Manju Devi suffered in pain for two months last year as she worked on a farm near Delhi, unable to break away from duties that sometimes had her standing for hours in the waist-deep water of a rice paddy, lifting heavy loads in intense heat and spraying pesticides and insecticides. When that pain finally became too much to bear, she was rushed to a hospital.

The doctors’ verdict: Devi had suffered a prolapsed uterus and would need a hysterectomy. She hadn’t said a word to her family about her discomfort because of societal taboo over discussing a “women’s illness,” and with two grown children and three grandchildren looking to the 56-year-old widow to help put food on the table, Devi had relied on painkillers to stay in the fields.