According to University of California, Santa Cruz labor sociologist Steve McKay, who traveled extensively on container ships with Filipino crews in 2005 for his research on the masculine identity in the shipping market, raw materials for the bolitas can range from tiles to plastic chopsticks or toothbrushes. A designated crew member boils them in hot water to sterilize them, and then performs the procedure. There are also different preferred locations for insertion. Some have one on top or bottom, and others have both. One shipmate told McKay that others have four, one on top and bottom and on both sides, "like the sign of the cross." Another said: "I have a friend at home, you know what his nickname is?" McKay recalled. "Seven."
The practice is unique to Southeast Asia and dates back to at least the 16th century, though no one is sure if it has been continuous. Italian scholar Antonio Pigafetta accompanied Ferdinand Magellan and his crew on their explorations and journaled about a similar behavior in what is currently southern Philippines and Borneo. Apparently, it was also practiced in Thailand and Indonesia, but vanished from the historical record in the mid-17th century, when men bowed to the pressures of Islam and Christianity.
Mckay was shocked to learn that it still existed in what, based on his extensive conversations with Filipino seafarers, seemed like great numbers. In the extremely limited body of academic literature on this topic, there aren't many numbers. One 1999 study found that out of 314 randomly selected Filipino seamen in the port of Manila, 180, or 57 percent, said they had them.
According to McKay's interviews, danger of infection and resulting pain seemed to be worth their reception by droves of Brazilian prostitutes. According to one of his papers, one shipmate told him: "'Filipino seaman are famous for them...that's why they [women in port] like us, why they keep asking for us,'" he said. "'When they hear that Filipinos are coming, they're happy.'"
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