Nisea Nisani was curled on a plastic mat outside the hospital’s intensive care unit. His wife lay on a bed inside, battling for her life after a bomb blast.

There was some good news, said Mr Nisani, his eyes red and raw; although shrapnel had fractured both her legs, pierced a lung and torn into her diaphragm, his wife’s doctors were hoping to transfer her to another ward. At that point he would have to tell her that their nine-year-year-old son, Nisofin – their only child – had not survived.

“We’ve not yet told her, said Mr Nisani, wiping his eyes with a towel. “We thought it might damage her heart.”

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Mr Nisani’s wife and child, struck by a bomb blast last Thursday in the southern Thai city of Pattani, were the latest victims in an ugly, slow-simmering separatist insurgency that has transformed the region into a militarised zone.

While the casualty figures from most of the incidents of violence are low, the number of victims since 2004, when the insurgency restarted, has somehow crept past 5,000. More remarkably, this little-noticed violence is playing out just a few hours drive from holiday resorts and beaches such as Phuket and Krabi, packed with foreign tourists.

This week, in what observers hope will be a breakthrough, the Thai authorities are to hold their first openly-acknowleged talks with the most significant of several militant groups behind an insurgency that dates back to the 1970s. Thai military officials will meet with representatives of the Barisan Revolusi Nasional-Coordinate (BRN-C) in Kuala Lumpur, in an event hosted by the Malaysian government.

“It’s a big step for the Thai government,” said a national security adviser to the government of prime minister Yingluck Shinawatra, asking not to be identified. “It’s a huge political risk. But we want to get this it sorted out once and for all.”

The insurgency in Thailand’s deep south has its roots several factors. At its heart is the fact that anywhere up to 90 per cent of the population of Narathiwat, Pattani, Yala and Songkhla – are ethnic Malay Muslims, rather than Theravada Buddhists. Three of the provinces once formed the independent Sultanate of Pattani, which was annexed only in 1909.

Those involved in the separatist movement say they are trying to protect customs, language and religious rights and to resist the migration of Buddhists to the south. Despite attempts by al-Qa'ida-affiliated groups to establish a handle here, it remains an insurgency drive by ethnic demands for greater autonomy rather than religious ideology.

The insurgents have taken their battle to the state with a combination of targeted assassinations and bombing campaigns. Alongside police and soldiers, many teachers and low-ranking officials have been targeted. The tactic of taking on such soft targets is designed to spread fear. Amnesty International estimates two-thirds of victims are civilians.

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Sapeing Sulong, who had eight children, was a deputy headman in Suannok, a quiet village 15 miles from Pattani. Ten days ago, he was driving to the house of the second of his two wives when gunmen armed with an AK-47 rifle and a shotgun opened fire.

Struck several times in his right side, Mr Sulong leapt from the vehicle and lay in the foliage by the edge of the lane, seeping blood. “This is where he hid,” pointed Mr Sulong’s step-brother, Lachit Singh, standing on a stretch of back-country road surrounded by rubber trees and paddy fields.

Local people heard the gun-fire but were too afraid to move. “The doctors at the hospital said if he’d been brought in immediately, perhaps he would have lived,” said Mr Singh.

At the home 55-year-old Mr Sulong built close to a mosque, his family declined to speculate on who was responsible for the attack, perhaps through fear. His boss, headman Ismail Leamo, said there had been no threats or warnings. “It makes no sense for us to say what happened to him,” he said.

But at the police station in the town of Kho Pho, where Mr Sulong’s bullet-ridden black Honda Accord was parked in a compound, officers had few doubts. “He worked for the government, he was an officer. Normally it’s the government officers who are targeted,” said a policeman who knew Mr Sulong but who asked not to be be named.

The Thai authorities have held a series of discrete, under-the-radar meetings with several of the insurgent groups since 2005 in Malaysia, Bahrain and elsewhere. Even now, former prime minister Thaksin Shinawatra, brother of the current premier, holds unofficial meetings with representatives.

Yet the talks have made little progress. The Thai government has often appeared distracted by domestic political turmoil or suffered from factionalism, while at the same time wondering whether the figures they were meeting with had control over the actual fighters.

The authorities appear to have been pushed to the negotiating table by several factors, including a growing realisation among those involved that the BRN-C was the most significant of the groups.

Tony Davis, a Bangkok-based analyst with IHS Jane’s, said the insurgents had also stepped up their attacks. In February, at least 16 insurgents were killed when they launched an assault upon a well-defended Thai marine base.

“In the last few years the situation has deteriorated on the ground with the insurgents attacking with increased capacity. The flip-side is that it’s more difficult for the authorities to keep saying ‘we are on the right track’,” he said.

The Thai state has responded to the insurgency by amassing up to 70,000 of police, soldiers and paramilitaries in the south. Today, the landscape is filled with army bases and journeys are punctuated by check-points manned by heavily-armed troops.

Campaigners say one fall-out of the militarisation is widespread abuse. Individuals are detained under emergency laws, held without charge and sometimes tortured, before being released or set-free by the courts.

At an office close to the Pattani river, Anukal Aweaputah, of the Muslim Attorney Foundation Centre, said that since 2004 he had represented 600 people accused of being linked to the insurgents.

He said the both the police and army were involved in torture, which had become increasingly sophisticated. These days taking someone’s clothes and placing the person next to an air-conditioner, hanging them upside-down and putting a plastic bag over somebody’s head were preferred to beating, which leaves marks. Were police or soldiers ever punished for such abuse? “Not once,” said Mr Aweaputah.

Sometimes the violence of the south slips from its boundaries. In the spring of 2004, Somchai Neelapaijit, a Bangkok lawyer went missing close to his home. At the time he had been representing five men from the south accused of attacking an army depot and stealing weapons.

His wife, Angkhana, said she believes his body was burned and thrown into the Mae Klong river. After endless lobbying, five policemen were arrested and one was found guilty of coercion but the judgment was overturned. “Everybody knows what happened. But they have no body so they couldn’t charge them with murder,” she said.

Those working for peace in the region say they consider the talks between the government and insurgents a positive step but expect few immediate results. “We support the dialogue. We want it to be a long and continuous process. We want people to understand the process and wait until it is completed,” said Soraya Jamjuree, of the Women’s Civic Network for Peace and a professor at Songkhla University.

It remains unclear what the government is willing to offer. During her election campaign in 2011, Ms Yingluck said she would consider greater autonomy for the south. Yet the national security adviser to the government said at this point “nothing is on the table”. The authorities want the insurgents to end the violence as a gesture of good-will.

Once again, it is unclear whether those representing the insurgents, a BRN-C team led by a man called Hassan Taib, have it in their power to halt the killings. It has been reported that many of the ‘old guard’ of the movement are unhappy with the insurgents’ tactic of assassinating teachers.

Among those murdered was Cholatee Charanchol, a physical education teacher at the Tangyong school on the outskirts of Narathiwat. On January 23, Mr Charanchol was overseeing lunch in the green-painted cafeteria alongside the main building when two men approached him, took out hand-guns and shot him in the head.

Mr Charanchol’s seven-year-old daughter, Muhiyat, was among the pupils who saw everything.

At the family home, Mr Charanchol’s widow, Pausiah, said her husband, a 30-year teaching veteran, lived for the children and for his family. He organised football tournaments and on occasions would load a flat-bed truck with pupils and take them to Pattani to watch a local league game.

Mrs Charanchol said she had received compensation from the government and that the education fees of her three children would also be taken care of. But she worried how she would cope with her two boys, Mohammed, 11, and 14-year-old Mubarak. “It will be hard. I cannot be a model for my sons,” she said.

As she spoke, Muhiyat was completing a drawing with crayons. She had drawn a village with a football field located next to her home. There were three green hills and two yellow suns.

Mrs Charanchol said that in the days after the shooting, a psychologist from the hospital had come to visit the little girl. They had moved her to another school but she was now frightened her mother would be killed next.

“She is a strong girl,” Mrs Charanchol said quietly. “I try to stop her talking about it. I want her to forget it.”