AT 30, CHAYA Doke says she hardly has any strength to work on the sugarcane fields. She got her uterus removed on a doctor’s advice at age of 19. “I would suffer from abdominal pain after labouring on the fields. He asked me to undergo the procedure, and said I have a tumour that may convert into cancer,” she says. She was married off when she turned 12, and seven years later, she already had four children and so agreed to remove her uterus.
“But now I feel weak, I have back pain all the time. But I have no option but to work on the sugarcane farms,” she adds. Like her, Asha Shinde also underwent a hysterectomy when she was 22. She spent Rs 10,000 on the procedure. “The doctor said my uterus had moved down due to lifting heavy weights. I was in a hospital for a week after the surgery,” the 40-year-old says.
Some years later, she started suffering from back pain. “I required a second surgery that cost us Rs 1 lakh. It was due to the hysterectomy,” she alleges. Shinde earns Rs 400 daily together with her husband.
Hysterectomy as last option, not first
Hysterectomy is a procedure to remove uterus due to fibroids, cancer, endometriosis, uterine prolapse or abnormal vaginal bleeding. It is advised only when medication or alternative treatment fails to work. However, removing the uterus can impact a woman’s health with a permanent end to menstruation and pregnancy, and sometimes adverse effects such as back and abdominal pain. The rate of hysterectomy in Beed, at 36 per cent, is unusually high indicating that women, whose medical conditions can be handled by medication, are instead being advised surgical intervention.
Many health organisations came together on Wednesday to demand an inquiry into the alleged illegal hysterectomies of woman labourers in Beed district, known for sugarcane farming.
A study, commissioned by the Maharashtra State Commission for Women in 2018, indicates that the rate of hysterectomies in Beed stands at 36 per cent. According to data from the National Family Health Survey, this figure is a sharp contrast to the rate of hysterectomies conducted in Maharashtra, which stands at 2.6 per cent. Not only that, it is also much higher than the rate across India, which is 3 per cent. In 2018, out of the 200 women surveyed in Beed, 72 had undergone a hysterectomy. In 2019, out of of 271 surveyed, 56 had undergone the procedure.
Hysterectomy is a procedure to remove the uterus due to fibroids, cancer, endometriosis, uterine prolapse or abnormal vaginal bleeding. “We found that 11 private hospitals regularly conduct hysterectomies in Beed. The state government must investigate whether each case required this surgery or was conducted without medical reason,” says Dr Abhijeet More from Jan Arogya Abhiyan. He added that they had submitted a charter of demands to the health and women and child development departments on Tuesday. More added, “At least 85 per cent hysterectomies in Beed are conducted in private hospitals.”
According to a health worker, Rukmini Nagapune, many private doctors instil the fear of cancer and convince villagers to undergo a hysterectomy. “Each procedure costs Rs 60,000, and these women have to take a loan for the surgery,” she said.
Health and women’s rights activists have demanded the implementation of the Clinical Establishment Act to establish a protocol for private clinics and an audit in Beed to assess the actual count of hysterectomies.
“There should be a proper contract and women must be provided safe practices for cutting sugarcane,” says Shiv Sena MLA Manisha Kayande. Anup Kumar Yadava, director in-charge of the Directorate of Health Services, said, “We had formed a committee under the collector to look into the high number of hysterectomies. Some doctors and clinics were found guilty of this malpractice and we will soon act against them.”