North Korea: Appalling health care failures costing lives on massive scale

“The government has resolutely maintained that it is committed to, and capable of, providing for the basic needs of its people and satisfying their right to food and a proper standard of health.  The testimonies presented in this report suggest otherwise.”

 So reads the opening paragraph of the Amnesty report The Crumbling State of Health Care in North Korea, released today. Accounts gathered from North Koreans who had recently left the country, as well as information provided by health care professionals and aid workers, suggest that the authorities in North Korea are failing the population in every conceivable way with regard to health. To summarise: Extreme hunger and malnutrition are rampant, with stunted growth in children commonplace; many people are forced to scavenge for wild food with little or no nutritional value, which often causes digestive problems; spending on medical care per person is alarmingly low and amongst the worst in the world; hospitals are unhygienic and poorly equipped, with amputations reportedly taking place without anaesthetic and with unsterilised equipment, and doctors are routinely paid in cigarettes or with scanty food rations, causing people to attempt to self medicate. In addition to all of this, contagious diseases and in particular an epidemic of TB, are currently gripping the country.

Grim reading indeed. There are accounts from young homeless orphans, who crushed up corn powder with tree bark to fend off hunger pains, and from an elderly woman, who had no relatives to assist her in paying for medical care and was forced to go without, as well as a young man who underwent a leg amputation without any pain relief. A 20-year-old woman, who had fled to South Korea, summarised the situation ominously as "If you don't have money, you die." So much for a free health care system, accessible to all. 

The picture is bleak, a desperate picture, says the Guardian. An underfed population, consequently vulnerable to illness and disease and without recourse to adequate treatment or medication. How can it be in this context, that the authorities persist in their insistence that provision is adequate? A series of failed government policies has compounded the problem as well as a rejection of substantial aid and intervention offers. They do not want to be seen to be in receipt of handouts.  They might not want to, but this is now a case of need, not want. And desperate need at that. 

The report’s primary recommendation is that food shortages are acknowledged and humanitarian assistance is urgently accepted. There are other recommendations too, and these also involve a focus on need. The authorities are urged to ensure the need-based and equitable distribution of health facilities, food aid, goods and services throughout the country; to cooperate with the World Food Programme and donors; to allow unrestricted access to independent monitors and to ensure that medical professionals are adequately and regularly paid. With top billing on the BBC’s revamped Asia-Pacific web site today, as well as an interview with the author on the Today Programme, let’s hope this report is not something that can be ignored by the authorities. You can read more about the report’s findings and recommendations here.