In the foothills of the Himalayas, two men lift their shirts to reveal wide scars on their bodies.
Both aged in their 40s, they appear self-conscious – even embarrassed – but they want to share their story.
The men – called Kanchha and Ram – sold their kidneys, driven by financial desperation. Kanchha is still in pain and unable to work because of the side effects from the surgery.
“It’s impossible to count how many have done it,” he says. “Everywhere, this village, that village, so many people have sold their kidneys.”
Image: Ram and Kanchha show their scars
Image: The tell-tale scar, evidence of kidney removal
The village of Hokse in Nepal has a unique and exceptionally troubled history. It’s known as Kidney Valley because someone from almost every household has sold a kidney.
Brokers have been visiting the area for years, persuading people to part with an organ, despite the fact it’s illegal.
Locals have desperately tried to shake that infamy in recent years – they feel duped, damaged by it. Some say they were exploited, some claim they were even told their kidneys would regrow. Some have died as a result of what was done to their bodies.
And now tragically, poverty is fuelling another health crisis in Nepal – with kidneys again at the heart of it.
Image: The village of Hokse in Nepal is known as Kidney Valley
Increasing numbers of Nepalis have chosen to work overseas in the Gulf States and Malaysia to make more money for their families back home. But that’s come with its own jeopardy.
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Young, once healthy men are returning to Nepal in desperate need of a kidney transplant. Some scientists say it is the result of exposure to extreme heat and severe dehydration.
Image: Suman showed Sky News his scar
A few years ago, Suman, 31, was so broken financially and emotionally, he considered ending his life. He felt he had “no option” but to travel to India to sell his kidney to a woman pretending to be his sister.
It was a physically excoriating process that has scarred him. He was paid £3,000.
“I felt weak and I lost consciousness,” he says. “When I woke up, it was really hurting. Now I can’t work and I try to tell anyone I can, not to sell their kidney.”
Image: Suman speaks to Sky News
Image: Sky News visited the village of Hokse
Suman was not certain if the doctor knew what he was doing but Indian law is clear – donors must be related and they must present the relevant paperwork.
Organ trafficking remains a major concern in India. It is fuelled by a wide gap in demand and supply.
The lack of donors has given rise to a black market, with doctors and hospitals among those exposed in investigations into “cash for kidney” rackets.
But it is not unique to India. Estimates suggest that globally, one in 10 transplanted organs have been trafficked.
“The agents made fake documents in Kathmandu, including Indian ID cards,” says Kanchha, who also sold his kidney in India.
“My kidney was given to a fake sister. I think the doctor in India knew I’d sold it.”
In Hokse, locals insist no-one sells their kidneys any more – but some are still taking extreme risks to try to improve their lives.
Image: Jit Bahadur Gurung has dialysis three times a week
Jit Bahadur Gurung spent three years working in Saudi Arabia. Aged just 29, he’s had four hours of dialysis – which he does three times a week – at the National Kidney Center in Kathmandu.
He looks fatigued and withdrawn.
“I had to work in extreme heat – around 50 degrees,” he says. “We didn’t have time to have lunch, go to the toilet or drink water.”
Describing the moment he realised something was wrong, he says: “I was overheating. Suddenly I felt my feet swelling and I couldn’t walk. Then I was told my kidney had failed.”
Image: People have been left needing dialysis
Image: On the dialysis ward
Symptoms of kidney failure can often go unnoticed and by the time migrant workers arrive back in Nepal, it’s often too late.
Jit is desperate for a donor. But the donor has to be a relative and there aren’t enough positive matches.
Ishwor is 34 and still searching for his lifeline. He says he worked 16-hour days for seven years in Dubai.
“I was working long hours in high heat without sleep,” he says. “My body started to swell up like I’d been beaten.”
Image: Symptoms of kidney failure can go unnoticed
Dr Pukar Shresth, a pioneering and renowned surgeon at the Human Organ Transplant Center in Nepal, used to only perform transplants on the elderly, but has recently seen young people with scarred and shrunken kidneys.
He noticed a pattern – young men going to work in high heat, with little water and returning with “completely failed kidneys”.
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“It is very grave because about one third of all transplants are these labour migrant workers who have come from abroad,” he says.
“This has caused a huge burden to our health resources health facility because they account for more than 30% of the total transplant number in our country.”
It’s a disproportionate figure since overseas workers represent around 14% of the Nepali population.
Dr Shrestha believes education is key – informing young men going overseas about the importance of having water, taking breaks and a good diet.
Image: Young men are returning with damaged kidneys
A young doctor working alongside him is collecting critical data about where the men have been and what conditions they faced. The men have to have medical tests before they can travel abroad for work, which is why it’s believed they were in good health previously.
The fact is they feel forced to work in some of the world’s hottest places and they have very little agency.
While some countries like Qatar have reduced the hours people can work in the sun, Nepalis’ suffering hasn’t stopped.
Multiple studies have shown the risk of extreme heat in the Gulf States has only escalated in recent years due to climate change.
And a recent report by Human Rights Watch stated migrant workers are mistreated and viewed as “disposable”.
The hospitals of Nepal are a stark warning shot about the dangers of a warming world and the heavy price being paid by those at the coalface.
Anyone feeling emotionally distressed or suicidal can call Samaritans for help on 116 123 or email jo@samaritans.org in the UK. In the US, call the Samaritans branch in your area or 1 (800) 273-TALK
Additional reporting by Rachael Thorn, Asia producer
A hidden, underground military base in eastern Ukraine is so secret, soldiers change into civilian clothes whenever they step outside to avoid drawing attention.
Journalists are not usually allowed access.
But the unit that has been using this vast, subterranean warren of war rooms, a dormitory, kitchen, canteen and makeshift gym as its headquarters since the summer is imminently relocating, so Sky News was invited inside.
Lieutenant Colonel Arsen Dimitric – call sign Lemko – is the chief of staff of 1st Corps Azov of the National Guard of Ukraine, one of the country’s most effective combat forces.
Image: Lemko
He sat with us in the base, next to a large square table, covered by a map of the Donbas region.
His soldiers have been fighting in this area since the summer, countering a surge in Russian attacks in and around the frontline city of Pokrovsk.
“We aim to destroy as much of the enemy as possible,” he said.
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“Will we take losses? Yes. Will it hurt? Absolutely.”
But he said if Russia is allowed to advance, even more Ukrainians will suffer.
“Their [the Russians’] only advantage is numbers,” he said.
“They don’t care how many people they lose.”
Lemko said almost 17,000 Russian soldiers had been killed or wounded fighting in this section of the warzone alone between August to November.
Ukrainian video footage of the battlefield showed Russian armoured vehicles being taken out by drones and artillery fire.
At one point, Russian soldiers mounted on motorbikes try to advance, only to be stopped by Ukrainian fire.
“Our task is to hit them as hard as possible in various areas,” Lemko said. “We focus on our operations, others on theirs, and leadership will negotiate the best possible terms.”
The Azov Corps soldiers are fighting over land that should be handed over to Russia, according to an initial draft of a peace deal proposal between Kyiv and Moscow put forward by the United States. This is despite swathes of the Donbas remaining under Ukrainian control.
But General Oleksandr Syrskyi, the head of the Ukrainian armed forces, has since told Sky News that simply surrendering territory would be “unacceptable”.
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3:31
Giving up territory ‘unacceptable’, Ukraine’s military chief says
For Lemko, he says the job of his troops is to inflict as much damage as possible on the Russian side to help strengthen Ukraine’s hand in negotiations.
“Simply giving it [land] away isn’t the way,” he said.
“Diplomats do their work, we do ours. Our job as soldiers is to give as many advantages as possible to our negotiating team. And we’re doing exactly that.”
Lemko, who has been battling against Russia since the Crimean annexation in 2014, also had a warning for the rest of Europe about a rise in hybrid attacks, such as mysterious drone sightings, acts of sabotage and cyber hacks suspected of being linked to Moscow.
He said Ukraine’s experience showed that if attacks by Russia that fall under the threshold of conventional war are not successfully countered, full-scale conflict could follow.
“Ukraine once lost a hybrid war that had been waged since the very start of our independence,” he said.
“Because of that defeat, there was a physical operation against us in Crimea and then a physical operation in 2022.
“Now the hybrid war has reached its climax, and it is moving into the Baltic States and Europe.
“That is why, in my opinion – and in the opinion of most of our officers – now is the moment for all countries to unite and counter this hybrid war. Because the consequence may be a physical one.”
Production: Katy Scholes, security and defence producer, and Azad Safarov, Ukraine producer.
At least 25 people have been killed after a fire at a nightclub in Goa, the state’s police service has said.
The fire reportedly started around midnight on Saturday local time.
The majority of victims were kitchen staff at the club – although around three to four tourists are thought to be among those killed.
Videos on social media showed emergency services lining up to help the injured – some of whom were taken to nearby hospitals.
Dr Pramod Sawant, Goa’s chief minister, said: “I am deeply grieved and offer my heartfelt condolences to all the bereaved families in this hour of unimaginable loss.”
He later said he was “closely reviewing the situation arising from the tragic fire” – adding six additional people had been injured.
“All six injured persons are in a stable condition and are receiving the best medical care,” he said.
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Image: Pic: NDTV
Image: Fire at nightclub in Goa. Pic: NDTV
Authorities worked through the night to bring the situation under control and all bodies have been recovered, the state’s police chief told reporters, according to Reuters news agency.
India’s Prime Minister Narendra Modi said the deadly fire was “deeply saddening”.
He said he had spoken with Goa’s chief minister and that “the state government is providing all possible assistance to those affected”.
Dr Sawant said he has “ordered an inquiry” to discover what happened after visiting the site.
Image: Pic: AP
“The inquiry will examine the exact cause of the fire and whether fire safety norms and building rules were followed,” he said.
“Those found responsible will face most stringent action under the law – any negligence will be dealt with firmly.”
Goa, a small state on India’s western coast, is a popular tourist destination, attracting millions of tourists every year.
Russia launched a massive missile and drone attack on Ukraine overnight, after US and Ukrainian officials said they would meet for a third day of talks aimed at bringing the war to an end.
The two sides said they had made progress on a security framework for post-war Ukraine, but that any “real progress toward any agreement” will depend “on Russia’s readiness to show serious commitment to long-term peace.”
Russia launched 653 drones and 51 missiles in its attack on Ukraine, triggering air raid alerts across the country, Ukraine’s air force said.
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Giving up territory ‘unacceptable’ – Ukraine’s military chief
Ukrainian forces shot down and neutralised 585 drones and 30 missiles, the air force said, adding that 29 locations were struck.
At least eight people were wounded in the attacks, Ukraine’s minister of internal affairs Ihor Klymenko said.
Russia conducted a “massive missile-drone attack” on power stations and other energy infrastructure in several regions, Ukraine’s national energy operator Ukrenergo said on Instagram.
Ukraine’s Zaporizhzhia nuclear power plant temporarily lost all off-site power overnight, the International Atomic Energy Agency said.
The plant is in an area that has been under Russian control since early in Moscow’s invasion of Ukraine. It is not in service, but needs reliable power to cool its six shutdown reactors and spent fuel in order to avoid any catastrophic nuclear incidents.
Image: Russia struke a train station in the city of Fastiv. Pics: Reuters
Zelenskyy condemns ‘meaningless’ strikes
Ukrainian President Volodymyr Zelenskyy condemned the strikes as “meaningless” from a military point of view.
He said energy facilities were the main targets, but a drone strike had “burned down” a train station in the city of Fastiv, in the Kyiv region.
“The Russians’ goal is to hurt millions of Ukrainians, and they have sunk so low that they are launching missiles at peaceful cities on St. Nicholas Day,” he said.
“That is why additional pressure is needed. Sanctions must work, and so must our air defence, which means we must continue to support those who defend our lives.”
Ukraine strikes oil refinery
Meanwhile, Russia’s defence ministry said its air defences had shot down 116 Ukrainian drones over Russian territory overnight.
The General Staff of the Ukrainian Armed Forces said Ukrainian forces had struck Russia’s Ryazan Oil Refinery, while Russian Telegram news channel Astra shared footage appearing to show a fire breaking out and plumes of smoke rising above the refinery.
Over the last few months, Ukraine has used long-range drones to target Russian refineries in an attempt to deprive Moscow of the oil export revenue it needs to continue the war.
Meanwhile, Kyiv and its Western allies say Russia is trying to cripple Ukraine’s power grid and deny civilians access to heat, light and running water in winter, which Ukrainian officials call “weaponising” the cold.
On Monday, Mr Zelenskyy will meet Sir Keir Starmer in London to discuss the ongoing negotiations mediated by the US, along with French President Emmanuel Macron and German Chancellor Friedrich Merz.