In rural India, climate migrants have hysterectomies to survive, report says

Years of failed monsoons, extreme heat and droughts have led residents of Beed, a district in the top sugar-producing state to leave and become day labourers on plantations, said the report by the International Institute for Environment and Development (IIED), a London-based think-tank.

The research found more than half of the Beed women who had gone to work on sugar plantations had undergone surgery to remove their uteruses compared with less than a fifth from households that had stayed in the district.

"Contractors cutting one- or two-days wage for missing work causes women to feel they have no choice but to have their wombs removed so their periods or pregnancy don't prevent them from working," said Ritu Bharadwaj, a principal researcher with the IIED and the paper's lead author.

"Hysterectomies are a symptom of economic distress in the region that is exacerbated by the climate crisis," she added, saying the findings underscored the far-reaching - and hard to quantify - loss and damage caused by climate change.

Rising heat and extreme weather fuelled by climate change are battering subsistence farmers in India and elsewhere, leading to more frequent crop failures that drive people to migrate.

Global temperatures have risen more than 1.2 degrees Celsius (2.2 Fahrenheit) since preindustrial times and are now approaching a 1.5C degrees of warming mark that scientists fear could herald a transition to costlier and deadlier climate change impacts.

HEALTH RISKS

During the 30 years to 2011, Beed experienced a significant lack of rain once every five years, but the number of years with a deficit doubled in the decade ending in 2022, the IIED researchers found.

Due to the lack of rain and other factors including debt and lack of awareness about welfare schemes, increasing numbers decided to migrate, according to the research that included interviews with more than 400 Beed families.

Contractors working for sugar mills prefer employing couples, where the husbands do the cane cutting and the wives clean and load. They earn about 250 Indian rupees ($3) for each ton of cane they load and work 12-16 hours per day, the report said.

Scared of seeing their income dwindle and with no bathroom facilities available, many women seek hysterectomies at private clinics, the research found, adding that they were often unaware of the potential health risks.

Back and joint pain, osteoporosis, pelvic discomfort and mental health issues were among the common health problems reported by women who have undergone the procedure, said Bharadwaj.

"We spoke to 20–25-year-old women who were experiencing menopausal symptoms after undergoing hysterectomies," she added.

Private hospitals perform hysterectomies for "quick money", said Narendra Gupta, of Prayas, a non-profit based in Rajasthan, India, which was not involved in the new research.

A lawsuit filed by Gupta prompted India's Supreme Court to tell the government last year to take action against doctors and hospitals performing unnecessary hysterectomies.

He said that women often faced "indirect pressure" from their employers.

Following media reports - including a Thomson Reuters Foundation investigation - about a surge in hysterectomies, Beed's district administration said in 2019 that private hospitals would need its permission to perform the procedure.

But IIED researchers found many women were now simply going to private hospitals in adjacent districts.

"The action did not stop hysterectomies because it was only trying to treat the symptom, not the root cause," Bharadwaj said.