Archive for the ‘UNWHO’ Category

Maternal mortality rate increases sharply in N. Korea

Monday, October 15th, 2007


*View the UN report here

The number of North Korean women who have died while giving birth rose drastically in 2005 from five years earlier due to worsening health care conditions in the impoverished communist state, a report said Monday.

Maternal mortality rose to 370 per 100,000 births in 2005 from 67 in 2000, according to the report issued jointly by the United Nations Population Fund, UNICEF, the World Health Organization and the World Bank.

Although the rate is lower than the global average of 400 deaths per 100,000, it is 26 times higher than that of South Korea with the rate of 14 deaths per 100,000.

Sub-Saharan African countries have the highest maternal mortality rate of 900 per 100,000, followed by Southeast Asia’s 450 and East Mediterranean countries’ 420.

The comparable figures for the United States, the Western Pacific Ocean and Europe are 99, 82 and 27 respectively.

Blurb from report:

The MMR estimate for 2005 (370) was higher than the 2000 MMR (67). The predicted PMDF in 2005 was higher than in 2000, because the GDP estimate (in purchasing power parity) used in the 2005 model was approximately 75% lower than the estimate of US$ 14 996 used in the 2000 model.


Expert says N.K. becoming more open, better at dealing with national disasters

Monday, September 24th, 2007


North Korea is becoming more transparent and effective in dealing with disasters, spurred by both internal and external factors, an Asia-Pacific regional specialist said in his latest paper.

Dr. Alexandre Mansourov, a securities studies professor at the Asia-Pacific Center for Security Studies (APCSS) in Hawaii, noted five trends in the North Korean government’s responses over the past decade to nationwide shocks, including floods, typhoons, drought and avian influenza outbreaks.

Increasing transparency is one of the trends, with Pyongyang more quickly admitting to disasters that have struck the nation, he said in a paper (download here) released last week through the Korea Economic Institute in Washington.

It took North Korea several years to admit the impact of natural disasters in the mid-1990s that led to massive starvation and chronic food shortages. But in August 2000, when it was hit by Typhoon Prapiroon, North Korea released the news three weeks after it occurred, and in the two following years, when other typhoons struck, North Korea reported it within three to six days, Mansourov said.

Pyongyang immediately acknowledged flooding in August 2007, he said.

“Observers agree that the timeliness, details, and amount of coverage of flood damage and rehabilitation work in August 2007 is unprecedented.”

North Korea is also showing institutional knowledge and a capacity for disaster management, with new organizations growing out of a decade of learning and experience, such as various provincial centers, the professor said.

The North Korean Red Cross Society has been exceptional, he said, working with the International Federation of Red Cross and Red Crescent Societies, and has made itself the leading agency in disaster preparedness and response.

Inter-agency coordination has also increased, with deputy prime minister-level working groups working closely together in each disaster since the flood of 2001, as there are preventive programs through which basic relief supplies are stored in town and villages.

For example, the 10-year strategy against avian influenza, worked out by the emergency commission in 2005, would have been unthinkable a decade ago, Mansourov wrote.

Another notable trend is the increasing cooperation between the North Korean government and international humanitarian community, gradually allowing joint needs assessments and monitoring, he noted.

Mansourov argued that external factors helped bring about the changes.

“International factors did make a difference in what happened in (North Korea), especially through the introduction of innovative ideas and dissemination of best humanitarian practices,” in addition to foreign aid, he said.

The scholar also argued that while the country’s top leader, Kim Jong-il, does control any institutional changes, there is also adaptation driven by needs.

“There has been some degree of autonomous institutional learning and adaptation; it is incremental in nature and caused by both positive and negative feedback from the environment regarding institutional performance in crisis situations,” he said.


More Help Needed to Improve NK’s Public Health

Wednesday, May 23rd, 2007

Korea Times
Lee Jin-woo

A middle-aged American doctor who grew up in South Korea has stressed that it’s time to move on to helping North Korea with public health issues.

“North Korea’s food situation is at least better. We need to move on to public health issues including rebuilding the North’s nine provincial and 200 county hospitals,” John A. Linton of Yonsei University’s Severance Hospital in Seoul told The Korea Times in an interview on Monday. The 47-year-old doctor heads the hospital’s international health care center.

Linton, who is well-known for his Korean name Yin Yo-han and thick South Jeolla Province accent, proposed a three-stage medical support program for North Korea from the South Korean government.

“Number one, we need to help them with a vaccination program, which should be followed by supplies of diagnostic equipment,” he said. “The final stage should be an exchange of doctors between the two Koreas.”

He said North Korean doctors need basic diagnostic equipment _ ultrasound and x-ray machines, and clinical pathology supplies _ as well as more operating theaters.

“You have to have a healthy population in the North, for them to survive and become competitive enough to receive economic finance and business opportunities.”

He hoped that large-scale medical support to the North on a regular basis would be discussed during ministerial talks between the two Koreas in the near future.

“Nobody can argue with health care,” he said. “North Korea has been an enemy, but now at the same time they are brothers. Even if they are an enemy, you must help them.”

Linton, who visited the North 17 times between 1997 and 2003 to help eradicate tuberculosis in the Stalinist state, said it should be South Korea, not the United Nations or the World Health Organization (WHO), that needs to take the lead in helping the North.

“You have to be very, very careful with the U.N. and WHO. They treat the two Koreas as two separate countries differently,” he said. “Eventually policy should be looking towards unification. South Koreans should take the lead.”

Asked whether he is a big fan of South Korea’s engagement policy toward Pyongyang, dubbed the `Sunshine policy,’ he said he supports it wholeheartedly. Linton, however, emphasized the need to guarantee transparency in the process.

“We should not encourage some of the North Korean leadership as middle management is very corrupt. We should not reward corrupt people there. That’s not for us that’s for North Korea.”

His dedication toward helping the North was initiated by his mother, who worked to eradicate tuberculosis in Suncheon in South Jeolla Province for some 40 years. She decided to donate ambulances to North Korea in 1997.

“When we got there in Pyongyang, we suddenly received a special request from North Korea asking for assistance treating TB throughout the whole country,” he said. “We visited the entire country while helping them fight TB.”

In his autobiography published last year, Linton recalled his unforgettable experiences as an interpreter during the bloody Kwangju pro-democracy movement in May 1980.

He served as a translator to people who occupied the provincial capital against the then military regime led by former President Chun Doo-hwan.

“Immediately following this experience, I was labeled as an insurgent ,” he said. “The American embassy in Seoul asked me to leave Korea, just for translating for three to four hours for reporters.”

He said his experience in Kwangju changed his personal life and made him understand what injustice is and how dangerous newspapers are.

He said such a great sacrifice should never ever happen again on the Korean Peninsula.


About 16 million immunized against measles in N. Korea

Friday, April 20th, 2007

Kyodo News

About 16 million children and adults have been immunized against measles in North Korea in one of the fastest responses to a major outbreak of the disease, it was revealed Friday.

The mass vaccination was organized by the U.N. Children’s Fund, the World Health Organization, the International Federation of the Red Cross and Red Crescent Societies and North Korea after the government asked for help in February.

According to the international organizations, the immunization campaign was done in two phases, with 6 million children aged 6 months to 15 years vaccinated last month and 10 million people aged 16 to 45 years immunized earlier this month.

The campaign was arranged following the appearance of several cases of measles in North Korea last November. By February this year two adults and two children had died and more than 3,600 had been infected.

Measles had not been reported in North Korea before this outbreak since 1992, according to a joint press release from the international organizations involved, and many health workers in the country were unfamiliar with the disease.

“This was a remarkable example of good cooperation between different organizations,” said Jaap Timmer, the International Federation’s head of delegation in North Korea.

“The Red Cross mobilized more than 15,000 of its volunteers to visit families and explain the importance and benefits of the vaccination campaign.”

Measles is spread by contact with fluid from an infected person’s nose or mouth and is highly contagious. Symptoms include fever and a rash.

Sending vaccines and syringes to North Korea cost about $6 million, the press release said.


S. Korea Investigating Aid to North

Monday, January 22nd, 2007

Donga (Hat Tip DPRK Studies)

It is expected that the government’s aid to North Korea will be affected as the international community has decided to investigate the general situation of aid projects using U.N. funding including the United Nations Development Program (UNDP). So far, the government and private groups supporting North Korea have often used international organizations as a means to give humanitarian aid to the North, as such aid through the World Health Organization (WHO), United Nations Children’s Fund (UNICEF), World Food Programme (WFP) and others are less influenced by the inter-Korean relations.

Last year, the government and private organizations didn’t provide previously planned corn aid to the North in the aftermath of North Korea’s missile and nuclear tests. However, they spent 5.912 billion won in malaria preventive measures and infant and child support.

In 2005, they sent products worth 25.773 billion won in food aid and quarantine measures against malaria. Besides, they provided goods worth 2.254 billion won in aid and preventive measures against malaria with the North in 2004, and offered North Korea goods worth 20.303 billion won in corn, malaria preventive measures, and vaccine and immunizing agents in 2003.

The total sum Korea spent on the North in humanitarian assistance over the last 10 years (from 1995 to 2004) amounts to $119.43 million, 7.99 percent of the total U.N. financial aid of $1.49 billion to North Korea. During the period, apart from world organizations, the government gave the North $1.16 billion in financial support.

A government official said, “The government’s support for North Korea through international groups is its obligation as a responsible member of the international community,” and added, “Assistance for North Korea through world organizations is for humanitarian purposes, and as far as I know, there is no possibility for misappropriating funds since the aid is being carried out based on a principle of providing 100 percent goods.”

However, contrary to the above government’s official statement, the government seems rather perplexed at the suspicion that its aid through world organizations was diverted to be used for the North’s nuclear development program. The government has used world organizations as an indirect route for its aid toward North Korea because it was worried about getting embroiled in accusations that it is being too lenient on North Korea.

Unification Minister Lee Jae-Jeong also said in his inaugural speech that even humanitarian aid should be divided into emergency aid, assistance in loan form and aid for development, and that emergency aid should continue under any circumstances in order to emphasize the continuation of government’s support for North Korea through world organizations.

Minister Lee has so far expressed regret to the WFP over the suspension of food aid to the North and emergency relief aid for North Korea’s catastrophic flood damage. Another government official stated, The “UNDP seems to have nothing to do with humanitarian aid since it is aid for the development of North Korea. Still, it will still affect the government’s humanitarian assistance program for the North in the future.”

Meanwhile, it was revealed that the government is investing in the Tumen River Area Development Programme (TRADP) the government has been participating in since 1995 under the auspices of the UNDP. An official at the Ministry of Finance and Economy noted, “This year, the government will pay $181,000 for the operating expenses of the TRADP office.”


N. Korea Builds Hospital for Bird Flu Patients

Friday, January 5th, 2007

Korea Times

North Korea finished constructing a hospital ward for patients with bird flu and other contagious diseases with financial support from the World Health Organization (WHO), a media report said Sunday.

The WHO had been helping North Korea to build the isolation ward inside a Pyongyang hospital since June, said the Chosun Sinbo, published by the General Association of Korean Residents in Japan.

In early 2005, North Korea reported an outbreak of avian influenza at several chicken farms in Pyongyang and asked for help from the international community.

“As part of preventive measures against the spread of contagious diseases, this ward was constructed in cooperation with the WHO,’’ the pro-Pyongyang newspaper said.

The report, however, did not give details on when the hospital ward would open officially.

According to the newspaper’s earlier reports, the isolation ward in Songsin Hospital will be a single-floor building with eight rooms covering 695 square meters of land.


North Korea’s stunted policy stunts children

Tuesday, March 15th, 2005

Asia Times
Aidan Foster-Carter
March 15, 2005

It’s a cliche to complain how little we really know about North Korea. Hard facts, and especially figures, are indeed hard – as in hard to come by.

In some fields this is perfectly true. The military, obviously. Does North Korean leader Kim Jong-il have the bomb or bombs? How many? Where is he hiding them? All countries keep that kind of information secret.

But no other nation in the world fails to publish any regular statistics about its economy. This 40-year silence should temper hype about market reforms. Without numbers, neither local enterprises nor external donors or (they wish) investors can do more than gamble in the dark. They really do need to know. Providing accurate numbers is a basic prerequisite of being a modern state.

Yet North Korea possesses a Central Bureau of Statistics (CBS), and it is not idle. No doubt the Dear Leader demands economic data – for his eyes only. But in some fields, the CBS does publish its work. One example was North Korea’s 1993 census, its first ever.

More recently the CBS has worked with international aid agencies to collect information that the latter need in a key area: hunger and its human consequences. The latest fruits of such cooperation have just been published in the “DPRK 2004 Nutrition Assessment Survey”, a joint product of the Central Bureau of Statistics and North Korea’s Institute of Child Nutrition (ICN), with financial and technical help from United Nations Children’s Fund (UNICEF) and the United Nations World Food Program (WFP). The two chief consultants were from Australia and Vietnam, so this was a regional Asian effort. It follows earlier surveys carried out at two-year intervals, in 1998, 2000 and 2002.

It was the WFP that released this report, at a press conference in Beijing on March 7. It is in fact dated November 2004; the survey itself was carried out in October. The delay wasn’t explained. Perhaps the lag was attributable to translation time and to make sure it was fit for publication generally.

I’m often critical of North Korea, so all the more reason to give credit when it’s due. This is an impressive, highly professional report comprising 104 pages, five chapters, 46 tables, 24 figures. The sample was 4,800 children, ages up to six, and 2,109 mothers of children under two, drawn evenly from seven of North Korea’s nine provinces plus the capital, Pyongyang.

Having taught social science research methods in a former life, I get a kick out of reading about random and cluster sampling (sad, I know). Then I pinch myself. This is North Korea. An official document! All these numbers! And on a potentially very sensitive subject, too.

For what this survey measures, with grim precision, is what years of hunger have done to the bodies of small children – and I do mean small – and their mothers in North Korea.

To be technical, there are three main criteria:

*Underweight (for age) is self-explanatory;
*Stunting, low height for age, signals chronic malnutrition;
*Wasting, worst of all, is low weight relative to height, indicating acute malnutrition. Each of these categories is sub-divided into mild and severe cases. For the mothers, a fourth measure was used: MUAC (mid-upper arm circumference). Less than 22.5 centimeters means they aren’t eating enough.

So how are Juche’s (juche is the policy of self-reliance) children faring? The WFP’s press release tried to look on the bright side. Since the last survey in 2002, the proportion of young children chronically malnourished (stunted) is down from 42% to 37%. Acute malnutrition (wasting) eased from 9% to 7%. But those underweight rose from 21% to 23% – though for children under the age of two, those most at risk, this fell from 25% to 21%. One in five children had diarrhea, and one in eight showed symptoms of acute respiratory infection. But mothers have made no progress: a third were anemic and malnourished, the same figure as two years ago. Vitamin A deficiency is common.

Much depends on where people are living. Things are less bad in Pyongyang and in the southwestern Hwanghae farming region than in bleak northeasterly Hamgyong and Ryanggang provinces. Ryanggangites get to eat meat, fish or eggs just once every three weeks on average. Chagang in the far mid-north is bleaker still, but North Korea doesn’t allow access to this area – probably because of military bases located there. Thus, no survey was conducted in Chagang, which means no food aid either; the WFP is strict about that – surveys first.

Even at the national level, the few slight improvements offer scant comfort. The more than one-third (37%) of North Korean’s under six who are stunted – and especially the one in eight (12%) who are severely stunted – will grow up stunted and stay that way. Even once Korea is reunified politically, they will stand out physically: dwarfed by their Southern peers.

Seoul, meanwhile, has different – nay, opposite – child health issues. With uncanny timing, the very same day as the WFP released its survey on the North, education officials in the Southern capital reported that one in 10 schoolchildren in Seoul is overweight. Obesity rates are growing fast, too. As the old adage has it, the rich slim while the poor starve.

Back in the North, the WFP doesn’t appear to be leaving any time soon. Richard Ragan, head of the program’s Pyongyang office – and an American, to boot – said he hopes the agency will shut up shop one day, once the government and the private sector can stand on their own feet.

But for now, one anniversary a proud North Korea won’t be celebrating, is that this year marks a whole decade since it first, reluctantly, asked the WFP and other agencies for help coping with flood and famine. While the worst of the famine has eased, food self-sufficiency – in a country so mountainous that this is a ludicrous goal anyway – looks as remote as ever.

So still, in 2005, the WFP has extended the begging bowl for Kim Jong-il – whose own priorities evidently lie elsewhere. Ever prickly Pyongyang has bitten the kind hand trying to feed it, forbidding UN agencies to launch their usual formal consolidated aid appeal this year. Nonetheless the WFP is seeking $202 million with which to buy 504,000 tonnes of food, mainly grains.

And no wonder. In January North Korea cut its Public Distribution System (PDS) rations to starvation level: 250 grams of cereal per person per day, the lowest in five years. Such cutbacks don’t usually happen until March, when last year’s crop typically runs out. This is all the more odd, since 2004’s autumn harvest is thought to have been the best in years.

Luckily, the WFP currently has enough stocks – as it did not, in the recent past – to feed all of its target group: a staggering 6.5 million North Koreans, or nearly one-third of the entire population. The main categories within this group are 2.7 million children from birth to the age of 10 and 2.15 million people in food or work programs. Other beneficiaries include 900,000 elderly, 300,000 pregnant women and nursing mothers, and 350,000 in low-income households. The latter are a new category: victims of the post-2002 reforms that have seen inequalities widen, even as the state retreats ever further from providing any help to the millions of citizens whom its disastrous past and half-baked present policies have starved and stunted.

That’s my take, not the WFP’s. Diplomacy precludes any such critique from a UN body. Yet the raw data, the results – written indelibly on the bodies of innocent children, marked for life – are there for all to see. It’s ironic, but the same regime that branded this suffering on its people is at least now registering and owning up to the outcome: collating and publishing these damning data, putting its name to the survey, and signing off on it. That’s a start.

Where his statisticians boldly go, will the Dear Leader follow? It’s so simple. Ditch nukes; watch aid explode instead. Let the children eat, and grow. If not, what future is there?


DPRK health care data quality audit

Wednesday, December 1st, 2004

The GAVI Alliance (formerly known as the Global Alliance for Vaccines and Immunisation) is a public-private partnership focused on increasing children’s access to vaccines in poor countries. Partners include the GAVI Fund, national governments, UNICEF, WHO, The World Bank, the Bill & Melinda Gates Foundation, the vaccine industry, public health institutions and nongovernmental organizations (NGOs). The GAVI Fund provides resources for the Alliance programs. The Alliance provides a forum for partners to agree upon mutual goals, share strategies, and coordinate efforts.

In 2004, The GAVI Alliance commissioned a data quality audit of the North Korean immunisation system to facilitate future collaboration.  The audit was designed to assist countries receiving support to improve their information systems, and aid with accuracy in reporting.

The report is saved to this website here:DQA_2004_KoreaDPR.pdf
On the web, it is located here.

The results of the audit are not surprising given the centrally-planned nature of the North Korean health bureaucracies combined with their penchant for secrecy.  I recommend reading the full report to get an idea of how efficient of how socialist institutions are with data, but here are some points I considered interesting:

-District immunization information is not passed on to the national level, but combined at the county level.

-Out of 206 counties, 168 were audited.  The rest were excluded for “security reasons”.

-The Ministry of population and Health contains a National Hygeing Control Committee, which controls the National Hygeine and Anti-Epidemic Institute which is responsible for the Expanded Programme on Immunization.  This program was supported by UNICEF and the WHO.

-Officially, immunizations are offered in all 206 counties to children under one year old.  Records are suposed to be made on an individual’s Child Health Card, and in the doctor’s own ledgers.  These health cards are stored at local health facilities and are supposed to move with the child.  Immunizations are distributed by the national government and are carried out one day per month.

-Outside of the national level, where one computer was used to for entering data, no computers were seen (all done by hand).

-In cases of county data, many errors were detected in the addition of monthly subtotals which could not be explained by the district staff.  The auditors concluded that the district used the 2003 figures rather than admit to missing 2002 data to meet the criteria of the audit.

-County managers do not take the previous year’s achievements into account in order to set realistic targets for the next year.

-Supervision of immunization activities was weak.  Only two counties could provide a written schedule of supervision.

-One health unit destroyed its records.