North Korea marked the 60th anniversary of free, universal healthcare on November 13th with media articles on how the people’s living standards have risen thanks to the healthcare system provided by the state.
Rodong Shinmun, the daily publication of the Chosun Workers’ Party, published an article entitled, ‘The People’s Happiness Blooming Like a Flower with the Benefits of Free Healthcare.’ In it, the Party asserted, “Hospitals and clinics appeared in the cities and rural areas, of course, but also in the most rural mountain villages and distant isles, all the places people live, so everyone has been able to enjoy all the free healthcare that they need.”
Yet defectors agree that North Korea not only lacks many of the healthcare facilities it claims to provide; it is also the case that money must change hands if anything is to be done. it is an outcome that was inevitable as soon as doctors and nurses stopped receiving their assigned rations during the early days of the famine period.
To illustrate the true nature of North Korean medical care today, Daily NK asked five defectors for their experiences.
▲ “Doctors won’t care for patients without money, and all procedures cost money”
Kim Bok Sun, who recently defected from her hometown of Chongjin in North Hamkyung Province, said, “Doctors will only see patients with money. Treatment only happens once agreement has been reached on the cost of the alcohol for disinfecting surgical instruments, cotton swabs, gauze, injections, operating room fees and pay for doctors, nurses and support staff.”
Also, Kim added, “No matter how urgently a person needs treatment; if they do not have the ability to pay then they will not get it.”
Kim, recalling the situation in 2011 when she received surgery for appendicitis at a provincial hospital in North Hamkyung Province, went on, “Before dealing with me, the doctor called my guarantor and agreed on the cost of the surgery. I recall the doctor received 50,000 won, his assistant got 30,000 won and four nurses each received 15,000 won.”
Choi Sung Ho, who used to work as a driver at another hospital in North Hamkyung Province, recalled, “Back in 2011 there were three ambulances at the hospital, but one of them was used privately by the hospital director and we received no fuel for the rest, so we had to ask around for gas if we ever wanted to use them,. Patients who were going to get discharged from hospital would register the day before and pay in advance so that the gas would be available the next day.”
“Patients could only be carried from and to places within the city,” the source went on. “For people who fell sick at work or home, the fee had to be taken to the hospital by a courier, and that cost was about 10,000won per kilometer.”
Lee Song Chol, who worked for the state’s medical equipment and drug management office, agreed, saying that in addition, “Hospital patients had to get all three meals a day from their homes. It became hospital culture for patients to give food to their nurses and doctors at least once or twice a week, too.”
▲ “Ordinary citizens find their own drugs… while cadres pocket the deliveries”
Cho Bong Yon, who was treated for third-degree burns in Hamheung during 2011, said, “The hospital will tell you that there is no more medication, so most patients with prescriptions have to go out to village merchants to buy them, which ain’t cheap.”
“There are pharmaceutical factories in Chongjin, Hamheung, Suncheon and several other places, but because of the lack of raw ingredients they don’t operate properly, production volumes are tiny and most of it goes straight onto the open market,” Cho went on. “Therefore, local patients are left purchasing expensive drugs made in China or that have been sent in by the UN.”
“The small amount of medication that does make it to hospitals is normally taken by hospital managers and Party cadres, so it gets sold off as well,” he concluded.
