It may seem hard to maintain a ritual of cleansing in Phuket, Thailand’s centre of sin and decadence, but once a year it’s easy to join in with the Thais on this nine-day purge, which starts this year on 8 October. Buy a white festival outfit from a local stall for a couple of dollars and secure a place on Ranong Rd around 8am to watch the morning procession. Be warned, though, that the tempting mango-and-sticky-rice you buy for a streetside breakfast that morning might not stay down after what follows.

An eerie, expectant quiet surrounds the town centre as clusters of expectant people line the roads. Firecrackers and drumbeats to ward off evil spirits break the silence, and wafting smoke fills the air as the macabre parade begins. As the first participants – known as mah song, or ‘horses of the gods’ in Thai – pass by, you may feel your stomach lurch at the sight of the large, shiny and pointed objects thrust through their cheeks. Trickling blood drips gruesomely onto their torsos, blending into their brightly coloured traditional costumes.

As horrible as it is to watch, it’s hard to prise your eyes away from the unfathomable lengths some of the participants go to. Women in traditional pink garb thread matching parasols through their cheeks. Some mah song menacingly slice their tongues with axes, while others carry the frame of a child’s three-wheeled plastic bike through holes in their skin. Even more terrifying is the size of the rifles chosen by some, balanced by faithful supporters on either side. But it doesn't end there: swords, daggers, flowerpots – everything and anything is fair game.

The cutting ceremonies take place at the six temples located around Phuket Town. Head to one before the procession to watch the faces of the mah song being carefully sliced open and disinfected (and also afterwards to see the instruments withdrawn). Individuals choose their own objects, and some seem to compete to fit the heaviest, bulkiest or strangest item through their cheeks – it’s believed that the more pain they feel during this event, the more success they’ll enjoy in the coming year.

The mah song are specially chosen to shift evil from individuals and bring good luck to the community, and it's claimed that they feel no pain as they march around Phuket Town in a trance for two hours, ‘possessed’ by the purifying spirits of the Nine Emperor Gods, who they believe will protect them from any harm or scarring.

But the mutilation is not the only part of the process. All Thais must adhere to ritual cleansing activities during this period – including abstaining from alcohol, meat and sex – to ensure good health and peace of mind. The festival originated when a visiting troupe of Chinese performers fell ill, and practised some of these rituals in order to recover. (Some mah song today are supposedly able to suddenly and unexplainably speak Chinese, with no previous knowledge of the language.)

Once you've had enough of the bloodshed and your stomach is feeling settled, wander along Ranong Rd, which is lined with festival stalls selling rainbow-coloured varieties of freshly squeezed juices and delicious vegetarian food – a special delight for non-meat-eaters, who may often find regular Thai markets a bit of a gamble. These stalls stay open from dawn until very late and offer everything from Thai salads and curries to pad thai and other dishes with a Phuket twist – especially their version of the humble fried potato, twirled on a stick and coated with tom yum flavour.

The afternoon is a good time to grab some food and head to the beach until the festival’s night-time ceremonies begin, when participants undergo further trials of faith in the temples of Phuket Town: common themes involve bathing in hot oil, fire-walking and climbing ladders made of daggers. (Ask at your hotel to find out which temple will be featuring which activities that night.)

If you’re visiting Phuket specifically for the festival, you won’t want to miss the closing ceremony – the final send-off to the gods. Get to the Phuket Rd roundabout early to secure a place; we recommend sitting at a windowside table inside a restaurant as Thai festival-goers, particularly the youngsters, like to throw firecrackers into the streets at night. The final parade begins with deafening thunderclaps and drifting smoke as group after group of Thais in robes hoist in the air golden shrines covered in more fireworks than you’ll see in the USA on Independence Day. Though it may seem like a big party, keep in mind that this is an important spiritual event for the locals, so please be respectful.

The closing ceremony is frightening and exhilarating at the same time – it almost makes you feels like you’re in a war zone, which is perhaps not surprising for a festival of so many contradictions. Celebrating peace, faith and good health through self-mutilation and deprivation, through fire, rockets and a general atmosphere of anxiety, this annual event is a fascinating way to see a very real slice of life in Phuket.

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