By – Sritha M
Abstract
This article aims to discuss how the mass hysterectomies of Dalit and Adivasi women working in Maharashtra’s sugarcane fields are not merely isolated events, but are parts of a much bigger system built on caste-gendered structural violence. In it, the state’s lack of labour protections, the profit motives of private healthcare, and the caste-based disposability of bodies all come together to surgically remove women’s reproductive organs so that their labour can be utilized without interruptions. Further, this article also shows that this pattern is spread across India beyond the sugarcane industry, and argues that no single person or body is to be blamed for this phenomenon. It discusses several financial, social, and physical conditions that guide these women to resort to this procedure.
Introduction
“There is no human rights violation worse than having to remove your uterus so you can enter an informal economy that does not care for you” – Nirja Bhatnagar, ActionAid, Mumbai.
Archana Ashok Chaure was married off to a sugarcane labourer at 14, following which she began working rigorous hours of labor every day, often interrupted by her womanhood. At an age where she did not even know what marriage was, she was part of a much bigger system – one that marries off young girls into illegal child marriages where they work by cutting and gathering sugarcane. Another victim of this system was Ashabai Prabhaskar, married at 13 and a mother of four by 21. She, like the other women, faced interruptions from her rigorous 16-hour work shifts due to recurrent UTIs from the lack of hygienic menstrual products and clean water. For these women, missing a day of work meant heavy fines to be paid to the mukadams or sugarcane contractors. These situations are what pushed these women to opt for an expensive but permanent solution: a hysterectomy.
According to surveys conducted by the local NGOs in 2019, it was found that the rate of hysterectomies amongst women from Beed, one of Maharashtra’s biggest hubs for sugar cane workers, was 36% compared to a national average of 3%.
The System
The Mukadam system is a traditional labour contracting system that is largely used in South Asian agricultural and construction sectors. The system works like this: a Mukadam acts as a middleman or labour contractor hired by sugar factories to recruit cheap labour. Workers are often hired in pairs (called koytas), usually a husband and wife, generally through informal, unwritten contracts. The Mukadam advances loans and manages the labourers’ wages in exchange for a fee. These men earn a commission of around 15-20% and take at least 30% of the workers’ wages. The workers are often hired with false promises of financial advances that cover travel and living expenses, and while this may initially work, it soon becomes a cycle where they are stuck in debt. The debt becomes almost impossible to repay in time because of their low wages, and workers who cannot pay it off within the first season return to work under the same harsh conditions for the following seasons. The Bonded Labour System (Abolition) Act, 1976, clearly bans this practice altogether. But in the Mukadam system, workers are still held accountable for these debts, even though legally the debts are to be considered null and void. This system is not only horrific, but it is also unconstitutional and illegal.
The workers do not get breaks, and fines are imposed for every time they miss the set daily requirement for harvested sugarcane. For female workers, period pain or pregnancy would mean more missed days of work, therefore more lost wages and added fines. Besides, these women resort to using rags during menstruation, which are often reused with no clean water to wash them and nowhere to dispose of them. Tampons or pads remain almost completely inaccessible due to how expensive they are. This leads to numerous infections and complications like Pelvic Inflammatory Diseases (PID), Vaginitis, Leucorrhoea, etc., all inevitably linked to poor menstrual hygiene, lack of clean water, and lack of sexual and reproductive health awareness.
The Caste Dimension
Nearly 80% of the sugarcane harvesting and transport workers are seasonal migrants who come mainly from the drought-prone areas of the Marathwada region. A number of these workers are from the tribal areas of Dhule and Nandurbar. Importantly, the majority of these workers come from scheduled castes, scheduled tribes, and minority sections.
The caste system has historically subjected the SC and ST communities to the most physically brutal forms of labour. It decides the healthcare conditions for these communities; though government healthcare may be accessible, Dalit and Adivasi women still share experiences of discrimination and denial of basic care. It is a system that determines which bodies are available for discipline and socially marked as disposable.
In her work “Who is a woman and who is a dalit?”, Sowjanya T explains that modern society often leaves out Dalit women from the equation of social justice. The notion that ‘all women are white and all men are black’ becomes ‘all women are upper-caste and all men are Dalit’. The lack of intersectionality while understanding social justice issues pushes women into the lower end of the hierarchy, and Dalit women even lower. The caste system creates a system of ‘graded patriarchy’, and for Dalit women, this ties along with the ‘graded inequalities’ of caste.
Historically, upper-caste men have had access to Dalit women’s sexuality and body, and this does not only reflect in sexual violence, but also in labour. Every year, many female labourers in the sugarcane industry are sexually assaulted by supervisors and landowners. Female workers in western Maharashtra’s fields are subjected to routine abuse and rape by the landlords and middlemen. This becomes another common reason among the women in this industry for hysterectomies – to avoid pregnancies from repeated abuse. Agricultural women workers were 32% more likely to undergo a hysterectomy compared to other occupation groups, said a study published in the ‘Journal of Medical Evidence‘.
Beyond sugarcane: a pattern across India:
The “solution” of removing the uteruses to make Dalit and Adivasi women’s labour “more efficient” is not solely a story of the sugarcane industry of Maharashtra. Manual scavenging, a practice that is heavily sanctioned by caste, shows an estimated 1.3 million Dalit workers pushed into its labour force, and around 75% of these are women employed. “There is an increasing incidence of hysterectomies among the women manual scavengers of Jalaun, which leaves their families destitute and trapped in debt bondage,” claims local activist Kuldeep Kumar Baudh. Manual scavenging puts female workers through several health and occupational hazards. The direct handling of human excreta, the indirect ingestion of toxic chemicals, and the physical strain of carrying heavy waste loads on their heads or hips often lead to severe gynecological complications, including pelvic inflammatory disease (PID), hormonal imbalances, and even increased rates of miscarriages. Further, the women who work in the practice of manual scavenging are from different Dalit caste communities like Valmiki in Punjab and Delhi; Haila and Halalkhor in Madhya Pradesh and UP, and Mister and Dome in Bihar. These women are subjected to sexual and physical violence regularly from their employers, contractors, and community members, whether that is as punishment for missing days of work or otherwise.
In almost every industry, the same caste groups ultimately bear the cost – Dalit and Adivasi communities. It is a pattern that finds itself repeating wherever Dalit and Adivasi women make up the majority of the workforce. Specific industries like sugarcane, tea, and manual scavenging all may reform and transform themselves with time, but the structure of it will remain the same: caste determines who does the work, gender determines whose bodies are surgically altered, and the state stays silent.
Conclusion
Mass hysterectomies, therefore, are not to be chalked off as isolated events but as a part of a much bigger system built on caste-gendered structural violence that stubbornly replicates itself across industries like sugarcane, manual scavenging, tea, etc. This is because it operates anywhere Dalit and Adivasi women perform the least protected and the most physically demanding work. In these conditions, no woman is explicitly forced to get a hysterectomy. No contractors, no doctors, and no families force these female workers. But, when a woman works around sixteen hours daily, where missing even a single day costs her a fine and abuse, the system has already chosen for her. The coercion is built through the conditions set for her. This makes us question who is to be held accountable. Is it the Mukadam who sets the conditions? Is it the doctors who perform the surgeries? Is it the sugar mill contractors who refuse to take responsibility? Or is it the state that fails its promise of protecting the labour force? The answer is all of them, and none alone. The violence is systemic, and until and unless the system is held accountable as one, the hysterectomies will continue.
Author’s bio
Sritha M is a student of B.COM. LL.B (Hons.) in Jindal Global Law School, O.P Jindal Global University. Having an interest in human rights and gender studies, Sritha’s writings are driven by the need for social justice and critical engagement with the status quo.