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The Brutality of Sugar: Debt, Child Marriage and Hysterectomies

by Megha RajagopalanQadri Inzamam March 24, 2024

This story was produced and published in collaboration with The New York Times

Archana Ashok Chaure has given her life to sugar.

She was married off to a sugar cane laborer in western India at about 14 — “too young,” she says, “to have any idea what marriage was.” Debt to her employer keeps her in the fields.

Last winter, she did what thousands of women here are pressured to do when faced with painful periods or routine ailments: She got a hysterectomy, and got back to work.

This keeps sugar flowing to companies like Coke and Pepsi.

The two soft-drink makers have helped turn the state of Maharashtra into a sugar-producing powerhouse. But a New York Times and Fuller Project investigation has found that these brands have also profited from a brutal system of labor that exploits children and leads to the unnecessary sterilization of working-age women.

Young girls are pushed into illegal child marriages so they can work alongside their husbands cutting and gathering sugar cane. Instead of receiving wages, they work to pay off advances from their employers — an arrangement that requires them to pay a fee for the privilege of missing work, even to see a doctor.

An extreme yet common consequence of this financial entrapment is hysterectomies. Labor brokers loan money for the surgeries, even to resolve ailments as routine as heavy, painful periods. And the women — most of them uneducated — say they have little choice.

Hysterectomies keep them working, undistracted by doctor visits or the hardship of menstruating in a field with no access to running water, toilets or shelter.

Removing a woman’s uterus has lasting consequences, particularly if she is under 40. In addition to the short-term risks of abdominal pain and blood clots, a hysterectomy is often accompanied by the removal of the ovaries, which brings about early menopause, raising the chance of heart disease, osteoporosis and other ailments.

But for many sugar laborers, the operation has a particularly grim outcome: Borrowing against future wages plunges them further into debt, ensuring that they return to the fields next season and beyond. Workers’ rights groups and the United Nations labor agency have defined such arrangements as forced labor.

Workers in a cane field near NSL Sugars in the Beed district of Maharashtra, India, last year. Mills pay contractors to employ field workers. (Saumya Khandelwal for The New York Times)

“I had to rush to work immediately after the operation, as we had taken an advance,” Ms. Chaure said. “We neglect our health in front of money.”

Sugar producers and buyers have known about this abusive system for years. Coca-Cola’s consultants, for example, visited the fields and sugar mills of western India and, in 2019, reported that children were cutting sugar cane and laborers were working to repay their employers. They documented this in a report for the company, complete with an interview with a 10-year-old girl.

In an unrelated corporate report that year, the company said that it was supporting a program to “gradually reduce child labor” in India.

Labor abuse is endemic in Maharashtra, not limited to any particular mill or farm, according to a local government report and interviews with dozens of workers. Maharashtra sugar has been sweetening cans of Coke and Pepsi for more than a decade, according to an executive at NSL Sugars, which operates mills in the state.

PepsiCo, in response to a list of findings from The Times, confirmed that one of its largest international franchisees buys sugar from Maharashtra. The franchisee just opened its third manufacturing and bottling plant there. A new Coke factory is under construction in Maharashtra, and Coca-Cola confirmed that it, too, buys sugar in the state. These companies use the sugar primarily for products sold in India, industry officials say.

Both companies have published codes of conduct prohibiting suppliers and business partners from using child and forced labor.

“The description of the working conditions of sugar-cane cutters in Maharashtra is deeply concerning,” PepsiCo said in a statement. “We will engage with our franchisee partners to conduct an assessment to understand the sugar-cane cutter working conditions and any actions that may need to be taken.”

Coca-Cola declined to comment on a detailed list of questions.

The heartland of this exploitation is the district of Beed, an impoverished, rural region of Maharashtra that is home to much of the migrant sugar-cutting population. One local government report surveyed approximately 82,000 female sugar-cane workers from Beed, and found that about one in five had had hysterectomies. A separate, smaller government survey estimated the figure at one in three.

“The thinking of women is, if we get the surgery, then we’ll be able to work more,” said Deepa Mudhol-Munde, the district’s magistrate, or top civil servant.

The abuses continue — despite local government investigations, news reports and warnings from company consultants — because everyone says somebody else is responsible.

Big Western companies have policies pledging to root out human rights abuses in their supply chains. In practice, they seldom if ever visit the fields and largely rely on their suppliers, the sugar-mill owners, to oversee labor issues.

The mill owners, though, say that they do not actually employ the workers. They hire contractors to recruit migrants from far-off villages, transport them to the fields and pay their wages. How those workers are treated, the owners say, is between them and the contractors.

Those contractors are often young men whose only qualification is that they own a vehicle. They are merely doling out the mill owners’ money, they say. They could not possibly dictate working conditions or terms of employment.

Nobody pushes women to get hysterectomies as a form of population control. In fact, having children is commonplace. Because girls typically marry young, many have children in their teens.

Instead, they seek hysterectomies in hopes of stopping their periods, as a drastic form of uterine cancer prevention or to end the need for routine gynecological care.

“I couldn’t afford to miss work to see the doctor,” said Savita Dayanand Landge, a sugar-cane worker in her 30s who got a hysterectomy last year because she hoped it would end her need to visit doctors.

India is the world’s second largest sugar producer, and Maharashtra accounts for about a third of that production. In addition to supplying major Western companies, the state has exported sugar to more than a dozen countries, where it disappeared into the global supply chain.

The abuses are born from the Maharashtra sugar industry’s peculiar setup. In other sugar regions, farm owners recruit local workers and pay them wages.

Maharashtra operates differently. About a million workers, typically from Beed, migrate for days to fields in the south and west. Throughout the harvest, from about October to March, they move from field to field, carting their belongings with them.

Instead of wages from farm owners, they receive an advance — often around $1,800 per couple, or roughly $5 a day per person for a six-month season — from a mill contractor. This century-old system reduces labor costs for sugar mills.

Inside the sugar mill in Satara district in western India. From about October to March each year , the mills work nonstop. (Saumya Khandelwal for The New York Times)

Our reporters interviewed people at every stage of the supply chain, including dozens of laborers, contractors, mill owners and former executives at multinational companies. The Times also examined medical records and interviewed doctors, lawmakers, government officials, researchers and aid workers who have spent careers examining the livelihoods of Maharashtra’s sugar workers.

Ms. Chaure is petite, barely five feet tall, with a tiny gold nose-ring in the shape of a flower and a grin that takes over her whole face. She speaks a million miles an hour and, when she feels particularly passionate, she grabs your wrist to make sure you are listening.

“It’s easy for people to take advantage of us,” she said, “because we have no education.” She has spent her life cutting sugar for a mill owned by NSL Sugars.

She began working in the sugar fields as a preteen and, now in her early 30s, she expects to continue for the rest of her life. The work has kept her family in the most grueling poverty, the kind that makes her skip meals so her three children have enough to eat.

Ms. Chaure knows there is nothing for her beyond sugar. But she hopes things will be different for her children.

‘There Wasn’t Any Option Left’

Ms. Chaure laid back on an operating-room cot last winter preparing for her hysterectomy. The hospital was bigger than any near her village, with clean floors and a busy, professional-looking staff.

As she looked at the white ceiling, the thought crossed her mind that, once she slipped out of consciousness, she might not come back.

Her hands trembled.

Who, she wondered, would look after her children?

“But since there wasn’t any option left for me,” she said, “I did it.”

Archana Ashok Chaure with her son, Aditya. Since her hysterectomy, she has not been able to work without pain. (Saumya Khandelwal for The New York Times)

Ms. Chaure had traveled to a city hospital hours from her village.

On a given day, the waiting room is crowded with patients from the countryside sitting nervously on metal chairs or cross-legged on the floor as a loudspeaker blares out names.

The women often have familiar ailments: pain that radiates down from their lower backs and prolonged or irregular periods that make work more difficult.

For Ms. Chaure, it was a heavy kind of ache, like a pull. She had pain in her hip, too. It pulsed down her leg and never seemed to go away. Her periods were irregular, which she suspected was from working all through her pregnancies, often forgoing food.

In the fields, Ms. Chaure, like the others, sleeps on the ground, spends hours a day hunched over and carries heavy loads on her head.

Tampons and pads are expensive and hard to find, and there is nowhere to dispose of them. Without access to running water, women address their periods in the fields, with reused cloth that they try to wash discreetly by hand.

“All the problems are intermingled with their personal hygiene and their economic condition. They have to work so hard,” said Dr. Ashok Belkhode, whose Maharashtra practice includes gynecology.

Hysterectomy is a routine surgery performed around the world, though infrequently for 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 hysterectomy rates. But in Maharashtra’s sugar industry, everyone — contractors, other workers, even doctors — pushes women toward the surgery.

That is what happened to Ms. Landge, a mother of four with a red bindi and arms full of green bangles. She lives in a tiny concrete home atop a hill, overlooking her village and acres of farmland that turns the color of mustard seeds during the dry months.

Doctors prescribed painkillers and vitamins for her back and abdominal pain, but every appointment cost her a day’s wages and a fee for missing work.

“Everywhere I went,” Ms. Landge said, “hysterectomy was suggested.”

Savita Dayanand Landge, left, along with other women working to get a trailer attached to a tractor after a day’s work in Pawarwadi in December. (Saumya Khandelwal for The New York Times)

Ms. Chaure ended up on the operating table because a sonogram showed that she had ovarian cysts, her medical records show.

Instead of simply removing the cysts, her surgeon told her she should have a hysterectomy. She did not question the advice. She knew so many women who had done the same. She was terrified of getting cancer. And maybe this would end her pain, and the doctor visits.

“I might not be able to work well if the problems persist,” she said.

Years earlier, to pay one of her children’s medical bills, Ms. Chaure had sold a pair of gold earrings, a gift from her father worth about $30. Now there was nothing left to sell.

So she and her husband borrowed more money from their sugar contractor, promising to return next season to repay it. They already owed so much, Ms. Chaure figured, that they would have to go anyway.

The surgeon removed Ms. Chaure’s uterus, a cyst, an ovary and a fallopian tube. In an interview, her surgeon said it was necessary because the cyst was unusually large.

The Times shared details from Ms. Chaure’s file with Dr. Farinaz Seifi, the director of gynecology at Bridgeport Hospital and a professor at the Yale School of Medicine. “There was absolutely no indication for hysterectomy,” she said.

‘I Was Very Young’

In her wedding photographs, Ms. Chaure stares straight-faced into the camera. She had never met the groom. But that was normal. The same had happened to many of her friends.

Like many rural women in Maharashtra, Ms. Chaure does not know her exact age. She figures she was about 14 on her wedding day. It was two years after she dropped out of her village school so her parents could take her to the sugar fields.

“I was scared to get married,” she recalled, “really scared.”

She knew that marriage meant the end of something. She had dreamed of becoming a nurse. She could picture it — she would wear a crisp, clean uniform and work beneath a whirring ceiling fan, protected from the sun.

Ranjit Bhausaheb Waghmare, a contractor who hires laborers for Dalmia Bharat Sugar . There is “no possible way” for a worker to repay an initial advance in one season, he said. (Saumya Khandelwal for The New York Times)

But marriage is the moment when many girls give up their futures, and their bodies, to sugar.

Every fall before the harvest, usually in October, the mill owners dispatch contractors to villages in Beed like Ms. Chaure’s to recruit laborers.

Child marriage is illegal in India and is regarded internationally as a human rights violation. Its roots in India run deep, and it has complex cultural and economic causes.

But in this part of Maharashtra, two economic incentives push girls into marriage.

First, sugar cutting is a two-person job. Husband-and-wife teams make twice as much as a man working alone. The two-person system is known as koyta, after the sickle that cuts the sugar cane.

Second, the longer that children accompany their parents in the field, the longer parents must support them. So families often seek to marry off daughters young, even in early adolescence.

“If we are married, their stress reduces and the responsibility is shifted to our husband’s shoulders,” Ms. Chaure said. “So they marry us off.”

Several women recalled being married only months after their first periods.

The links between marriage and sugar go so deep that girls were once married at the mill gates. Even now, weddings are often held before the harvest and the term “gate cane wedding” still comes up.

“Without koyta, there would be no reason to get married,” said Zhamabai Subhashratod, a 30-something sugar laborer who was married in her early teens and later had a hysterectomy.

Contractors, too, have an incentive to find brides, even if it means pressuring parents to marry off young daughters, said Tatwashil Baburao Kamble, the former head of Beed’s child-welfare committee.

“I’ve seen cases where the contractors tried to get it done before taking laborers to the farm — all their belongings were packed,” Mr. Kamble said. “All that was left was to get married.”

Some contractors even lend money for weddings.

“I’ve paid for weddings, for hospital bills,” said Bapurao Balbhim Shelke, a contractor who formerly worked for Dalmia Bharat Sugar.

“I just add the amount to the next year’s bill, and they can work it off,” said Dattu Ashruba Yadav, a contractor who lives in Beed. He said he had lent one couple 50,000 rupees, or about $600, for their wedding. That represents several months of a typical couple’s earnings.

Mira Govardhan Bhole has been working in the sugar fields since her marriage, about a year after her first period. Ms. Bhole is in her 30s but has a round baby face that always looks cheerful.

As a newlywed, she would disappear into cooking to avoid her husband.

When he told her she would have to cut sugar, she sobbed uncontrollably. “They brought me by throwing me in the vehicle,” she said. “I hadn’t even taken a bath or anything.”

In the field, she felt overwhelmed. There, sugar cane surrounds you, the stalks growing so high and close together that you can make out the sky only in patches.

The men bend forward, whipping machetes. The women usually do the rest.

First, they tear the sharp leaves off the cane. It takes practice. Pull downward and you will be fine, but stroke upward, even by accident, and the leaves make gashes as thin as paper cuts.

What Ms. Bhole remembers most about her first weeks is that her palms hurt so badly that she cried and cried.

After stripping the leaves, the women stack the cane in bundles.

They carry the bundles on their heads, then load them onto trucks.

Season after season, the weight can break down the disks in your neck, leaving a constant stiffness. If you ask doctors in the region what happens to the bodies of women in the sugar fields, this is the first injury they mention. Ms. Chaure has this problem, too, and she winces when she thinks about it.

More relentless, though, is the punishment of field life. The workday often ends after midnight, when trucks have hauled away the last of the day’s crop. Women sleep under tarpaulin tents with their families on thin mats cast onto the ground.

They wake as early as 4 a.m. to fetch water, build a fire, boil tea and cook lentils and vegetables. They wash clothes in a basin and then it is back to work, stripping and hauling sugar cane.

Life in a temporary settlement in the district in December. (Saumya Khandelwal for The New York Times)

Workers said there were almost never official contracts or records tallying how much they cut. At the end of the season, contractors almost always declare that a balance remains.

“There is no possible way they could pay it back within one season,” said Ranjit Bhausaheb Waghmare, a contractor for Dalmia Bharat Sugar.

Dalmia supplies Coca-Cola in Maharashtra, according to S. Rangaprasad, who runs one of the mills there. Dalmia records also list Mondelez, the owner of Cadbury, as a customer. The company said it was “deeply concerned to hear allegations of labor issues at one of our suppliers. We will investigate.”

Pepsi’s franchisee also buys from Dalmia, but from mills outside the state, PepsiCo said.

Ms. Bhole sometimes fantasizes about a different life. A relative in a city a few hours away works as a housekeeper. The idea of getting paid to do chores sounds incredible.

But she says that no matter how hard she and her husband work, at the end of each season, her contractor says they still owe money. They have to return.

Worker-rights advocates say this is tantamount to bonded labor, a practice banned by law.

When Ms. Chaure’s husband took her to the fields after their wedding, she hoped they would be done in a season. That was more than 15 years ago. They are still in debt.

“We take an advance, repay some, and again take another advance,” she said.

The sugar mills keep all of this — child marriage, underage labor, wage debt and working conditions — at an arm’s length. Child marriage, they say, is a social problem that has nothing to do with the industry.

They say the contractors are responsible for the workers.“The mill does not take on the burden of employing them,” said Mr. Rangaprasad, the head of a Dalmia mill.

Things Could Have Changed

Shubha Sekhar, a Coca-Cola executive who has focused on human rights in India, talked during the Covid pandemic to a group of university students. Speaking by videoconference, she described the challenges of operating in a country that Coke’s own documents identify as risky because of child and forced labor.

Typically, corporations buy from suppliers, she explained. With sugar, she said, at times “one doesn’t have visibility of what is happening beyond, in deep agriculture.”

But those deep fields are typically just outside the doors of Coke’s own suppliers. Sugar cane loses weight — and value — each minute after it is cut, so mills are usually built close to the farms.

All of the problems, including child marriage and hysterectomies, have been known in the region for years.

There was even a moment, not too long ago, when things might have changed.

In 2019, the newspaper The Hindu BusinessLine reported on an unusually high number of hysterectomies among female sugar-cane cutters in Maharashtra. In response, a state lawmaker, along with a team of researchers, launched an investigation. They surveyed thousands of women.

Their report that year described horrible working conditions and directly linked the high hysterectomy rate to the sugar industry. Unable to take time off during pregnancy or for doctor visits, women have no choice but to seek the surgery, the report concluded.

By happenstance, Coca-Cola issued its own report that year. After unrelated accusations out of Brazil and Cambodia about land-grabbing, Coca-Cola had hired a firm to audit its supply chain in several countries.

The auditors, from a group called Arche Advisors, visited 123 farms in Maharashtra and a neighboring state with a small sugar industry.

They found children at about half of them. Many had simply migrated with their families, but Arche’s report found children cutting, carrying and bundling sugar cane at 12 farms.

Nearly every laborer interviewed by reporters said children commonly worked in the sugar fields. The youngest ones do chores. Older ones perform all the work of cane cutters. A Times photographer saw children working in the fields.

The 2019 report includes an interview with a 10-year-old girl who “loves to go to school,” but instead works alongside her parents.

“She picks the cut cane and stacks it into a bundle, which her parents then load onto the truck,” the report says.

Arche noted that Coca-Cola suppliers did not provide toilets or shelter. And it cited “flags in the area of forced labor.” Only a few of the mills it surveyed had policies on bonded or child labor, and those applied only to the mills, not the farms.

The government report called on factories to provide water, toilets, basic sanitation and the minimum wage.

Few if any changes have been carried out.

Major buyers like PepsiCo and Coca-Cola say they hold their suppliers to exacting standards for labor rights. But that promise is only as good as their willingness to monitor thousands of farms at the base of their supply chains.

That rarely happens. An executive at NSL Sugars, a Coca-Cola and PepsiCo franchisee supplier that has mills around the country, said that soda-company representatives could be scrupulous in asking about sugar quality, production efficiency and environmental issues. Labor issues in the fields, he said, would almost never come up.

Soda-company inspectors seldom if ever visit the farms from which NSL sources its sugar cane, the executive said. The PepsiCo franchisee, Varun Beverages, did not respond to calls for comment.

Mill owners, too, rarely visit the fields. Executives at Dalmia and NSL Sugars say they keep virtually no records on their laborers.

“No one from the Dalmia factory has ever visited us in the tents or the fields,” said Anita Bhaisahab Waghmare, a laborer in her 40s who has worked at farms supplying Dalmia all her life and said she had a hysterectomy that she now regretted.

Tents of migrants settled alongside a sugar mill in December. The migrants do not have access to proper sanitation, drinking water or electricity. (Saumya Khandelwal for The New York Times)

Ed Potter, the former head of global workplace rights at Coca-Cola, said the company had conducted many human rights audits during his tenure. But with so many suppliers, oversight can seem random.

“Imagine your hands going through some sand,” he said. “What you deal with is what sticks to your fingers. Most sand doesn’t stick to your fingers. But sometimes you get lucky.”

Sanjay Khatal, the managing director of a major lobbying group for sugar mills, said that mill owners could not provide any worker benefits without being seen as direct employers. That would raise costs and jeopardize the whole system.

“It is the very existence of the industry which can come into question,” he said.

One thing that changed after the government report was a rule intended to prevent unscrupulous doctors from profiting off unneeded surgeries.

“Some doctors have made it a way to earn more money,” said Dr. Chaitanya Kagde, a gynecologist at a government-run facility in Beed. (Though public hospitals offer hysterectomies free or at reduced cost, they are often far from rural women.)

Women who have undergone hysterectomies at Wadgaon, in eastern Maharashtra, in May. More than a dozen sugar workers in the village have had the surgery. (Saumya Khandelwal for The New York Times)

The new rule required the civil surgeon, the district’s top health official, to approve hysterectomies.

But hysterectomies on younger women continue. Though many doctors agree that some surgeons perform them too often, they also note that patients request the surgery.

In an interview last May, Beed’s civil surgeon at the time, Suresh Sable, said the government should not second-guess doctors. “It’s not necessary to question their authority,” he said.

He said his office still approved 90 percent of hysterectomy requests.


One day last May, a few months after the harvest, Ms. Chaure and her husband made their way to the plot of land they farm near their home. It was 104 degrees. There was almost no shade or breeze and the air was so hot it took the shape of waves in the distance.

Her son, Aditya, was at the age where he was putting everything in his mouth — the back of a sticker, a Good Day biscuit, a pink toy watch. He was so preoccupied that he seemed to have forgotten to fuss.

Ms. Chaure, wearing a light floral sari, scooped him in one arm and hiked down the field.

Ms. Chaure walking home in Kawadgaon with her three children in October. In the sugar season after her operation, she stayed behind and worked the family smallholding. (Saumya Khandelwal for The New York Times)

It had been about six months since her hysterectomy and Ms. Chaure’s body hurt worse than usual.

Everything ached, especially her midsection. She was fed up with doctors and the work that had done this to her.

For the first time since being a teenager, she did not know whether she could migrate to cut sugar cane that season.

But the idea of borrowing more money without working to repay it terrified her.

She already stretched the family budget paper thin — growing tomatoes and peppers in a patch behind their home of concrete and corrugated metal.

“We have wasted our whole lives in this work,” she said.

By September, with the harvest looming, she still did not know if she could work. The contractor, she said, had been hassling her and her husband to take a bigger advance.

“It makes me so mad when those people say, ‘Nobody forced you to be a laborer,’” she said. She was washing her family’s clothes in a plastic bowl, slapping each garment against a rock. “Nobody chooses this life.”

It had been an exhausting few days. All three of her children had been coughing. The day before, she and her husband had fought, and he had hurled a basket of fresh cotton that she had just picked to the ground, covering it with mud. It could not be sold.

Finally, her husband left for the fields, to work alone. She stayed behind, resigned to the fact that it would push her family even deeper into poverty.

She worries about her children. She still harbors hopes for Aditya and his two big sisters, who are about 8 and 5 years old.

But Priyanka, the oldest, drove her crazy, skipping school to horse around with her younger siblings. Ms. Chaure remembers missing school herself, then dropping out. She remembers her dreams of being a nurse.

She wants things to be different for her daughter.

“I want her to be someone,” she said. “Do something in life.”

But for all her optimism, Ms. Chaure knows how tough it will be for her children, and how things are likely to go.

“They don’t like it,” she said. “But they need to get used to this life.”

Ms. Chaure taking a break during her work at the smallholding in December. (Saumya Khandelwal for The New York Times)

Ankur Tangade contributed reporting. 

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