The Systemic Abuse of East African Care Workers in the Gulf

This briefing paper documents first-hand accounts of East African care workers in Saudi Arabia and the United Arab Emirates (UAE,) exposing the systemic cycles of abuse they endure. It also sets out clear recommendations for governments, businesses, and investors to ensure these essential workers receive the dignity, rights, and protections they deserve.

The demand for migrant care workers is rising as Saudi Arabia and the UAE—two of the largest economies in the Gulf region—continue to expand and privatise their healthcare sectors. This growth has been fuelled by foreign direct investment (FDI) in healthcare, responding to the region’s ageing population, a push to strengthen medical tourism, and mandatory health insurance policies.

These factors are also driving a greater reliance on migrant care workers, particularly domestic workers and nurses from Ethiopia, Kenya, and Uganda. The healthcare sector in these countries is already heavily dependent on migrant labour. Foreign workers make up 96% of healthcare staff in Abu Dhabi and 90% in Dubai, while in Saudi Arabia, migrants account for 57% of nurses and 60% of doctors.

While this expansion presents employment opportunities, it also exposes migrant workers to severe risks. Many nurses face racial discrimination, contract deception, and illegal task assignments, while domestic workers endure extreme physical abuse, excessive working hours, and near-total employer control. Recruitment remains largely unregulated, leaving many workers vulnerable to exploitative conditions.