North Korean Economy Watch

…does not sound like very easy job based on the most in-depth media coverage of their operations published in the Washington Post.

The story portrays the sad state of the DPRK’s medical facilities and shows just how much local doctors struggle to serve their patients.  According to Eugene Bell Foundation Chairman Stephen Linton:

“I’ve seen doctors who tried to capture sunlight by reflecting it from a mirror,” [during surgery] he says.

By North Korean standards, [this] patient is fortunate. She’s been given a local anesthetic, which is rare in a country where surgeons routinely etherize patients, strap them down and try to finish the operation before they come to.

and  

Like most hospitals and care centers in North Korea, the facility employs a direct-fluoroscopy machine, an X-ray device that irradiates the patient from behind while the doctor examines an image projected on a fluoroscopic plate of glass between them. “The negative is the doctor’s retina,” says Linton, who frequently admonishes physicians for submitting themselves to the machines’ potentially fatal doses of radiation. Most physicians in North Korea use them regularly, and suffer the consequences. The radiologist at Kosong, for example, has receding gums and low hemoglobin, common signs of radiation sickness. Three of his colleagues have died over the years — one from radiation overdose, another from cancer and a third from tuberculosis.

But the toll poor infrastructure takes on the provision of good health care is only exacerbated by the difficulties the DPRK bureaucracy puts in his way:

Of the 36 NGOs that began operations in North Korea as famine gutted the rural population in the mid-1990s, all but a handful have left in frustration. And Linton is particularly demanding: He insists on delivering his supplies personally, lest they be diverted to another facility or end up on the black market. When government officials balk, Linton refuses to resupply the site. So each of his two resupply visits annually is preceded by lengthy and sometimes rancorous negotiations.

“They say they want to save wear and tear on the vehicles, so they need to cut our sites by a third. Fine. I’ll cut theirs as well. Mary, I’ll need a red marker.”

Most of the cancellations involve small sanatoriums in rural areas — the very sites his donors are so keen to support. Linton suspects his hosts want to avoid those facilities because, relative to the urban care centers, their poor sanitation makes them legitimately hazardous. And the wear-and-tear issue isn’t just a red herring. Spending days crisscrossing the countryside on unpaved roads takes a huge toll on the delegation’s fleet of SUVs — vehicles that, between Linton’s visits, the ministry is allowed to use for its own purposes. In resource-starved North Korea, even government officials must barter to replace broken fan belts and transmissions. The last thing the bureaucrats want is to risk losing a precious automobile.

Linton is also apparently given a curfew when he is required to be back at this guest house in Pyongyang.

It seems Tuberculosis is running rampant at the moment:

South Korean sources suggest that tuberculosis has affected as much as 5 percent of North Korea’s population of 23 million. Linton estimates the Eugene Bell Foundation has treated up to 250,000 patients, 70 percent of whom might have otherwise died.

The whole article is well worth reading.

Donations can be made here.

The full article can be found here:
Giving Until It Hurts
Washington Post
Stephen Glain
3/9/2008, Page W16