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Our investigation with The New York Times into thousands of coerced hysterectomies in the sugar farms of Maharashtra, India, has had an immediate and resounding impact that continues to reverberate. Since the publication of the series, it has spurred action from major multinationals in the food and beverage industry, the sugar industry’s main watchdog group, and U.S. and European governments.
We revealed a brutal system of exploitation where women are married into a life of harvesting sugar from a young age, trapped in debt, and pushed to get medically unnecessary hysterectomies so they can keep working in the fields. It also exposed the harsh methods used to prevent people from leaving this life behind — a regime of kidnappings, beatings, and intimidation that sullies the supply chains of Coca-Cola, PepsiCo, and Mondelez, some of the world’s largest companies.
In response:
— The New York City comptroller, who oversees hundreds of billions of dollars in pension investments, including nearly $1 billion in stock in Coca-Cola, PepsiCo, and Mondelez and others who buy sugar from Maharashtra, is pressuring the companies to work with labor groups in the Indian state and is rallying other institutional investors to do the same.
— The U.S. government’s Department of Labor included sugar produced in Beed, Maharashtra, in its list of goods produced by forced labor. A spokesperson for the U.S. Embassy in New Delhi expressed concern about “the poor working conditions in the Maharashtra sugarcane industry” and says it is working with labor groups, the Indian government, and the private sector on the issue. Sources tell us the State Department has encouraged American companies to use their buying power as leverage to push sugar mills to make changes.
— The Norwegian ethics council, which advises the Norwegian sovereign wealth fund (the world’s largest, at about $1.8 trillion) is investigating at least one company in its portfolio.
— The U.A.W Retiree Medical Benefits Trust, a $60.5 billion pension fund, signed a letter pushing companies to improve labor practices.
— Coca-Cola said in December that it had established a group that would provide at least some cane cutters with first aid, health, and safety training from January 2025. Four mills will participate, including three that Coke buys from. The group will also train factory middlemen on wage transparency and seek to formalize contracts with farm workers.
— Prior to that, Coca-Cola had released a statement condemning the exploitation and took further action by quietly meeting with Indian government officials and sugar suppliers to discuss responsible harvesting practices.
— PepsiCo and Mondelez International, the owner of Cadbury, pledged to investigate the reported abuses. Mondelez severed ties with Dalmia, one of the mills profiled in our series.
— Dalmia, which also supplies Coca-Cola, said it would institute health screenings for workers, and recently arranged to provide sanitary pads, shoes, socks, and gloves to some workers.
— Bonsucro, a sugar industry body that sets standards for the sector but has been accused of relaxed oversight, created a human rights task force which will initially focus on the reports of coerced hysterectomies.
The FDA is pushing for medical technology companies to do a better job including women and people of diverse gender identities when testing new medical devices. The agency’s new guidance calls for companies to think more carefully about sex and gender differences when designing their studies, make sure they’re recruiting a diverse mix of participants, and properly analyze and report how their devices work for different groups. While companies don’t legally have to follow these recommendations yet, they represent what the FDA believes is the right approach to ensure medical devices are safe and effective for everyone who might use them.
This update comes after decades of women being left out of medical research, which has meant doctors and patients often lack accurate information about whether devices and drugs work as well for women as they do for men. The FDA points out that many groups have been historically excluded from these studies, including transgender and nonbinary individuals. Multiple barriers have contributed to this underrepresentation, including fewer opportunities for participation, concerns about fertility and pregnancy risks, family responsibilities limiting trial commitment, and selection criteria that unintentionally exclude certain demographics. Though more women are being included in medical device studies than ever before, the FDA says most areas of medicine still need to achieve better representation.
Advocates have been calling for more guidance from the FDA for years, which The Fuller Project has chronicled in our medical research series. For example:
In Sex Matters: Medical Research Overlooks Women, Maggie Fox offered a status report on medical research about women three decades after Congress ordered the NIH to include women in clinical trials at the same rates as men. The update? Research on women still lags, and women and girls are paying the price with their health and their lives.
In Why Heart Disease Research Still Favors Men, Fox reported that while men and women are equally likely to suffer heart attacks, women are more likely to die from theirs, one of the many symptoms of the medical system’s neglect of women.
In ‘My community is still dying’ — How the dearth of Black women in clinical research worsens health disparities, Erica Hensley reported that by 2020, there was just one Black woman for every 10 white women in FDA-approved drug trials, despite Black women being more likely to be diagnosed late and die from female-specific diseases, like breast, ovarian and cervical cancer.
Hensley’s story, New federal report calls out clinical trials for excluding pregnant women highlighted the lack of medications on the market that have been tested for safety and efficacy in pregnant women, and looked at an influential federal panel that is challenging the unspoken rules of excluding pregnant women from clinical trials.
The Justice Department and Federal Trade Commission have announced a civil enforcement action against financial technology company Dave Inc. and its CEO Jason Wilk for allegedly violating the FTC Act and the Restore Online Shoppers’ Confidence Act. The lawsuit claims Dave misled consumers about its cash advance services by deceptively advertising “up to $500” in instant advances while rarely providing such amounts, charging hidden “express fees” and recurring monthly fees without a clear way to cancel, and implementing a deceptive tipping interface. The complaint also alleges that Dave falsely claimed customer tips would purchase meals for needy children, while the company kept most tips for profit and made only nominal charitable donations.
“The Justice Department is committed to stopping companies and their executives from preying on financially vulnerable consumers with deceptive advertisements, hidden fees and subscriptions that are difficult to cancel,” said Principal Deputy Assistant Attorney General Brian M. Boynton.
The move comes 18 months after a Fuller Project investigation into the Earned Wage Access industry, a $9.5 billion, fast-growing sector that has been almost entirely unregulated. The story showed how paycheck apps, which include such brands as Dave, EarnIn, Daily Pay, and Brigit, offer high cost cash advances, which like payday loans, are disproportionately used by women of color. Our reporters found that the young women who use the apps often end up trapped in a cycle of debt — with promises of quick cash for groceries, rent and children’s birthday parties masking effective annual interest rates of over 300%.
The complaint, filed in the U.S. District Court for the Central District of California, seeks consumer redress, monetary civil penalties, and a permanent injunction against future violations. It amends and replaces an earlier FTC complaint that only named Dave as a defendant and did not seek civil penalties.
This case highlights increasing regulatory scrutiny of fintech companies, particularly those offering services to financially vulnerable consumers. The inclusion of the CEO as a defendant also signals a willingness to hold individual executives accountable for corporate practices.
Since then two states, Maryland and Connecticut, have stepped in to regulate these apps, requiring most smartphone-based cash advances to follow their states’ interest rate limits — 36% for Connecticut, 33% for Maryland for small loans — with tips and instant access fees included.
Read our original investigation, which was published in partnership with the Los Angeles Times.
The U.S. has banned imports from Asli Maydi, the Somali company that supplied frankincense oil to the popular U.S. essential oils brand doTERRA, over the use of forced labor.
The ban follows an investigation published last year by The Fuller Project into the abuse and exploitation of women frankincense sorters working for Asli Maydi in Somaliland.
DoTERRA, which generates more than $2 billion in annual sales, has built its brand on ethical sourcing, promising that it pays workers well and invests in the local communities where harvesters live and work.
The company has cut ties with Asli Maydi and halted its Somaliland operations, but it has continued selling bottles of the so-called “king of oils” for more than $100. It recently introduced a new frankincense product, largely drawing on stock from its Bulgaria distillery, where frankincense from Somaliland was processed. In the last year, doTERRA has imported more than 70,000 pounds of frankincense from the distillery, according to import data.
“Trading in goods made with forced labor is in direct opposition to American values. When goods are manufactured at the cost of someone’s health, safety, or freedom, we all lose,” said U.S. Customs and Border Protection Senior Official Performing the Duties of the Commissioner Troy A. Miller in a press release.
Customs and Border Protection (CBP) identified five indicators of forced labor: deception, physical violence, abusive working conditions, intimidation and threats, and withholding of wages. CBP has the authority to ban imports of merchandise believed to have been produced using forced labor, or any work that is performed involuntarily and under the threat of penalty. The importer can either prove the items were not made with forced labor or re-export them, or they may be destroyed.
In the past, CBP has banned imports of diamonds from Zimbabwe, seafood from specific fishing vessels, and goods produced by China’s Uighur minority. “With this action, we are sending a message to those who continue to disregard basic human rights: your goods are not welcome in the United States,” said Executive Assistant Commissioner of CBP Office of Trade, AnnMarie R. Highsmith.
In a statement, a doTERRA spokesperson said the company “has an unwavering commitment to ethical sourcing,” had ceased purchasing from Asli Maydi in 2022, and that an investigation by Sidley Austin verified that Asli Maydi had violated the supplier code of conduct. “Like with any regulatory agency, the company regards this matter with the utmost importance and will fully cooperate with authorities to ensure adherence to all relevant laws.”
A representative from doTERRA did not immediately respond to a request for comment.
CBP issued the ban after a joint petition from the Corporate Accountability Lab, a Chicago-based human rights legal group, and the Horn of Africa Charity Organisation (HOACO), a group that advocated for the alleged victims, which have conducted their own investigation into labor abuses at Asli Maydi.
The group is also calling on authorities to penalize doTERRA for importing goods produced using forced labor and to investigate Asli Maydi and its founder, Barkhad Hassan.
Until last year, doTERRA sourced much of its frankincense from Asli Maydi in Somaliland, a self-declared republic north of Somalia. Workers there harvested resin from Boswellia trees, and much of that resin was sent to a doTERRA facility in Bulgaria, where frankincense is stockpiled and distilled. DoTERRA formally canceled its contract with Asli Maydi in December 2023.
At doTERRA’s 2024 annual convention, co-founder Emily Wright said the company has “years worth of resin from Somaliland that will give us time to find the best way forward.” She also acknowledged doTERRA’s withdrawal from the region, saying, “I want you to know this is not the end. We have pulled out of the Sanaag region temporarily but we are not giving up on this part of the world.”
More than a dozen women working for Asli Maydi told The Fuller Project in 2022 that the company routinely underpaid them, required them to work in harsh conditions linked to health problems, and was led by a politically powerful man whom several women accused of sexual harassment or assault. Some of these allegations, as well as claims that Hassan had underpaid or never paid harvesters, were also the subject of a documentary by Vice News.
When presented with the Fuller Project’s findings in December 2022, doTERRA said it would “temporarily suspend” its operations in Somaliland. To investigate, the company hired Sidley Austin lawyer Sara George, who recently concluded that “the supplier did not meet the high standards we expected of them,” according to a doTERRA statement. George also said the evidence she reviewed did not support the claims of sexual harassment or assault, though the victims maintain their allegations.
The Corporate Accountability Lab and HOACO concluded that Hassan engaged in deception, intimidation and corruption in order to “orchestrate a climate of fear designed to keep Asli Maydi on top.” CAL and HOACO “applaud” CBP’s decision to issue an WRO.
The report found that Hassan failed to pay harvesters for frankincense resin they harvested and that women sorters received $1 for working days of more than 13 hours in poor conditions. Numerous women reported that they were sexually assaulted, raped, or pressured to pose naked for photographs by Hassan and his associates. According to the report, Asli Maydi “eliminated all other options for harvesters, sorters, and their families,” and these conditions qualify as forced labor.
The report also details some of the intimidation tactics Hassan allegedly employed to establish dominance in the region. The report says Hassan ran his company “like a criminal gang,” and he armed his employees, “allowing him to prevent opposition or competitors from challenging his dominance.” In 2018, four young Somali activists were arrested and fined after Hassan reported them for insulting Asli Maydi, the report alleges.
CAL and HOACO recommend that doTERRA compensate victims, create a fund for survivors of gender-based violence, create a worker-driven remediation program for harvesters and sorters, and invest in the sustainability of frankincense trees in Somaliland. They also recommend that doTERRA take disciplinary action against staff who knew or should have known about the abuses, review and update current sourcing policies, provide financial transparency on social programs and donations through its nonprofit Healing Hands Foundation, and conduct a third-party investigation into the use of Healing Hands funds.
The groups also recommend that U.S. authorities should further investigate Hassan, Asli Maydi, and doTERRA for forced labor, and that Somaliland authorities should investigate Hassan and his business enterprises for theft, bribery, labor code violations, and gender-based violence and harassment.
Hassan did not immediately respond to a request for comment. He has previously denied all allegations of abuse and exploitation.
“DoTERRA must acknowledge their mistakes and begin a process of genuine engagement,” HOACO director Amina Souleiman said in a statement. “This should start with a sincere apology for harm done to the frankincense harvesting communities … The community is committed to seeking accountability until these issues are addressed.”
*This story was updated on 11/4/2024 after receiving a statement from doTERRA.
For the first time in nearly three decades, the government is poised to require companies to disclose every month how many women and people of color they employ on federally-funded construction projects.
The new rules, proposed in late February by the Biden administration, follows a story by The Fuller Project in December that revealed women have been systematically left out of the booming alternative energy sector – including construction jobs in solar and wind. Our investigation found women comprise only 31% of the clean energy workforce – virtually unchanged since Barack Obama promised 5 million green jobs in 2008.
The Biden administration has made historic investments in green energy, including $370 billion in clean tech subsidies in the Inflation Reduction Act and billions more in Bipartisan Infrastructure Law. But without a mandate to track the participation of women and other historically under-represented groups in construction, civil rights advocates say the country risks leaving the majority of Americans behind.
“We cannot count on any private company, which is focused on the bottom line to, on its own, implement these national priorities, like hiring more women,” said Madeline Janis, executive director of labor organization Jobs to Move America. “If there is not good reporting and follow up, there’s nothing.”
In an emailed statement, Michele Hodge, acting director of the Office of Federal Contract Compliance Programs, said the proposed rules were meant “to ensure that federal contractors are hiring workers that look like America.” Communities that had “been left behind in the past are a key part of this Administration’s vision for an economy that works for everyone,” she said.
The Fuller Project’s Louise Donovan and Moraa Obiria visited a massive dumpsite in Kenya, where waste pickers, most of them women, make a living by sifting through trash collecting recyclable items to sell. As the world generates nearly two billion tons of household trash each year, an estimated 20 million waste pickers around the globe often are able to recover more recyclables than formal waste management systems. But scientists say not enough attention is being paid to the toll this work is taking on this workforce’s reproductive health. They warn that it is an issue of global concern.
A hub of criminal activity, Nairobi’s dumpsite is a particularly challenging environment to report from for journalists. After spending over a week breathing in toxic air, the journalists were sick and experienced ongoing headaches.
Once published, the story was shared with those involved in negotiations for the first-ever treaty to restrict the growth of plastic pollution. The findings were also discussed at a UN conference on the Stockholm Convention on Persistent Organic Pollutants, a global treaty designed to protect human health from chemicals in the environment (the specific talk focused on how chemicals impact different genders).
In order to reach a wider audience, the story was published both internationally, with VICE World News, as well as in The Nation, east Africa’s largest newspaper. The reporting prompted additional media coverage, with journalists in India and across Africa writing follow-up stories highlighting the same connection between toxic trash and waste pickers’ reproductive health, drawing further attention to the issue.
Donovan also shot, edited and wrote the script for a video to accompany the story. With over 11K views, it’s The Fuller Project’s most watched Instagram video to date (the second highest has just over 1,000 views).
The story was co-bylined by reporters from Kenya and the UK. Obiria is a gender reporter for The Nation, while London-based Donovan is a Fuller Project reporter covering labor issues. The pictures were shot Brian Otieno, a Kenyan photographer. Every source and expert quoted in the story, bar two, is Kenyan, ensuring the reporting highlighted the voices and perspectives of those impacted by this issue.
In October 2023, California Governor Gavin Newsom signed a law making the Golden State the first in the nation to require venture capitalists to disclose the gender and race of the founders they fund.
Female founders and civil rights groups say this bill could make a huge difference in exposing the most discriminatory venture firms in Silicon Valley and create more opportunities for women-run firms. According to the business data firm Pitchbook, companies founded by all-female teams accounted for just 2% of venture capital funding last year. Those led by Black women and Latinas received even less.
The Fuller Project was the first news outlet to bring significant attention to the issue. Following their story, published in partnership with The Guardian, our reporter Hanisha Harjani made appearances on the national NPR program Here and Now, Marketplace, and CapRadio, in Sacramento, the state capital. Their work was shared widely among advocates and lawmakers ahead of Governor Newsom’s deadline to sign or veto Senate Bill 54, which was passed by California lawmakers in September.
California represented over 40% of the $246 billion in venture capital funding invested in the United States in 2022, according to data provided by Pitchbook. Because the law will apply to venture capital firms based in California along with those that invest in the state or solicit funds from residents, the law’s impact will likely resonate from Silicon Valley to Wall Street and beyond. The Fuller Project was widely cited when Governor Newsom signed the law.
For the last decade, every survivor and first responder of the Sept. 11, 2001 terrorist attacks in New York City who later developed cancer has been eligible to receive health benefits from the U.S. government. Everyone except women with uterine cancer.
But following The Fuller Project’s reporting, U.S. Health and Human Services (HHS) officials added uterine cancer to the list of conditions covered by the government program that monitors and treats those who lived and worked in Ground Zero — the 1.5-square-mile portion of New York City where carcinogenic dust and debris lingered for months after hijacked planes took down the World Trade Center twin towers in 2001.
By the beginning of 2024 more than 318 uterine cancer patients had received access to cancer treatment, monitoring and victim compensation funds.
“We’re relieved and feel like we can finally exhale, knowing many women will now receive the benefits they deserve,” said Tammy Kaminski, a chiropractor based in West Caldwell, N.J. who volunteered for months at Ground Zero and later developed uterine cancer in 2015.
The decision to add uterine cancer to the list came after multiple stories from The Fuller Project and its partners about how women were systemically left out of the government’s World Trade Center Health Program (WTCHP).
The reason cited for uterine cancer exclusion was “insufficient evidence” that it was linked to 9/11. But stories run by The Fuller Project and its partners — Reckon, The Star-Ledger/NJ.com and The Cut — revealed the lack of data was due to the small number of women included in the early days of the program, which resulted in skewed data that ultimately excluded conditions that affect women.
The program uses its own data to aggregate 9/11 causation and subsequent treatment coverage, so uterine cancer and other female-specific conditions like auto-immune disorders were left off the list because patients in the mostly male program never developed those conditions — a catch-22 with women as the collateral damage. There was no data to prove causation for women’s conditions because it wasn’t collected — part of a systemic problem in health research.
Following our collaborative reporting U.S. congressman Frank Pallone (D-N.J.) sent a letter to HHS Secretary Xavier Becerra and health program administrator John Howard urging them to act. Pallone sits on the House Energy and Commerce Committee with jurisdiction over federal health policy, and also serves a district where many 9/11 survivors and first responders live.
Just over a week after Pallone’s letter, HHS released a final rule that uterine cancer patients could immediately apply for the program, noting that a “delayed effective date would defer the agency’s ability to provide life-saving treatment and result in less favorable treatment outcomes and survival rates for covered individuals.”
This story and subsequent outcome resulted from dogged follow-up and innovative newsroom collaboration. Over the last four years, reporter Erica Hensley and The Fuller Project exposed the initial exclusion, followed the policy process to add uterine cancer, and ultimately, the delay, when after more than six months officials hadn’t followed through on their promises to add women with uterine cancer to the coverage rolls. It was our final story about the delay in January 2023, which landed in front of Pallone and his constituents, that finally prompted federal action.
Advocates for uterine cancer awareness say the news is an opportunity to spread the information about 9/11 health program enrollment, but also uterine cancer in general, which is often misdiagnosed or diagnosed late and leads to worse outcomes.
“They were told the air was safe to breathe. They were told their cancer wasn’t caused by 9/11,” said Matthew Baione, a lawyer who has been one of the earliest advocates for the cancer’s inclusion. “Now these women can feel vindicated and can access free healthcare that is statistically more likely to extend their lives.”
The U.S. essential oils company doTERRA used to source most of its frankincense oil from Somaliland, but workers told us the company did not practice the ethical approach it preached. More than a dozen women working for doTERRA’s frankincense supplier, a company called Asli Maydi, said the company routinely underpaid its workers, required them to work in harsh conditions that are linked to health problems and was led by a politically powerful man whom multiple women accused of sexual harassment and assault.
For this two-year investigation, co-published with the Guardian, The Fuller Project spoke to 13 frankincense sorters (women who divide frankincense resin by color, grade and quality), three alleged sexual harassment victims, and a former U.S-based sustainability consultant who accused the supplier, Barkhad Hassan, of rape. He denied all of the allegations.
“People are scared of Barkhad Hassan and his gang,” one woman said at the time. “We are living a life of hell.”
Reporting this story was difficult in a culture that made women ashamed to speak about how they’d been victimized. One woman kept describing how she “felt terrible” and was not herself after one of the incidents in question — she was too ashamed to say the word “rape” aloud to our reporter, the translator explained. She later talked more explicitly about the assault in a written statement. Our reporter earned her sources’ trust by continuing to show up — speaking with them several times for months before formally interviewing them, periodically checking in with them throughout the process, and being dedicated to the story despite publishing setbacks.
The story’s impact was swift and powerful. Presented with The Fuller Project’s findings before publication, doTERRA said it would “temporarily suspend” its operations in Somaliland and investigate the matter. Within weeks of publishing, the sorters had formed their own cooperative and are now working for themselves. In December, doTERRA severed its ties with the local supplier Asli Maydi, citing breaches of contract.
The Fuller Project’s reporting drew attention for the first time to the exploitation of women sorters by a company that says it champions community investment and competitive wages. DoTERRA markets to women, engages mostly female “wellness advocates” to sell their products, and counts among its influencers prominent female athletes and celebrities including singer/songwriter India Arie Simpson, professional tennis player Sloane Stephens, and Olympic Gold Medalist Jamie Anderson, according to their website.
U.S. customers expressed dismay and disappointment that doTERRA wasn’t implementing the ethical practices it promised. This story helped them make an informed choice about the products they were purchasing and gave them the ability to vote with their wallets.
For the thousands of women who lived and worked in lower Manhattan during the September 11 attacks — many of whom breathed dust from the towers for months afterward — the profound and sometimes fatal long-term impacts on their health remain understudied and undercovered.
The federal World Trade Center Health Program (WTCHP), which was created to provide free medical monitoring and treatment for 9/11 survivors and responders, relied on initial research conducted overwhelmingly on male first responders to determine what treatments would qualify — which means some of the most common conditions for women survivors, such as breast cancer, went uncovered for years.
For The Fuller Project and The Cut, reporter Susan Rinkunas spent months speaking with women who had survived 9/11 to later be diagnosed with cancer, asthma, auto-immune or mental health disorders, who revealed what this critical lack of research on women survivors means for their health.
When our story published, just ahead of the twentieth anniversary of the September 11 attacks, some of those women were battling uterine and endometrial cancers that were still not covered by the WTCHP; a hearing to discuss whether uterine cancer should qualify for coverage was scheduled for later that month. By November, an advisory committee unanimously approved a recommendation to include uterine cancer under the WTCHP. A final ruling is expected by mid-2022.
