Douching/vaginal cleaning habits among female sex workers.

In industrial countries, vaginal douching has been reported to be with pelvic inflammatory disease (PID) and ectopic pregnancy, while in the less developed countries have investigated the risk associated with vaginal douching is highly culture-related habits. THE PROJECT: An ethnographic study was conducted to learn about douching habits among female commercial sex workers (FCSWs) in the three sex industry complexes in Surabaya representing high-paid, middle-paid and low-paid locations. The study, specifically, aimed (i) to describe the habits with regard to women's cultural practices and (ii) to explore the possibility of their readiness to change or modify such habits. THE FINDINGS: FCSWs in the complexes show similarities on such habits. They bring their own traditional knowledge on practices and agents (betel leaves, turmeric, lime and bitter herbs) obtained from their places of origin or in the nearest marketplace. In the same time, they learn about the practices and "modern" agents (toothpaste, soap, facial cleanser, antiseptic and the like). Even though they douch more than three times a day (specially after sex with clients), they see douching as a way to keeping healthy and clean, and do not see their sex work as potentially health-threatening. However, if they learn of new ways of douching or new agents, they are willing to do so, as long as they are convinced that it is good for their health. LESSON LEARNED: A holistic, multidisciplinary action research be carried out on the issues surrounding commercial sex works, in connection with sexual and reproductive health and sexually transmissible disease. Gender imbalance needs urgent attention and solutions.