Since North Korean leader Kim Jong-un vowed to dismantle nuclear test sites, talks are continuing to achieve the complete denuclearization of the Korean Peninsula. Once the North commits to the denuclearization, the radical opening of the country will begin, and people of the two Koreas will soon be able to travel freely on the peninsula.
Experts noted that lively exchanges of people and goods would raise concerns for a spread of infectious diseases such as tuberculosis and hepatitis B. They urged a step-by-step preparation to help the North advance its healthcare capabilities.
Then, which area should the two Koreas focus the most to prepare for a reunified Korea? Healthcare experts picked maternal and child health issues as the No. 1 problem to be resolved in the North. They said if the South should help the “reunification generation” who will be born after reunification, it should identify the North’s current status in maternal and child healthcare and tackle the causes of the problems.
N. Korea’s infant mortality 8.8 times higher than that of S. Korea
Infant, child and maternal mortality rates are indicators of maternal and child health. Low readings of the three are often considered as the vicious circle. Among the three, infant mortality and child mortality are indicators of a country’s health status.
For the past several decades, the two indicators have fallen rapidly around the world.
South Korea’s high infant mortality rate of 254 deaths out of 1,000 live births between 1921 and 1925 steadily declined to 80 out of 1,000 in the 1960s. The figure further came down to 3 out of 1,000 in 2014.
North Korea’s infant mortality rate has also been declining from 95 in the 1960s. However, the nation still had 26.4 deaths out of 1,000 births in 2014, which was 8.8 folds higher than that of the South, according to UNICEF data.
The two Korea’s gap is wider in child mortality. While the South’s child mortality rate was 3.6 out of 1,000, that of the North stood at 33.4, 9.3 times higher than that of the South.
As for maternal mortality, another major indicator of a country’s health status, the North’s figure was seven folds higher than that of the South. In 2013, the North had 76 maternal deaths per 100,000 births, while that of the South was 11.5.
Gynecological characteristics of North Korean defectors show the dire situation of the North well, experts noted.
According to a survey of North Korean defector patients who visited the National Medical Center, 24.4 percent of the pregnant women suffered complications associated with pregnancy. Among the pregnant, 56.4 percent had medical problems. Also, cervical cancer and precancerous lesions frequently occurred in North Korean female defectors.
Premature birth, No. 1 cause of child deaths in N. Korea
The North’s poor maternal health status stemmed from multiple causes such as the poor health of infants, children, and mothers. However, experts point out that the reason is the malnutrition, coming from the dilapidated healthcare system and poor socioeconomic situations.
Latest data showed that prematurity was the most significant cause of death among North Korean infants and children.
According to the World Health Organization, 36 percent of North Korean newborns aged less than one month died from premature birth as of 2016. The No. 2 cause was congenital anomalies (19 percent), followed by asphyxiation and trauma (18 percent).
Among those aged from one month to 59 months, pneumonia killed 34 percent of the North Korean young children, injury, 15 percent, and diarrhea, 12 percent. In total, more than half of the children’s deaths came from infectious diseases.
The causes of the child mortality included premature birth (34 percent), acute respiratory infections (14.9 percent), and congenital anomalies (12.8 percent) in 2015.
Postpartum hemorrhage was the most common cause of maternal death (33 percent), and abortion and embolism (12 percent, respectively). What’s worth paying attention to is that a whopping 14 percent of the maternal deaths resulted from non-gynecological reasons such as a weak immunity derived from malnutrition during pregnancy, according to UNICEF data in 2010.
“North Korea has been failing to provide adequate maternity and postpartum care due to outdated hospital facilities, equipment and the lack of medicines,” said Cho Kyung-sook, head of the social services projects department at the Ministry of Health and Welfare. “As North Korean physicians find it difficult to provide proper medical care and treatment, the country has been unable to lower the infant mortality rate.”
Cho went on to say that not only North Korean pregnant women but all the North Korean people are suffering from undernourishment. “Natural disasters and economic difficulties across the North, and low vaccination rates due to the collapse of the healthcare system negatively affect infant and child mortality rates in the North,” she said.
‘Just a few, short-term aids will not resolve the issue’
Experts said the South should provide long-term healthcare infrastructure and socioeconomic support based on a correct analysis of the North’s healthcare reality.
“Maternal and child health projects cannot produce immediate results within a year. This is why it is important to find out how the North’s system is operating to prevent infant mortality and protect pregnant women,” said Joo Seong-hong, a physician at the NMC who has been offering medical care for North Korean defectors.
Hasty support without knowing the details may end up being ineffective, he said. “North Korea does not even announce related statistics. Based on indicators such as infant and child mortality rates, we should set up a long-term plan and support them continuously,” he said.
Cho from the health and welfare ministry expressed a similar view. “Maternal and child health projects are not a kind to finish in several steps like vaccinations. Such projects need lots of cost and time,” Cho said. “We should set priorities in detail, make attainable goals, and establish a sustainable strategy for the long term.”
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