[A female worker cuts sugarcane in a field in Maharashtra. (File photo| Reuters)1]
In India, the region of Maharashtra has a strikingly high rate of hysterectomies performed on women in comparison with the rest of the country. This rather odd fact has a simple explanation: it is a pretty creative expression of the exploitation of female workers.
The region of Maharashtra is, among other things, a central place of sugarcane production. Female workers come to this region every year to perform sugarcane cutting for six-months. A hysterectomy is the surgical operation completely removing the uterus. The removal of the uterus can be performed either abdominally or vaginally2, the abdominal technique being more common in not-very-ethical-private clinics, as being less costly and more technically accessible. Needless to say, the abdominal technique requires to open the abdomen, which –(un)surprisingly- leaves a scar. Not the best for psychological recovery when you are coerced into getting a hysterectomy.
Indeed, female sugarcane cutters get so many hysterectomies not because cutting sugarcane gives you womb cancer, but because they are coerced into it by their employers. The work of female sugarcane cutters is known to be a very physically exhausting and a very low paid job. The scarce wages already reveal the exploitative part of the system, but the very situation of the women, socially dominated, also lead to reported sexual exploitation3.
Most women working in the fields are migrants that come every year, after the monsoon. They get paid in advance for six months, and when they miss one day of labour, they ought to pay the earning of the day through a system of taxes. The working conditions are terrible: the lack of sleep and lack of clean water are principal causes of daily infections. When they have their menstruation, women use basic or home-made pads, and do not get to use proper sanitary bathroom equipment. Most workers are illiterate, from lower casts and fear their employers, richer and from higher casts. These women don’t have access to property, they don’t own any land. The work of sugarcane cutting is one of their few safeguards, and they don’t want to risk losing it by addressing the issues they face. In this situation, the women are married early, mostly before the legal age of eighteen.
When they get to the field, the employers recommend them to get a hysterectomy. The surgery would simply erase the problem of menstruations and make them gain -or save- the earning they usually lose some days a month. Because of their poor working conditions, women experience daily health problems, some of which are related to their menstruation -excessive bleeding, violent cramps. Since they are immigrants, most of the female workers don’t have health insurance, or don’t know they can be covered by a public system. They rely on the network of their employers, that lead them to consult private clinics that have incentives in performing hysterectomies. The operation is very profitable for the private clinics and put the family of the patient into debt. The cost of the operation is equivalent to six-months salary of sugarcane cutting. When they get to the private clinics -taking a day off the field-, women are told that the operation is unavoidable: mostly, they are told they have cancer and will die if they don’t get hysterectomy. They are not told what the effects of the operation are, and they can’t look out for a second medical opinion. Once they go through the operation, they don’t have time to physically recover and almost immediately get back to their work. This provokes greater abdominal and back pain, and female workers are unable to perform the same amount of work they were used to achieve before the operation.
In 2019, the NGO Tathapi reported this scandal, which led to a big international media coverage4. Activists pushed an investigation against the private clinic providing those surgeries. Till this day, no progress has been made. This scandal, that was covered in 2019 still hasn’t met any support in court, and the mediatic coverage has faded. As long as we raise awareness of these women’s struggles, the fight continues.
1 In The New Indian Express, Over 13,000 female sugarcane workers in Beed have undergone uterus removal surgery, says probe panel, 29th August 2019.
2 Nirmala Duhan. (2012). Techniques of Hysterectomy. 10.5772/28782.
3 Rina Chandran, Sexual abuse plagues female workers on India’s sugarcane fields, Thomson Reuters Foundation, August 2, 2016
4 Katie Clarke, Forced Hysterectomies Performed On Indian Female Farmers To Boost Productivity, The Organization for World Peace, July 26, 2019;
Jill McGivering, The Indian women pushed into hysterectomies, BBC News, 6 February 2013;
Meena Menon, Beed: High hysterectomy rate among sugarcane cutters signals unethical medical practices, poor work conditions, Firstpost, June 14, 2019;
Elizabeth Puranam, Inquiry into alleged coerced hysterectomies begins in India, Aljazeera, 10 Jul 2019.