Sunday, 21 May 2023

DPR Korea: A true people’s health system

medical students in Pyongyang
by Dermot Hudson

The socialist healthcare system of the Democratic People’s Republic of Korea (DPRK) has a long history.
    On the 1st January 2023, it was 70 years since the DPRK introduced universal, free medical care. On the 1st January 1953, it was introduced in the DPRK according to the provisions of DPRK cabinet decree No 203 “On Enforcing Free Medical Care System for the People”, which had been adopted some weeks earlier on the 13th November 1952 under the guidance of President Kim Il Sung. Prior to that, free medical care for industrial and office workers based on insurance had been introduced in 1946 (two years before the NHS was created in the UK).
    The DPRK’s health service was not created under ideal conditions of peace but in the flames of war when the country was being pulverised by the carpet bombing of the aggressive US imperialists. Moreover, at the time the DPRK was not a rich or prosperous country, it was a new country which had emerged from the ruins of Japanese colonial rule.
    From the 1st January 1953 all medical care in the DPRK became completely free at the point of need for all. This includes doctor's visits, hospital treatment, convalescence and medicines. Even dentistry is included and also fares to hospital are paid. There are no hidden fees such as car parking charges or charges to watch TV in hospitals. Further legalisation by the DPRK in 1960 and 1980 legally buttressed free healthcare.
    The DPRK has the unique section doctor system, whereby doctors from a local clinic take charge of the surrounding area and visit people in their homes to give up check-ups and medical advice. Usually a local DPRK doctor looks after 130 households. This is a big contrast to the present NHS GP system, under which it is often impossible to see a doctor and only telephone or online consultations are possible. In the DPRK they say “Go to the doctor before you are ill”.
    Special priority is given to mothers who give birth to many children, the DPRK has many triplets. Concern for the health of women is something taken very seriously. There is the Pyongyang Maternity Hospital, which has over 1,000 beds. In recent years the Breast Tumour Institute of the Pyongyang Maternity Hospital was constructed.
    The DPRK has a dense network of medical establishments such as general hospitals, specialised hospitals, hospitals or clinics, from the highest down to the lowest unit of administration such as ri and dong. Factories have their own medical staff and even their own hospitals.
    According to data, there are as many as 9 000 public health agencies. The DPRK has witnessed the increase of hygienic and anti-epidemic bodies by 38 times, of hospitals by 53.8 times, and of doctors and pharmacists by 322 times during the period from 1946–2006.
    Already in the 1970s it ranked in the advanced countries in terms of the number of doctors, medical facilities and beds for every 1 000 people. According the World Health Organisation (WHO), in 2010 the DPRK had 143 hospital beds per 10,000 of population. This compares with 24.6 per 10,000 in the UK in 2019, 28.7 per 10,000 for the USA in 2017, and 124.8 per 10,000 for south Korea in 2018. The DPRK is way ahead of other countries.
    In 2010 the then director of the WHO Dr Margaret Chan said of the DPRK: “They have something which most other developing countries would envy.”
    In recent years the DPRK constructed new state of the art hospitals such the Okryu Children’s Hospital, the Ryugyong Ophthalmic hospital and many others. In the DPRK, hospitals are linked together by an advanced telemedicine system.
    A delegation of the British Group for the Study of the Juche Idea and the Korean Friendship Association of the UK was able to visit the Okryu Children’s Hospital that was completed in 2013. It has a total of 32,000 square metres of floor space, making it quite large – larger than many UK hospitals. We were only able to see a small part of the hospital as there was not enough time, however, what we saw was most impressive. The hospital was positively ornate, with marble floors and pillars. The hospital was decorated in light colours that gave a warm and cheerful atmosphere to the place. In the UK hospitals are usually regarded with fear and apprehension, but this hospital seemed such a welcoming place. We saw rooms for rehabilitating disabled children. There was a school within the hospital so that children do not miss schooling when they are in the hospital. We also saw a telemedicine room. Here the hospital is linked to other children's hospitals in the country so that doctors in different hospitals can consult with each other instantly.
    I also visited the Ryugyong Ophthalmic Hospital in February 2019. This was opened in 2016 and took only seven months to construct. It has eight floors with 100 inpatient beds. The hospital offers both inpatient and outpatient treatment. There is one doctor per room. The hospital was spotlessly clean.
    The DPRK’s healthcare system is self-reliant and operated with 100 per cent DPRK resources and labour, no foreign doctors or nurses work in DPRK hospitals. The DPRK medical care system showed its resilience when COVID‑19 struck the country in May 2022. The healthcare system was assisted by the Korean People’s Army (KPA), who were mobilised to help. The COVID‑19 epidemic was overcome within 91 days and the fatality rate was minimal. This was achieved without the dubious so-called ‘aid’ of the imperialist countries and south Korea.
    The universal, free medical care system of the DPRK is a true product of the people-oriented system, the socialist system and the popular policies of the Workers Party of Korea.