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| Doctors and officials from government and non-governmental organizations attend a symposium on North Korea's healthcare and medical situation at Seoul City Hall, Thursday. Korea Times photo by Jung Da-min |
Doctors urge medical exchanges come first in inter-Korean projects
By Jung Da-min
When discussing the economic outlook, many believe AI (artificial intelligence) and inter-Korean joint economic projects will be the driving forces of the Korean Peninsula's future.
However, doctors and officials who have been studying North Korea's health system say cross-border medical exchanges should come before joint economic projects.
Among them is Park Sang-min, a professor of family medicine at Seoul National University Hospital. During an interview with The Korea Times on Thursday, he said there are two major reasons why medical issues matter.
The gap between the two Koreas
Before the 1990s, when the former Soviet republics started to collapse, medical treatment and people's health were not much different in the two Koreas.
North Korea's medical situation, however, deteriorated in the 1990s as the country suffered a lack of medicines when supply chains in the Soviet republics dried up.
According to United Nations Population Fund data, the life expectancy of North Koreans is recovering, reaching 72.1 in 2014, up 2.8 years from 69.3 in 2008. It was 73.4 in 1993 before the country suffered the so-called Arduous March in the mid-1990s.
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| Park Sang-min |
"The North's life expectancy is recovering but the country is still going through a state of confusion seen in other transition countries," Park said.
"A series of natural disasters like floods and famine in the 1990s caused an overall reduction in social resources and the national healthcare budget was also reduced. This led to the formation of informal medical markets, bringing side effects such as weakening national control over residents' healthcare and abuse of drugs among people."
In particular, North Korea suffers a high incidence and mortality from infectious diseases such as tuberculosis. According to the World Health Organization's (WHO) 2017 Global Tuberculosis Report, the number of cases detected in North Korea in 2016 was 130,000, up 20,000 from the previous year. About 11,000 people died, more than double the 5,000 in the previous year.
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During the period, the number of tuberculosis cases worldwide decreased 2 percent and deaths 3 percent.
"The international community's financial assistance to North Korea is needed and South Korea's role is important," Park said. "In particular, about 65 out of 100 donations to North Korea by WHO were supported by the South Korean government's inter-Korean cooperation fund."
Health security and humanitarian grounds
Some people might question the necessity of South Korea helping with North Korea's healthcare sector.
There are two reasons, according to Park.
"One reason comes from the concept of health security," he said. "If an infectious disease is not managed in North Korea, it will eventually spread to South Korea and pose a risk to the health of South Koreans as well. How could we discuss inter-Korean economic projects when there is a threat to people's health?"
Another reason is based on humanitarian grounds.
"In the era of unification, North Korea is the companion we should go with," Park said. "If there are vulnerable people in the North, we need to help ensure their health."
Low fertility and aging in the North
When discussing inter-Korean medical exchanges, the population crisis is another major area, Park said.
"The United Nations Population Fund's 2014 data already showed that the fertility rate in the North stood at 1.89, on decline from 2.01 in 2008 and 2.2 in 1993," he said. "The replacement level is about 2.3."
On Radio Free Asia's (RFA) Wednesday report on North Korea's population crisis, citing data released by Washington-based organization Population Reference Bureau (PRB), he said the issue of low fertility and aging is not new but the data shows the process is under way.
According the RFA report citing PRB's 2018 World Population Data Sheet, North Korea's total population this year increased to 25.6 million, up 100,000 from a year ago.
North Korea's population growth is projected to slow according to the data, with the population reaching 26.7 million by 2030, up 1.1 million in 12 years, and 26.8 million by 2050, up 100,000 in 20 years.
Data on PRB's website also shows the percentage of population aged 65 and above in 2050 in the North will likely reach 20 percent, double this year's number. The figure in South Korea would reach 35 percent.
According to World Bank data, the percentage of population aged 65 and above was 14 percent in South Korea last year, while it was 9 percent in the North.
Meanwhile, South Korea's fertility rate fell to a record low of 1.05 last year, down from 1.17 a year earlier, according to Statistics Korea data.
