North Korean health system in crisis

By staff writers/ Mercury

July 16, 2010 8:46am

SURGERY without anaesthetics and unsterilised needles illustrate the desperate state of North Korea's healthcare system.
Food shortages have persisted since the 1990s famine and some North Koreans survive partly on grass, tree roots and bark, the rights group says.
The communist state says healthcare is free for all, but Amnesty says many witnesses have told it they have been paying for all services since the 1990s.
Doctors are usually paid in cigarettes, alcohol or food for consultations and take cash for tests or surgery.
"If you don't have money, you die," the report quotes a 20-year-old woman refugee as saying.
The report, citing World Health Organisation figures, says the North spends less on healthcare than any other country - less than $US1 per person per year. Amnesty says its report is based on interviews with more than 40 North Koreans now living overseas and with health professionals in the country.
It paints a grim portrait of hospitals lacking anaesthetics and medicines, with unsterilised needles and bloodstained sheets.
A 24-year-old defector from northeastern Hamkyong Province told Amnesty that a doctor amputated his left leg from the calf down without administering anesthesia after his left ankle was crushed by a train when he fell from one of the carriages.
"Five medical assistants held my arms and legs down to keep me from moving. I was in so much pain that I screamed and fainted from pain," said the man, identified only by his family name, Hwang. "I woke up one week later in a hospital bed."
Doctors also often work without pay and have little or no medicine to dispense, and must reuse the scant medical supplies at their disposal, the report says.
The report quotes a 56-year-old woman from the northeastern city of Musan who had her appendix removed in 2001 without anaesthesia. "I was screaming so much from the pain, I thought I was going to die. They had tied my hands and legs to prevent me from moving," she said.
Amnesty says many people bypass doctors and go to the markets to buy medicine.
Catherine Baber, Amnesty's deputy Asia-Pacific director, said the North failed to provide for the most basic health and survival needs of its people - "especially worrying as North Korea fights a tuberculosis epidemic".
Quoting WHO figures, the report estimates that 5 per cent of the population of 24 million are infected with tuberculosis. Pyongyang has begun refusing US food aid despite a 2008 UN survey showing 9 million people do not get enough to eat.