I've been to North Korea and observed its medical system and routinely go to improve its healthcare. AMA!
I'm a medical student that had the amazing privilege of going to North Korea last year with a group of medical students and surgeons. We were in Pyongyang for a week as well as in Wonsan for two days. I am part of a NGO that serves to improve the healthcare of North Korea. We made history by establishing the first international conference between North Korean medical students and internationals in North Korea. We spent a bulk of the time interacting with medical students from Pyongyang Medical College as well as in the hospitals in Pyongyang and Wonsan. I've also written an 80-pg senior thesis on the history and theology of the North Korean Church, so if you have any questions on that, head over to r/Christianity! I would be happy to answer any questions regarding DPRK healthcare and its relationship with Christianity in the past and currently. I took over 4,000 pictures, but selected about 150 and is posted below. I apologize in advance for the photo dump and the time it may rob you of.
I just returned from the frontlines of the war in Ukraine, being in a city in no man's land between the Ukrainian army and Russian separatists. My brother and I were there to provide medical care and distribute foods and products. Our city was shelled quite often in our duration there. I've also been to around 20 countries and have seen many different hospitals systems like Russia, Cambodia, Uzbekistan, Kyrgyzstan, and Ukraine. I've also been at the bloody Kyrgyzstan Revolution in 2010 that claimed about a 100 lives. If you have any questions regarding those too...
Wow, what a thought-provoking question. Yes! Perhaps not from their technology, but from their character (especially doctors). Their tenacity, resilience, and compassion is what American doctors can learn from. Imagine a healthcare system without the pressures of making millions and corrupt insurance companies bleeding out the population. Doctors know they don't know they have much to work with, but they do all that they can.
TB and Hep B are two of the biggest diseases in NK. Many doctors that serve these people contract those diseases and often die from them. That speaks volumes on their life. They work with urgency, and they serve with empathy.
So perhaps medicine isn't about making money to buy a yacht or a new set of drivers. Maybe it's about serving the people.
American medicine is more about paying back debt these days... but that spirit of empathic service is what draws people in. Still.
Glad to know they get to practice so.
Sure, but the exorbitant costs of medical education can be traced to exorbitant costs in healthcare, many of which go to insurance companies being unchecked.
Let's not forget about the collusion between those insurance companies, the pharmaceutical companies, and the doctors themselves. This trifecta is the core of our problem, and no amount of "universal health care tax" will fix that.
This is a wonderful answer, thankyou for saying this. I wish to be that kind of doctor some day, that works for compassion first, and money second.
I hope so too one day!
I kind of have a tangential follow up question; as i'm a non-american, and you've experience with medical practices in several different countries, has 'Obama care' in your opinion, solved any of the money problems you speak of with regard to healthcare in the US? Where I am, healthcare is paid in taxes and there is no direct cost for getting treated. I can't envision what it would be like to have to deal with an exorbitant bill at the end of such an ordeal. I've equally never considered before, a healthcare system powered by debt.
Good question! First of all, consider medical education. Most doctors finish paying back student loans (for university and for medical school!) 10-15 years after they finish medical school, depending on their income and speciality. For doctors who may want to do long-term medical work in impoverished countries, it's difficult to do so when you're tied down financially. $60,000 per year plus whatever costs is not helpful. Obamacare has solved some issues, but the larger picture remains untouched and unaddressed. I think the American dream has captured too many minds and hearts, with insurance companies and hospitals caring about profit and patients. Whenever profits and patients compete, guess who wins? I've seen so many families bankrupt after fighting cancer, etc. You just can't pay for expensive treatment.
Surgeries that cost $300,000 in the US may cost under a $1000 in other nations. Lawsuits of doctors don't help, and in the US we have a huge culture of suing doctors. It's getting out of hand.
$60,000 a year?! Wow. I knew it was high but I didn't realise it was that high. I paid ~£3500 a year but that's increased to around £9000 today.
It's really interesting, I can see how there's many different factors at play and never even factored escalating cost of education into the equation.
Anyway, a fascinating photoset. I spent a good amount of time, pawing through them all and that rusty scalpel will give me nightmares ;)
Thanks for sharing and best of luck with your graduation. FWIW, there's a lot of comments in here asking about 'financially supporting a despotic regime'. If NK is beginning to open its borders, it should be encouraged. Shining light on a dark place is needed and I believe what you're doing is of great benefit in breaking down those borders of ignorance, and hate.
Well, bless the stars for you not having to pay too much! Thank you for your time! I hope it was informative and inspirational. And thank you for your insight. I do trust that I'm not doing a negative impact there. Thanks for understanding.
So I see you are a medical student but you have stated that your senior thesis was on the history of the NK church - I was curious why your school would allow a medical student to do a senior thesis on a completely non-medical topic? Or do you attend a faith-based university?
Well, sorry if I am unclear, but in my undergraduate studies at UVA, I majored in Religious Studies and was able to write my senior thesis on the history of the NK church. Sorry for the confusion!
It's a great medical school! I go to VCU at MCV. I'm not a doctor yet, just going to medical school. Study hard! But make sure you know what motivates you. I keep my scrubs on my wall so every morning I wake up and see that this is what I want to do. If you have a motivation to genuinely help people and not have the financial laud motivate you, then that's good. I think white coats were never meant to remain in their pristine conditions, but they were meant to be dirtied. Where better to dirty them than in impoverished communities?
What was it like? What was the worst thing you saw there? Any stories you can tell about visiting?
It was sad, to be concise. Haunting, almost. The people there are wonderful, very hospitable and kind. The system, on the other hand, is a different story. The worst thing was the poverty and the effects of the system not being distributed equally. The worst thing I saw...I was instructed to write a 55-word description of it after the trip as a way to cope with what I saw:
Koreans don’t scream - they wail with emotion. I traced the shrieks out the North Korean OR to another. Open doors. A young patient, no older than I. Strapped arms, chest, legs. Shrieking. Open abdomen, conscious patient, casual surgeons. Head turns - ferocious eyes rife with pain. Anesthesia? Not enough money. The cries of a debilitated warrior. Insomnia.
Another story: I was almost not able to make it out of the country with what I was carrying. I can't say what exactly on the internet though, sorry, but it really was a miracle. At the checkpoint, they had me take out all books, electronics, computers, cameras, and flash drives. As I was taking everything out, I threw up a prayer, and at that moment, the guard watching over me was called away, and in that time I thrust "things" into my jacket (I had already been patted down). They checked my other belongings and I was safely out.
EDIT: Okay, some of the material was photos that I couldn't post on the internet. I'm not taking out nukes or Bibles or anything!
I can't say what exactly on the internet though, sorry
Out of privacy concerns, or does the DRK still have some control of you? You've openly mentioned that you are omitting things at several places in your album, so I'm kind of curious now what's holding you back ;-)
Yes, out of privacy concerns not for the DPRK but for the NGOs that still go. If I say something that raises eyebrows and they link me to the groups that are making great progress, I can deter or hinder that progress by being careless.
You may not be here to answer anymore, but why 55 words? How many words did you end up writing? This is tugging at my curiosity!
55 words was an exercise to concisely explain what I saw and went through. I don't know why 55, that's what I was instructed to write. No more, no less.
I did write my personal statement for medical school about that too though.
I can't say what exactly on the internet though, sorry, but it really was a miracle.
I'm actually curious how you make sense of this. I mean your comment contains two interesting elements.
On one hand, you have the situation in NK. Poverty, a screaming patient being operated on without anesthesia due to lack of money. On the other hand you have your problem with getting out of the country.
Why do you think God helped you, but didn't make somebody find some unused anesthesia somewhere? It seems the patient has it considerably worse, after all. He's stuck with the regime and may not survive the operation (if there's no money for anesthesia I don't think things are much better with antibiotics). So why is it you who gets divine favor?
Also I'm curious about how you think this works. Pretty much all Christians I talked to say God doesn't interfere with free will. So in what manner could the guard get miraculously called?
Edit: Also, I appreciate that you're trying to do good, but going about it in such a reckless manner is dangerous business. If you need to bring unathorized materials across the borders of a dictatorial regime, please seek out somebody who can teach you how to do it in a relatively safe manner.
Good question. As a Christian, I'm Reformed, which many have problems with, especially anyone who is non-religious. It seems to be an unfair system of favorites with God. To talk about divine favor would be to talk about predestination. Would you like to discuss that? Why were any of us born in the US or outside North Korea and why aren't we on that table? I ask myself that frequently. I don't know why. The only thing I'm sure of is that I'm thankful of the family I was born into.
Given this so-called privilege, I really hope it's not some high horse I can sit on, but a means to help those who are in less favorable positions and conditions. Our guide had surgery without anesthesia too but he's alright, so I can't speak for the patient I saw but I hope he is okay.
Christians can come in generally two different camps on free will, and I kind of am in the mix. God can intervene divinely and I think He does at times. Was it coincidence that the guard was called away when I prayed? You may attribute it to luck.
Okay. I'm not taking nukes out of the country or anything. Just some pictures and other things that guards may not like. I would never, endanger the good progress going on. Hopefully.
Just to be clear you worship a God that is okay with people being tortured, raped, murdered and worse atrocities as the status quo?
I'm genuinely curious why you would worship a god that is seemingly so ineffective and cruel.
I would not be okay with a God that is okay with that, and He is not okay with it. Do you blame God for other men's actions and their irresponsibilities of those actions?
Why are you trying to improve their healthcare? My understanding was that Kim Jong-Un had single-handedly cured ebola, MERS AIDS and cancer.
In all seriousness, whether or not the civilian population believes North Korean scientists have done that, do North Korean doctors believe it? Or are they more educated/more cynical than that? Or is the whole thing not as widely circulated in North Korea as it is over here?
Haha! Well, we were actually impressed with the organization that North Korea undertook to quarantine itself from Ebola. In fact, a few days after I left, the country shut down, so I was very fortunate.
No. But you are instructed to say what you have to say. In the Operating Rooms, we had the freedom of not being shadowed by guards, and the doctors and I had honest conversations. The whole population has a general idea of how debilitated the government is. You may have heart of the Great Famine of North Korea in the 90's. Massive flooding resulted in destroyed crops (North Korea is 80% mountainous and 20% of the land is arable, but only 1.6% is used for permanent farming) and 5-6 years of intense famine. Many died, and people resorted to eating tree bark or cannibalism as you may have heard. It was a dark time, and really, many people were saved only because of American and South Korean NGOs flooding the land with tons of food (Christian Friends of Korea sent in 700 tons of rice and other food in that period of time).
Sorry, I got sidetracked.
In the Operating Rooms, we had the freedom of not being shadowed by guards, and the doctors and I had honest conversations.
This is interesting. Fully honest like the doctors are aware of how bad things are and how much the government makes things up? Would love to hear some more about the OR conversations.
Sure. Yes, they are. North Koreans aren't stupid, and they are aware of what's going on. A disillusioned society that's okay with the current situation like Brave New World and 1984 isn't exactly realistic, because I think people eventually catch on how dystopian society is and that it doesn't feel right.
For example, one doctor is separated from his family. They live in another nation and he has not seen them for ten years. The only mode of communication is sneaking out hand-written letters in the OR to be mailed out. How devastating!
Most of the older generation of doctors have been trained outside the nation. They have a hierarchy of each specialty. The top neurosurgeon was trained in Romania under a US neurosurgeon. They have seen the outside world and they know how hospitals SHOULD be.
A very common phrase we heard from them was, "It happens." We ask, where's your bovie? It broke. Oh. It happens.
A very common phrase we heard from them was, "It happens." We ask, where's your bovie? It broke. Oh. It happens.
While they are worlds apart (and the situations are very different), your comments remind me of my family's struggle in Cuba and what those people are still going through. Nothing at the level of North Korea, but everyone sees past the BS and propaganda of the U.S. being evil and the "Revolution" working for the people.
Very interesting insight. Thank you!
Cuba and North Korea don't have a bad relationship actually! I have heard of the hardships of Cuba and it is nothing to be taken lightly. I hope the people in North Korea can be given a new set of eyes!
More importantly, does kim actually have a rear trapdoor?
And sweet jesus, you actually refused to bow down to supreme leader's statue and walked away like nothing had happened?
Kim have a rear trapdoor? I don't even know if his bodily trapdoor works. ;)
Yeah. For me bowing down to the statues would violate my religious beliefs. They were okay with it, probably because I'm younger and I must be stupid.
If your religious beliefs require you to needlessly put your life at risk like that you should really reexamine your beliefs.
I don't think any sane God would care that you went through with a small gesture so you could help people without being killed.
Well, there are many doctors who go to North Korea without religious beliefs who do put their lives at risk. How should we diagnose them? I think though I am motivated by God and my own religious beliefs, we share a common desire to help a nation. I, for one, don't want to see a nation burn itself to the ground as the rest of the world warms itself over the embers.
They put their lives at risk to help people. A worthy cause that should be respected.
You put your life at risk by refusing to make an empty gesture for nothing.
Your life is precious, don't throw it away over something so incredibly small.
Make a small bow, pretend to show respect, you dying over a petty refusal to do so wastes your own life and stops you from helping people. I can't respect stupidity like that.
Ah, I didn't see the context of your point. I thought you were referring to my overall trip. Sorry, there are so many comments to reply to it gets a bit hazy. My apologies.
Perhaps it is stupidity in refusing to bow, I think that is a matter of opinion. I think conviction goes a long way, and I don't shy away from my resolve to do what is right. I don't believe in appeasement, and I think that and unhealthy compromises do far worse.
Is there a subversive or rebellious counter-culture among the youth? If so, how much influence does Western culture have on them?
Edit for spelling and grammatical pedantry.
Good question! We were surprised to discover that they were able to not only identify iconic figures like Beyonce and Bieber, but they were also able to carry conversations about them. I would not say the younger generation is iconoclastic. Western culture is very limited in entering the country. Internet is not necessarily accessible to the youth or most of the country. Sometimes TV shows some news and pokes fun at these characters or the rest of the world. Plus, in my conversations with the younger generation, we were monitored by guards and professors, so genuine feelings may not have been expressed.
Maybe they gave the kids a script to follow so that they would appear friendlier? Idk, this is just me.
I do think so! They are taught in school what to say and what not to say. For the medical student conference, we brought in tons of gifts for each participant: Korean-English dictionaries, American medical supplies (like a stethoscope, blood pressure cuff, etc.), and shirts. They were immediately confiscated by the faculty. I really hope they were seen as safe and given to the students.
If something were to happen to you, how comfortable would you be knowing you would have to receive medical care in North Korea?
Oooh. I trust the doctors! Because I'm a guest, I know they would treat me to their best ability. Beyond that, I'm not sure. :)
Thank you for doing this AMA!
It is my understanding that in North Korea though freedom of religion is written in the constitution, de facto religion is discouraged (in line with the atheist/Juche ideology) and the state goes as far as abducting religious people (like missionaries, priests, pastors) and abusing human rights on the faithful. Also, on wikipedia there is written that the "Catholic Church in North Korea" is in fact controlled by the government. If this is the Church you are referring to, what can you tell us about it? (If it isn't that Church, can you please talk about the one you wrote your thesis on?) Also, what do you mean by "relationship between healthcare and Christianity"?
Thank you for taking the time to read through this! Yes, visit the DPRK website and you'll find them boasting the freedom of religion. One thing about the country is I felt that most of it was a facade, correctly taught and passed down by the Soviet Union. Only the best clinics and hotels and programs would be exhibited to tourists. Juche can be likened to a religion/philosophy, and the leaders have established themselves as deities or demigods. Yes, missionaries have been abducted and imprisoned. But the media doesn't report that a lot of Christians that are caught with "actions against the State" are simply just deported. The three Americans detained last year - some of them had a bit more under their belt than "Christianity" that landed them in hot water, although I can't reveal this over the internet. Sorry, when I refer to the Church in capital "C", that refers to the ecumenical church, so the whole of Christianity in North Korea.
The current state of Christianity is that it is heavily persecuted. Rumor says that Kim Jong Un executed 80 Christians in his first few months when he ascended the throne by the firing squad or dogs. The North Korean church has, in the past, actually been incredibly large and boisterous and was a fireball for spreading Christianity in the East. This was suppressed by Japanese colonization in the early 1900's - 1945 and then the subsequent Communist regime from 1950 - present.
There are 4 state run churches in North Korea: 1 Catholic church in Pyongyang as well as 1 Protestant church and 1 Russian Orthodox. There is 1 Protestant church in the northern region too. I had the privilege of visiting the Protestant church in Pyongyang (called Bungsoo), though it felt more rehearsed than anything else.
In terms of the "relationship between healthcare and Christianity", American missionaries actually were the first ones to introduce western medicine into the country and made great strides in healing the country. One of the first missionaries saved the life of the prince of Korea at the time after an assassination attempt left him mortally wounded. Since then, he found favor in the king's eyes and was granted space and resources to build a hospital (Severance Hospital). American missionary doctors came to the nation bringing medicine and taking care of leper colonies, often dying in the process.
Are North Korean women sexy?
Haha, they look just like South Korean women, just without the layers of plastic surgery!
From your imgur album:
There are many fake churches in the US too.
Can you expand on what you mean by a "fake church" ?
hmm, maybe I should have phrased that differently. I lived as a missionary kid overseas. I believe I'm far from perfect, and I really do my best to reserve my judgments. But coming from churches that are persecuted to the US is quite a culture shock. A lot of churches are doctrinally wrong, and some what I may call heretical. The influence of money has swayed many into believing trendy things such as the prosperity gospel.
Even if churches don't espouse that theology, many motivations are money-spurred. Unfortunately that's the reality. I love the American Church, but I also see the potential pitfalls it may fall into.
It means he's a religious asshole.
Haha, well I'd rather be a religious asshole than just an asshole! :)
Ahh, it's the passive aggressive smilie face!
passive aggressive sad face :(
Were you allowed to walk around by yourself? And how did you get into this project?
No, I was not permitted to walk around by myself. If I was in a public restaurant and I wanted to go to the bathroom, the guard once followed me in and waited outside my stall! Sometimes they were strict, other times they were lenient. But they were very nice people.
I found this project through a missionary doctor I knew that goes there periodically.
What's a public restaurant in North Korea like?
Haha very similar to a regular restaurant. The guides took us to the more "fancy ones". They were just like regular Korean restaurants!
In case OP doesn't reply, I recall seeing another post about NK and one the OP commented that resturaunts are very empty, as if they are only meant for tourists.
I would concur!
Wow! This sounds like it has been an amazing opportunity. Also your entire album on imgur is fantastic.
I have a question about perceptions of disease in North Korea. Were there many differences between your group and the doctors/med students you worked with in your understanding of the mechanisms or treatment of specific diseases?
Did you have an opportunity to interact with many North Korean patients and get a feel for their perceptions of medicine?
Also, It seems like you have a huge amount of experience in countries most Americans don't have a good feel for. Coming in with that knowledge, was there anything about this experience that made North Korea stand out that you didn't expect?
Thanks so much for taking the time to do this!
Thanks! Thanks for your time to look through it.
1) Yes, medical education is limited and the standards are much lower. Within the US, we have advanced labs working on the pathways of diseases and how to inhibit such. We also garner much information from the rest of the world. Imagine a country so isolated that they rely primarily on their own findings. Like a kid who wants to study by himself without any textbooks. Couple that with the deficiencies of funding (30% of GDP goes to military), and it's nightmarish. Only with foreign aid are real strides made to combat these diseases. 2) Yes, a big emphasis remains on Koryo medicine (traditional, oriental medicine) such as acupuncture, herbs, and home remedies. Most people understand the hospitals can't do much, so they accept their fate if they become incredibly ill. There is also a huge demarcation and disparity between the elite and the commoners - they are treated much differently and are also admitted into different hospitals. 3) Yes, as I posted before, the Pyongyang General Hospital was probably the worst hospital I've been to (and I've been to some terrible ones). The worst thing I saw...I was instructed to write a 55-word description of it after the trip as a way to cope with what I saw: Koreans don’t scream - they wail with emotion. I traced the shrieks out the North Korean OR to another. Open doors. A young patient, no older than I. Strapped arms, chest, legs. Shrieking. Open abdomen, conscious patient, casual surgeons. Head turns - ferocious eyes rife with pain. Anesthesia? Not enough money. The cries of a debilitated warrior. Insomnia.
What are the people like? What are the medical facilities there like in general? Also, this may sound like a dumb question, but are there a lot of animals in North Korea? Like are pets and farm animals common?
Hey! Great question. The people can be likened to South Koreans - possessing a very un-nuanced culture in the sense that they respect the elders, they are very kind and respectful to guests, and they strongly emphasize family and community. I first came in with a biased view (thanks, media) that these people must be completely brainwashed and cold and embittered. Quite the opposite, and I have felt more welcome in the midst of North Koreans than perhaps in most churches in America.
The medical facilities are poor, but it depends on which hospital you visit. There are 3 hospitals in Pyongyang, 2 being private and one being a public one for the common people. The 2 private hospitals are incredibly advanced, almost equivalent to American hospitals. The public one is the worst - worse than any I've seen in Russia, Ukraine, Kyrgyzstan, or Cambodia. Haha we saw very few pets! Maybe one-two dogs on the street. In the countryside, a lot of oxen are employed, although I did not see any horses. A Korean American has imported excellent goats into the country in the northern regions, elevating nutrition with goat milk and the like.
I can't tell what is going on in this picture. Can you elaborate?
Young boys are sweeping a kilometer long airfield at the Pyongyang airport.
I know that Military officers from the North Korean Army are "studying" in Geneva, Switzerland. That's interesting tho. Do you think that there are many other people, that are studying in well developed country, such as the Switzerland and other countries?
Thank you for the interesting AMA!
Oh interesting. I wonder what they're doing in Switzerland. North Korea spends an exorbitant amount of its GDP on its military, and it boasts over a million soldiers in its army of a population of about 25 million. Yes, many go to do internships or training in other post-Soviet countries or Communistic countries like Russia, China, Romania, Cuba, Vietnam, Cambodia, etc. Stanford university and some universities in NYC actually have fellowship exchange programs and sometimes train doctors or students in the US for 2-week periods or longer.
Is the religion/churches completely state-run? Is it mandatory to be attend or 'be religious'? Or frowned upon? Thanks.
Churches are state-run, yes. There are 4 state run churches in North Korea: 1 Catholic church in Pyongyang as well as 1 Protestant church and 1 Russian Orthodox. There is 1 Protestant church in the northern region too. I had the privilege of visiting the Protestant church in Pyongyang (called Bungsoo), though it felt more rehearsed than anything else. It's not mandatory to be religious, in fact, all North Koreans I met admit to not having a religion, and would quickly change the subject. So I'm guessing it's frowned upon!
Like what this guy experienced? (at 23:26)
I noticed some of the students carried smartphones with them during the conference. Is this normal?
Do you think the medical students believed any of the NK ideologies?
Btw thank you for doing the AMA. The gallery was stunning and I've never seen more candid photos of NK
Thank you, and thanks for your time! Smartphones are becoming an in thing. I don't recall seeing smartphones too much, perhaps also some of the smartphones you saw were held by our Korean American medical students.
They just set up a 3G network! $200 for 2 GB of data!
EDIT: $400. sorry.
Does N Korea have any medical schools or do physicians receive training elsewhere? Are hospitals technologically in the dark ages or are they pretty modern?
Yes! There are 10 provinces in North Korea, and each claims to have a medical school, along with the Pyongyang Medical College in Pyongyang. Here's an interesting statistic for you: there are around 181,000 medically trained staff (includes nurses, etc.) in North Korea. Around 33 physicians and 41 nurses per 10,000 people. Ethiopia has a ratio of 0.2 physicians and 2.4 nurses per 10,000 and South Korea has a ratio of 19 physicians per 10,000. So why does North Korea have more? The quality the doctors receive are less (they have less resources and information to work with) and standards are much lower. But, their character is something else! Very determined and resilient doctors. Some doctors that work with leprosy colonies or TB clinics end up contracting those diseases and dying from them. However, many doctors have traveled to Eastern Europe (Russia, Romania in particular) to receive further training. Some go to America, Kenya, SE Asia, China, Japan to receive more training too.
Depends on which hospital. The provincial hospital and the Pyongyang General Hospital (affiliated with the Pyongyang Medical College) suffer from poor reception of resources and funds from the governments. The military and private hospitals in North Korea fare much better and are almost equivalent to American (almost).
Do you know if any doctors have defected from out-of-country training?
Not to my knowledge! I don't think other doctors would advertise such, it would make the country look bad. I'm sure some have or have tried to.
What was the prevalence of addiction to harmful substances like methamphetamine, and what were doctors attitudes to those addicted?
I have to say you seen like an incredibly interesting and thoughtful person; sincerely all the best to you.
Thank you! Obviously, we weren't shown the so-called factories that may or may not produce methamphetamine. Personally I would not be surprised if such factories existed in North Korea. Methamphetamine makes very good sense in producing and exporting to allied nations like in SE Asia. Already, inspectors aren't welcome, so it would be a good strategy.
We didn't see patients with methamphetamine. Most of our patients were for surgeries, although there are TB and Hep B clinics we help out with.
Did, at any point during your trip, anyone act particularly hostile towards your group?
Nope! Everyone was very kind. I was just scolded a lot for taking too many pictures by our guides ;)
Why could you not reveal a lot of the things you said you couldn't reveal? You mention several times about things which you cannot reveal over the internet, why is that the case if you are outside of NK?
Good question. The reason is two-fold. One is I am actually revealing too much already. I do want to keep going back but I don't want to be banned from the country.
The second is that there are still a lot of work my organization does and other NGOs do and my revealing of information could risk the great progress they are making.
If you're still doing this AMA, how practical is the public medical system? As in are there any sort of folk medicines like there is in some parts of africa? What were your living conditions like? Is it uncommon for students to go to North Korea? And what sorts of things are you doing to improve their health care? And although this isn't what this is about, how does Korea compare to the other countries you've been to, medically?
The North Koreans boast of a free, universal health care system. Free, but not quality. The healthcare budget spends around less than a $1 per person per treatment. That's incredibly low. South Korea's average is $1093. North Korea ranks among the lowest health care expenditure.
Yes, there is traditional medicine called Koryo medicine, which involves acupuncture, herbs, teas, and other foods as healing. North Korea is very proud of their Koryo medicine, saying that Western medicine has a lot to learn from them.
Our team stayed in a decent hotel. We had a TV in our room with only one channel (the state channel). Mosquitos were monsters, and we suffered from so many attacks at night. Couldn't complain about the living conditions, I've been in worse places.
Yes, it is uncommon for students to go to North Korea. I haven't heard of many that do go.
We provide better medical equipment, for example: C-arms (x-rays) for surgeries, microscopes for surgeries, and then basic surgery tools, etc. North Korea's production of medicine and other medical paraphernalia has dropped, surprisingly. They used to make their own IV bags but somehow that has disappeared, so they have to import theirs from China. A lot of what we do is to educate and train future doctors. We also teach doctors new surgical techniques and then do the complicated surgeries that they may not be able to do.
North Korea's infrastructure is similar to post-Soviet countries like, say, Russia, Uzbekistan, Kyrgyzstan, and Ukraine. Things seem to be archaic and fixed beyond the need to be fixed. I'd say NK hospital system is the worst I've seen, worse than Cambodian (which says a lot).
Do you think it's possible that they take the good equipment that you give them and put it in the hospitals for the elite?
We get this question a lot. That's why we do many confirmatory trips to see where the equipment goes. The equipment we bring does not go to the elite hospitals - those elite hospitals have the means of procuring their own nice set of equipment from Germany, Norway, Sweden, etc.
Though we won't turn away patients who may be of the elite status, we really hope to make an impact from the bottom up!
As a young pastor in an American church I just wanted to say that I pray God blesses your ministry to the people of NK and in Ukraine. Are there any religious or social beliefs generally held by NK people that you have seen make practicing medicine more difficult in North Korean hospitals?
Thank you pastor! God bless you too and your church. hmm. I didn't encounter that, but that's a good question. If you look into the history of the church and medicine in Korea, Korea has been a conservative nation and in the beginning, unwilling to pursue modernity. The missionaries brought in two huge factors: medicine and education. When the first missionary doctor saved the life of the prince of Korea, hospitals were opened and Koreans saw the merits of western medicine. No strange religious beliefs like Christian Science or whatnot, not accepting blood transfusions.
do you think sanctions play a part in the parlous state of the country?
It's difficult. Politics being a power play. I don't know if lifting sanctions would help the country more if it lets dictator run unchecked.
Even with the embargoes and sanctions, NGOs are still making their ways into countries. My politics professor at UVA said that NGOs and missionaries are now much more influential and impacting than organizations like WHO or UN or other nations because of the ground-level personnel they have and the emotional connection they can share with the people. Even with sanctions, good people are doing good work!
Thanks for your pictures and insights! I'd like to ask, what is the appeal of NK to international tourists? Is it mostly the forbidden aspect of it, or like Schadenfreude, or are there actually fun things to do that make it worth the trip?
Haha, I wouldn't say it is Schadenfreude! Many go just to see it. People love to travel, and they like going to new places. Others are there for business, others are volunteers like myself.
They provide some great entertainment. They have dolphin shows, great concerts, they even have a Pyongyang marathon this upcoming fall I believe! While there's not a lot to do, they are growing this tourism sector.
North Korea has a medical school?
Yes! Many, 10 provincial medical schools and one in Pyongyang. A western one opened up in Pyongyang called PUST.
Hey! I enjoyed the photos and the stories. What nationality/ethic background do you have?
Yes, Korean American!
Approximately how many foreign doctors:North Korean doctors did you see? Oh, and also, i'm guessing Reddit is banned in the DPRK? ;)
There are very very few foreign doctors. The ones we see are probably only temporarily there for week trips.
Nope! Was able to access it! Also facebook and gmail are available. Unlike China -___-
All those NK medical students in that conference look so "normal" - did you happen to maybe get a sense of fear or disquiet behind their facades?
Did you witness any human rights violation while there? (not sure if you could even answer this outright)
I couldn't detect any sense of fear or disquiet. They seemed really fun and jovial. Aside from what I posted at the top, I did not witness any human rights violations (and seeing extreme poverty).
How did the North Koreans react if/when they found you were of Korean descent but spoke many other languages other than Korean?
They were quite happy actually. They were happy to learn that all 4 of my grandparents are from North Korea. They were impressed with my languages. Some were also learning Russian at the moment so I was able to converse with them.
I live in South Korea so I've been very fascinated with NK and I've visited the DMZ a couple times and heard many opinions about it. Do you think North Korea is going to change anytime soon? Maybe once Kim Jong un is gone? Its seems like the North Koreans are imprisoned in their own country. They have so little freedoms. But it seems like enough people know about the outside world at this point. Are the North Korean people doing anything to try and spread awareness or overthrow the government? Do you think this will happen any time soon?
Also random question that seems to have so many different answers floating around on the internet... Is weed legal in NK?
Do I think North Korea will change anytime soon...hmm. I don't think so. In Eastern Europe, they said the only way Russia would pull out is 2 ways: 1) the realistic way: St. George descends on a dragon and routs the Russian army and 2) the miraculous way: they voluntarily pull out.
It may take some sort of St. George like another famine or economic collapse to collapse the current government. Kim Jong Un isn't necessarily any better than his predecessor, in fact he is reported to have executed many including 80 Christians by the firing squad or dogs in his first few months after his ascension to the throne.
On the flipside, please be aware that the media loves to negatively portray North Korea. How come we don't hear about more doctors or NGOs? How come we don't hear about CFK that donated over 700 tons of food to North Korea during the Great Famine of the 90's? The country is slowly being opened up, and tourism is increasing.
I don't think a revolution would be realistic. The army is too strong and the government too powerful.
Marijuana grows wildly, just like it grows wildly in Russia or Central Asia. I don't think it's legal. The main substances we saw was a lot of alcohol drinking and a LOT of cigarette smoking.
Not OP, but as far as the DPRK goes, the end of the regime could potentially end in several ways. The most probable is complete economic collapse. The DRPK primarily relies on trade with China (and Russia to a much smaller extent since the collapse of the Soviet Union) and what it can muster from it's own self-sustainment attempts.
Overthrow of the government by the people is always a possibility, but an unlikely one given the iron fist the regime is known to exercise. Those deemed traitors to the regime risk not only their own lives, but those of their family members as well. The government does a well enough job of keeping security under tight enough control to help suppress any major movements.
The third possibility is military intervention, but I don't see that occurring offensively; only if the DRPK should try invading the ROK instead of its normal sabre rattling.
There is another possibility of Kim Jong-Un's successor openly turning the country around. There was thoughts before he took power that he would possibly be a much more progressive leader compared to his father and grandfather in part due to his alleged time in Switzerland, but those hopes turned out to be completely wrong.
The main problem with most of the scenarios regarding the end of the DRPK is the rehabilitation cost. East Germany took quite a bit of resources from West Germany during German re-unification, despite East Germany being the best off economically of the Warsaw Pact satellite countries. Even a relatively bloodless collapse of the DRPK is going to make a major impact to the finances of the ROK for many years.
Thank you for your insight! North Korea also relied on trade with Japan, but in the past 5 years relationships have been strained (I know not why). Large boats on the Eastern shores that would once routinely visit Japan now sit vacant and as ghost ships.
I don't see how military intervention would work out also. North Korea has ties with other nations like China and Russia that would prevent the US and its allies to risk a move like that.
There's a very well written paper that may be to your interest. I don't remember the title or author exactly, but a quick google search might do it. The paper explored the possibility of both nations reuniting and the potential of being an economic powerhouse. The South is already competing with the rest of Asia as one of the top economic nations. The North is rich with minerals, gold, gas, etc. but is not arable. Yes, the costs of rehabilitation would be enormous, but if the DPRK is willing to be vulnerable and ask for help, I'm sure the rest of the world would not be hesitant to help.
I would suggest removing the picture of a patient (especially his face) if he has not giving you right to post it on a website. I think it is (highly) unethical to do that.
I'm wondering how many hospitals there are? And why do the people know english so good? I can't imagine going to the USA and then back to North Korea.
Did the doctors ask about how life was outside north korea? Why didn't they try to leave the country?
Thanks for posting this interesting album and doing this AMA.
You're right, I'll try to take that down. Thanks for the notice. There are 10 provinces, each one possessing a hospital.
In Pyongyang, there are 3 hospitals (2 private, 1 public), though we suspect there is a fourth only for the top government officials.
Some people know English well because they've studied abroad in Europe or the US. These are very, very rare occurrences and it's difficult to go outside the country as a North Korean.
Some doctors do internships or fellowships in other nations, particularly Eastern Europe, Russia, China, Japan, or African countries. Stanford University actually has a working relationship with North Korean doctors and habitually invites some over. Can they defect? Maybe. They remain in North Korea, I think, because of the intense obligation they have to the family and community. Especially if they are senior doctors with a plethora of knowledge and experience, they have a tremendous responsibility in raising the next generation.
Why, of all the places on earth, did you choose North Korea? How often do you fear for your life or that you'll make a wrong move without realizing it?
P.S.: You are now tagged on RES as "Dr. DPRK".
What's RES? Not too familiar with all of Reddit's jargon.
I've been to many other countries too! Over 20. If you read in my short text, there are many other places I've been, some perhaps more dangerous than NK.
you've mentioned ukraine and other hot locations, is it true that part of "field" health workers are covered agents?
Sorry, what do you mean by covered agents?
Oh, I understand. I don't know, but certainly no one our team was. I'm just a student and probably too dumb for any agency haha.
During your time in North Korea did you come across their fabled drug Kumdang-2 that can cure AIDS, MERS, SARS, Ebola and several others? Russia Today
Haha we did ask about such drugs. Obviously no doctor believes in a solve-all. HIV is actually not a high prevalence in NK, but TB and Hep B are.
Why don't you think it's wrong to support the regime in North Korea by going there, spending money there, offering your services and making the US and your family vulnerable to their kidnapping/blackmail?
Well first of all I hope you don't make the assumption that we're going there to scrub the toes of the elite officials. That's not what we are there for and that's not what we do. I get this question a lot, but we didn't spend much money (aside from transportation and hotel costs). We brought in mostly medical supplies and these were for the provincial hospitals and the poor public hospital for the commoners. The media can contort your thinking into thinking that anyone who goes to NK is probably going to be detained, which is not the case. About 2,000 tourists go through North Korea each year, and the three incidences last year were more political than anything.
Why would you help America's #1 enemy?
I don't know about #1 enemy. I'm definitely patriotic, but we have a lot of other enemies abroad and also a lot of problems within these fine walls. 30,000 deaths per year in shootings here? c'mon...
We believe that we are more developed/better than North Korea. But is there something you think we could learn from them?
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