When we left Nepal, we watched a plane board from Kathmandu to Sharjah, UAE. Every single person boarding the plane was male, except for two young women. Every single man appeared under the age of 40, most younger than 30. Backpacks were slung over their shoulders and most were dressed in the Western fashion, except for the rare tilak or Brahmin tuft of hair at the back of their head. Each one had a wondrous, shocked expression pasted on his face, as they glanced down repeatedly at their tickets and back again at the boarding sign.

Every month, nearly 16,000 Nepalis travel to the Gulf States for temporary work, and thousands more go to other countries in the Middle East. Almost half of all households have at least one family member who is currently working or has previously worked abroad. Migrants often suffer high levels of abuse and exploitation. Routine harms include contract substitution and fundamental changes in the nature or conditions of work, non-payment of wages, unsafe work conditions, inadequate rest, inhumane housing conditions, and confiscation of identity documents. Hundreds of workers die while working abroad each year, often from work-related causes. Immigrant laborers are traded like currency in the Middle East: 2 Filipinos is equal to one Nepali, one Filipino for two Nepalis. 3 of every 4 day laborers in Kuwait is Nepali, Indian, or Pakistani.

This means that entire Nepali villages are void of young men. In the context of earthquake relief, there is a marked dearth of male laborers to help rebuild. As far as family planning goes, migration patterns have a tremendous impact on adherence and use: Family planning is often discontinued when husbands are abroad, and then women rely on less effective emergency contraception when they return for a visit.