Infections have been spreading further than before, with the remote and tightly secured Deep South – affected less by earlier waves of the pandemic – now reporting outbreaks in prisons and emerging clusters linked to a religious school and a popular Pattani fish market.

Yet in this Muslim-majority region of Buddhist Thailand, vaccine coverage remains limited. Less than 5 per cent of people have received a vaccine against Covid-19 in the provinces of Pattani and Yala, total population 1.1 million, according to health authorities. Those who have been jabbed tend to be from wealthier, more urbanised areas – and the majority are Buddhist.

For the region’s much larger Muslim community, 17 years of conflict between Thai security forces and secessionist rebels has fostered a deep mistrust of authority. The ongoing insurgency is deep-rooted and continues to this day, having claimed more than 7,200 lives so far – many of them civilians.

“There’s no trust between officials and the people,” said Artef Sohko, president of The Patani, a political action group advocating self-determination for people living in the Deep South. “When you’re in a conflict zone the officials have all the power, so when it comes to a health crisis like this people are extra wary, and don’t trust the officials.”

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Martial law has been imposed on the violence-plagued region since 2004, with the Thai state accused of widespread surveillance, forced cultural assimilation and other abuses against the Muslim-majority population in the years since.

Suspicion of the government’s intentions is so high that Artef said it would be better if an international organisation seen as impartial, such as the International Committee of the Red Cross, were put in charge of the region’s vaccine roll-out.

Conflict, hesitancy

A brief ceasefire unilaterally called last year by main rebel group Barisan Revolusi Nasional (National Revolutionary Front) held for a few months, but bloodshed has since returned to the region – with 16 killings between April and May across more than 70 violent incidents, according to conflict monitor Deep South Watch.

Most attacks go unclaimed, though Artef of The Patani said his group had sent “a letter to BRN to hold off on their violent campaign … and show leadership” amid the pandemic.

Vaccine hesitancy, meanwhile, seems to be spreading almost as quickly as the virus.

“Everyone in my village is scared that they might get sick or die from the vaccine,” said Ar-esah Hama, who lives in the shadow of Narathiwat’s forested Budo mountains, several hours drive from the nearest town or clinic.

The 70-year-old is at high risk of complications or death if she were to contract Covid-19, but she said she will not get the vaccine – which for most Thais is currently China’s Sinovac jab – “until the whole village gets it”.

Another hurdle, according to Artef, is that “most rural people hold religious beliefs against the vaccine” – though he expressed confidence that the region’s population were “like any Thais, if middle class people tell them vaccines will save their lives, they will go get vaccinated”.

Fatima, a 24-year-old cafe owner in downtown Pattani, was not so sure. “I don’t know anyone who trusts the vaccine,” she said, citing inconsistent information on Thailand’s vaccination roll-out and fears that the jabs were rushed into production.

Meanwhile, a third field hospital for coronavirus patients with some 100 extra beds has opened in Yala province – under lockdown until July 17 – as a fifth opens its doors in neighbouring Narathiwat. And across the region, the number of cases keeps climbing.