economic necessity slowly turned into a health crisis neither of them fully understood at the time. Surendra recalled noticing early symptoms that did not initially seem alarming. 'I used to feel tired quickly. My body would ache even with small effort, and I had trouble breathing,' he said. It was only later, after medical tests, that he learned both his kidneys had stopped functioning. Sagar's experience followed a similar pattern, though it unfolded more dramatically. While working abroad, he was diagnosed with high blood pressure and continued working under the assumption that it was manageable. Over time, his condition worsened. 'I would get severe headaches, my legs would swell, and I felt exhausted all the time,' he said. 'But I thought it was because of long working hours.' One day, his body gave way. 'I collapsed after work. I was conscious, but I had no strength left in my body,' he recalled. Medical tests revealed that his kidneys were more than 85 percent damaged. He was told he would need either dialysis or a transplant and was advised to return to Nepal. Back home, the diagnosis was confirmed again. What followed was a physically and emotionally draining period of dialysis, during which his condition continued to deteriorate. 'I became so weak that I could barely walk,' he said. Both Sagar and Surendra believe their conditions were shaped by a combination of factors: unmanaged blood pressure, lack of timely health check-ups, harsh working environments and poor diet. 'When you are working abroad, especially in extreme heat, you don't always eat properly or drink enough water,' Sagar said. 'One problem leads to another.' Their stories reflect a broader trend. According to Nisha, research conducted by her team at Global Health Advocacy and Research Organization (GHAR) found that a significant portion of young dialysis patients in Kathmandu are migrant workers, many in their 20s and 30s. 'People don't realise how serious it is until it's too late,' Surendra said. 'There are no strong signs in the beginning.' After years of dialysis, his family decided to pursue a transplant. His parents travelled from their village to Kathmandu, despite having little prior understanding of the procedure. His father was not a match, but his mother was. His mother's decision to donate her kidney, Nisha reflected, was like 'giving birth a second time.' The transplant was eventually carried out after months of preparation, supported in part by funds raised through the book and contributions from supporters. During the book launch alone, around Rs 5 lakhs was raised, which, combined with some government assistance, helped make Sagar's transplant possible. The organisation continues to channel funds toward their ongoing treatment while also providing them with financial support, including stipends, as they navigate recovery and uncertainty.Today, Sagar is recovering and trying to rebuild his life. Surendra, however, is still waiting. Without a suitable family donor, he has been placed on a cadaver transplant list, where patients receive organs from deceased donors if families give consent. Until then, dialysis remains his only option. Despite their circumstances, both emphasised the importance of awareness. 'We think everything is normal until it becomes serious,' Sagar said. 'At least once a year, everyone should get a full health check-up.' Nisha's work, through her organisation and network of healthcare professionals, extends beyond individual cases. She highlighted ongoing efforts in advocacy, research and policy, including pushing for better protections for migrant workers and raising awareness about basic but critical health practices. Simple factors such as hydration, access to restrooms and regular monitoring of health conditions, she said, can make a significant difference but are often overlooked in demanding work environments abroad. The event concluded with Sagar and Surendra joining the stage, bringing a deeply human perspective to the issues discussed. Their presence grounded the evening, turning abstract concerns into lived realities. Notably, the event was made possible with generous logistical support from Dwarika's Hotel, which provided the venue and hospitality, allowing the focus to remain on the stories being shared. What began as a conversation around a book ultimately became a reflection on pain in its many forms, personal, physical and systemic.