Notice the guy on the tourist's back has no harness or other safety equipment. He's just hanging on (for dear life) with hands and feet. Health and safety rules are somewhat different here.
Like elsewhere in Phuket, Karon Beach is massively over touristed and filled with the unappealing side of mass tourism : pushy restaurant, bar, massage staff trying to get you to go into their place. I'd strongly suggest getting a nice resort (I stayed here) where you don't have to go outside to get fed and entertained.
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