Archana Ashok Chaure has given her life to sugar. She was married to a sugarcane laborer in western India around age 14 — “too young to have any idea what marriage was,” she said.
The debt to her employer keeps her in the field.
Last winter, she did what thousands of women here are pressured to do when faced with painful periods or routine ailments: she underwent a hysterectomy and returned to work.
This keeps sugar flowing to companies like Coca-Cola and Pepsi.
The two soft drink makers have helped turn the State of Maharashtra into a sugar-producing powerhouse. But An investigation by The New York Times and the Fuller Project, a global nonprofit newsroom, found that these brands have also profited financially from a brutal labor system that exploits children and leads to the unnecessary sterilization of women in working age.
People at every stage of the supply chain were interviewed, including dozens of workers, contractors, sugar mill owners and former executives of multinational companies. The Times also examined medical records and interviewed doctors, lawmakers, government officials, researchers and aid workers.
Young girls are forced to contract illegal child marriages to be able to work alongside their husbands cutting and collecting sugar cane. Instead of receiving wages, they work to pay their employers' retainers, an arrangement that requires them to pay a fee for the privilege of missing work, even to see a doctor.
An extreme, but common consequence of this financial trap is the hysterectomies. Labor intermediaries lend money for surgeries, even to resolve such routine ailments as heavy and painful menstruations. And the women, most of them uneducated, say they have few options.
Hysterectomies keep them working, undistracted by doctor visits or the difficulties of menstruating in a camp without access to running water, bathrooms or shelter.
Removing a woman's uterus has lasting consequences, particularly if she is under 40 years old. In addition to the short-term risks of abdominal pain, it often causes early menopause, raising the chances of heart disease and osteoporosis.
But for many female sugar workers, the operation has a particularly grim outcome: Borrowing against future wages sinks them deeper into debt, ensuring they return to the fields next season and beyond. Workers' rights groups and the United Nations labor agency have defined agreements as well as forced labor.
Sugar producers and buyers have been aware of this abusive system for years. Coca-Cola consultants visited sugar fields and mills in western India and, in 2019, reported that children were cutting sugar cane and day laborers were working to pay off debts to their employers.. They documented it in a report for the company, including an interview with a 10-year-old girl. In an unrelated corporate report that year, the company said it was supporting a program to “gradually reduce child labor” in India.
PepsiCo confirmed that one of its largest international franchises buys sugar from Maharashtra. The franchise just opened its third manufacturing and bottling plant there. A new Coca-Cola factory is being built in Maharashtra, and Coca-Cola confirmed that it also buys sugar from the State. These companies use the sugar primarily for products sold in India, industry officials say. PepsiCo said the company and its partners buy a small amount of sugar from Maharashtra, compared to the state's total production.
Both companies have codes of conduct that prohibit suppliers and business partners from using child labor and forced labor.
“The description of the working conditions of sugarcane cutters in Maharashtra is deeply worrying,” PepsiCo said in a statement, adding that it would take all measures that “may be necessary.”
Coca-Cola declined to comment on a detailed list of questions.
The heart of this exploitation is Beed district, an impoverished rural region of Maharashtra that is home to much of the migrant sugar-cutting population. A local government report surveyed approximately 82,000 Beed sugar cane workers and found that approximately 1 in 5 had had a hysterectomy. A separate government survey put the figure at 1 in 3.
The abuses continue despite local government investigations, news reports and warnings from company consultants, because they all point to someone else as being responsible.
Large Western companies have policies that promise to eradicate human rights abuses in their supply chains. In practice, they rarely, if ever, visit the fields and rely heavily on their suppliers, the sugar mill owners, to oversee labor issues.
However, the mill owners claim that they do not actually employ the workers. They hire contractors to recruit migrants from distant villages, transport them to the fields, and pay them salaries. The treatment given to those workers, the owners say, is between them and the contractors.
These contractors say they are simply distributing the money of the mill owners. They cannot dictate working conditions or terms of employment.
India is the second largest sugar producer in the world and Maharashtra accounts for about a third of it. In other sugar regions, farm owners hire local workers and pay them wages. In Maharashtra, instead of farm owners' salaries, about a million workers receive an advance—often about $1,800 per couple, or about $5 per day per person for a six-month season—from a mill contractor. This centuries-old system reduces the labor costs of sugar mills.
In the fields, where she has spent her life cutting sugar for a mill owned by NSL Sugars, Chaure, like the others, sleeps on the ground, spends hours a day hunched over and carries loads on her head.
Women often have familiar ailments: pain that radiates into the lower back and prolonged or irregular menstruation that makes work difficult.
Hysterectomy is a routine surgery performed around the world, although infrequently on women in their 20s and 30s. In India it is more common, including as a form of birth control, and other parts of the country also have high rates of hysterectomies. But in Maharashtra's sugar industry, everyone — contractors, other workers, even doctors — are urging women to undergo the surgery.
In their wedding photographs, Chaure stares into the camera. She didn't know the groom; that was normal. The same thing had happened to many of her friends.
Like many rural women in Maharashtra, Chaure does not know her exact age, but she is in her mid-30s. She estimates that she was about 14 years old on the day of her wedding. It was celebrated two years after she dropped out of school in her town so her parents could take her to the sugar fields. “I was afraid to get married,” she remembers, “very afraid.”
Chaure ended up on the operating table because an ultrasound showed she had ovarian cysts, her medical records show.
Instead of removing the cysts, her surgeon told her she should have a hysterectomy. She didn't question the advice. She knew many women who had done the same thing. She was terrified of developing cancer. And maybe this would put an end to her pain and her visits to the doctor.
The surgeon removed her uterus, a cyst, an ovary and a fallopian tube. In an interview, his surgeon said it was necessary because the cyst was unusually large.
The Times shared details of Chaure's file with Farinaz Seifi, director of gynecology at Bridgeport Hospital in Connecticut. “There was absolutely no indication for a hysterectomy,” she said.
In this part of Maharashtra, two economic incentives push girls to marry.
First of all, cutting sugar cane is a two-person job. Husband and wife teams earn twice as much as a man working alone.
Secondly, the longer children accompany their parents in the countryside, the longer their parents will have to support them. This is why families often seek to marry off their daughters young, even in early adolescence.
“If we are married, their stress is reduced and the responsibility shifts to our husband's shoulders,” Chaure said. “So they marry us.”
Workers said there were rarely official contracts or records accounting for the amount of sugar cane they cut. At the end of the season, contractors usually declare that there is a balance remaining.
In 2019, a state legislator's investigation into the high number of hysterectomies in Maharashtra led to the change of a rule aimed at preventing unscrupulous doctors from profiting from unnecessary surgeries.
“Some doctors have turned it into a way to earn more money,” said Chaitanya Kagde, a gynecologist in Beed.
The new rule requires the civil surgeon, the district's top health official, to approve hysterectomies.
But hysterectomies continue in younger women. Although many doctors agree that some surgeons perform them too frequently, they say that patients request the surgery.
In May, Suresh Sable, Beed's civil surgeon at the time, said the Government should not question doctors. He said his office still approved 90 percent of requests for hysterectomies.
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