Promoting Resilience and Mental Health in Thailand’s Conflict-Scarred Deep South

For communities in the Deep South of Thailand, conflict has resonated through generations. In this region, particularly in the provinces of Narathiwat, Pattani, Yala, and select districts in Songkhla, over 7,000 people have lost their lives, and more than 3,000 children have been orphaned since January 2004. This unrest has shaped at least two generations, resulting in visible turmoil and unseen psychological wounds, such as PTSD and depression.

Suchart Setthamalinee, a Human Rights Commissioner, highlighted the unique cultural challenges surrounding mental health in the region. “Culturally in the South, disabilities are seen as a punishment from God. People do not want to be connected to any form of disability,” he said, indicating that this stigma can often lead to the concealment of individuals with mental health issues.

“Exposure to conflict and violence without access to critical supportive services can quickly erode a child’s development and basic rights. There has been no systematic assessment of the prevalence of psychological trauma in the Deep South and there are no mental health hospitals in Narathiwat, Pattani, and Yala,” said Suchart. “Education on human rights, child rights, and disability rights is therefore an integrated step toward sustainable peace for these affected populations and communities. Many of these community members are not aware of their own rights.”

To address these deep-seated issues, the World Bank, through a grant from the Human Rights, Inclusion, and Empowerment Trust Fund (HRIETF), supported the Thai Health Academy, National Human Rights Commission of Thailand, and other stakeholders in launching a training of trainers (TOT) program that aimed to strengthen skills within the communities to promote resilience, mental health, and human rights.

The training program was developed in collaboration with a diverse range of stakeholders, from government representatives to directly impacted families, ensuring the curriculum was relevant to the local context. The outcome was a comprehensive curriculum split into four modules, delivered through a series of workshops across a six-month period in 2022. The clear feedback from the first cohort emphasized the significance of trust in the peace-building process.

Dr. Nantawat Sitdhiraksa, a psychiatrist and Director of Thai Health Academy, who was instrumental in shaping the curriculum, reiterated this sentiment: "Without trust, nothing can be done in the Deep South. People crave help but grapple with knowing whom to trust." In light of this, the Thai Health Academy recognized the need for communities to be active participants, instilling a sense of trust and assurance that both they and their children would directly benefit from the program.

Integral to the curriculum were community visits, giving participants the opportunity to assume leadership roles, disseminating the curriculum's knowledge to more community members. These visits not only served to reinforce the lessons but also highlighted the benefits of tools like play therapy for children.

Furthermore, the curriculum championed experience sharing as a crucial trust-building method. It aimed to foster a genuine connection between service providers, whether from the government or civil society, and those affected by the ongoing conflict and violence.

Protecting the rights of children - A School’s Perspective

The program has already had tangible results. An example can be found in Narathiwat province's Ban Ta Ba school, a hub for children from conflict-affected areas. The school is home to 441 children, with over 100 of them boarding due to the high risks in their home environments. Risks that could include bullying, self-harm, sexual violence, and limited access to education and nutrition, particularly when parents work across the border in Malaysia.

Amidst these challenges, Pollawat Noodang, a TOT-trained counselor at Ban Ta Ba, has trained a 4-person team of counselors. This team plays a crucial role in monitoring and evaluating children, supporting ongoing cases, and implementing well-being and anti-bullying activities.

Noodang is responsible for overseeing 117 schools in the Thai-Malay border in Narathiwat province. He credits the training for transforming how he has been able to share what he learned to provide better support to children and teachers. "The TOT allowed me to train teachers to identify at-risk children through symptom observation and also integrate child rights and anti-bullying into the curriculum," he explained.

An NGO’s Perspective

NGOs have also felt the ripple effect of this program. Luukrieang, an NGO in Yala province, has been pivotal in supporting children affected by the ongoing conflict. Beyond education, they manage a network of health volunteers and operate a shelter for orphans. One innovative initiative, following their Training of Trainers completion, is the "Auntie Next Door" program. Here, local women, referred to as "aunties," are trained on child protection.

Mayuri Singdad, is a community health volunteer who conducts biweekly checks at 30 homes, surveying children's well-being. While she's had exposure to many health programs, she attests, "Luukrieng's training is the most extensive, teaching me case identification systems such as red, yellow, green coding."

For Mayuri, it's not about compensation. "Giving safety to the child is always our first priority," she affirms. "I do not do this for the money, I do it for my community. We are a family of volunteers." She further reveals her long-held ambition, "I wanted to be a nurse since I was very young but couldn't afford schooling. Luukrieang has provided me an avenue to serve my community as a health volunteer."

Mayuri is but one of the 63 dedicated individuals in Luukrieang's trained community health volunteer network in Yala. They convene monthly, discussing current cases, sharing insights, and strategizing for the future.

This melding of human rights with the teachings and traditions of Islam has been crucial for the predominantly Muslim population of the Deep South. By aligning the universality of human rights with religious tenets, the training program bridges cultural gaps, fostering sustainable peace and resilience.

The accomplishments of the Training of Trainers (TOT) curriculum and network are undeniable in their role of bolstering support for the children in the Deep South. As of December 2022, the Thai Health Academy reports that the regional TOT network has grown, now boasting over 500 participants. The reach and depth of its impact are recognized by Mr. Steingrimur Sigurgeirsson, Advisor at the Ministry of Foreign Affairs of Iceland and a significant donor to the Human Rights Inclusion and Empowerment Trust Fund. He proudly acknowledges, "This project is serving the most vulnerable groups in the region– the disabled, LGBTI+, women, and children."

The TOT network aims to further engage with young individuals affected by conflict, offering them resources to turn past adversities into positive actions. This initiative equips community members with the essential skills and knowledge to assist youth impacted by violence, advocate for child rights, and boost their community's ability to tackle arising issues. With its ongoing growth, the TOT network brings together people from various backgrounds, all dedicated to ensuring a better future for the children in the Deep South.