42 American Scientific Research Journal for Engineering, Technology, and Sciences (ASRJETS) ISSN (Print) 2313-4410, ISSN (Online) 2313-4402 © Global Society of Scientific Research and Researchers http://asrjetsjournal.org/ “People’s Etiology”: Sexual Disease Treatment by Canvasser K. M. Mahmudul Haque* Lecturer, Department of Anthropology Jatiya Kabi Kazi Nazrul Islam University Trishal, Mymensingh, 2220 Email: anthromahmud@gmail.com Abstract This writing provides valuable information on sexual disease and its treatment. This qualitative study design allowed the researcher to gain insight into the lives of men that have been affected by the sexual disease. Here methods of data collection were thorough and methodical through the interview with unstructured and open- ended questions and observation and analyzed the data using grounded theory was an arduous task but worthwhile. This study influenced researcher to think about identity in the field; at the same time, it influenced him to think about the limitations of street research on a sensitive issue. The study was justified by the knowledge how people react to sexual disease and the problems they experience as a consequence of sexual disease, or it's treatment. Knowing about the people's perception about the sexual disease and treatment, clients and canvassers' narratives on male sexual health was another important part of this study; and also to know about canvassers' perspectives. Own cultural beliefs affect people when it comes to surmounting diseases and receive proper medical help. In Bangladesh, we see that people not only in rural areas but also in urban areas have a different perception of sexual disease. People treat their disease by the canvasser from a street, not from a well-furnished hospital. However, the question is that why people use traditional treatment by a CANVASSER (non-professional doctor)? A historical study could show us more dimension of the treatment process of canvassers in Bangladesh. It also gives us an idea what people think about own sexuality and how they relate this thinking in their everyday life. The researcher hopes this study will help us to know about street canvassers' and their clients' knowledge/ideas on the sexual disease and sexuality. It will also contribute to consider about further study in this area. Keywords: Biomedicine; Canvasser; Client; Etiology; Folk Medicine; Sexual Disease. ------------------------------------------------------------------------ * Corresponding author. http://asrjetsjournal.org/ American Scientific Research Journal for Engineering, Technology, and Sciences (ASRJETS) (2017) Volume 38, No 2, pp 42-50 43 1. Introduction One speaker, one round throng, one show, one hour these are the ingredients of one cycle of one common scene of an urban area. The rapid growth of urbanization creates new kinds of group of people. Street canvassers are such kind of individuals who can make a throng of a moment in an urban footpath. The belief associated with sexual disease of street canvassers and clients and their action to manage the situation with considering their socio-economic condition is crucial in this tech-age. More than twenty million people are living in Dhaka city. Although the living standard of Bangladesh is being upgraded, the matter of sorrow is that scores of the urban people are out of health care system. These people are just upgrading the number of problems. Mohakhali (Flyover), Airport (International Airport and railway station), Farmgate, Rampura(Television Centre), Jatrabari (Bus Stand), are very known to people because of the specialty of these places. However, in these locations, we not only find flyover or television center but also find such people who are stronger than a pillar of the flyover and faster to spread the ideas than television center. They are in a relationship where Canvassers is on one pole and Clients on the other side; who do not take biomedical facilities for sexual disease treatment. Their health problems are broad and multidimensional. Rates of acute and chronic medical diseases among them are high. These people feel hesitated to express their sexual problem to the doctor, and they do not take advanced treatment. In this paper, I want to explore what is their perception of sexual disease and how they explain the etiology of this disease. The primary objective of the present study is to know the belief that influence people to visit street canvassers to cure sexual disease and to investigate people's action to cure disease with considering their lifestyle, socio- economic condition, ecology, and surroundings. Knowing people's aspect of the disease and knowing the etiological explanation of sexual disease is highly emphasized and analyzed here. Canvassers sell an enormous amount of drugs. So these drugs should be studied by protecting public health by consuming potent drugs. Article-15, the constitution of the Peoples Republic of Bangladesh takes the responsibility of provisioning the civil service. "Primary Health Care Strategy" declared in Alma-Ata in 1978 is highly accepted by the government. So public health issue is the necessary sector to study. The researcher has come across the reality that there are a high number of penile problem cases, especially penile dysfunction, premature ejaculation, urethritis, etc. in recent years. So the researcher wants to conduct this study to assess the holistic situation of these diseases among the people and to investigate the causes of these which are diagnosed with the help of canvassers. The authors in [1] describes that in Bangladesh 14.2 percent married men have at least one symptom of Sexually Transmitted Infections. 2.9 percent people have a discharge of penis. 11.5 percent reported pain and burning sensation during urination. According to canvassers and clients, urethritis or pain in the penis during urination is a sexual disease. So this is an important sector for research that why do the patients infect with these diseases and how do they treat them. The author in [2] noted that "Urinary tract infections and sexually transmitted diseases are prevalent throughout the world. Since most people, particularly in the underdeveloped countries do American Scientific Research Journal for Engineering, Technology, and Sciences (ASRJETS) (2017) Volume 38, No 2, pp 42-50 44 not go to allopathic doctors for treatment, either because they lack access to modern medical facilities or are too shy to discuss these diseases with unknown doctors" (p-72-73). Here researcher tried to look at the factors which demonstrate the treatment practice. So the study will help to know the whole situation. This study focuses on folk treatment in the urban area which is a new dimension to reveals the urban treatment practices and beliefs. The author in [3] noted that a significant amount of oral and written evidence from a wide variety of sources were reviewed by The House of Lords Science and Technology Committee in early 1999 to scrutinize complementary and alternative medicine (CAM) including herbal medicines. It noted that public satisfaction with CAM is high, and that use of CAM is increasing. The biomedical approach is not always appropriate for people because they have a specific explanation about disease and treatment. Why inhabitants in a city do not take the biomedicine and why they take alternative medicine are highly essential to know with a postmodern view or critical medical anthropology. The author in [4] noted that every culture has its particular explanation for ill health. Culture provide people with ways of thinking that are "simultaneously models of and models for reality". Therefore, it is necessary to know the perception of the people about sexual disease. In Bangladesh several pieces of research have been done on public health related issues but not enough research has been done specifically on canvasser and sexual disease treatment. The author in [5] noted that in the last decades, some researches include different rituals, worshiping, customs and affects of superstition of pregnancy to birth of the child, depicts the socio-economic condition of village midwives, describes the influence of hujur (Muslim religious specialist), pir (Muslim saint), Kobiraj, Brahman (Hindu top most caste) in Bangladesh's society. To know the local understandings and interpretations related to the body, health, and complications these are significant. Similarly, research of the author in [6] also helps the researcher to know the relation between health and religion. She made a research on religious practices at shaheenpur village in Comilla. She described broadly about disease and curing in his Ph.D. thesis. She has shown how people take herbal treatment to be cured; discussed elaborately how religious beliefs an essential part of treating disease. She explains the effects of religious healing, especially 'tabij' in her research. These literature by and large shows the existence of cultural practices of local healing. In fact of the above studies will provide insights into my empirical studies on sexual disease and treatment practice by a canvasser. The most important thing is that there are so many researches on traditional healing system but few types of research are on sexual disease treatment. Some researches or reports have been published, but they are on sexually transmitted disease. Not only this, they are not related with canvasser. The researcher will try to explore this new essential of public health issue. 2. Methodology As this research implicates many different groups researcher decided to collect data from selected spot Vatara (the main research location), although the researcher visited the different center point of the city like Mohakhali, Airport, Farmgate in Dhaka city to get further data using the random sampling, he selected various groups of respondents. The researcher randomly selected 150 canvassers and clients in different kinds of professions. The socio-economic background of his respondents is not representative of Bangladesh as a whole (but they came from different areas of Bangladesh). From canvassers, the researcher collected data such as the etiological explanation of sexual disease, their perception of the sexual disease, which type of people come, their perception of this profession, etc. On the other hand from clients, the researcher collected data like the perception of sexual disease, etiology, perception about healer and healing system, determinants to go to a canvasser, a hindrance to American Scientific Research Journal for Engineering, Technology, and Sciences (ASRJETS) (2017) Volume 38, No 2, pp 42-50 45 going to the hospital, perception on biomedicine, etc. All of the respondents were Male because no female members of society join in a throng. In addition to interviews, the observation was used in this research to ensure the reliability of the information. The unit of data collection in the study field was fundamentally the client of a canvasser who buys the product from street canvasser. The canvasser itself was also taken as the unit while analyzing the data. The researcher collected data from the field for 90 days. In-depth questioning was the principal methodology to gather information for this research. An unstructured and open-ended questionnaire was employed due to the qualitative nature of the study and to establish a close rapport with the respondents. A checklist was also developed to collect some basic information and to guide through the fieldwork effectively. In every set of questions, there are three core issues: reasons for using traditional treatment of the respondents, the respondents' perception of and access to information regarding treatment. In some cases, twice or thrice unstructured interview with the single person was arranged to achieve reliable information. Maximum data was collected through this method for the whole study. 3. Etiology: Difference from biomedicine Researchers explore that etiology of the disease is a significant indigenous medical phenomenon, of any society and in particular stems out from the meaning system (culture). The authors in [7] noted that "Medieval Persian physicians depicted that ED might be happened as an upshot of an explicit illness of penis, testis, and seminal vessels, or for the attachment of neighboring organs such as rectum. The association between ED and psychological factors such as depression and rage was recognized by medical circlings in Persia." Historically people think that the etiology of the sexual disease is so important to prevent the disease from the society. Historical perception may or may not be matched with a modern etiological explanation or culturally it may vary, but historical explanation helps people to explore the new ideas. 3.1. Canvassers' Explanation Canvassers' best choice of number is three, so they say to avoid three major works which create sexual disease. "Just avoid three…You will be free." Although they suggest more than three they suggest strictly avoiding these factors because these factors are responsible for the sexual disease. According to canvasser firstly people should avoid ‘masturbation'. "If you do this in your life You will be a ‘Hijra' You will lose your wife" ‘Masturbation' is the most inquisitive thing to the canvasser by which sexual disease is developed among the people. Canvassers of a street try to prove that they may be poor by wealth or economy but they are highly affluent with knowledge of the sexual disease. What they speak is like a historic speech. Even they say- American Scientific Research Journal for Engineering, Technology, and Sciences (ASRJETS) (2017) Volume 38, No 2, pp 42-50 46 "Hello listen to me, my brother…You will not get this in the other" They try to prove that every word of a Canvasser is a word from a holy place. So their explanations of causes of diseases are real and scientific. According to Canvassers Masturbation is the cause of sexual disease. They say that among the young generation there is a common notion … ‘‘Until we have hand ..We are men…We will not bend …Towards women" ‘So listen to me young Brother'………….. "Just think, never do this….Otherwise, you will lose penis" Canvassers' opinion is that masturbation creates a problem for penile function. When someone masturbates, he just does ‘abnormal' thing which hindrance the normal activities of the penis. Canvassers cite an example about masturbation. They say if we look at the handle of a rickshaw we will see that the handle which is made by iron is become paler at first. After few days it will lose its real color. After passing some days then, it loses the starting shape. Not only this even after few years it may be needed to change because of shape. So they try to understand people that friction with the hand an iron-made handle may lose its shape then why not a penis, this is a normal idea according to them. But … "This is a material thing brother…..You will lose manhood forever." Canvassers say that material thing like a handle of a rickshaw may be replaced, but someone cannot change his penis. This isGod gifted and only at one time. Canvassers say that people cannot control their sexual desire when they walk on the road. When they see a seductive woman in the road their sexual desire increases but at that time they cannot fulfill it. So after reaching home they just say (doing masturbation)…‘Today is hartal, so shutter closed, today is hartal so shutter closed' and after few days the shutter of their life is closed forever. Or ‘Mayuri, Munmun, Bilkis Suck me suck my penis.' Moreover, after that when they lose their sexual power even a hen has a price value/social value but he has not. Canvassers explain that when someone masturbates, he cannot control his emotion. Rather he tries to get the full orgasm. So at that time of masturbation people force their penis. Even the delightful orgasm depends on the amount of strength. So more force brings more orgasm. However, the problem is that when people force on their penis, they do not maintain equal distribution in the whole penis. Therefore an extended time pressure in certain part of the penis makes the penis thin. So there is a common sexual disease that is an imbalance between top and bottom glans of the penis. Not only this, the penis turned into a bending position towards right or left. Right or left bending position depends on the hand. According to Canvassers, this is a major sexual disease. Canvassers say that most of the time people masturbate with saliva. However, this is so much harmful to people. American Scientific Research Journal for Engineering, Technology, and Sciences (ASRJETS) (2017) Volume 38, No 2, pp 42-50 47 According to Canvassers saliva is one kind of acid. People should not use it in masturbation. They say that if anyone mixes saliva with rice and then gives it to a hen to eat then after eating this hen will die within few minutes. Therefore, saliva is not good for health. Canvassers strictly forbid people to masturbate. According to them, onetime masturbation is more harmful than 48 times intercourse. By masturbation, people try to get an orgasm, so they ejaculate more semen. Canvassers say this creates another problem. Gradually people will lose their intense semen. It will turn into feeble. The second factor which is strictly forbidden by the Canvassers is unlawful intercourse or extramarital intercourse. Especially they try to understand the people that out of marriage they should not make any sexual relation. They say if someone is very much needed to make sexual intercourse then he should avoid these women who make more and more sexual intercourse. They indicate to the prostitute. Not only prostitute they also say to avoid wonderful women. ‘Beautiful nipple like beautiful apple.' In the market, we see some beautiful apple, but we do not know that formalin is used to reserve it. So the inner side of the apple is not as beautiful as outside. It may be rotten on the inner side. Like this apple, a beautiful woman may be stunning on the outside, but the inner aspect of the women is dreadful. Prostitute and beautiful woman make sexual intercourse here and there. So there are a huge amount of virus in their vagina. The viruses of syphilis, gonorrhea are available in their vagina. These viruses are not seen easily. With a microscope, people can see more than millions of viruses in their vagina. Therefore if anyone makes an intercourse with a prostitute, he may be attacked by these viruses. "Gonorrhea, Syphilis Damage your penis." "Hello brother be careful If you pee towards west You are a great fool." The third factor is related to nature that is if someone pees against the sun than the sunbeam will affect the penis. Pee towards the west is harmful. Canvassers always say that religiously it is forbidden by the God in Islam. So they suggest no try to go beyond religion. According to Canvasser, the sunbeam can damage the sexual power. It makes blacker the penis and testis will hang more than past. It means people will ejaculate very early when their testis is downwards. Etiology of premature ejaculation is described by the Canvasser something differently. According to Canvassers if someone kisses on the lower lip of a woman then he will ejaculate rapidly. So they prohibit people to avoid this. Canvassers prohibit making intercourse within 20-40 minutes after eating heavily. Because Canvassers recognize it as a key element for creating sexual disease. It decreases the sexual power. Canvassers acknowledge the urethritis as the etiological factors sexual disease. They recognize that if anyone does not wash the penis well after ejaculation, then it causes the sexual disease. Canvassers say that pubic hair is responsible for a sexual disease like a lean penis. If anyone does not cut pubic hair, he will be American Scientific Research Journal for Engineering, Technology, and Sciences (ASRJETS) (2017) Volume 38, No 2, pp 42-50 48 affected by this. They cite an example that it is seen that the man who has shorter hair in the head belongs a wide neck, but the long hair man belongs a skinny neck. According to them, dream pollution is the major factor. Most of the time people do not care about dream pollution. People do not wash it rather they sleep with it. So it creates a stone inside the penis which causes asexual problem later. "You may use a cotton bud to clear the ear but what will use inside the penis so the stone will damage your sexual life even causes death." Frequent dream pollution is recognized as a sexual disease which creates another problem. People usually see sexy women, sexy videos, pictures, the sexy heroine in the movie, etc. After that, they cannot forget it easily. They think more and more. Finally at night…. "Shakira comes in a dream and goes away, but the man loses his semen, the most valuable thing in the world, within this few second." Canvassers recognize an important factor and prohibit to do this that is a sexual relation of man with man. They think that this is religiously forbidden if anyone does this then he must be affected by the sexual disease. The researcher found that one of the Canvassers said that some people are cursed by the god, so they are affected by the sexual disease. He thinks that erectile dysfunction or impotence is imprecated from God if people do the unreligious thing. 3.2. Client's explanation Clients' explanation about causes of sexual disease is something like Canvassers' explanation. The most recognized factor for the sexual disease is the masturbation. According to clients, sexual desire is present always with the human being. No one knows when the desire will arise. When a man sees the sexy woman or sexy thing the top head becomes hot. Then the lower head (penis) gradually becomes hot. When the two become hot at a time, the man has to do something immediately. However, most of the time it is not possible to make intercourse, so the man has to choose alternative options and last of all he explores the easiest thing that is masturbation. Masturbation is regarded by the clients as a harmful action. In clients opinion, it causes so many sexual diseases like penile dysfunction, erectile dysfunction, premature ejaculation, etc. most of the clients say that they did masturbation much time. They cannot imagine how many loses they occur in their life. The researcher found one of the clients was in class seven and not more than 13.5 years, but after getting puberty, he cannot calculate how many times he has masturbated. According to the client, his penis is enough for intercourse by length, but it is so thin only for masturbation. Clients express that when people see any sexy thing one kind of liquid comes out from the penis. This is not normal liquid. It indicates one kind of sexual disease. When people are on the outside of home like on a bus or market, they cannot overcome it because there are so many seductive things, and they cannot wash it at that moment. Therefore it dries in the penis and the surrounding area. It causes stone in the penis. Clients say that if there is a stone in the penis, then the patient will suffer a lot. The sufferings begin with that the patient cannot substitute urine easily. He will feel serious pain in the penis. The urethra will be divided into two parts then the urine will come out through two ways. Therefore American Scientific Research Journal for Engineering, Technology, and Sciences (ASRJETS) (2017) Volume 38, No 2, pp 42-50 49 patient cannot pee at one time. Few drops of urine must stay in the penis. Clients' opinion is that when someone cannot finish his pee at one time, the rest of the urine will impose him to pee within some moments. Therefore diabetes which is not harmful apparently and very much available in the society causes sexual disease later. Sexual disease like premature ejaculation, shorter penis, etc. are developed by eating some vegetable like pumpkin, tamarind, etc. According to clients in these foods, some kinds of toxic are available which damages the sexual desire, and gradually people lose their long-lasting intercourse, and the penis will be shortened. Therefore clients try to avoid these things. Going to the brothel is another cause of sexual disease. Clients think that prostitutes are affected by the sexual disease. If someone makes intercourse with them, he will definitely be affected by these diseases. Smoking is another factor sexual disease. Few of the clients think that smoking affects sexual power. If people smoke, then they will be unable to erect their penis. Among these few clients think that only Gold Leaf cigarette may affect, other cigarettes have slight nicotine so people can take a cigarette. The researcher found that one of the clients is a security guard. According to him, night duty is the cause of sexual disease like erectile dysfunction, feeble penis, the liquidity of semen, etc. He also said that if someone becomes an employee before getting maturity, then he will be affected by the sexual disease. 4. Conclusion Future qualitative studies on the impact of sexual diseases are required to improve knowledge and understanding of how people cope with the sexual disease and on the consequences of sexual disease on urban and rural people is necessary to provide insight into how sexual disease affects urban and rural people and feedback would make interesting comparison with my research findings. More independent studies into the effect of sexual disease on individuals are needed to provide unbiased information on the impact of sexual disease before treatment being considered. It is highly likely that conducting one to one interviews with both client and canvasser transcribing feedback would produce deeper insight into how people adjust to living with the sexual disease. Research is required into the impact of sexual disease on younger people, and future studies are required to gain deeper insight into the significance of conflicting opinion between client and canvasser on the consequences of sexual disease and its treatment. Considering reports of sexual disease by clients of canvassers in studies that included samples further research is required to gain insight into the incidence of sexual disease among people and the significance of these findings. 4.1. Limitation of the study Anthropological research is very tough because of the necessity of establishing a relationship and anthropologists does not work in a controlled field like that of natural scientists, because which is theoretically expected, so not exist. As this research is related to an anthropological perspective, researcher has to face some problems during the research. So researcher tried to overcome all the problems with the help of his merit, knowledge, and labor. However some of the complexities and limitations are given: Firstly, the researcher had not enough time; secondly, no intimate and in-depth relationship and an unconscious gap between them and the researcher and thirdly, only oral information concerning health and no involvement or observation to treatment processes American Scientific Research Journal for Engineering, Technology, and Sciences (ASRJETS) (2017) Volume 38, No 2, pp 42-50 50 4.2. Ethical issues The researcher was concerned about the consent from the interviewees. To maintain confidentiality researcher tried to cross-check data from a respondent by using the twice interview. The researcher used the pseudonym of the respondent for their privacy. Acknowledgements All the respondents are highly appreciable for their cooperation. Conflict of Interest No conflict of interest. References [1] M. M. K. Khan, M. Alamgir Kabir & M. A. Matin, “Factors Affecting STIs Among Married Men in Bangladesh” The Indian Journal of Family Welfare. vol.49 No.2. 2003. [2] S. Hossan, B. Agarwala, S. Sarwar, M. Karim, R. Jahan and M. Rahmatullah, “Traditional use of medicinal plants in Bangladesh to treat urinary tract infections and sexually transmitted diseases”, Ethnobotany Research and Applications, vol. 8, p. 061, 2010. [3] A. J. Mills, The Philosophy of Psychology, John Wiley & Sons Inc. 2001. [4] C. Geertz, The interpretation of cultures: selected essays. New York: Basic Books, 1973. [5] T. Blanchet, Women, Pollution and Marginality: Meanings and Rituals of Birth in Rural Bangladesh, University Press Limited, 1984. [6] J. Ellickson, A believer among believers: the religious beliefs, practices, and meanings in a village in Bangladesh, Michigan State University. 1972. [7] M. Khaleghi Ghadiri and A. Gorji, “Natural remedies for impotence in medieval Persia”, International Journal of Impotence Research, vol. 16, no. 1, pp. 80-83, 2004.