NARATHIWAT, Thailand – Post-traumatic or chronic stress, paranoia, depression and desensitization are among major psychological problems facing men, women and children in Thailand’s deep south since the separatist movement resumed armed struggle in 2004.
More than 6,700 people have died during the 13 years of conflict in the provinces of Pattani, Yala and Narathiwat, a troubled region with almost two million population of which Muslims and ethnic Malays are the majority.
During the first 10 years of armed conflict, 3,000 women were widowed and nearly 6,000 children orphaned, according to the Ministry of Social Development and Human Security.
“The loss of lives and physical suffering have affected the mental health of the population in the region (...) with a particular impact on direct victims, their families and witnesses of violent incidents,” said Dr. Pechdaw Tohmeena, Director of the Mental Health Center for Southern Thailand.
Having graduated from London and previously worked for the Health Ministry in Bangkok, Pechdaw has created a network of professionals and volunteers in the region since 2004 to help identify and treat patients who often avoid going to hospitals due to risks of being stigmatized.
Procedures and treatments vary for each victim and the support he receives from his family, the doctor said.
Many cases have been identified “because they visit the hospital after the violence,” but at other times, volunteers are the ones who detect the victims’ symptoms after visiting their schools and homes.
The doctor pointed out that it is more difficult to treat the minors because they “tend to internalize” more events and because in the most severe cases, the mental effects can continue into their 20s.
In public schools, often guarded by military patrols as being one of the insurgent’s targets, as well as in Islamic schools, where security officers sometimes carry out raids and arrest teachers and students without warrants, students have been psychologically affected and have since received psychological support.
In October 2016, a bomb detonated in front of a school in Narathiwat killed a four-year-old girl and her father and injured 10 other civilians.
“When visiting the place after the incident, 700 children of that school showed symptoms of psychological trauma (...) for example, they drew pictures of armed soldiers and explosions,” said Pechdaw, whose mental center trains teachers to help the affected students.
According to humanitarian organizations, cases of torture by security forces have been reported, which requires an “intense” work of experts to help victims recover.
“More than 90 percent of people who go to the clinic were able to recover, although some relapse. On the other hand, if they do not receive treatment, the problems persist,” Pechdaw said.
The victim’s state of normality is sometimes earned through the desensitization towards the conflict.
“After 13 years, people have normalized the conflict. After the violence, they would ask: ‘How many people have died?’ ‘And injured?’, and then returned to their daily lives. They almost didn’t respond to horrors. They have desensitized themselves,” Pechdaw ditched.
Armed attacks, murders and explosions occur almost daily in Pattani, Yala and Narathiwat despite the deployment of 40,000 security forces and a state of emergency.
The insurgents claim they have been discriminated in the Buddhist-majority country and demand a separate Muslim state that covers the area of the three provinces that once were part of the Patani Sultanate, a kingdom annexed by Thailand over a century ago.