The young man wears only shorts. He is drenched in sweat, tears welling from his eyes. As he stares straight into the blinding morning sun, he moans intermittently – clearly, he is in a great deal of pain.

A huge dragon rears its head above the man, its golden scales bathing the street in an ethereal light. Its lithe, shining body stretches through the morning traffic, surrounded by hundreds of people, most of them ethnic Chinese, dressed in white. The dragon’s fangs snap together and its head jumps onto a slowly passing pick-up truck. A crowd of drummers surrounds the vehicle.

The man tries to turn, but soon gives up. The two steel tubes that pierce his cheeks are so heavy they stretch his skin downwards across his jaw. Two excited boys in white hold the tubes. Their eyes are bloodshot. They are hooked on the blood that flows in a thin line out of the corner of the man’s mouth.

The man with the steel tubes rammed through his cheeks has rushed past me. He has been walking the streets of Phuket town since 6am. Many others follow, bleeding, howling, shaking their heads. They are the chosen ones this year.

The Vegetarian Festival started when a Chinese opera company visited the island of Phuket, in Thailand, some 180 years ago and fell ill during its stay. The actors ate only vegetarian food for a month, and made a full recovery. Local people were duly impressed, and the incident is still honoured today. Every year, hundreds of men walk the streets of the city for several days, piercing their cheeks with anything from knives to umbrellas to table legs.

For nine days, the blood flows, the crowds of locals jostle for a better look, and the tourists who have braved it are almost certain to turn pale and nauseous at least once. But there are few foreign spectators for the daily processions, despite the town’s close proximity to some of Thailand’s most popular beaches and international tourist resorts.

Khun Chai is 46 years old, a veteran of the festival who has been participating in processions for 20 years. His eldest son is also a devotee.

“I don’t choose to do this,” says Khun Chai. “I am chosen by the god, the god of my temple. I first got pierced 20 years ago. At that time, we only used needles. These days local people produce implements for piercing.”

Anything will do, it seems, from swords and daggers, to candles, chillis and straws. Even sharpened, ornately carved table legs, lawnmowers, small sailing boats, shards of glass, bicycle chains or two-metre (6.6m) metal poles weighed down with pineapples are used.

“This is not a macho thing. We get pierced, but we represent the entire community, and we take the bad luck from local people by what we do. The piercing is like a sacrifice.”

Khun Chai is an adherent of Bang Neow Temple, one of six Taoist Shrines on Phuket that organise the festival. While the event stretches over nine days, Chinese Thai adherents to these temples, and others across the country, don the white clothes that must be worn and observe strict rules for a month – no meat, no alcohol, no drugs, no sex, no lying, cheating or killing and no wearing of leather.

Khun Chai explains: “We eat vegetarian for the entire festival. My family eats the vegetarian food only on the first day, after that I am alone. The men who get pierced stay in the temple for the duration of the festival. We abstain from sex and alcohol. My family accepts what I do. My wife has to accept it, I am chosen by the gods.”

The young men and women (few of the latter) who are chosen to pierce themselves, and hence carry the sins of all others with them, can be either complete novices or festival veterans. Some of the men’s faces, like Khun Chai’s, are scarred from years of repeated cuts. Others, especially the girls, still have smooth cheeks, and are about to change their appearance, however slightly, forever.

To be chosen is to become a ma song, an ‘entranced horse’. These men and women are said to have supernatural powers and to bring good luck to the community.

Perhaps the most incredible thing about the entire event is the fact that, here in Thailand, the participants are not perceived as freaks or eccentrics. Many of the men in the procession are also heavily tattooed, some with biker designs, others with protective spells applied by monks in Khmer script. Again, this is so common that it doesn’t raise any eyebrows.

Women are rare amongst the self-mutilators. Bang Neow Shrine does not have any female devotees, although another shrine – Bantharue Temple – has a number of women ma song. Sticking to more traditional values, the needles the women use are short, thin and sharp. Local people seem to be especially keen to be blessed by these pierced ladies who walk the streets in their flowing white gowns.

I leave Khun Chai in the temple yard and follow the procession into a wall of fog. Firecrackers explode all around, and a local Chinese deity, carried on a float by four bearers in yellow T-shirts, follows in the wake of the dragon. Other festival-goers carry long bamboo poles with hundreds of red firecrackers attached in long belts. They all light up at the same time. The noise is incredible, even painful. The street explodes in a shower of sparks and red paper, which soon covers the tarmac ankle-deep, like printed blood. The bearers try and duck under their god for protection. The men with the poles lower the firecrackers directly above the floats. Red shards of paper rain from the sky and cover everyone and everything. The float is completely obscured by a cloud of small explosions. Bits of firecrackers fly in all directions – untamed pyrotechnics at their most dangerous.

Young men with steel rods through their tongues and cheeks stand around the bearers, taunting both audience and fireworks.

Another pole of firecrackers ignites above my head. The bearers bend underneath the float. One man, a small podgy guy, stands in front of the float, in front of his God, hands raised, looking towards the sky and screaming at the top of his voice. I can’t hear him but I can see the scream. For a second we make eye contact. I feel like I’m looking at something more. He smiles and screams, madly, insanely happy to be standing in this cacophony of noise and red paper rain.

During the main three days of the processions, about 100 pierced men, supported by small groups of friends and relatives, share the roads of Phuket with thousands of locals, many of them carrying the floats on which Chinese deities are mounted. Phuket’s Chinese inhabitants line the side of the road. Many shops and houses have set up small shrines in front of their doors. The pierced give their blessings. They hand out sweets and fruit, while continually shaking their heads manically from side to side. The locals, rows and rows of white-clad figures, standing in front of the beautiful two-storey 19th-century Sino-Portugese houses, watch with respect, and welcome any pierced man or woman, no matter how crazed he or she might seem. The pierced, if they can talk, intone blessings.

A huge copper bowl is mounted on a small cart. The bowl is filled with boiling oil. Several big, bare-chested men dance around the float, wildly waving towels about. Every now and then, they dip the towels into the hot oil, form a wide circle, and flagellate themselves, with much noise and violence. Their skin turns from brown to red, their tattoos fade under a film of sweat and blood.

Another group of tough guys, also stripped to the waist, carry steel axes. They form impromptu circles and start licking the blades. Soon the blood flows all over Phuket town.

Khun Chai is not too impressed by some of these efforts. Bang Neow Shrine is conservative by festival standards. “No chair legs or huge contraptions here. We only use knives, swords and other small items.”

Khun Chai is unnecessarily modest. His eyes are bloodshot, and his cheeks are crossed with small scars of dried blood. He looks his age, and more. Most of the men who get pierced – more often Thais than Thai Chinese – are also heavily tattooed; they look as if they live hard lives. It seems that the Taoist gods prefer their avatars to be tattooed maniacs.

Khun Chai agrees: “Yes, an awful lot of the men have tattoos. Some have their tattoos done in Buddhist temples. My tattoos were done in a temple in Phuket, but the monk has been long dead. Now my son tattoos me. But the men are not to be judged by their looks. It is a man’s personal behaviour that decides whether he is good and respectable or not.”

In the afternoon, a wide curtain of thousands of fire-crackers is draped across the main gate of the Bang Neow Shrine. Temple orderlies, dressed in white, are milling excitedly in the yard. The noise on the street is drawing closer. The sounds of drums and shouting spill into the compound. One by one, the pierced men enter through the curtain of fireworks into the yard, supported by their friends. Some stagger; others strut. Some look happy to be released from their tortures; others have clear bright eyes, filled with spirit and pain. The fire-crackers go off as the first float enters the yard, which explodes in a great crowd of dust. Thousands mill around the exhausted men, who slowly remove the outrageous variety of implements from their faces. Medics patch up the worst cases with plasters and Chinese paper.

Freed of their physical tortures, the ma song head for the prayer hall. In front of their deity, many convulse, calmed by temple orderlies, slowly deflating back into ordinary human beings, caked in blood, but filled with divine glory.

End