Many parents have also been unable to cure their sons and daughters of the infection, which can cause death if left untreated, due to the scarcity of pharmaceuticals in the impoverished country, as well as the enormous costs associated with treatment, the sources told RFA’s Korean Service.
A large number of urban schools and daycare centers in North Korea were affected with cases of tuberculous meningitis—a bacterial infection of the brain and spinal cord—between July and August, according to one source from North Hamgyong province, near the border with China.
While authorities moved quickly to shutter the facilities and control the spread of the infection, mortality rates among children already affected have been high, he said, while those who have not died continue to experience severe symptoms due to a lack of complete treatment.
“An unknown illness that affected children in large cities—including Chongjin, Hamhung and Pyongsung—between July and August has been identified as tuberculous meningitis by the central government’s investigation team,” the source said, speaking on condition of anonymity.
According to the source, many of the deaths from tuberculous meningitis were the result of children’s hospitals’ failure to diagnose the infection in a timely manner.
Nearly all of the cases involved children under the age of seven, which is customarily when North Koreans begin receiving tuberculosis vaccinations, he said, while those four and younger were particularly hard hit.
A second source from Chagang province told RFA that many children’s hospitals had failed to diagnose cases due to “backward medical facilities and poorly skilled staff,” and said the outbreak was only identified through a government investigation launched following the rapid spread of the infection.
However, even after the outbreak was identified, hospitals often lacked the necessary drugs for treatment, and when parents were able to find the drugs in pharmacies or in Jangmadang (unofficial marketplaces), they could rarely afford them, he said.
The source said that “children infected with tuberculous meningitis are still suffering from pain,” and that while some of their symptoms are severe, “their parents just give up on their treatment, because the drugs are simply too expensive.”
Insurmountable costs
North Korea’s Sunchon Pharmaceutical Factory in South Pyongan province’s Sunchon city and Ranam Pharmaceutical Factory in North Hamgyong’s Chongjin city both produce the antibiotic Streptomycin, which can treat tuberculous meningitis, but the source said one bottle of 20 milligram pills sells for 4,000 won—the equivalent of an entire month of wages for managers of rural factories.
Six months of treatment with other imported antibiotics—the minimum amount of time usually required to cure the infection—can cost up to 400,000 won, which is nearly impossible for most families in North Korea to afford, he said.
One U.S. dollar is worth approximately 130 North Korean won, according to the official exchange rate, though the same amount fetches between 8,200 and 8,320 won on the black market.
Because of the prohibitive cost of pharmaceuticals, the source said, “some affected children are still suffering from the after-effects of the infection, including the paralysis of their extremities.”
Other complications that can occur if tuberculous meningitis is left untreated include brain damage, build-up of fluid between the skull and brain, hearing loss and seizures.
While North Korea’s constitution states that all citizens have access to free medical care, a report released last May by the Seoul-based Citizens’ Alliance for North Korean Human Rights said that many illnesses go untreated if the patient is unable to provide money or gifts to doctors.
Reported by Sunghui Moon for RFA’s Korean Service. Translated by Changsop Pyon. Written in English by Joshua Lipes.
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