Mumbai: Health cards for women sugarcane labourers, medical check-ups twice a year, reporting of all hysterectomy surgeries and a medical audit of all such cases among women below the age of 35 — these are a few recommendations made by a Maharashtra government-appointed panel to probe rampant hysterectomies among cane labourers in Beed district of Marathwada.
The committee headed by Shiv Sena’s Neelam Gorhe, deputy chairman in the state legislative council, submitted its report earlier this week to the state’s public health minister, Eknath Shinde.
The seven-member committee comprising legislators, experts and government officials conducted a survey of nearly 82,000 women. Of these, almost 13,500 women admitted to having had their woman wombs removed over the past 10-15 years.
“Some of them who underwent the surgeries years ago don’t even have their relevant medical documents, but they said they faced certain illnesses time and again and weren’t getting better, and so they opted for the surgery. This can be avoided if the basic health infrastructure is improved,” said Gorhe, a Shiv Sena MLC.
The panel was appointed in June after Gorhe raised a calling attention motion on cane labourers from Beed undergoing hysterectomies in large numbers.
At the time, Shinde informed that 4,605 women had undergone womb removal surgeries in the Beed district in three years from 2016-17 to 2018-19.
SOP for doctors, full medical check-ups
The Neelam Gorhe-led panel has made several recommendations for various state government departments to implement, with a bulk of them focusing on regular and adequate medical care to women sugarcane labourers.
According to the recommendations, all women labourers will be required to undergo medical check-ups before leaving their homes for migratory cane cutting work, and once again after returning to base. District health officials will be required to maintain a separate register of their medical examination reports.
Additionally, a primary healthcare centre representative will be required to visit the premises of sugar factories — where a bulk of the labour works — for regular health check-ups. Besides, the women will also be issued health cards containing their medical history and will get a full medical check-up, including a note of their haemoglobin count, twice a year.
All rural doctors, including those from private hospitals, will have to strictly adhere to standard operating procedures while treating any complaints related to menstruation, sexually transmitted diseases and so on. If hysterectomies remain the only option, doctors will be required to follow a standard operating procedure for the surgery too and fill out the relevant medical forms, including getting the patient’s consent.
The panel further recommended that all private hospitals will also have to submit a monthly report of all the case histories of hysterectomies performed to the district health officer, who will not only inspect them but also conduct special audits in cases where a woman under 35 has had her uterus removed.
Living conditions of cane labourers
Besides emphasising medical care of women sugarcane labourers, the Neelam Gorhe-led panel also worked with the state’s sugar commissioner and labour commissioner to give suggestions on improving living conditions of these workers.
Accordingly, all 195 registered sugar factories will have to register cane labourers with the labour commissioner’s office, provide them with protective gear for their work, clean drinking water and toilets, as well as transit homes.
The panel has also advised the sugar commissioner to approach the Maharashtra Housing and Area Development Authority to explore the option of providing such labourers mobile homes that they can use at their destination of work as well as in their villages.
Other recommendations include overtime wages beyond eight hours of work, crèches for children of labourers, advance six months food grain ration supply to them before they migrate for work, providing sanitary napkins at a highly subsidised cost, among others.