The scars run deep among the children of Thailand's forgotten war
Eight years of conflict in Thailand's deep south leaves its marks on those most vulnerable, with many showing high levels of stress and trauma
Mentally scarred and afraid to set foot outside his home in Thailand's deep south, Ahmad is one of thousands of children orphaned by a war largely forgotten by the rest of the world.
After years living with the menace of bombs, shootings and curfews, many youngsters in Thailand's insurgency-wracked deep south are exhibiting high levels of stress and trauma.
"When I do go out I stay near my home … I never go far away," Ahmad, 12, said as he chewed timidly on the collar of his football shirt.
His 15-year-old sister Sunnah said their father's murder by unknown gunmen six years ago marked the end of her childhood and left the siblings without parents following the death of their mother in an accident. They now live with an aunt. Their names have been changed in this report to protect their identity.
"I don't feel safe, especially with strangers," she said. "I suspect people when they look at me. The soldiers are the worst."
Anger, introversion and fear are common symptoms of depression or post-traumatic stress disorder (PTSD), said government mental health expert Pechdau Tohmeena, explaining children are bearing the brunt of the eight-year conflict.
"Fear is the number one issue. Some kids have seen their parents shot in front of them, their family shops burned, relatives beaten or tortured," she explained at a clinic in Pattani, a city at the heart of the insurgency.
"They hear rumours about the violence. They see helicopters flying overhead with their guns pointing down on them. It's hard to live as a target every day."
Over 5,300 people have died in the region since 2004 in bombings, killings - including beheadings - and shootings by insurgents, as well as military raids targeting suspected militants.
Nearly 60 of the dead have been aged 15 or younger, while hundreds more youngsters have been injured, according to conflict monitor Deep South Watch, the majority caught in crossfire.
On October 31, an 11-year-old boy joined that toll when he was gunned down in an ambush with his father, in an attack that also left his nine-year-old brother in a critical condition in a district of Yala, one of three southern provinces that have been under a state of emergency since 2005.
The number of orphans in the region is a growing concern, with non-governmental organisation the Pattani Juvenile Observation and Protection Centre putting the number at more than 5,000.
While there is little comprehensive research on the mental health effects of the conflict, the statistics are alarming and experts say they are getting worse.
Nearly 22 per cent of 11 to 18-year-olds had PTSD symptoms, which is believed to be more than double the national average, according to a 2010 study of 3,000 children across Thailand's three southernmost provinces.
Just under 40 per cent showed signs of emotional or behavioural problems including anxiety, loss of confidence, poor attention spans, fear and aggression.
"Some of these kids have grown up only with violence," said Panpimol Wipulakorn of the Rajanukul Institute, a government mental health agency, who led the survey. "Some primary school kids even told us what they most need to improve their lives is a gun - that is not the normal response of a school child."
There are some positive signs that mental health is creeping up the agenda. Eight years ago, when the insurgency started, there was just one government psychiatrist for the three southern provinces - now there are 40.
But as violence rages, there are mounting fears that an angry and emotionally-damaged new generation will enter the insurgency, a possibility that has not escaped the attention of the government or the militants.
"Both sides want them … and if these kids continue to grow up in conflict, the threat is that in 10 or 20 years there still won't be peace here," said Pechdau.