When we discuss gender equality in jobs, our attention usually stays limited to corporate desk jobs, maternity leave, or boardroom pay gaps. But for women standing on the margins of India’s agriculture sector, this battle is not about basic facilities like maternity leave. It is a desperate fight for their very survival and existence — a struggle for their bodily integrity.
A horrifying reality that continues even today is that women farm labourers are forced to get their wombs (uterus) removed. The sole reason is so they can work continuously in sugarcane fields for long hours without the pain of periods or the need for any leave.
This heart-wrenching truth is not from some distant land. It belongs to the sugarcane fields of Maharashtra — one of India’s most developed states — particularly in Beed district, among seasonal migrant women workers.
This is not a sudden health issue. It is a deliberate economic compulsion. The roots of this tragedy lie not in any medical emergency, but in an institutional and exploitative labour structure that forces these women to pay the “biological cost” of their own bodies just to survive.
The entire cycle of exploitation begins with the ground-level system known as the ‘Jodi’ system.The Cruel Economics of the 'Jodi' System
The complete structure of sugarcane harvesting is built on the ‘Jodi’ (pair) system. Contractors (Mukadams) hire husband and wife as a single unit instead of individual workers.
Debt Trap: For the 6-month season (September to March), these couples are given an advance of ₹1 lakh to ₹1.5 lakh, which immediately traps them in a vicious debt cycle.
No Sick Leave: There is no concept of sick leave in this system.
Double Penalty: If a woman misses even one day of work due to severe period pain, heavy bleeding, or pregnancy complications, the contractor imposes a heavy fine of ₹500 to ₹1,000 per day — almost double her actual daily earnings.
According to a report by Pune-based NGO SOPPECOM (Society for Promoting Participative Ecosystem Management), these women perform back-breaking labour for 18 hours a day. Sometimes they load and unload sugarcane in trucks throughout the night. For this brutal work, they receive only ₹300 to ₹400 per day (£4 or $3.88 to $4.64). The huge gap between official labour standards and ground reality clearly exposes the exploitation.
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The level of pressure and helplessness here goes far beyond normal. The stark difference between national, state, and district data reveals the terrifying scale of this crisis:State vs District: According to the National Family Health Survey (NFHS), the average hysterectomy rate (uterus removal surgery) in Maharashtra is 2.6% — lower than the national average of 3.2%. But in Beed district’s sugarcane fields, the story changes completely.
2019 Government Data: Out of 82,309 women farm labourers in Beed, 13,861 work in sugarcane harvesting. The hysterectomy rate among only these sugarcane workers stands at 17%.
NGO Independent Survey: In a separate study by local NGOs on a sample of 200 women, the rate was shockingly high at 36% (meaning 1 in every 3 women had her uterus removed).
Major Investigation Reveal: Under pressure from social activists, when local administration probed the issue, it came to light that in the last decade alone, more than 13,000 women sugarcane workers in Beed district had undergone hysterectomy. Some victims were young women below 25 years of age. Most victims are in the 30-35 age group. Such a major invasive surgery at such a young age completely destroys their bodies.
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| Asha, a 29-year-old, sugar cane cutter from Beed district has three children had a hysterectomy. Photograph: Chloé Sharrock/MYOP |
This is not just data, it is another doorway to exploitation — when women go for treatment, they are trapped more by doctors’ greed than by disease itself.Exploitation by Rogue Private Clinics and the Health Crisis
Living conditions in these fields are abysmal. Women live in temporary huts on the edges of fields with no clean toilets, no safe drinking water, and no access to sanitary pads. This leads to constant serious gynaecological problems, urinary tract infections (UTIs), and painful uterine cysts.
When these helpless women visit local private doctors to protect their livelihood, they fall prey to the greed of the medical system:
Fear of Cancer & Unnecessary Surgeries: Instead of treating minor infections or cysts, private clinics scare women by claiming, “Your uterus is now useless and will cause cancer if not removed.” They market the surgery as a ‘one-stop solution’ to periods, pain, and future medical expenses.
Medical Scam: Between 2016 and 2019, 99 private hospitals in Beed alone performed over 4,605 such surgeries, making huge profits by misusing government health insurance schemes.
New Debt Cycle: Contractors themselves provide loans for these expensive surgeries, pushing women into deeper debt and bonded labour. They are forced to choose between bodily integrity and basic economic survival. In most cases, it is not direct physical force, but economic pressure, lack of awareness, and the exploitative labour system that compel women to take this self-destructive step.Forced Menopause at Age 30Removal of the uterus (and often the ovaries) at a young age completely destroys these women’s hormonal balance. They are pushed into forced menopause at just 30-32 years of age.
The consequences are devastating: unbearable joint and bone pain, osteoporosis, and extreme physical weakness at a young age. Lifting heavy weights later becomes life-threatening for them.Not Just Maharashtra: A Nationwide Crisis and Systemic Failure
This horrific crisis is not limited to Maharashtra. Last year, researchers published a paper in a peer-reviewed journal raising serious concern over similarly high hysterectomy rates among women sugarcane and farm workers in Andhra Pradesh, Telangana, and Bihar. Poverty, illness, and contractor pressure are identical in these states. Researchers demanded a national hysterectomy surveillance system to monitor this data closely.
Administrative Failure: According to the latest data from the Indian Sugar Mills Association, nearly one-third of India’s 506 sugar mills are in Maharashtra. Every year, around 1.5 million workers migrate from drought-prone areas. Sugar mill owners and contractors are extremely powerful politically and economically.
Although the government has formed inquiry committees, increased monitoring, and set up vigilance cells, the pace of change on the ground is painfully slow, and this exploitation continues unchecked.
This is not an ordinary health problem — it is a deadly combination of poverty, patriarchy, exploitative labour practices, weak healthcare infrastructure, and corporate greed.Conclusion: The Bitter Reality of Global Supply Chains
Maharashtra’s sugar belt is not an isolated region. It is an integral part of the global economy that supplies sugar to giant multinational companies like Coca-Cola and PepsiCo.
Following a major investigative report by The New York Times in 2024, Coca-Cola stated it was “deeply concerned” about forced hysterectomies and committed to investigating the matter. However, activists and victim women on the ground say the problem has still not been fully resolved.
Moreover, research by Symbiosis International University reveals that nearly 80% of women working in these fields have faced some form of sexual harassment, molestation, or exploitation — by fellow workers, supervisors, or truck drivers. Due to poverty, social stigma, and fear of losing work, these women never speak out. Complaining often means immediate job loss.
The sugar that sweetens the world’s mouth carries a bitter truth: every bit of its sweetness comes from the blood, sweat, and forced sacrifice of the bodies of India’s helpless rural women. Behind the glossy corporate supply chain advertisements, this harsh reality is carefully concealed.
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