Esther Banales
UNITED NATIONS, Jul 15 2010 (IPS) – The fragile health system in the cash-strapped Democratic People s Republic of Korea (DPRK), long described as one of the world s most secretive countries, is on the verge of collapsing, Amnesty International (AI) warned Thursday.
In a report released here, the London-based human rights organisation said the situation was so dire that amputations and other major surgeries were being done without anaesthesia.
The hospitals and clinics in the country are rundown and operate with frequent power cuts and no heat and, even though free health care is guaranteed by law, doctors don t receive salaries and have to charge their patients, sometimes in cigarettes or clothes.
Medicines are supposed to be provided in hospitals for free, but AI says that citizens accept as common knowledge that they are sold through black market vendors, who also give advice on their use to the uneducated population.
Among the most popular drugs sold is jeong tong pyeon, a highly addictive painkiller derived from opium.
Every citizen of DPRK is entitled to free medical care to the full, an official at the DPRK mission in the United Nations told IPS. The universal medical care system of DPRK is the full free service; no fees for medicine, vaccination, medical examination, surgery, etc. All medical persons are adequately paid by the government.
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DPRK is a state party to the International Covenant on Economic, Social, and Cultural Rights (ICESCR), which obliges members to protect the rights of the population to the highest attainable standard of health , as noted in the Amnesty report.
Information provided by AI is based on the testimony of 40 North Koreans who left the country between 2004 and 2009, some of whom lived near the border or had relatives in neighbouring countries who provided them with better access to health care than other citizens would enjoy.
Several refer to the widespread practice of mixing wild foods like tree bark and weeds with grains in order to make food go further . This custom has a huge impact on health and increased 20 percent by 2008, according to the World Food Programme (WFP) and the United Nations Food and Agriculture Organization (FAO).
The DPRK government has not accepted humanitarian assistance from the United States since March 2009, according to the report due to strained relations , and requested the World Food Programme (WFP) to refocus its operations from the original 131 counties and eight provinces to the current 65 counties and seven provinces, as the WFP website explains.
The operations were refocused due to the sustained poor resourcing situation, Lena Savelli, WFP s spokesperson for the DPRK, told IPS. Available food stocks and resources were prioritised for upholding distributions of fortified foods to the most vulnerable groups, women and children.
Meanwhile, data published by WFP shows that 33 percent of the population is undernourished.
With the current size of operations and available resources, WFP is only able to address part of the food gap faced by the country, Savelli explained. So far in 2010, WFP has distributed some 40,000 metric tonnes of food to hungry North Koreans and a further 44,250 metric tonnes is planned until the end of the year, should sufficient funding be made available from donors.
Savelli said that the lack of donor funding is still a major challenge that frequently forces us to scale back activities, remove certain beneficiary groups from distribution lists, limit food assistance to partial rations of fortified food, and cancel projects under food for community development .
In April, Margaret Chan, director-general of the World Health Organisation (WHO), visited the country and said that notable achievements had been made in the areas of immunisation coverage and maternal and child health.
However, the report indicates that conditions are still severe. The former director-general of the WHO, Gro Harlem Brundtland, told the press in 2001 that DPRK s health system was near collapse and that equipment, medicines, electricity and money were needed to prevent a major health crisis.
Currently, according to Savelli, one-third of children under the age of five are stunted and a quarter of pregnant women are malnourished. Among the 2.5 million people targeted by WFP, 80 percent are described as vulnerable groups , who are provided nutritional support.
WFP supports 11 local factories that produce the food in- country, Savelli noted. To ensure the assistance gets to the women and children that need it, the food is distributed through child institutions orphanages, kindergartens, nurseries, primary schools and hospitals.
In the report, Amnesty International urges the North Korean government to ensure that the state meets its national and international obligations to respect, protect and fulfill the right to health. It also encourages the DPRK to cooperate closely with the U.N. in addressing food insecurity, health and other related issues in the country.
The international community is called on to ensure that the provision of humanitarian assistance in North Korea is based on need and is not subject to political conditions.
The government welcomes international cooperation in the health area, the DPRK official told IPS.
