Recently, there has been an increasing trend in some parts of India of women undergoing expensive and unnecessary hysterectomy surgeries. A hysterectomy is a medical procedure to remove a woman's uterus. such a surgery is usually recommended in four main situations: 1) excessive menstrual bleeding (usually due to fibroids), 2) pelvic pain that does not respond to treatment, 3) uterine prolapse, and 4) cancer of the uterus, ovaries, or cervix. This trend is most prevalent in Maharashtra, India's second most populous state.
The Working Life of Sugarcane Cutters
Prior to every harvesting season, sugar mills specify their labor
requirements to middlemen known as 'Mukkadams,' who subsequently recruit
workers through verbal, informal agreements. These laborers are typically
organized into 'Jodis,' or pairs, consisting of a husband and wife who
remain under the Mukkadam's supervision throughout their employment. After
assembling the necessary number of Jodis, the Mukadam signs a formal
contract with the mill, receiving an advance payment in return. From this
sum, he pays each pair between ₹50,000 and ₹1 lakh for their
four-to-six-month commitment, a portion of which the workers use to cover
their migration to the worksite. The Mukkadam acts as an essential
intermediary, managing wages, overseeing medical needs, and facilitating
communication between the mill and the workers, all while earning a
commission based on output.
Cane cutters endure grueling 12-to-18-hour daily shifts that begin at
4:00 AM. Any absence due to health issues results in a penalty of
approximately ₹500 per day imposed on the Jodis by the Mukkadam. Although
the Contract Labour (Regulation and Abolition) Act of 1970 is intended to
safeguard these workers and prevent such exploitation, neither the mills
nor the state governments enforce these protections effectively, leaving
laborers vulnerable. Additionally, beyond their arduous field labor, the
women in these pairs are responsible for all unpaid domestic duties,
including cooking, cleaning, and childcare.
When the harvest begins, the Mukkadam directs each pair to their
designated location. Upon arriving with their belongings, families, and
sometimes livestock, these migrant workers reside in makeshift,
tarpaulin-covered shelters constructed near the mills or directly in the
fields. These living conditions are devoid of basic sanitation; lacking
toilets, workers are forced to defecate in open fields. Furthermore, these
cramped, inadequate tents offer little security or shelter. Access to
electricity and running water is nearly nonexistent. Women and girls face
additional burdens, as they are responsible for hauling water for the
family from communal wells and are often forced to bathe in public, open
spaces.
The Rise in Female Hysterectomies
In 2019, Maharashtra’s drought-prone Beed district drew national concern
when local reports highlighted an alarmingly high prevalence of
hysterectomies among its female population. This trend is deeply rooted in
the social reality of rural India, where menstruation remains a taboo
subject. Within the context of sugarcane harvesting, pregnancy and
menstruation are perceived as impediments that hinder a woman's ability to
perform at peak capacity.
Most female cane cutters in Beed are married between the ages of 12 and
16, subsequently joining their husbands in the fields as part of a "Jodi"
(couple) unit. Because men typically manage the contracts, handle the
wages, and make major household decisions, these women have minimal agency
regarding their own labor and migration.
A lack of formal education and limited access to healthcare contribute to
poor menstrual hygiene, with many women relying on unsanitary, damp rags
that heighten the risk of infection. Because sugar mills enforce strict
quotas, contractors (Mukkadams) often view a woman’s absence due to
pregnancy or her menstrual cycle as a barrier to fulfilling production
targets. While Mukkadams may not explicitly command women to undergo
surgery, the intense pressure to avoid job loss or daily fines creates a
coercive environment. Often, Mukkadams will even provide the upfront
funding for the procedure, later recovering the cost through wage
deductions.
Beyond external pressure, some women choose to have the surgery
voluntarily, driven by a cultural misconception that a woman’s uterus
serves no purpose after childbirth. Many hope that removing the organ will
end their menstrual cycles, thereby allowing them to work longer hours and
increase their productivity. Exploitative private clinics further fuel
this trend; fraudulent doctors often manipulate women suffering from
common issues like pelvic pain or discharge, using fear tactics to
convince them that their condition is life-threatening and requires
surgery.
Data from the Maharashtra State Commission for Women’s 2018 study
indicated that roughly 36% of female sugarcane workers in the state had
undergone a hysterectomy. Between 2016 and 2019 alone, about 4,600 women
in Beed underwent the procedure, establishing Maharashtra as a state with
one of India's highest hysterectomy rates.
Ultimately, this surgery is often viewed as a financial investment
costing approximately ₹35,000, or roughly a full season's wages for a Jodi
made in the hope of securing higher earnings. Yet, the expected gains in
productivity are contradicted by the severe outcomes reported by many
women. Beyond the financial burden, post-surgical patients frequently
suffer from chronic physical and mental distress, including depression,
insomnia, back pain, and joint issues.
As mentioned, the threat of fines and denial of work from labor
contractors, growing social conditioning, and poverty force these women to
remove their uteruses. The ones reaping the excessive profits are the
capitalists. They generate excessive profits by producing 'cheap' labor.
Furthermore, some doctors exploit this opportunity, misleading women by
citing 'cancer risks' to pressure them into undergoing surgery at their
clinics. The average cost of a surgery is about ₹35,000, for which women
have to take loans. This creates an uncertain burden! There are reports
that some women faced further physical complications due to the
hysterectomy, requiring additional operations costing up to ₹1 lakh.
Here, a joint team of labor contractors, doctors, and moneylenders is
exploiting these women. They have even created a society favorable to them
during this period a society where surgery has to be performed in places
where only awareness should have been created! This is a huge challenge.
The root causes are a lack of education, poverty, and the absence of
government intervention.
In a capitalist country, it is natural that the issues of the working
class do not reach the public domain, and corporate media will support
them. Recently, the production of E20 petrol has been increased, leading
to a significant rise in sugarcane production. These changes have created
conditions for these primitive, anti-labor practices to increase even
further. A world that is 'comfortable' for capitalists is being created
again and again!. But who pays for this comfort? While the
expansion of E20 petrol promises a greener future for our vehicles, it is
being fueled by the blood and health of our most marginalized workers. In
the second part of this report, we will investigate the direct correlation
between the push for increased sugarcane production, the industrial
influence of key political figures, and the deepening crisis facing these
women. The story of the cane-cutter does not end in the field it continues
in the corridors of power.
