Medicine against the odds in N Korea

By Sarah Buckley
BBC News Online

Aid workers who visited victims of last week's explosion in North Korea have spoken of doctors dealing with horrific injuries in very basic conditions.

But this is not surprising in a country with limited medical supplies; where doctors have been known to take the skin off their own legs to help burns patients.

Patients and relatives in Sinuiju were in a state of silent shock

Gerald Bourke and Richard Ragan of the World Food Programme said the People's Provincial Hospital in Sinuiju, near the Chinese border, was fairly clean and spacious but that equipment was scarce.

They said that of the 40 or 50 critically injured patients they saw, only two of them were on intravenous drips.

"We saw no modern equipment, nothing that could be plugged in," said Mr Bourke, the WFP's representative in Beijing, told BBC News Online.

"A lot of the patients had been stitched up, but the thread... was more like twine, it was very thick," he said.

"It shows these guys were probably operating in a hurry trying to stabilise people," said Mr Ragan, WFP country director of North Korea.

Some North Korean hospitals are not even heated

The victims were suffering from facial and eye injuries, internal injuries and broken or severed limbs.

Many had lost the sight in one eye, sometimes both; one woman had had both feet blown off.

"The faces of the kids were a mix of being burned and lacerated and several of the children had had the skin ripped off of them," Mr Ragan said.

He said the doctor in charge of the hospital, who was assisted by about 10-15 staff, was "very calm", given he was responsible for 360 emergency cases.

The doctor "said only 15 patients had died, and this was two days after the blast. So one could argue that they're pretty skilled physicians but are working with very limited supplies and equipment", Mr Ragan said.

Both Mr Bourke and Mr Ragan said that what struck them most was the "eerie silence" in the hospital.

There's an absence of almost everything except beds and doctors and patients and desire Stephen Linton, EugeneBell Foundation

"A couple of the children were whimpering and moaning but most of them were lying stock still in their beds," said Mr Bourke.

The relatives of the injured children were also quiet, Mr Ragan said. He described the parents of one eight- or nine-year-old boy who were having to hold their son down to stop him having spasms.

"You could clearly see the father didn't know where to turn", he said.

The rudimentary conditions the WFP officials witnessed are typical of many North Korean general hospitals, according to Stephen Linton, founder of the EugeneBell Foundation, a US NGO that provides the country with medical supplies and treatment facilities.

"The medical people are very dedicated, but the problem is modern medicine is predicated on a river of supplies and equipment, and that river has dried to a trickle in North Korea.

"There's an absence of almost everything except beds and doctors and patients and desire," he said.

He said some doctors were forced to grow cotton to make bandages, or to whittle their own splints; virtually every hospital grew its own herbal medicines; and surgeons often took their tools home to sharpen them.

North Korea has embraced cheaper, complimentary medicine

"Most doctors have lots of scars on their legs because they give grafts from their own skin", he said.

Mr Linton said the medical training programmes were of a similar length to those in Europe and every province has a medical school.

"Doctors are recommended to prioritise herbal medicine before the harder to obtain Western medicine," he said.

"They're very creative and hard working but everything that most people take for advantage is lacking," he said.

He said the conditions in the buildings were also very basic.

"They're not even often well-lit... some of them aren't heated.

"Patients wear their parkas in bed in the winter."

As a result, a lot of people received out-patient care because they could eat better and keep warmer at home.

"I don't know if medicine would be so popular in the West if (doctors) had to operate under the conditions in North Korea," he said.