GoodFriends: Research Institute For North Korean Society

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North Korea Today No. 373 November 2010

[“Good Friends” aims to help the North Korean people from a humanistic point of view and publishes “North Korea Today” describing the way the North Korean people live as accurately as possible. We at Good Friends also hope to be a bridge between the North Korean people and the world.]
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Central Party Instructs, “Increase the Import of Chinese Medical Supplies”
Urgent Treatment Needed for a Highly Contagious Tuberculosis Strain in S. Hamgyong
Patients Complain Long Waiting Time for Tuberculosis Medicine
Normal Doses of Tuberculosis Treatment Fatal to Malnourished Patients
Veteran Punished for Singing a Folk Ballad
Body Searches Intensify Amidst Harvests in Eorang County
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Central Party Instructs, “Increase the Import of Chinese Medical Supplies”
The Central Party has decided to increase the weight of Chinese medical supplies among the imported medical supplies. Usually, the hospitals for government officials imported medical supplies and used them. French medical supplies were mostly used in Bonghwa Clinic which treats the high-ranking officials in Pyongyang (higher than ministerial level), German medical supplies were used in Namsan Clinic which treats the vice ministers (vice minister level), and Russian medical supplies were mostly used in Chosun Red Cross Central Hospital, Pyongyang Medical University Hospital, and Kim Man Yu Hospital which treats the general government officers under vice minister level. Sometimes, the dong (ri) clinic which is used by the ordinary residents is equipped with the medical supplies furnished by UN, but more likely than not there is no medicine. The ordinary patients end up purchasing medical supplies in the market by themselves and go to the hospital to ask for treatment. Most of the medicines that are circulated in the market are from China. Sometimes medical supplies manufactured by Soonchun pharmaceutical factory or private individuals are circulated, but the amount cannot be compared with the ones imported from China.

According to a medical officer in Pyongyang Health field, the hospitals for government officials use approximately 30% of Chinese medical supplies and less than 5% of domestic medical supplies; the rest of them are imported goods from places like France, Germany and Russia. Until the manufacture of domestic medical supplies is stabilized, the Central Party instructed to gradually increase the weight of the import of Chinese medical supplies as it takes less distribution costs and the effect is not very much inferior considering its cheap price. The medical supplies imported from places like France, Germany and Russia are less effective and even harmful sometimes because even if they may be medicines of sovereign virtue, they are the expired drugs at a giveaway price. The hospital grinds them, uses them to make domestic medicines, and sells them to the clinics used by ordinary citizens. It aggravates the illness or even kills the patients as they use the medicine believing they are good.

The doctors who currently work in the clinic say that they have to bear with such side effects due to the critical shortage of medical supplies. Especially, the residents suffered severely this year because various diseases were running rampant due to the flood damages and antibiotics were in short. The situation in Pyongyang City was not particularly different, and Lee InYoung (alias), a doctor who works in the dong [smallest level of urban government] clinic, says that he was not able to help patients from dying as a result of waterborne disease because there was not any solutions. When it was reported that the mortality from the lack of medical supplies has increased even in Pyongyang, the Central Party instructed to reorganize the medical supply import guidelines and to fill the certain number of medical supplies by importing more from China. “Even if we import Chinese medical supplies, most of them will go to the government officials, but the government officials will do so if they can purchase better medicines,” Mr. Lee anticipates. “These Chinese medicines will be sold in the clinic in each dong or region, and the residents will use them eventually.”


Urgent Treatment Needed for a Highly Contagious Tuberculosis Strain in S. Hamgyong Province
Although the Second Center for Disease Control and Protection of Hamheung City, South Hamgyong Province, announced that the number of registered tuberculosis patients is more than a thousand, officials have not been able to determine an exact figure. Yet, a Hamheung City physician in charge of tuberculosis patients claims that the number of individuals with open tuberculosis alone is in the thousands. This disease is so highly contagious that infected patients should receive treatment immediately, but most patients do not seem to show critical concern for their condition because they are poor. Moreover, while some patients do not even realize that they have symptoms, others view treatment as overindulgences because they can scarcely feed their family and themselves.

Unfortunately, the Center for Disease Control and Protection does not have adequate resources to manage this problem and locations in the South Hamgyong Province often turn away infected individuals. Only very critical patients are hospitalized.

Although patients with open tuberculosis may go to a sanitarium where they receive treatment and carry out simple work to feed themselves, such as growing vegetables, most do not have the ability to do so. Formerly, patients received rations by turning in a provision suspension certificate. However, a ration distribution program no longer exists. Thus, individuals who want to go to the sanitarium must provide for themselves.

Even patients in tuberculosis wards cannot expect to receive appropriate treatment. First of all, medication is on short supply. Second, patients are generally malnourished. As a result, the effectiveness of treatment is very low. In October, when temperatures fell below zero, many patients’ conditions were exacerbated with common colds. The death toll accordingly increased greatly, and during the last week, the daily average of patient fatalities was nine to ten. Although hospital officials were embarrassed with this increase, they could not find a way to resolve the predicament.

Patients Complain Long Waiting Time for Tuberculosis Medicine
The security authorities of South Hamgyong Province asked the Central government for medicine as they determine that the status of tuberculosis patients in the Province in the second half of the year has become unmanageable. The Ministry of Health rushed a good amount of medicine so that they can deal with the urgent situation. As the rumor of medicine spread a large number of outpatients began to swarm to the hospital. Even though they are outpatients most of them have not visited the hospital for a long time because the medicine was not there. They come to the hospital at 8am to get the medicine. As the number of new patients increases the number of patients trying to receive the drugs also increased. It used to take less than an hour to see a doctor including the waiting time. Now, it takes several days to be examined by a doctor and receive medicine. As such, the level of complaints from patients and their family is rising due to prolonged waiting time.

Suh JaeKuk (alias) expressed his anger, saying that the problem lies with doctors playing tricks to profit from the situation rather than the higher demand for drug. According to him, it is because “doctors are trying to get bribes from patients with cigarettes or things they need.” Despite the extra supply of medicine, the amount of available drug is still limited. As the demand for TB drug rises, doctors naturally take advantage of the situation and profit from it. They call patients to come to the hospital, which might take a few days to visit, and give only a tiny amount of drug less than the normal dose. Some patients criticize, “They want to keep you sick so that you have to be dependent on the drug longer. That is why they give you only a little amount of drug.” Since doctors are not immune to the food crisis, they often appropriate some medicine and sell it out in the market, or they accept bribes in return for drugs. However, a doctor at Hamheung Second Hospital disagrees, saying there is misunderstanding. One cannot deny the existence of some corrupt doctors profiting with bribes, but in fact, doctors often have to adjust the amount of drugs given to weak patients because taking a normal dose of TB drug could do more harm than good if the patient is suffering from malnutrition.

Normal Doses of Tuberculosis Treatment Fatal to Malnourished Patients
An experienced doctor who has been working in the tuberculosis division of a hospital for fourteen years says that injecting normal doses of TB treatment to patients is sometimes hazardous. “We [in North Korea] use three types of TB medications: streptomycin, isoniazid, a TB vaccine, and rifampicin (tubocin) for vicious TB. While rifampicin used to be imported from abroad, streptomycin and isoniazid were formerly mass-produced in the Sooncheon Drug Factory and in factories in Nampo, Pyeongyang as well as Hamheung respectively. Accordingly, rifampicin was scarce and only used for emergency cases. Streptomycin and isoniazid, on the other hand, were readily available. However, since the 1990s economic crisis, drug factories failed, and the supply of streptomycin and isoniazid dramatically fell. These days North Korea receives rifampicin from the World Health Organization. One thing to note is that streptomycin and rifampicin are so strong that they can kill cells in the body. Thus, patients treated with these drugs must be well-nourished with protein. If patients cannot afford to eat meat, they should at least eat eggs. However, most cannot afford eggs either. Those without adequate protein will become weakened despite a proper course of medication. When severely malnourished, they can even be killed by normal doses of drugs. This is a great dilemma for doctors who cannot afford to feed patients. The only thing doctors can do is adjust doses. Although people should eat well, they cannot. Consequently, the number of TB patients is continuously increasing,” he said in worry.

A Veteran Punished for Singing a Folk Ballad “The Moon that Lee Tae Baek Played Under”
According to an order of the People’s Defense Ministry Department of the General Staff, the nationwide “Civil Defense Drill” commenced on September 10th at the Sooncheon Cement Factory in the South Pyeongan Province. Labor for the project, repairing the river bank in the agricultural district under the inspection of the City Propaganda Department, was provided by the factory. In order to soften the atmosphere, department workers encouraged leisure activities for amusement among laborers during rest periods.

Factory workers reported that laborers sang songs and danced. Moreover, a veteran named Kim Hak Chul (false name), discharged from his military service in July of this year, melodiously sang his favorite song. Not only did City Party Propaganda Department workers and the Primary Party Secretary applaud Kim for his talent, the audience sang along and danced to Kim’s song.

After returning from the Civil Defense Drill, Kim’s ability became the talk of the factory and was reputed to be no less than that of a professional. The rumor continued for a week and ultimately came to the attention of Factory Security Department workers. They later learned that the song Kim sang was a South Korean folk ballad named Moon.

Representatives later contacted Kim in order to question his motive for singing a South Korean song in public. Kim was later assaulted and arrested. During his hearing, Kim declared that he was not aware the song was from South Korea. He further stated that he would manage the situation and thought that “[this song] was from his homeland because he learned it in the army.” He also begged to be pardoned and promised not to make the same mistake again.

The hearing continued for a week, and Kim was sentenced to six months in a labor training center for the crime of singing, and distributing knowledge of, a South Korean song in public. Although Kim’s parents cordially pled for leniency, their request was denied. Moreover, City Department workers and the Primary Party Secretary who ordered the formulation of the amusement gatherings were criticized and punished by the City Party Propaganda Department. The sentiment among laborers concerning the incident was bleak.

Body Searches Intensify Amidst Harvests in Eorang County
Under the order of the Ministry of Agriculture, the entire nation is busy with harvesting crops. In the North Hamheung Province, Provincial Party officials and the Provincial People’s Committee are being sent to every county and city in order to encourage harvest preparations with an ideology campaign. They are also monitoring the work DWU (Democratic Women’s Union) members as well as middle school and college students who have been deployed to rural areas by Eorang County officials from October 6th.

According to a Provincial Party official sent to Eorang County, this year’s yield will dwarf that of last year’s. Even the most productive collective farm, with a record yield of five tons of corn per one jeongbo (2.45 acres), is expected to produce less than 3 tons per unit due to this year’s abnormal climate. He also warned against losses, requesting that farm officers secure every grain and emphasized that respectable harvest records cannot be attained amidst the projected low yields and widespread thievery. Every year, hungry soldiers from a nearby army base as well as mobilized workers steal from the corn harvest, resulting in significant losses.

The official further commented to “watch the DWU members especially.” Following this edict, farms intensified their body searches to prevent workers from hiding grain in their clothes. DWU members typically steal in order to compensate their losses from not being able to sell at markets due to their forced harvest work. Women typically steal five to six cobs of corn daily. Although some collective farms decided to use young students for work in lieu of DWU members due to their presumed innocence, their decision ended in disaster. Middle school students not only steal as much as DWU members, who attempt to do so discreetly, they steal openly. Accordingly, a significant amount of reports received by local police stations are of instances involved with young students.

Nevertheless, DWU members report they have been stealing for many years. In order to bypass body searches, they make large pockets inside of their clothes to hide corn. In addition, they do not wait until they finish their work but steal whenever the chance arises, particularly on their way to lunch or dinner. In other cases, some people dig deep holes in the ground to hide corn and come back to retrieve them at night.

This almost comical dilemma repeats every year. Registered farmers attempt to curb thefts because of their obvious losses. Mobilized workers desperately steal because they know it will be difficult to survive through next spring if they do not gather contingency food during the harvest season. Despite the official announcement to tighten control over thefts, the response from residents is as follows, “Can the initiatives against theft work when people are starving?”


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