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 said, “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.

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.

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.

Archana Ashok Chaure, a sugarcane laborer and mother of 3 who has not been able to work without pain since a hysterectomy, at her family’s home in Kawadgaon, India, on May 21, 2023. In Maharashtra’s sugar industry, everyone — contractors, other workers, even doctors — pushes women toward the surgery. (Saumya Khandelwal/The New York Times)

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 younger than 40. In addition to the short-term risks of abdominal pain and blood clots, it often 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.

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, 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.

A mother of a child bride, herself a sugar-cane worker, leaving a counseling session with child welfare workers in the Beed district of Maharashtra state, India, on Oct. 6, 2023. The industry relies on couples, often married very young, working together under exploitative contracts that keep them in debt and tied to the jobs each season. (Saumya Khandelwal/The New York Times)

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. PepsiCo said the company and its partners purchase a small amount of sugar from Maharashtra, relative to the total production in the state.

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 1 in 5 had had hysterectomies. A separate, smaller government survey estimated the figure at 1 in 3.

Women who work in the sugarcane fields, all of whom have undergone hysterectomy surgeries, show their scars in Wadgaon, India, May 22, 2023. In Maharashtra’s sugar industry, everyone — contractors, other workers, even doctors — pushes women toward the surgery. (Saumya Khandelwal/The New York Times)

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.

A Push Toward Surgery

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.

India is the world’s second-largest sugar producer, and Maharashtra accounts for about one-third of that production.

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 1 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.

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.

In the fields, where she has spent her life cutting sugar for a mill owned by NSL Sugars, Chaure, like the others, sleeps on the ground, spends hours a day hunched over and carries 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.

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

“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, although 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.

Married to and for Field Work

In her wedding photographs, 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, Chaure does not know her exact age but is in her 30s. 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.

She knew that marriage meant the end of something. She had dreamed of becoming a nurse. 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 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,” Chaure said. “So they marry us off.”

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

Early Warning Signs

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.

Contract workers in a cane field near NSL Sugars in the Beed district of Maharashtra state, India, on Dec. 11, 2023. As western soft-drink makers have helped turn Maharashtra into a sugar-producing powerhouse, they have profited from a brutal system of labor that exploits children and leads to the unnecessary sterilization of working-age women. (Saumya Khandelwal/The New York Times)

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 Bharat Sugar and NSL Sugars say they keep virtually no records on their laborers.

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.

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.

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. (Although public hospitals offer hysterectomies free or at reduced cost, they are often far from rural women.)

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

But hysterectomies on younger women continue. Although 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. He said his office still approved 90% of hysterectomy requests.

The New York Times