··· International Market & Trends
As regards healthcare, there is a marked difference between what official claims state and the reality. Nominally, medical treatment is provided free of charge to all citizens, and some general figures are also good, with one doctor every 304 inhabitants and one hospital bed for every 78; however, a report prepared by Amnesty International and based on extensive interviews with North Korean refugees opens a window on the real health status of the majority of the population, which is under continuous threat. The combination of natural disasters, limited cultivable land and economic mismanagement, a bad famine hit the country in the early 1990s and brought about a million people to die of starvation. The government then started to encourage the population to eat wild foods such as roots, grasses, stalks and tree bark, claiming that they were healthy and safe. As the food shortages worsened, wild foods including varieties, that can be poisonous or cause severe digestive problems, became a consistent part of many North Koreans’ diet, and by 1996 the UN estimated that they accounted for some 30% of it. Still nowadays, in the lean months, households often mix wild foods with grains, such as corn or rice, in order to make their limited food supply last longer. According to Reuters, Pyongyang keeps spending most of its earnings and often also diverts aids towards its million-strong army and the development of nuclear weapons and missiles instead of feeding its millions of malnourished people. Food shortages are still a common problem and significantly affect general health conditions. Public health information is also lacking and many people do not visit doctors when they are ill, or if they do, they cannot afford more complex treatment. Health facilities are reported to operate with frequent power cuts and no heat. Even basic medicines
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and essential sterile disposables are missing, and because medical personnel often do not receive salaries, doctors charge illegally for their service, thus excluding the poor from medical care and medicines. Witnesses even said that surgery is often performed without anaesthesia. In consequence of the newly arisen tensions between the two Koreas and with the USA, the two biggest donors, it is now even more difficult for aid organizations to supply food and basic medicines to the North Korean people. Unless a change in the party’s aggressive and mismanaging policy occurs, there are minimum hopes for a fast resolution of the crisis.
South Korea The demilitarised zone (DMZ) between South and North Korea is the world’s most heavily-fortified frontier. Right beyond it, a totally different world from the totalitarian North makes the difference between the two countries even more striking. Only about 190 km away from Pyongyang, Seoul is one of the most modern metropolis in the world, the capital of one of the major world economies and among the most affluent Asian countries. Its 50 million population enjoy average life expectancy of 81 years, a per capita gross national income of over US$22,000 and a GDP that topped US$1.116 trillion in 2011 and grew by despite the global crisis. As far as healthcare is concerned, the contrast is also sharp. The South Korean healthcare system is based on a compulsory national health insurance established in 2000 from the integration of several existing health insurance funds. funded by taxes, integrated by private health insurance that cover additional expenses.
INTERNATINAL MEDICAL MAGAZINE FOR B2B