Ootepew lies with his withered leg under a mound of coarse blankets, his face stoical as he awaits an amputation. It is more than a week since he trod on a landmine outside his home in Burma's Kayin state, and his wounds have begun to fester. In a messy and bitter war between insurgent groups and the Burmese army that has spanned decades, this clandestine killer has become the weapon of choice.
Burma is the only regime in the world still planting landmines. A tenth of the Burmese population live just a few ill-chosen footsteps away from a blast that could maim or kill, according to the International Committee to Ban Landmines (ICBL). Despite this, the Burmese authorities still churn out mines modelled on old Chinese and US designs at the state-run ammunition factory.
The actual number of mines produced each year is unknown outside of the Burmese military, but it is likely to be in the thousands. "The anti-landmine campaign has been extremely successful: each year land has been cleared and stockpiles destroyed. This is simply not the case in Burma," says Yeshua Moser-Puangsuwan, research co-ordinator of the ICBL, a network of organisations that won the Nobel Peace Prize in 1997.
The Burmese government has long operated behind a veil of secrecy, making access to the nation's landmine casualty numbers extremely difficult. The ICBL counted 2,587 in the 10 years to the end of 2009 – 183 killed, 2,207 injured and 197 unknown. The actual figure is certain to be far higher. Ten years ago, Burma was in the top 10 countries for mine casualties. Five years ago it was in the top five. For the past three years it has been in the top three. The most recent data shows an average of around 4,000 landmine casualties globally each year. In every country in the world the number of casualties is dropping, apart from Burma, where they have remained high year on year.
Only Colombia and Afghanistan have more mine deaths and injuries each year than Burma. These two worst-offending nations are signed up to the 1997 Mine Ban Treaty, have destroyed their stockpiles of weapons, and are involved in a programme to de-mine. Burma is alone in having a widespread and relentless problem and doing nothing to address it.
The government's justification is that the country has long borders and a problem with people trafficking and drug running. But, as Yeshua Moser-Puangsuwan explains: "Mine warfare in Burma is simply accepted military doctrine and it doesn't get reviewed."
Over the border in Thailand lies the hilltop town of Mae Sot, a halfway house for Burma's refugees. Burmese women with white circles painted on their cheeks and men draped in wrap-around lungis populate every corner. The Thailand Burma Border Consortium estimates that around 142,000 refugees live in camps around Mae Sot.
The sprawling humanitarian heartland of medical facilities and aid agencies faces the quagmire of shattered lives, displacement and disease caused each day by the war in Burma. The spectacle of those such as 70-year-old Ootepew, limbs crushed and writhing in agony, is familiar here. But the elderly patient is impassive, he just once betrays his emotions – when asked about his repatriation his sunken eyes flash a look of fear.
The Burmese military leadership and ethnic minority rebels have been locked in a brutal and volatile conflict for 50 years. In their struggles for autonomy, many insurgent groups have become caught up in long-running feuds with each other and splinter into new groups to take up arms.
When asked about the origin of the mine that mangled his leg Ootepew is unequivocal: it was the junta that planted it. Ethnic refugees, victims and campaigners in Mae Sot often solely level blame for landmine atrocities at the regime. The reality is more complex: the ICBL has counted 17 different militias scattering landmines in Burma since 1999. Burmese villagers are determined to ensure the junta is held responsible for every aspect of the humanitarian disaster, while the warlords who head the militias play Russian roulette with the lives of those in their own communities.
Government-made landmines are powerful enough to kill instantly. The rebel devices – rudimentary bombs consisting of a glass bottle stuffed with nuts and bolts – deliver bone-shattering, dirty wounds, much like Ootepew's injury.
Survivors face an amputation without anaesthetic in a wooden hut in the jungle, after which they will attach a bamboo shoot to their stump and attempt to walk. When the rebel landmine kills, it is a slow and painful death caused by gangrene or other infections. A lucky few, like Ootepew, are helped by friends to drag their shredded limb across the border to Thailand.
Agencies covertly collecting data on landmine "accidents" have recorded a spike in the number of victims spilling into Mae Sot since the start of the year. The recent influx started with an officer of the junta treading on an explosive device, sparking a wave of violence.
Dr Cynthia Maung is a witness to this upsurge. The Karen refugee arrived in Mae Sot more than 20 years ago, one of many pro-democracy activists who fled during the violent crackdown on the 1988 student uprising. She set up a clinic to help the tide of injured and displaced people turning up every day, and her workload has since sizeably increased.
From inside her makeshift accident and emergency unit, the walls of which are lined with posters of Aung San Suu Kyi, the soft-spoken, weary-looking doctor says: "The people who come here don't know who they are. Many have been on the run for so long that they don't know where they're from or when their birthday is."
Ootepew will come here once his leg has been severed, as Dr Maung has established a dedicated prosthetic limb clinic. A Burmese woman, Mya Aye, has become a permanent resident since having both her legs blown off by a mine. Her torso lies face down on a flimsy bed in a hut, her two disused prosthetic limbs rest by her bed.
The International Committee of the Red Cross estimates the total number of amputees in Burma to be 12,000, of whom the majority are likely to be landmine victims.
A recent undercover investigation by two European charities revealed widespread use of child soldiers, human shields and forced labour by both the junta and rebels. More than 800 mine victims were interviewed. The findings showed that children and villagers were forced to walk through infested areas to check for mines. Of the victims in the study, 13 per cent were children and around half were civilians.
The biggest thorn in the side of groups such as the ICBL is their inability to engage the government. There has been no official comment since 2009, when a foreign ministry representative spoke at a regional mine ban workshop in Bangkok. The government has shunned UN meetings.
Although rebel weapons contribute a significant part of the landmine blight in Burma, aid agencies argue that a strategy to combat the problem must start with the leadership. "If the authorities in the country can't join the Mine Ban Treaty today, they should at least order a moratorium on any new mine use and make serious offers to negotiate with the armed insurgency," says Yeshua Moser-Puangsuwan.
The junta refuses to stop planting mines so long as the rebels continue to do so. The rebels, meanwhile, scatter explosive devices to ward off attacks by the junta. This puts the warring sides in a permanent state of stand-off, with innocent victims like Ootepew in the line of fire. Should current conditions prevail in Burma, where tensions can flare up again at any time – the tragic human waste from the insidious weapon lurking in the jungle will continue unabated.
Last November's election, the first in Burma for 20 years, was dismissed by western powers as a sham.
Aung San Suu Kyi's National League for Democracy boycotted the vote and a pro-junta party stormed to victory with an almost 80 per cent majority.
The new president, Thein Sein, is one of several generals of the junta who shed their uniform to contest the election. Although the military has officially handed power to the new government, members meet for just 15 minutes a day.
In such conditions the nation's scattered arsenal of explosive devices is unlikely to top the agenda. Meanwhile the human detritus lies strewn across the jungle.