Healthcare as a Human Right in North Korea

What is the definition of healthcare in North Korea; or even health care in general? Is Healthcare a Human right in North Korea? In a world comprised of different cultures, and people is a world full of different ideas. Each country and region have different ideas on how their own systems should work based on their own ideologies, religions and cultural context. This means that healthcare also has a different definition based on what cultures value and what they see as appropriate. North Korea had once claimed that its free, socialist Universal Healthcare that employed more than 44,000 general practitioners, is failing with no adequate supplies, inadequate hospitals and a shortage in staff (Demick, 2010). Unfortunately, after North Korea’s brief improvement, they once again began the rapid decline in economic and health sections of North Korea due to the economic sanctions applied by the UN and the United States in 2006 (Yoon, Woo, Kim, Um, Park, & Seo, 2019).

North Korea’s healthcare system is in a healthcare crisis; workers are using and reusing supplies such as gloves and syringes; they also lack essential medications to properly treat patients (Zarocostas, 2010). This, unfortunately, can be contributed to the sanctions put in place by the UN and the United States; the sanctions hampered North Korea’s medical research and forced North Korea to fall back on home remedies to treat illnesses (Yoon, Woo, Kim, Um, Park, & Seo, 2019). Without pain medication or anesthesia to perform surgeries, many have to go under the knife without any pain reliever to lessen their pain levels. In such cases, a 24-year old man, Hwang, had to experience this first hand when Hwang had to undergo a leg amputation for breaking his ankle falling off of a moving train (McCurry, 2010). Another example is that a 56-year-old woman had her limbs tied down to prevent her from hitting due to the excruciating pain she was experiencing during her appendectomy (Demick, 2010). To compound this issue, the medical staff that work at the failing hospitals are not paid or are underpaid and usually have to work by candlelight to accomplish their work due to run-down facilities that have no heat or electricity (Zarocostas, 2010). This turns into paying doctors in other ways such as paying with alcohol, cigarettes, and food in exchange for needed tests or hospitalization (Zarocostas, 2010).

According to WHO's director-general Margaret Chan, North Korea claims to have a well versed, free health care system (McCurry, 2010). However, North Korea only spends less than, on average, about US$1 on an individual per year whereas the average globally is about US$716 a year (McCurry, 2010). Unfortunately, this means that many people go without the necessary healthcare that they need due to the expenses associated with the system (McCurry, 2010). For example, in 2014, North Korea experienced a severe tuberculosis outbreak and is considered dangerous and is a serious problem for not only residents of North Korea but for the people seeking help (Fahy, 2016). Migrants are attempting to look for refuge away from Kaos and they are being met with health abuses. Fortunately, North Korea started receiving food aid in 1996 from the Eugene Bell Foundation (EBF) and eventually switched to helping with treating tuberculosis instead; this involved x-ray machines and other diagnostic equipment (Fahy, 2016). The United Nations Commission of Inquiry found not only human rights violations, but also health violations (Fahy, 2016). Not only are North Koreans facing the healthcare crisis, but so are migrants and prisoners (Fahy, 2016). As of 2001, the death rate in Korea has increased by 40% because North Korea is losing against preventable diseases (Lamar, 2001). Former prisoners have said that in the prisons, they were sprayed with chemicals similar to the ones used on toilets; which can be very toxic and harmful to their body and many were isolated in different facilities (Fahy, 2016). Many have also resorted to self-treatment using morphine, illicit drugs such as “ice” and other opiate substitutes (Demick, 2010). Moreover, the rate of infection of tuberculosis was about 442 out of 100,000 people (Fahy, 2016).

The North Korean government and Ministry of Public Health are attempting and have begun to get this situation under control by ensuring the highest standards of health are attainable through the set healthcare system without any discrimination based on color, religion, or citizenship status (Fahy, 2016). To accomplish this, the government needs to be sure that all citizens can access this health coverage (Fahy, 2016). This would include education on tuberculosis and proper medication in re-education centers, detention centers as well as prisons (Fahy, 2016). Implementing a new and improved healthcare system would help the population of North Korea to start moving forward not only health-wise but economically (Fahy, 2016). To implement a new and improved health care system, North Korea needs to be held up to their promises of fixing their damaged governmental structure because, without new structures, North Korea will continue to struggle with providing basic necessities and healthcare to their own people (Owen-Davies, 2001). Unfortunately, migrants and prisoners are more susceptible to carry and spread tuberculosis through the population (Fahy, 2016). This can be contributed to the food famine and nutrition deficiencies, which can weaken immune systems and make people more susceptible to illness (Owen-Davies, 2001). This ultimately leads to the deaths of about 2 million people throughout the 1990s; all related to preventable illnesses (Demick 2010).

According to the article Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990-2015: a novel analysis from the Global Burden of Disease Study 2015 by Barber, Fullman, Sorensen, Bollyky, McKee, Nolte, Murray, et al; who measured the quality of care in North Korea, found that the Healthcare Access and Quality Index was 57-5 in 2005; 60-4 in 2010; 62-3 in 2015; and 70-6 in 1990. This allows us to see the decline and improvement of healthcare in North Korea and that the quality is pretty close to the quality in 1990 before the decline of the Soviet Union and the implementation of sanctions (Yoon, Woo, Kim, Um, Park, & Seo, 2019).

To conclude, North Korea does not currently consider healthcare a human right. North Korea does not currently have the resources to care for its own citizens and this is causing much more than just healthcare violations. Regular human rights violations are occurring as well because North Korea cannot feed its people or care for them. This means that the quality of care is less than ideal. Unfortunately, with penalties in place for countries, not following rules, this can sometimes do more harm than good, particularly in this case, specifically because we as a global community is constantly trying to monitor and be sure that regulations are upheld to the highest extent they can be at.