“Don’t discuss sex in depth. I warn you,” 32-year-old Wilia Putri told Her Report. “It’s taboo to talk about sex, so sometimes I just watch porn videos…The women aren’t satisfied; they just satisfy their partners. We try to reduce wetness in our vaginas because it makes our partners feel better…always changing our panties—for me, four times a day and twice at night, more if I feel moist.”
Inserting tooth paste, alcohol, bleach, chalk, sand and other antiseptics is a culturally and sexually normative behavior among Indonesian women trying to reduce vaginal lubrication, inflaming and thus tightening their vaginas, and increasing friction in an effort to amplify their partners’ sexual pleasure.
Other products unique to Indonesia are marketed to “address the problem of femininity,” strengthen the vagina “just like a virgin so as to make sex more intimate and harmonious like a new bride,” “keep husbands happy” and, thus, “preserve marital relationships.” The Tongkat Gurah Vagina (TGV), for example, is a 5-inch cigar-shaped plant root that is inserted inside the vagina just before sex, to absorb vaginal discharge and tighten tissue. Similarly, Daun Sirih, which are Betel leaves, are used to alleviate eye pain, cure ulcers, treat bronchitis, assuage bleeding gums and nose bleeds and, nonetheless, reduce vaginal discharge. And spa treatment, Ratus Vagina, smokes out the vagina with traditional herbs to fight infections, regulate menstrual cycles, aid infertility and revive the sensation of virginity.
“Vaginal practices are not as rare, exotic, or benign as sometimes assumed,” according to the World Health Organization (WHO). “Limited evidence of their biomedical consequences remains a concern; further investigation of their safety and sexual health implications is warranted.”
WHO consultation papers show that global health officials are aware of this activity, but there are no broad figures on its prevalence.
“We have not had any specific study regarding how much women do such practices. But in the discussion we had in society, there were more than 50 percent of women in Bali who did,” Debora Murthy, Head Division at Bali-based nonprofit, Yayasan Maha Bhoga Marga (MBM) told Her Report. MBM provides sexual health and economic empowerment education to women in collaboration with the Protestant Christian Church of Bali (GKPB).
The practice is indicative of a culture rooted in the submission of women. “[Women] are taught to do everything they can for their boyfriends or husbands. Especially since polygamy is legal in Indonesia, a lot of women feel the need to go the extra mile to pleasure their husbands even at their own expense,” said 23-year-old Bali-based social worker Flora Cohen.
But their own expense is not cheap. Studies dating back decades have observed the exfoliation of the vaginal and cervical mucosa and hypothesized that, while there is still no epidemiological association with HIV infection, women do show an increase in genital HIV-1 RNA shedding and therefore a higher potential for transmission. This is because such practices can and often do lead to ulceration, excoriation, necrosis and sloughing of the vaginal wall, which heightens the potential of stenosis and vesicovaginal fistulae, damaging the epithelium, altering vaginal pH levels and impairing mucosal immunity—all of which thereby facilitate the transmission of HIV infection.
Approximately 60,000 women of the five million in Bali alone are vulnerable to the HIV pandemic in Indonesia.
According to cumulative data by MBM, as of December 2013, the heterosexual transmission of HIV and AIDS accounted for 78 percent of those infected. MBM also gave 808 women in Bali who dry their vaginas pap smears. Of them, 47 percent had bacterial vaginosis and 21 percent had vulvovaginal candidiasis—both of which are fungal infections and affect yeast production.
“I can imagine that in more traditional parts of Indonesia, most women must be too afraid of losing their husbands because they are ‘afraid to starve to death,’” said 26-year-old Intan Anis Sunarmi who grew up in a traditional Javanese home. “That’s why they’ll just do anything to keep their husbands.”
But if they can’t keep their husbands happy, they often rely on getting clients coming…Prostitutes. Hookers. Whores. They get called a lot of universally derogatory names, but the reality is, they’re workers trying to make money like everybody else.
Intravaginal Practices in Balinese Sex Work
“Women in Bali are still facing discriminative practices within the social, cultural and political spheres,” Murthy of MBM explained. “[They] are not actively involved in decision-making; inheritance is only given to men. Women are given the burden to seek income and at the same time shall take care of all the housework. But, although many women contribute to bringing in income, very rarely are women given the opportunity to own the family wealth.”
Sex work gives Balinese women the potential to own their wealth and therefore support themselves in the event that their husbands don’t.
Although sex work is illegal in Indonesia, Bali has quite a big sex industry largely a result of tourism in cities like Sanur and Kuta, or on the outskirts of Denpasar. There are both indirect sex workers who work in bars, clubs and massage parlors for a supplementary income, and there are direct sex workers who work all day in concentrated sex complexes.
Balinese sex worker, Riyah, said her business she had built from the ground up went bankrupt and she was forced into sex work to make ends meet. “It was the end,” she said, “…when my husband fell for my own sister and took her as his wife.”
Likewise, Sara said, “I was forced to sell all we had just to put food on the table. I gave birth to one child. My husband still refused to work. I cried because I was scared. They forced me to do horrible things…I contemplated my life. How did it come to this? I thought of jumping in front of a train…”
Melly’s husband left her even before the birth of their first child. “I was five months pregnant when my husband left me,” she said. “Then I worked in the fields…I only earned Rp. 5,000 (about .38 USD) per day to feed my child…But it was never enough.”
Jobs that are traditionally for women, such as working in the fields for example, have been taken over by new harvesting equipment.
“All of these jobs that young women used to do have been replaced now by machines. So they don’t quite have a lot of employment,” said Emily Rowe, HIV-AIDS Program Manager at the Kerti Praja Foundation—the only nongovernmental clinic accessible to everyone in Bali and one of the few in Indonesia. The foundation has provides outreach, condom distribution, STI screenings and voluntary counseling and testing (VCT), educating sex workers on safer sex practices. It now reaches 3,000 sex workers as young as 13 years old to about 50 when they typically retire.
“They are all doing it to put their second cousins through university or paying off their grandfathers’ motorbikes or taking care of aunts in hospitals. It is never for themselves,” Rowe explained, in addition to feeding their children.
In the complexes girls can make about 150k rupiah (about $12 USD) and up from about 10 to 15 clients a night. “On average they will have about two men and a night so you take home about 200,000 rupiah (about $15 USD) a night…that’s about 4, 5 million rupiah a month (about $300-$380 USD). The average wage is 1.2/1.5 rupiah (about $92-$115 USD). Then you have the indirect sex workers and most of them are multitalented. They speak a bit of English; some of them have been to university; some are also working in the bars…they can make quite a lot of money. You can see why people do it.”
And in an effort to retain clientele, sex workers in particular use the aforementioned intravaginal practices to not only tighten their vaginas, but also as preventative cleansing measures against infections, since they are oftentimes unaware of the adverse effects.
“A lot of foreign clients love it if you’re a bit wet,” a former sex worker who wishes to remain anonymous said. But because of cultural norms, most clients do not. She was 22 when she started working in a complex 10 years ago, having used intravaginal antiseptics and added, “It is 100 percent for the pleasure of men; there is no joy in it for girls.”
The prevalence of HIV within female sex work populations in Indonesia had risen from one percent in 2000 to 18 percent by 2008. This is partly due to the clandestine nature of sex work and the stigma surrounding HIV.
Condom use remains dangerously low among sex workers at 30 percent, and STI prevalence remains high at nearly 50 percent. But still many women won’t go for testing in fear of the results and of precontrived rumors that she has an STI, which others might spread to reap her clients. It is therefore difficult to encourage sex workers to routinely screen themselves, and especially to encourage indirect sex workers who don’t necessarily identify.
“We used to meet [in support groups] every week, but that was a bit tricky because, if you go every week, they start asking why are you going to those meetings? The stigma is huge here. Sometimes they’ll talk about each other and say, Oh, she has HIV, because it’s very competitive,” Rowe said of the monthly support groups. “It’s a very secret society. We change the days, change the times…because sometimes they’ll see someone from their complexes and won’t want to deal with that.”
And to worsen the blow, the Indonesian government has adopted a relatively repressive approach to the sex work industry by simply arresting and returning sex workers to their respective areas of origin.
“The conditions cause women to be more vulnerable in seeking the welfare of herself and children,” said Murthy of MBM. But organizations like MBM are offering group programs that teach women to take control of their money, manage microcredit and develop the capacity to gain steady incomes. “[Managing capital] has improved the quality of life for women and their families. Women could make decisions to use their incomes for the education of their children, for nutritious food, for family health services and for saving.”
Similarly, the Kerti Praja Foundation offers a Relife program, which is an initiative to provide income generating activities for HIV+ women and their families, including HIV+ sex workers who are seeking an alternative form of income. Relife teaches them to sew bags from non-recyclable plastic waste, bottle caps and unwanted fabric donations from local designers, and sell them.
“I didn’t chose this road. It wasn’t that I took a wrong turn; there was only one path and I had no choice. No choice. Now here I am. I have to do whatever I can to see my child through school and survive. My life is for my kid. But If I hadn’t taken that turn, you know, to do this work, I wouldn’t have found my new life with my support group,” said a woman outside a Sanur Beach massage parlor. “I would be at home with a man that scares me and a hungry child. I was never going to survive unless I made a move. Call it right or wrong, but my child eats.”