- SUGAR GIRLS -

Abusive hysterectomies in India

India, 2019

Sugar Girls will be exhibited at Visa Pour L'image International Photojournalism Festival (Perpignan, France) from the 29th of August until the 27th of September.

In 2020, the story was rewarded with the French Ministry of Culture Production Grant for Female Photojournalists, the "Brouillon d'Un Rêve" Grant by La Scam, and the Contemporary Documentary Photography Production Grant by the CNAP (National Center for Fine Arts). 

In May 2019, activists from Beed district, Maharashtra in India, uncovered shocking facts : an abnormally high number of women, all working as sugarcane cutters, underwent a hysterectomy (total ablation of the uterus). Even more shocking, these surgeries were unnecessary, and performed coercively. 

The women are indeed tricked into believing that the procedure is mandatory by doctors from the private health sector, the latter being eager to generate profit from these surgeries. Some villages in Beed therefore show a hysterectomy rates as high as 35% of their women, aged less than 30 years all for most of them. 

My project therefore highlights why, and how, are these women tricked into these unnecessary hysterectomies.

 

First of all, the fact that this practice was discovered in Beed district isn’t a coincidence. This region is where most of the labor force of India’s « sugar belt », situated in the south of the country, can be found. Every year, dozens of thousands of laborers are hired in that district before migrating towards plantations where they will work during five to six months in harsh conditions. 

What needs to be understood is that these specific women, working in sugarcane plantations, are ideal preys for these doctors from the private health sector for multiple reasons. 

On one hand, these workers are particularly inclined to recurring health issues because of the very nature of their work in the fields, which pushes them to frequently consult doctors. The labor is indeed exhausting: work days of 12 to 16 hours, sugarcane bundles of dozens of kilos to carry on their head, malnutrition and dehydration… In addition, women face the impossibility of taking breaks when sick or on their periods, as they get fined of up to 500 rupees for a day of work missed. Sugarcane cutters are in addition unorganized workers, and this lack of structure gives space to abuse. 

 

On the other hand, child marriage, repetitive pregnancies at a very young age without any assistance or medical follow up, or systematic sterilization are common among women from such rural areas. Their bodies, mistreated by life and their work, age prematurely and endure health issues such as excessive bleedings, white discharges or uterine pain. In most cases, women first consult a doctor from the public health sector. But the hospitals often lack of adequate equipment such as sonograms, and women end up consulting doctors from the private health sectors known for being « more efficient », as it is said among the women. 

It’s those doctors that abuse of the vulnerability of the women and their lack of knowledge about their own body: they let them believe that a hysterectomy is the only solution. Profit is the only motive behind this fraud: surgeries made by doctors from the private health sectors are charged, and prices can be freely set by the practitioners. 

In addition, most of them aren't given any medical report after the surgery: not a single piece of paper, or at most a bill that isn’t even mentioning the procedure. The price for the surgery can easily oscillate between 20 000 and 50 000 rupees (around $250 to $650), trapping the women into a spiral of indebtedness. 

But the burden of these women doesn't stop here: the field contractors - the « mukadam » - also seeing here an easy way to make profit, are inciting some of their women workers to perform such surgery,  in exchange of a commission given by the private doctors. Furthermore, they also loan them the money for the surgery, with skyrocketing interest rates. 

 

This practice therefore shockingly reflects the objectification of these women’s body: worst, it has become a way to generate profit through its very mutilation. I therefore believe in the absolute necessity of denouncing this horrifying violation of human rights and medical ethics.

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© CHLOE SHARROCK 2020 / All rights reserved