At 20 years old, Made Karyati did not want to be poor. She had a real shot at her childhood dream of becoming a traditional Balinese dancer when she was accepted to an arts college in Denpasar, the Indonesian island of Bali's capital city, where girls from rural areas often go to make something of themselves.
Now, five years later, she's still in Denpasar, but she no longer dances. She helps run a bridal shop, though her work rarely involves fitting women into their wedding dresses. Instead, she performs the shop's vagina-cleansing service.
Deep in the countryside, about an hour drive from the Denpasar airport, Beauty House is modest—there's little inside besides a small selection of colorful dresses and empty chairs. Here, like at most salons and spas I saw in the area, ratus is on the menu—a popular Indonesian steam treatment that claims to rid the vagina of odors, discharge, and itchiness using charcoal and herbs.
"The main function of ratus is for cleaning the genital area," Made Karyati tells me through a translator. "After that, it's for giving the vagina a better smell. If women don't get the treatment, then they will have a white discharge in their vaginas."
Made Karyati sees about four women a week for the treatment, and she charges about 40 cents for a 25-minute session. To get started, Made Karyati or her cousin, Ketut, place a burning piece of charcoal into a short, small stool with a circular opening on the top. On top of the burning charcoal, they place a pack of herbs. From the herbs, a small, slow stream of smoke begins to rise up, at which point they ask their clients to sit and wait.
"Usually, women spend this time telling us about their sex lives, or the problems they're having with their vaginas," Ketut says.
Denpasar's a far cry from villa-studded Ubud, Bali's thriving Western tourist center made even more popular by Elizabeth Gilbert's memoir Eat, Pray, Love. Although it's only about an hour away, I couldn't find any spas there offering ratus.
"One time, we had a tourist," Made Karyati says. "She came with her Indonesian friends. But almost always, it's local women who come here for ratus."
Made Karyati and Ketut say that the women who come for the treatment at Beauty House are sexually active—virgins never get ratus, according to the cousins—and in Balinese culture, they say, this means their clients are pretty much always married. They're also generally in their 20s and "looking to clean up after sex," Made Karyati says.
Neither Made Karyati nor Ketut is married. Made Karyati ended up at Beauty House when a wealthier cousin—Nyoman, an economics lecturer at a university in party hotspot Kuta—took her to beauty courses while she was on holidays from college. She took a part-time job doing traditional Balinese makeup on the side to help support her studies in dance, and when Nyoman opened Beauty House, tucked away in an area outside Denpasar called Renon, shortly after, her family told her she should leave college to help run it.
Ketut followed Made Karyati one year later. She heard back at the family's rural home in the island's eastern regency, Karangasem, that her cousin had found relative success. Learning to perform the procedure was "easy," Made Karyati tells me. "I didn't have to take a course to learn it—I just learned by watching other people give the treatment," she says.
But when I ask how they could possibly be making money from such cheap treatments with so few customers every week, they tell me that money is too complicated and sensitive to talk about in Balinese culture. Made Karyati also says that the cash from the bridal shop goes to Nyoman, so she can't be entirely sure of their profits.
Both Made Karyati and Ketut say they don't know what the mix of herbs used for ratus are—but they're convinced the herbs, which they say they purchase directly from a wholesale distributor, work. (One Indonesia-based distributor of the packets used for ratus—or "V spas"—lists the ingredients on its packages as a "traditional herb," a flower, lavender, and jasmine, all of which are used for scent.)
What Made Karyati and Ketut say they definitely know about the treatment is that a woman should get ratus at most once every two weeks. Otherwise, they say, more frequent treatments will harm the uterus. Indeed, when VICE editor Arielle Pardes attempted a DIY vagina-steaming treatment at home in 2014, a gynecologist she interviewed "kind of balked" at first, presumably because the medical community considers herbal cleansing procedures like these to be risky or harmful for women. Nevertheless, the doctor ultimately gave Pardes "her blessing."
While Made Karyati and Ketut's method of ratus is common for Balinese women, all vagina-steaming treatments are not created equal. At the Adi Spa in the southeastern region of Nusa Dua, a ratus treatment runs profoundly more expensive at $75. Along with the herbal smoke, the package there includes a scrub, massage, bathtub treatment, and special "natural" drinks, and it lasts for a whopping two-and-a-half hours.
In the US, vagina steaming became something of a controversial fad last year after Gwyneth Paltrow recommended the treatment—called a Mugwort V-Steam—at Santa Monica's Tikkun Spa, which offers customers upscale takes on traditional Korean sauna therapies. "You sit on what is essentially a mini-throne, and a combination of infrared and mugwort steam cleanses your uterus," Paltrow wrote on her website Goop. In Korea, vaginal steaming is known as chai-yok and is conducted with a pot of boiling water mixed with herbs; Tikkun's V Steam lasts for 30 minutes and costs $50 per treatment. In addition to its "signature" procedure, the spa also offers specialized steaming treatments for burning body fat, infertility, post-partum issues, and even an anal-steaming treatment for men.
Read more: How Your Vagina Is Supposed to Smell
Back in Bali, there's little glamorous about the sweat-drenched stool in the bridal shop. Made Karyati says she rarely has the opportunity to use her makeup training—Beauty House, which is on the side of a bright brown dirt road, only really sees customers interested in their cheap ratus treatment.
"Almost every salon here does this treatment," Made Karyati says. "The only way we can compete with them is with this price."