Date: Sat, 9 Aug 1997 11:55:28 -0400
To: kim20@law.harvard.edu (Tae-hui Kim)
Subject: Re: medicines to DPRK (from KJ)

Dear Mr.Kim

I will send you a brief preliminary reply, between the lines of your message, as I am down with a cold. If you have further questions, please get back to me. I would also like to run this exchange on my home page, if you have no objection. Please advise.

I am cc:ing this response to Dr. Moon Pak, a Korean-American doctor from Michigan who is the recent president of the Christian Association for Medical Mission. The CAMM supports a hospital in North Korea and I have been cooperating in shipping ambulances and medical equipment/drugs into North Korea for them through Japan. A North Korean ship leaves from Niigata every two weeks and I have been able to ship and transship donations through it free of charge once goods come to Japan. Therefore you could ship your drugs there via Fedex, for example, to the bonded warehouse in Niigata and I could get them to North Korea, then arrange for them to be given to the Health Ministry for distribution and might join myself for monitoring if the contributions are substantial enough.

I am in the process of trying to work something out like that with Dr. Park & the CAMM. If you are able to generate such a campaign through American campuses, medical schools, drug firms, Korean-American students, etc., the result might be substantial and life saving and I would do everything to cooperate with you to see the donations are quickly and effectively sent to and properly distributed and administered in North Korea.

>I am a medical student at Stanford University in California, and along with many other Korean-Americans across the US, have been involved in fund raising for North Korean food relief for the past year or so. I've been reading your web site with much interest, and it has been useful in educating others about the situation.

>I am writing you for some advice. For the past month, I have been calling around and talking to various non profits about how to get medicines to North Korea. Though clearly medicine is not as important as food or even fertilizer, I think that a lot of Korean-American communities would be interested in allocating part of their fund raising money to transport medicines donated from U.S. pharmaceutical companies if it could be done cheaply.

>Do you think that the North Korean doctors and hospitals you visited on your trips would be interested in such medicines? If so, is there a way for me or you to contact them to ask them a number of technical questions, specifically:

They would definitely be interested and appreciative for such donations.

>1) In what quantity do they need medicines? From all reports, they need large quantities of first-generation antibiotics, but I'm wondering how much would be worth their while. My feeling is that at least $30-40,000 worth of antibiotics would be needed to be even worth the trouble to accept and distribute.

My daughter Debbie, interviewed a key official of the Health Ministry in Pyongyang last April when we were there. I attach the portion of her interview with him which is relevant, at the end of this message. If you feel a massive campaign will result, I will contact him at the Ministry, once substantial contributions have been collected, to seek their cooperation in the distribution. I do not want to contact them yet and raise false hopes as this has happened before and disappointment has resulted.

>2) Would they be willing to accept donations of antibiotics that have only 6 months left before expiration? Gathering a large amount of donated medicines is difficult nowadays, which seems to be the reason why US non profits are not sending actual medicines (instead of other medical supplies such as syringes and bandages), but I think that if North Korean doctors were able to use drugs closer than one year to expiration date, it would be easier.

It has been my policy lately not to ask too many questions in advance. People are prudent there and prefer to say "no" and not get themselves in trouble. There is no set policy on such inquiries and you get different answers from different people. When donations are sent they are gratefully accepted and used.

>3) Is there a physician that could take responsibility for accepting the medicines and distributing them? I know several bilingual Korean-American doctors who might be willing to accompany the medicines, but that would increase transportation costs.

The North Koreans feel they have enough competent doctors and those I have met (I spent nine days in a Pyongyang Hospital myself in April) confirms they are quite good and knowledgeable and caring. They only lack supplies.

>I think that other problems are solvable, like transportation. Mercy Corps Intl. in Portland now has a license to ocean transport medical supplies, or if necessary, perhaps we could fly them over, or perhaps you might be willing to take some boxes on your next trip. But the main thing is to make sure that North Korean doctors can use and truly need US medicines.

They can use them and these will not be wasted. The transportation problem has been solved I believe if you can get them to Niigata, Japan, which doesn't even require any special licenses. The Japanese Health authorities are generally quite strict about the import of foreign medicines but this hurdle has also been solved. I have gotten them to agree to accept any foreign medicines without red tape if they are destined to the Niigata bonded warehouse for re-export. The North Koreans, in turn, will accept any donations from me for this ship.

>Well, for all I know, you've explored these issues before. Thanks for getting through such an involved letter. Good luck in your future endeavors in North Korea and also Cambodia (I've been seeing your name in the papers for that, too). Please write me at this email address, or I'm available by phone (617) 493-6630.

I hope this has been helpful. You may also wish to get in contact with Dr. Moon Pak by e-mail

moonpak@compuserve.com

and get back to me.

Best regards,

Bernie Krisher

They told me about the present medical needs of the country. The three consecutive years of floods devastated their supply of medical drugs and nourishment. The flood disaster washed away drug factories and currently there is a shortage of medicines. The most effected from this problem are children under the age of six, who are weaker and more susceptible to diseases than adults. Diseases which were eradicated in the country have reemerged due to a combination of the contamination of the environment and malnutrition. Last year 145 children under the age of five died of malnutrition.

There are 2.089 million children under the age of 5, who must attend nursery schools or kindergarten. There are 26,900 nursery schools in the country. In a survey of these institutions, it is estimated that 15.6 per cent of the total number of children (320,000 children) suffer from first or second degree of malnutrition. I asked whether the Ministry of Health conducted these surveys. Dr. Kim said that the Ministry lacked the expertise to assess the situation and that they depended on experts from International Organizations such as UNICEF.

Dr. Kim said the country needs raw materials for vaccines. Before the flood, they did not accept vaccines from abroad (99.6% of the vaccines were made in the D.P.R.K.) but now they need to request such donations. Specifically, vaccines for measles, polio, typhoid, paratyphoid, diphtheria, whooping cough, BCG, and tetanus are necessary. Dr. Kim said that expensive medical instruments were not needed but very simple instruments such as blood pressure measuring devices, stethoscopes, thermometers, non-disposable syringes, microscopes, machines for heat sterilization of surgical tools, scissors, and pin sets. Besides vaccines and medical instruments, Dr. Kim said the country lacks antibiotics, analgesic drugs, hormone drugs and multivitamins.

There are 8,177 medical facilities and there are 29.7 doctors per ten thousand people. They feel that they have an adequate number of medical professionals. Among the 8,177 facilities, 1,506 are general hospitals; 836 are specialized hospitals; 5,704 clinics and 131 sanitary stations which practice homeopathy. There are a total of 200,000 hospital beds and all patients are treated free of charge.

Dr. Kim said the greatest needs lie in the 5,704 clinics in the rural areas. "If each clinic could get one needle, one blood pressure measuring device, one stethoscope, the people will be greatly helped," he said. I asked whether donors of medicines and/or medical devices could go to such an area of need and donate the supplies themselves. The officials from the Flood Damage Rehabilitation Committee and the Ministry of Health assured me that that would be possible.

My father and I returned to Tokyo today. We left on a 6 a.m. chartered flight to Beijing and connected onto a mid-morning plane to Tokyo. We went immediately from Narita Airport to the St. Luke's Hospital where he has checked in for further tests and treatment. He is extremely pleased with the medical care he received in Pyongyang and his condition has significantly improved since he first checked into the hospital. He had many visitors, both foreign and Korean, who reside in Pyongyang. He carried on his own survey of the food situation right from his hospital bed which he will report on as soon as he gets back on the computer.

This is Diary entry number 10. Other diary entries from the April 1997 donation trip to North Korea and photographs are also available.