Under the Loving Care of the Fatherly Leader

by Martin, Bradley K.

  By the time of my visit, Han told me, North Korea had more than thirty thousand doctors—one for every four hundred people.36 The North had ten medical colleges, a college of pharmacy and twelve other schools teaching nursing, dentistry, midwifery and so on. Hospitals ranged down to eleven-bed units serving villages. Physicians were organized to care for groups of families. Individuals’ medical record cards followed them throughout their lives. During the thirty-four years following liberation from Japanese rule, health workers had eradicated cholera, plague, malaria, syphilis and gonorrhea, they said. Average life spans had increased by decades, reaching seventy for men and seventy-six for women.

  I was intrigued by a nationalistic element that was prominent in North Korean thinking about health care. I heard vague, unbacked assertions that Koreans were unique in their health-care needs and that—partly because of that uniqueness, and in line with juche philosophy—locally developed remedies were best. Even while subscribing to some three thousand foreign medical journals, Dr. Han said, the thirty-two medical-research agencies in North Korea “develop medical science according to the physical character of our people. A few of our doctors studied abroad, but mostly we educated them in our own colleges.” Han himself-was one of the local products, he said, having been a “worker” prior to 1945. “Of course those who studied abroad know well about world treatment methods,” he said, “but they don’t know well how to treat our own people according to their own physical characteristics.”

  In line with this sort of thinking, North Korea was manufacturing most of its mass-consumption medicines. About 60 percent of that output represented traditional Oriental medicines, such as the ones Kim Il-sung’s father had dispensed in Manchuria. “Medicine appropriate to foreigners may not suit us,” Han told me. Besides, he said, the people liked the homegrown and home-brewed tonics, cold remedies and aids to digestion. The most famous of those was the human-shaped ginseng root, believed to prolong life. It grows in various parts of Asia—but the ginseng with the best medical effect grows only in Korea, around Panmunjom, I was told.

  I encountered some evidence suggesting that the merger of traditional Oriental and modern Western medicine might be incomplete. At the Chonsam-ri cooperative farm I visited the little hospital. Outside the building, a farm official pointed out the herb garden. “When our Great Leader visited here, he taught us we must produce a lot of medicinal herbs,” the official said. Then a woman described as an “assistant doctor” showed me around inside the clinic: surgery, internal medicine, physical therapy, lab, pharmacy, dentistry, obstetrics and gynecology.

  In front of one treatment room, however, she remained silent. A gaunt, disheveled, elderly man standing in the doorway of that room stared at me. The woman guiding me appeared annoyed and tried to shut the door in the old man’s face. Standing his ground, he continued to stare. The assistant doctor tried once more to shut the door, whereupon I asked her the purpose of the room. “Korean medicine,” she muttered impatiently, hustling me away. Possible explanations for this odd incident that came to mind were that the old practitioner might be a crank—perhaps an extreme xenophobe—or that he might be a suspected malcontent not cleared to talk with foreigners. But I was inclined to believe I had witnessed a minor battle in the professional turf-wars. In the woman’s voice I thought I detected the condescending tone some orthopedists might affect when speaking of chiropractors. As we walked past, I glimpsed inside the man’s room a large, wooden medicine chest of the traditional Korean style, with scores of tiny drawers.

  The official view on mental health care similarly emphasized locally developed remedies. When I asked Dr. Han whether Freudian-style therapy was employed, puzzled expressions appeared on the faces of my guide and my interpreter, both college-educated men fluent in English. The health official explained their bafflement: “Of course our doctors study this, but we don’t introduce it in our country.” Mental patients, he said, were hospitalized and treated with medicines and insulin shock. “We have good Oriental tranquilizers,” Han said. Doctors in North Korea “don’t exactly know the cause” of mental illness, he said, and so research was proceeding. Anyhow, he added, there was “not much mental illness—maybe one or two cases per one thousand”—in North Korea. “Some people ask why the rate is so low. We answer that our socialist system is good.”

  Rejecting vulnerability to the ups and downs of the world economy, North Korea for more than two decades had been following Kim’s philosophy of juche, which emphasized satisfying basic needs from local industries using locally available resources. Recall that this inward focus of the economy originally sought to reduce dependence on the Soviet Union—-which preferred a colonial-style arrangement of exchanging Soviet finished products for North Korean ores and other raw materials.

  Juche had led the North Koreans to develop the ability to produce an impressive array of goods. At the Industrial and Agricultural Exhibition in Pyongyang, which had been built in 1956, were displayed the “achievements of socialist construction”—thousands of products, from automated, close-tolerance machine tools to locomotives and excavation and tunneling machinery to pharmaceuticals to toys, all described as having been manufactured within North Korea, a country the size of Pennsylvania. “Maybe the quality needs to be improved, by Western standards,” conceded the exhibition director, a graduate of Kim Il-Sung University, “but we’re proud that we made it ourselves.”

  Before juche, the country had exported its mineral ores, he said. But Kim Il-sung had taught his people to use those ores at home. Even though the country lacked coking coal, which is important in steelmaking, “the respected and beloved leader Chairman Kim Il-sung said iron can be produced with our own fuels.” Kim’s slogan had been: “Priority to heavy industry with simultaneous development of light industry and agriculture.”

  “We’ve developed our industry so that we can export a large amount of machinery and equipment to foreign countries,” the exhibition director said. “We have plenty of natural resources and also we have laid the foundation of our economy. If our country is unified we can live a happy life.” North Korean shipyards, he said, were building 20,000-ton ships, and soon would turn out 100,000-ton vessels. Output of trucks—ranging up to a colossal 100-ton dump truck for mining—-was up nearly five times over 1959’s figure, he said.

  As for the machine-tool industry, which had interested me since my visit to the tractor factory, I learned that North Korean radial drilling machines were being exported to about fifty countries. The catalog continued: numerical controlled lathe, automatic copying multi-cut lathe, automatically programmed turret lathe, programmed milling machine, vertical lathe, universal tool milling machine, automatic thread cutting machine, gear slotting machine, air hammer, friction press, hydraulic press and so on. From 1946, the machine building industry’s output had increased 1,012 times, I was told, and North Korea was 98 percent self-sufficient in machinery and instruments. Having some acquaintance with factory machinery, from summer jobs in an aircraft plant during my college years and, later, reporting trips to innumerable factories in several countries, I was impressed.

  North Korea bought what it must from other countries, substituting to keep the need for imports to a minimum. The climate made cotton hard to grow and there was little land to spare for sheep to graze, so the country relied on Korean-developed processes for making fibers from locally available materials. The most notable was vinalon, made of anthracite and limestone—both of which were “inexhaustible in our country,” the director explained. (He added that when it came time to build the first vinalon factory, “the Fatherly Leader selected the site personally”) Production had expanded to the point that the annual cloth allotment was 35.2 meters per person—“so the question of clothing is completely solved.”

  Besides coking coal, petroleum was the other big lack in otherwise mineral-rich North Korea. Oil had to be imported from China, the Soviet Union and the Middle East. To reduce demand, and thus dependence on outsiders, the
government required that workers live near their workplaces and use public transit. In the cities, trolley systems used power that was generated in anthracite-fired or hydroelectric plants. The sparse traffic resulting at least in part from that transit policy helped give Pyongyang an almost deserted look, as if it were a ghost city.

  The juche policy contrasted with the South Korean development model, based largely on pushing exports and encouraging foreign investments, a policy that in North Korean eyes made the South nothing more than a colony of Japan and the United States.37 The difference could be seen in South Korean estimates that North Korea’s total external trade in 1978 had amounted to only about $1.8 billion—approximately one-fifteenth the volume of South Korea’s international trade.

  ***

  Whether visiting factories and farms or simply riding for mile after mile through broad streets lined “with trees and neat, multi-story apartment buildings in the park-studded capital of Pyongyang, I found the contrast between what was being said by outsiders and what I was seeing with my own eyes very sharp indeed. I was not the first visitor to wonder whether the authorities had arranged for visitors to see only showplaces, built—like a Potemkin village of Czarist Russia—to disguise underlying poverty and impress the credulous.

  My chance to take an unguided tour came after I realized that my hosts never scheduled appointments for me from roughly one o’clock in the afternoon until three or four. Instead, they kept urging me to take a rest in my room. It dawned on me that the North Koreans observed the custom of the siesta.38 They were leaving that time free because the people I wanted to interview would be napping—and because the guide and interpreter themselves wanted to rest. One day after lunch I yawned conspicuously and said I would like to have a rest. I could see the expressions of relief—the American had finally gotten with the program. We all took the elevator up together, and I got off at my floor. My handlers continued on to the floor immediately above me, where they had rooms. As soon as the elevator door shut, I took the stairs back down to the lobby. There, momentarily at least, the coast was clear. Trying to look as if I knew where I was going, I strode out into the park. Spying a narrow footbridge, I crossed to the other side of a stream and into what I took to be something approximating the real world of Pyongyang: both neat apartment buildings and, mixed into the urban landscape, realistically grimy sheds and small industrial installations.

  People looked at me suspiciously. I have no idea who was the first to rush off and inform the authorities that a lone foreigner was loose in the city, but it was only a matter of minutes before I turned around and saw a man tailing me. He was wearing a blue blazer (-with Kim Il-Sung portrait button, of course) and gray slacks. I decided to have a little fun with him, so I turned into an alley and then doubled back to the same street I had been walking on. I calculated my detour to allow enough time that a man innocently walking behind me would have passed the alley entrance and thus gotten ahead of me by the time I emerged. As I came out of the alley, I saw the plainclothes security man. He had stopped in front of what I took to be a miniature steel-making furnace housed in a shed, where he stood, having lit a cigarette. He was puffing it pensively, gazing at the fire of the furnace as if it were a particularly agreeable sunset. I half expected him to start declaiming on “the proud life of the smelters.”

  I stopped and waited for him to turn around, then stared at him so that he would be sure I knew what he was up to. What came over me, to challenge authority so blatantly? Merely the sort of irresistible rebellious impulse that a Western traveler in Pyongyang was subject to after a few days or weeks of experiencing the regime’s heavy-handed control. The plainclothesman only followed me, not forcing me to turn back. So for a couple of hours I enjoyed unaccustomed freedom of movement.

  I returned to the hotel after my stroll and found my handlers waiting for me outside the entrance, looking not a little panicked. One of them angrily suggested that “special spy training” had enabled me to give them the slip. I laughed and assured him that anyone who had grown up watching cops-and-robbers shows on American television was acquainted with the elementary techniques I had employed. Later, though, I thought about it and realized that with this episode I could have fueled, quite unintentionally, any speculation among North Korean officials that I might be the Washington agent they hoped to find among the American visitors. Had this been my ticket to the interview meeting with Kim Yong-nam?39

  The parts of Pyongyang I saw that afternoon turned out to be much like the places on the official itinerary: solidly built and clean, for the most part, with real people living in more of those beige brick apartment buildings, shopping in the stores and eating in restaurants.

  Still, strains and pressures were evident. Pyongyang’s deserted look during most hours of the day and night was not wholly a result of mass transit and housing policy. With manpower resources stretched almost to the breaking point, people simply had little time to stroll on the streets. As I had learned at the tractor factory, the government claimed that a maximum eight-hour workday rule was enforced, with another eight hours reserved for study and the remaining eight hours for rest, according to the dictum of President Kim. Parks and housing complexes were almost empty until late in the evening. Nurseries kept children until 8 P.M. or later while their mothers, if they were not working overtime at their jobs, presumably attended group study sessions.

  Among major problems facing the regime at that point, the need to provide more and better consumer goods was high on the list. When the Chonsam-ri farm deputy manager boasted to me about the people’s limited need to spend money, he failed to mention there was little in the stores for them to buy.

  Recall that the regime, shortly after the Korean War, had resolved policy disputes in favor of President Kim’s formula of going all out to build heavy industry, putting off until later an improvement in living standards beyond the spartan level. Then came the 1960s and Kim’s militaristic policy. As scholar Joseph Sang-hoon Chung noted in 1974, the average North Korean, “though his lot has improved substantially, has not benefited fully from economic development.”40 That could be seen clearly by comparing North Korea’s serviceable machine tools with its consumer goods, which were generally scarce, crude and monotonously lacking in variety. The country made basic appliances—refrigerators, electric rice cookers, washers, televisions—but had yet to place them in all households. That would take “a few years,” an official said. Furniture looked as if it had been banged together by pupils in a shop class; clothing was generally poorly tailored; the radio-phonographs in hotel rooms did not work.

  For some time, North Korean officials at higher levels had acknowledged the problems.41 Improvement had been a major goal of the six-year economic plan recently ended, but the planners had made little head-way on that score. “Improving the people’s life” was a major goal of the current seven-year plan, which emphasized upgrading the quality and variety of consumer goods. In his New Year’s speech, Kim Il-sung had said that in 1979 the country must “elevate the living standards of the people. All factories in the sector of light industry should operate to full capacity to produce more consumer goods.42

  Part of the quality problem was said to result from the laziness of some workers who lacked the communist attitude of “one for all, all for one,” and who were not behaving, in President Kim’s phrase, as “masters of the nation.” If a worker is not doing a good job, said a hothouse manager, “we educate him ideologically and politically so he can carry out his tasks well.” Criticism sessions might be held—“It’s something like mutual assistance so he can correct his mistakes and become a good gardener.” If a worker should work well, “we praise and honor him.” But the manager said that was “not a particularly fixed procedure.”

  In that stage of development of North Korean society, officials admitted, it was necessary to employ a system of material incentives. Work teams got extra money for exceeding not only quantitative quotas but also quality standards, and they-were su
pposed to find their pay docked if their work fell off.43 “As we are applying the cost accounting system which was created by our Great Leader, Comrade Kim Il-sung, when we produce more we can get extra money but when we produce less we get less,” said the hothouse manager.

  Another obvious way to improve the quality of goods would have been to reduce the reliance on locally developed technology—under which North Koreans had figuratively reinvented the wheel in a number of fields—and import either finished products or the plant machinery to make them. Indeed, the country’s leaders wanted to import additional selected technology from the countries most advanced in each field, which often meant from the West and Japan. The problem here was Pyongyang’s reputation for stiffing debtors.

  The usual estimate by outsiders was that North Korea owed about $2 billion abroad. The Japan External Trade Organization broke that down as $300 million owed to Japanese creditors, $ 500 million to Westerners and between $1 billion and $1.2 billion to other communist countries. Periodic promises to pay at least the interest due on those debts had not been kept. North Korean checks written on third-country bank accounts had even been returned for lack of funds to cover them. Although officials now talked of repaying the debts by 1984, foreign creditors were pessimistic about getting their money even by then. They cited both the unreliability of past assurances from Pyongyang and doubts that the ambitious goals of the economic plan could be met.

  Much of the debt was for plants and equipment imported during the crash program to raise the technological and output levels of the country earlier in the decade. Outsiders generally believed that Pyongyang had launched the effort with little planning or preparation, following the abortive Red Cross peace talks in 1972–1973 and the shocking glimpses of Southern advances that the talks afforded North Korean officials visiting Seoul. The move to import selected foreign technology represented a relaxation—but not abandonment—of the North Korean policy of juche.