Economy

Doctors sans ethics: How medical malpractice has made hysterectomies a big business in Marathwada

Radheshyam Jadhav Pune | Updated on April 11, 2019 Published on April 10, 2019

Hysterectomies are turning cane-cutter women in Marathwada into ‘living working machines’

The National Commision of Women’s decision — following a report by BusinessLine — to issue a notice to Maharashtra Chief Secretary UPS Madan asking for legal action to end the menace of womb removal by women working as sugarcane cutters has put the inhuman practice in the spotlight.

Married at the age of 15 or 16, girls in the drought-affected Marathwada region become mothers in the next couple of years. And then, by the time they are 22 or 23 years old, they have a hysterectomy — a surgery to remove the uterus. Thereafter these cane-cutter women become ‘living working machines’ for their entire life.

Medical malpractice

While cane cutting contractors have denied encouraging the practice, some of the women BusinessLine spoke to said that the contractors give them an advance for the surgery and that the money is recovered from their wages.

However, it goes well beyond that. Dr Shashikant Ahankari, a community health specialist, and president of the Halo Medical Foundation, based in Marathwada’s Osmanabad district, said there are socio-economic and medical malpractice angles to the story.

“Not only cane contractors but also medical practitioners’ vested commercial interests are behind this. (Carrying out) Unindicated hysterectomies is against medical ethics. Doctors have spread fear in the region that a white or red discharge would result in cancer,” said Ahankari, who has been involved in the community health speciality since 1978. Women, he explained, are made to believe that a womb is useless once children are born and also that they will not have to sit aside without work after a hysterectomy as they will not have periods or get pregnant. “You can see village after village where hysterectomies are being done. Many times the ovary is removed during the hysterectomy surgery,” said Ahankari.

There are no major studies or surveys on women cane cutters and the exploitation they have to endure. Medha Kale of Tathapi Trust, a women and health resource centre, said that her organisation conducted a survey in nine villages in Latur and Osmanabad in 2009-10 of hysterectomy operations and related issues faced by the women there.

“We wanted to understand the incidence, causes and also unethical practices in the medical sector regarding hysterectomies and resultant economic pressure on families. We found that some women who had undergone surgeries were not told about their diagnosis and many had not been given any medical papers of their own surgery.”

Work, work, work

Kale added that many women hardly got any rest after the surgery due to their work burden. “These women, from poor and marginalised sections, bear the brunt of the patriarchal exploitation,” she said.

A member of the Beed district administration, who contacted BusinessLine, said: “This is new knowledge for me that women go for a hysterectomy as they feel the menstrual cycle is a hindrance to work (cane cutting). It is a fact that many private practitioners recommend the surgery to stop white discharge. Also, there is mouth-to-mouth publicity and the surgery is popular among young girls to stop white discharges. There is a trend here that girls are married at the age of 15-16, then they have two children, then family planning and then a hysterectomy.”

Activist Manisha Tokale said that men, either contractors or their husbands, are only concerned that work is not halted at any cost. A cane-cutter woman carries 30-40 kg cane on her head and loads it in a truck or tractor. “There are no sanitary napkins or sanitation facilities available for cane-cutter women. Also, fear of womb cancer has been spread deliberately in this region, drawing women to go for a hysterectomy,” she said, adding that there has been no effort to create awareness on the rights of cane-cutter women.

Ashok Tangade, a local activist in Beed district, said that though people unaware of these harsh realities would find it hard to digest them, the truth is that the life of the poor cane-cutter women in the region is a vicious cycle of tragedy. “After a hysterectomy women are nothing but a machine that will not take breaks from work,” said Tangade.

Published on April 10, 2019
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