A Closer Look into North Korea's Healthcare System

Originally published on February 6, 2021

Given the current circumstances of the pandemic that prove to be detrimental to the world’s healthcare system, what does healthcare look like for citizens living in a strictly regulated country? Tae-il Shim, a North Korean defector currently residing in South Korea, provides insight on the definition of healthcare in North Korea. Ironically, North Korea boasts about the cost-free nature of their healthcare system. The validity of this advertisement is strongly refuted by Shim who claim otherwise.

He notes that access to healthcare is disproportionately offered, with individuals in upper classes taking advantage of this commodity. Those that are more affluent are afforded with access to eleven general hospitals with certain hospitals catered especially towards these groups of people. Shim highlights that despite this disparity, it is common to find slogans on these hospitals with phrases such as “devotion is the best medicine,” or “socialist medicine is preventive medicine.” He adds that the North Korean citizens have lost hope in the healthcare system such that they no longer have any expectations from the government to better address how to provide for the average citizen regarding their health.

Within the rather empty hospitals, Shim explains how there is often no electricity or heating, making it a normal sighting for doctors to perform surgeries using battery powered flashlights. These surgeries are performed only under the caveat that the patient can afford to pay for all related expenses. Contrastingly, wealthier patients pay for firewood to keep warm during surgeries.

Regarding equipment, Shim emphasizes that hospital beds are all that is left as there’s a great lack of medical equipment and medicine in the hospitals. As expected, patients are required to gather all required materials in order to undergo treatment. With all this information, it is no surprise that money dictates life or death for most citizens.

Shim recalls his past experience of having had to undergo surgery to remove tumors. He explains how he bought cotton, antibiotics, and anesthetics for his surgery, which were additional fees to the payment he had to make to the surgeon and the other staff members for his surgery. He notes that only after he arrived in South Korea, he realized how many international organizations have been providing medical aid to North Korea. Despite this international effort, he claims that these equipment and supplies are heavily controlled in the hands of merchants who sell it at astronomical prices.

Shim further explains the poor integrity of the country’s health care system, characterized by a lack of medical equipment and qualified medical staff. He recounts a severe injury to the left lung that was sustained at 3 in the morning, and the lack of paramedic services for anyone but the upper class. Instead, “it took [him] an hour to struggle to the hospital.” Upon arrival at the hospital, he notes the lack of medical staff presence at the emergency room where “only a drunken male urologist and a female nurse were staffing”. The urologist admittedly did not know how to perform the required operation, and the patient was asked to wait until a second surgeon arrived for their shift.

Despite the dire circumstances for the patient, a familiar surgeon arrived at 8 in the morning, and agreed to operate immediately. Whether the patient would have received the same treatment if not for his connections with the surgeon was not commented on, although he does consider himself “still lucky in that [he] did actually receive treatment.” The surgery was completed on an impromptu operating table, comprising four chairs, and no anesthetics or antibiotics were used.

In North American culture, it is quite commonplace for people to have childhood fears of hospitals and doctors, often growing out of this phobia with time. Contrastingly in North Korea, experiences such as the one shared by Shim demonstrates that people do not always grow out of their phobia of hospitals, and with reason; Without the benefit of class status, the process of receiving medical treatment becomes a grueling ordeal that one would try to evade at all cost.

Resources:

Shim, T. (2020, February 21). Ask a North Korean: What is the healthcare system in the DPRK really like? | NK News. NK News – North Korea News. https://www.nknews.org/2020/02/ask-a-north-korean-what-is-the-healthcare-system-in-the-dprk-really-like/