Although no incidents of swine flu in North Korea have been officially reported, and it is unlikely that the authorities would report them in any case unless numbers were stratospheric, it is true that there is a high possibility of an explosive outbreak in a destitute country such as North Korea.
According to the World Health Organization (WHO), the number of infected people in the world as of the 27th was approximately 414,000, with the deceased numbering 5,000.
In South Korea, as of the 28th, the total number of swine flu-related deaths was 29. In particular, the reported death of an otherwise healthy woman in her 20s, who was not considered high-risk, has shocked the nation.
The WHO notes that no incidents of swine flu have yet been officially reported in North Korea. However, most defectors with backgrounds in health care agree that, considering the closed nature of North Korean society and its highly inadequate health care system, incidents of swine flu are likely to be either suppressed or merely misdiagnosed.
The first case of swine flu in Mongolia last month has heightened concerns. As for China, the number of people infected with the swine flu in the country is the third highest in the Northeast Asian region, making the spread of the disease to North Korea only a matter of time.
Further, the illegal smuggling of North Korean citizens through China has increased significantly in recent years, and conditions such as the comings and goings of overseas Chinese and the temporary return of the children of high-level officials from studying abroad are risk factors. If swine flu were to enter the North, then there is also the possibility that it would spread rapidly through the jangmadang (market), which has become the primary means of survival for the people.
Since developed countries have been experiencing difficulties securing vaccines, it is highly unlikely that a country such as North Korea has an adequate amount. Also, if swine flu were to spread widely due to the low standards of sanitation in the North, the food insecure people would not be able to withstand the resulting carnage.
Lee Hye Kyung, who defected in 2002, was a pharmacist in North Korea, “In the mid-1990s, cholera was quite rampant,” she told the Daily NK, “but at the time, North Korea called it acute diarrhea and intentionally covered up incidents. North Korea tends to suppress outbreaks of infectious diseases."
She said that she had heard from several defectors from Hwanghae Province that in 2007 and 2008 more than 30 deaths resulted from an outbreak of the measles, but this too was kept a secret.
In North Korea, even in the cases of an outbreak of infectious diseases, the number of deaths is not usually reported if it is less than 10; if it exceeds 100, then the facts are conveyed to each region in the form of an official notice.
She explained, “It is unlikely that North Korea will make incidents of swine flu cases official before the number of deaths reaches an alarming level."
Lee did, however, favorably evaluate the fact that the North Korean authorities have recently strengthened cautionary measures against epidemics, "The North has demonstrated an improved attitude towards foreign-currency earners who go back and forth between North Korea and China than in the past,” she explained, “carrying out strict tests for virulent diseases through blood tests and sanitary measures."
The WHO plans to distribute swine flu vaccines contributed by developed countries to 100-some developing countries in November; North Korea is on this list.
It is anticipated that voices calling for the humanitarian donation of vaccines will only grow louder now that South Korea has started inoculating its own people.