The Hidden People of North Korea (25 page)

Getting admitted to well-equipped hospitals like the Pyongyang Maternity Hospital, the Pyongyang Medical University Hospital, or the Kim Manyu Hospital is only a dream for most people. Even if those hospitals admitted ordinary people, which they rarely do, getting timely transportation to them would be extremely difficult. Travel from one city to another often takes days and requires the payment of bribes to get on trains, buses, or, most commonly, open-bed trucks, nicknamed
ssobicha
, or “service cars.” Most patients are treated locally with herbal medicines gathered and mixed by a physician or pharmacist. An article in the North Korean press praises local hospitals and clinics that procure their own medical supplies for their efforts to “lighten even a bit of the burden shouldered by the great general who takes great pains to promote the people’s health.”
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Patients in need of complicated operations or modern medicines such as antibiotics must pull through by themselves.

North Korea’s doctors perform as well as they can under the circumstances. As employees of the state, they receive only subsistence wages, although they benefit from gifts of food and homemade consumer goods donated to them by grateful patients. Doctors dedicated to treating their patients perform heroically, for example by using old X-ray machines that expose their own bodies to dangerous levels of radiation. What must be most difficult for medical professionals is the frustration of watching patients suffer and die from diseases that could easily be cured if the proper medicines and equipment were available. The World Health Organization has estimated that North Korea depends on foreign donors for 70 percent of its most basic drugs.
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Norbert Vollertsen, a German physician who worked as an advisor in North Korea from 1999 to 2000 and later became an outspoken critic of the Kim regime, documented some of these frustrating conditions: “There were no bandages, scalpels, antibiotics or operating facilities, only broken beds on which children lay waiting to die.”
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A German technical advisor to a foreign aid group reported, “The hospitals, nurseries, kindergartens, and schools I witnessed personally were, in a word, ‘hellish.’… Bacterial infection and diarrhea are epidemic in the regions outside of Pyongyang, and because pharmaceuticals such as antibiotics are depleted, most of the residents live with one or two kinds of chronic disease.”
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The North Korean government has been so unhelpful to visiting health-care workers that some of the foreign medical organizations, including Doctors without Borders, Oxfam, and CARE, have withdrawn from the country.
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Beginning in 2006, the International Red Cross scaled down its assistance programs, diplomatically noting that the year was “marked by increased complexities in the implementation of the programs.”
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In 2006 the (South) Korea Center for Disease Control and Prevention examined the health history of over one thousand North Korean defectors.
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The average North Korean defector was three inches (eight centimeters) shorter than his or her South Korean counterpart and weighed seventeen pounds (eight kilograms) less. Of the North Korean sample, 77 percent had contracted diphtheria and rubella, 64 percent mumps, and 53 percent measles; 44 percent had a history of carrying parasites (a figure twelve times higher than in South Korea). Syphilis was eight times more frequently found in defectors than in a comparable South Korean sample. The United Nations’ 2006 World Population Status Report estimated the life expectancy of North Korean men to be sixty-one years, compared to seventy-four years for South Korean men (the ROK Ministry of Health says seventy-eight years); the comparable figures for women were sixty-seven and eighty-two years. North Korea’s estimated infant mortality was forty-three, compared to South Korea’s three, per one thousand.
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On the other hand, an entire mini-industry is devoted to the health care of Kim Jong-il, who, along with his top cadres, has access to the Ponghwa (Bonghwa) Clinic, which appears to provide medical care comparable to that found in hospitals in developed countries. A handful of top cadres have also been permitted to travel abroad to receive medical treatment in Beijing, Moscow, and Paris, and top medical specialists are sometimes flown into Pyongyang to advise North Korean doctors on special procedures to treat Kim.

Housing

It is difficult to determine what housing conditions are for the average North Korean because foreigners are not permitted to visit their homes, although foreigners are occasionally invited to see the apartment of a model citizen in Pyongyang. The capital city was almost completely destroyed during the Korean War and rebuilt in a modern design. Under the direction of Kim Jong-il, the city got a major facelift to prepare for the Thirteenth World Festival of Youth and Students in 1989 with the construction of rows of thirty-and forty-story apartment buildings on Kwangbok (“liberation”) and Tongil (“unification”) streets.

Compared to most large cities, Pyongyang is serene and orderly. High-rise buildings set among parks and monuments line broad but empty streets. Except when sand blows in from China, the air is clear because there are few vehicles on the streets and few factories operating. Visitors often find the city not so much quiet as disquieting, like an enormous Potemkin village, although hidden behind the tall buildings one can glimpse neighborhoods with winding streets and old-style tile-roofed houses.

The top cadres in Pyongyang live in large apartments or detached homes with small gardens located in neighborhoods surrounded by guarded walls to keep ordinary Koreans well away. They may also enjoy the use of a modest dacha in the countryside. Officials of somewhat lower rank live in high-rise apartments of three or four rooms, while mid-level officials get a one- or two-room apartment. Many people in Pyongyang and other cities live in single-story multiplex buildings of simple design or in traditional Korean dwellings. In the countryside, old tile-roofed and some thatched-roof houses from the early twentieth century can still be found.

The most prominent building in Pyongyang is the 105-story pyramid-shaped Ryugyong (Ryukyong, Yukyong) Hotel, designed to be Asia’s tallest hotel. Construction began in 1987 and was supposed to be completed in time for Kim Il-sung’s eightieth birthday in 1992. However, work stopped in 1989, and the French consultants withdrew the following year, complaining they were not being paid. Because of structural flaws and lack of materials, only the superstructure and façade were completed, and the building remains an empty eyesore overlooking Pyongyang, with a construction crane still perched at the top. There has never been an official explanation of what happened, and the North Korean media never mention the structure, even though it dominates the Pyongyang skyline. In 2009 Orascom, an Egyptian construction company, installed glass panels on the building to make it look less abandoned.

Visitors to Pyongyang stay at one of a handful of hotels catering to foreigners, the most popular being the twin-towered Koryo Hotel and the newer Yanggakdo Hotel, which is located on a small island in the Taedong River. Power outages in these hotels are less frequent than in other buildings, but to conserve electricity hallways are kept unlighted most of the time. High-ranking foreign officials visiting Pyongyang are usually put up in government-owned guesthouses.

The state or a collective owns most dwellings in North Korea, although it is said that in the countryside there are some old homes that the communists never nationalized because their owners were from solid working-class stock. Until July 2002, housing was almost free, but under the new economic-management measures, the government now charges rent on homes and fees for utilities. As in other socialist countries, housing in North Korea has always been in short supply. Extended families often live in two-room apartments, and newlyweds typically wait several years before they can move into their own apartment.

Power outages are a daily occurrence, and residents of smaller cities and towns may be without electricity for days or even weeks at a time. At night, people use kerosene lanterns and candles for lighting, even in Pyongyang’s high-rise apartment buildings. Streets are not lit, but monuments to the Kim family are brightly illuminated. Without power, there is no running water or elevator service. Only the homes and apartments of the elites enjoy central heating. Other residents warm themselves with small stoves, insulate their windows with vinyl sheeting, and huddle under blankets.

The head of the
inminban
(neighborhood or people’s group consisting of twenty to forty households), who is usually a housewife or retired worker, recruits residents for all manner of local activities, including neighborhood security, cleaning, maintenance, recycling, and road repair. The group leader also checks to see that the households participate in required communal activities, including composting and farming assistance. In apartment buildings, residents take turns acting as security guards, recording the comings and goings of nonresidents.

Changes in the economy and a weakening of government control are beginning to transform the housing market. Although houses and apartments cannot be privately owned, people find ways to buy and sell their homes anyway. The usual procedure is for two individuals to agree to trade homes and then to bribe housing authorities to change their residency registrations. In some cases people trade away their homes for needed cash and end up homeless. It even seems to be possible to construct private housing. According to one report, a business enterprise, usually an arm of a government, party, or military organization, uses money from investors to buy out owners of existing dwellings, tear down their homes, put up a new building, and sell the condominiums for a tidy profit. Considerable bribery is necessary to complete such a project, and relevant housing officials may even receive ownership of one of the new units.
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Because apartments and condominiums in desirable downtown locations can fetch thousands of dollars, and condominiums in Pyongyang sell for as much as $30,000 to $40,000, real estate purchases must be made with illegally gotten money.
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After all, the annual wage for most North Koreans is less than $100 in hard currency. Houses near marketplaces are in particularly high demand because when the authorities crack down on a market, vendors can take their customers to a nearby house and continue their business. A political lecture for domestic consumption mentions the existence of private inns in North Korea. Titled “Let Us Thoroughly Eliminate Private Accommodation Facilities and Give No Room for Enemies to Maneuver” and dated May 2004, this lecture alleges that private rooming houses springing up near railway stations and highways throughout the country can be used as hiding places for foreign spies.
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The lecture also notes that “ill-behaved women” entertain men in these houses.

The Uncertain Future of the New Economy

The Kim regime’s willingness to loosen economic restraints on the people and devolve economic responsibility to lower levels has fundamentally changed the character of the civilian economy, which has gone from being a struggling socialist command economy to an emerging protomarket economy. How far this change will go is hard to say. Those foreign analysts who see great promise in North Korea’s economy since the introduction of the July 2002 economic measures are really only seeing the emergence of a nation of very small shopkeepers. At the present stage, the reformed part of the economy is largely engaged in buying and selling cheap cottage-industry and Chinese-made goods, an activity that livens up the streets but does little to build a strong economy. It might not be an exaggeration to say that this is the sort of economic activity conducted in market towns in the Middle Ages. The sidewalk vending that is becoming popular in North Korea today was common in South Korea in the 1960s and 1970s, but in South Korea, by the 1970s, factories were beginning to turn out manufactured goods for the domestic and international markets, and by the 1980s South Korean heavy industry was taking its place in the front rank of the major economies. It is hard to imagine that North Korea’s dilapidated industries can make such progress in the coming years.

The economic changes that have come from the people, not the regime, are creating a new economic class of people with hard currency, usually earned illegally, while the rest of the population depends for its livelihood on barter and the worthless North Korean won. Formerly, the privileged economic class consisted of top party and government officials, who receive better rations than the common people and whose positions of authority make it possible for them to exact bribes. Today, the rich people, who are sometimes the same party and government officials, are those who know how to earn foreign currency. This phenomenon is similar to what happened in Russia in the 1990s. In North Korea, many of the newly wealthy class get their start with money from relatives in China or Japan. Most of their businesses involve trading: they have not progressed to the stage of buying up North Korea’s decrepit industries, which have not yet been put on the market, although entrepreneurs may “rent” some of them by taking a management position in return for infusions of cash or resources.

These nouveaux riche, who have foreign connections and whose families are often not native Korean, were formerly discriminated against as members of the unreliable political class, but now their foreign currency connections eclipse their political liabilities. They can rehabilitate themselves by providing generous donations to public projects, such as school improvements, and by being generous to members of the party and government bureaucracy. In fact, like flies to honey, cash-poor party members, bureaucrats, and police officers are drawn to these wealthy new entrepreneurs, forcing them to pay out money right and left in order to get things done and stay out of trouble. A former North Korean truck driver reports that he would lose 50 to 60 percent of his cargo on the drive from China to Pyongyang because each time he was stopped by security forces, he had to offer them some of his cargo as a bribe to let him proceed.
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