by Daniel Tudor
Sometimes, people miss their own parents’ funerals because they can’t make it in time. They have to carry these painful feelings of guilt for the rest of their lives. If someone dies while doing military service, the parents are notified of the death shortly afterward, but usually they can’t make the funeral. It’s especially hard if the parents live in the countryside, where telephones are a rarity. They get notified by telegram, which generally takes seven to ten days to arrive. These parents cannot do anything but go to their child’s gravesite, long after the funeral is over, and cry. After my grandmother passed away at my uncle’s house, my mom and dad had to wait for the local government to issue their travel passes. My parents used all their resources to get the passes issued faster, and just barely made it to the funeral before the coffin was lowered into the ground. You know what? My uncle only lived 100 miles away.
There is really no concept of an “undertaker” in North Korea. You can find one or two in town if you ask around, but they are mostly elderly people who just happen to have experience of taking care of corpses; they are neither certified nor licensed. My uncle found an undertaker for my grandmother this way. We could not afford to buy new clothes to bury her in, so we dressed her in her old, thin summer blouse. My mother suffered from nightmares for a while after that; she said grandma appeared in her dreams, saying it was too cold. Mother felt heavy guilt that she couldn’t get her a winter coat for the trip to heaven.
There’s no particular dress code for funeral hosts. My uncle was the host at my grandmother’s, and his colleagues helped him. At night, they played cards to stay awake. I helped my aunt cook rice and side dishes for guests. It was a good thing that the funeral was in winter. During the summer, corpses start to decay when the room gets hot.
In North Korea, there is no disposable cutlery or dishes, so you have to borrow from your neighbors. Funeral guests usually bring some food, maybe some corn or beans, with them. Some people give cash to the host to express their condolences. In return, funeral hosts pack up food from the service so the guests can take it home for their families. To North Koreans who are already suffering from economic hardship, you can imagine what kind of financial burden funerals can bring about.
My uncle’s friends were able to secure a gravesite for my grandmother. Certain mountains are assigned by local authorities to be used as cemeteries, and I heard they pick the best for themselves. It was winter, and the ground was firmly frozen, so it was hard to dig. People usually use a truck or a cart to carry the coffin. In our case, we used a truck. In North Korea, no one owns their own vehicle, so our family went to the truck factory and begged the manager to rent us one. Of course, we paid for the rental, gas, and the driver. My aunt said it would take more than a year to pay that debt back. My father offered to pay half, and I remember our family’s lives were harder for a while after that.
My family was never rich, but could live on corn soup or rice. We could only just afford the funeral expenses, but there are many people for whom even this simplest farewell is an unattainable luxury. They keep the ceremony among family members, set a table with a freshly cooked bowl of rice, then transport the coffin to the mountain in a cart, where they bury it themselves. Thinking of this, it’s not only the living in North Korea who are pitiful, the dead are, too.
Will I see my grandma when I go to heaven? It still breaks my heart that I had to bury her in thin summer clothes, but I hope she is now enjoying all the luxury in heaven that she couldn’t dream of while she was alive.
My grandmother always told me she would to live into her 80s, so that she could see me get married and have kids. She was only 61 years old when she died. In North Korea, when you enter your 60s, people think you have lived the natural span of your life. It makes me sad to think of people dying in their 60s as something normal. I can’t help thinking that if my grandmother had been in South Korea, she would have lived longer.
What is childbirth like in North Korea?
DT: At 19.3 deaths per 1,000 births, North Korea’s infant mortality rate is almost 10 times higher than South Korea’s. This is the result of poor facilities and a lack of money available for investment in maternity care. Of course, Pyongyang mothers have better options than those in the regions, as Yoo-sung explains.
Kim Yoo-sung:
I would divide North Korea into two republics—the Pyongyang Republic and the Regional Republic. Residents in the Pyongyang Republic have access to obstetricians, pediatricians and facilities of higher quality, while residents in the Regional Republic are denied access to all of these. My aunt moved to Pyongyang after marrying someone from there. Once she came to visit us in our hometown. She said she had her children at Pyongyang San Won and was delighted with it.
When my aunt told me how much more comfortable it was to have a baby and raise it in Pyongyang, I realized that the Pyongyang Republic was far superior to the Regional Republic I was living in. People in North Korea said that Kim Jong Il made sure that the medical service provided at Pyongyang San Won would be of satisfactory quality because he was heartbroken when he lost his mother due to gynecological disease.
In this column, I would like to talk about nursing and parenting in the so-called “Regional Republic” (rather than the Pyongyang Republic), and my own experiences in raising my baby daughter in South Korea, where I gave birth.
In South Korea, you can buy a pregnancy test kit from a drug store, meaning you can be almost certain you’re pregnant before receiving ultimate confirmation from an obstetrician. But it is uncommon for North Korean women to do this. They only go to see an obstetrician when they begin to get morning sickness or when they’re late with their period.
After a woman in South Korea finds out that she’s pregnant, she goes to see an obstetrician on a regular basis. Throughout every stage of their pregnancy, women get ultrasounds and regular checkups from experts. Ultrasounds do exist in North Korea and expectant mothers can have them several times throughout their pregnancy. But they cannot benefit from the regular medical checkups South Korean women have easy access to.
Also, South Koreans are more considerate of expectant mothers. This is not true of North Korea, unfortunately—they puff cigarettes without caring whether a pregnant woman is nearby or not.
In South Korea, when a woman in labor feels excruciating pain, she can choose to have epidural anesthesia. In North Korea, many women these days deliver their babies at hospitals. However, there are still a few women in rural farming towns who give birth at home. This isn’t a preferable way for most women. Also, when a woman wishes to get an abortion in the Regional Republic, sometimes nurses perform the procedure, which is illegal, at the woman’s home. Even in my old hometown, there was a nurse who performed abortions near my house for women in desperate circumstances.
South Korean parents use disposable diapers for their babies. But North Koreans still use diapers made from pieces of cloth that you have to wash over and over. South Korean mothers who simply choose not to breastfeed have access to a wide variety of powdered baby formula that they can easily buy from a supermarket. But in North Korea, women who cannot breastfeed their babies have to resort to goat’s milk from the farms, or any other edible food, in order to feed them. Affluent North Koreans buy South Korean baby formula when they cannot breastfeed. Even in the Regional Republic, people with money can benefit from services provided at hospitals from pregnancy to delivery.
When babies are 12 months old, they stop being breastfed and begin to eat the food grown-ups eat. Around this time, North Korean babies start going to nurseries. When the North Korean economy was better, almost everyone sent their baby to a nursery. But as the economy got worse and worse, people began to have their babies taken care of by grandparents instead.
Another major difference is that the South Korean government gives subsidies for parents with children aged up to seven years. The North Korean government provides no such subsidies. In North Korea, rich people benefit from various facilities and medical car
e. But people with less money have no choice but to raise their children in such unfortunate circumstances.
However, it occurs to me that the medical care rich North Koreans receive seems inferior to that which ordinary South Koreans receive here.
Can you get regular health check-ups in North Korea?
DT: Basically, North Korea follows the law of “one law for the rich, and another for everybody else.” In theory, everyone has access to free medical care; indeed, a poor person may be able to see a doctor, but that doctor’s access to good equipment and medicine might be severely limited. But if you are part of the new donju (“masters of money”) elite, or are a senior official, you’ll have access to good enough healthcare. For those at the very top, hospitals like Bonghwa in Pyongyang offer healthcare services that are considered on a par with any decent Western hospital.
Kim Yoo-sung:
Honestly, I don’t think I ever heard the phrase “regular health checkup” in North Korea. They weren’t very common in my hometown. You would just go to see a doctor in town when you felt ill. Of course, everything—all the treatments and surgery—are provided free of charge in North Korea.
However, while there is medical insurance in South Korea, there’s no such thing in the North. Until the early 1990s, all kinds of medical treatments and operations were absolutely free in the North. Despite the collapse of the North Korean economy in the late 1990s, it is still free to go and see a doctor, receive treatment and undergo surgery. But you have to pay for the medicine by yourself.
Article 56 in the North Korean constitution reads: “This nation strives to consolidate free public health care for all, and to focus on preventive medical treatments and to protect the lives of the people, and to improve the health conditions of the workers.” Since 1969, specialist doctors have been assigned to every city and county in North Korea. Doctors were specially assigned to mines around the country as well.
From 1990, general practitioners took on duties, such as researching the existence of contagious diseases, writing prescriptions and connecting patients with specialists. North Korea boasts of this, saying, “This system enables people to see a doctor who knows their medical backgrounds throughout their lives, and this also enables doctors to provide more systematic and sophisticated medical treatment suitable for people in their districts.”
North Korea’s medical institutions fall into two categories: ordinary hospitals and special hospitals. Also, there are hospitals called “hygienic preventive hospitals.” Among ordinary hospitals, “Bonghwa Hospital” and “Namsan Hospital” are for the elites of North Korean society. Ordinary North Koreans who are not elites can go to the Red Cross Hospital, the First and Second People’s Hospital or Pyongyang Medical School Hospital. Isn’t it interesting that you have to go to different hospitals because of your social status?
Zainichi Koreans from the pro-North Chongryon organization in Japan have built and opened the Kim Manyu Hospital, which is still operating in North Korea today. There are specialist hospitals, such as the Pyongyang OB/GYN Clinic and Pyongyang Central Tuberculosis Hospital.
Outside Pyongyang, people’s hospitals and medical school hospitals exist in every province of North Korea. People’s hospitals exist in every city and town across the country as well.
Universities in North Korea train medical students to qualify as doctors. It takes seven years for medical students to graduate with a degree. No national exams exist after graduation. As soon as you graduate from one of those medical schools in North Korea, you can practice as a doctor. But you have to pass all the exams in order to graduate from seven years of medical school.
There is only one school of medicine where you can study to become a pharmacist in North Korea. It’s called Hamheung School of Medicine. That degree also takes seven years. However, it only takes two years to graduate with a degree in nursing in North Korea. There are even some nursing schools in North Korea where the degree can be completed within one year.
At first glance, the health care system in North Korea may look appealing, even flawless. But the quality of health care seriously deteriorates when there is a cut in the government budget. The most horrific thing is that there is no compensation in the event of medical accidents.
But, to answer the question, there are no regular health checkups. Therefore, the healthcare system in North Korea fails to prevent diseases that are really preventable. In conclusion, I don’t think the healthcare system in North Korea is attractive at all.
PART 8
Defection from North Korea
[Introduction]
There are now 30,000 North Koreans living in Seoul, 2,000 in Europe, and many other small pockets of defectors dotted around the world. There are countless more living in China.
Widespread defection is a relatively recent phenomenon; yet again, the famine of the 1990s played a crucial role. When the DPRK’s state ration system failed, most people were forced to fend for themselves. For some, this meant crossing the border into China. At the time, border security was lax, and those who made the journey found a land of relative plenty. Some went there to make money and return home, and others decided they would be better off never coming back.
China, though, is dangerous for defectors. The Beijing government is a historic ally of the DPRK, and will send defectors back to meet a cruel fate—a labor camp, or worse. This fact leaves escaped North Koreans in China vulnerable to exploitation. North Korean women are often sold as wives, or forced into prostitution or to work as online “cam girls” for the entertainment of men in South Korea, for instance.
For most, South Korea is the intended final destination. To get there, defectors must escape twice—once from the DPRK, and once more, from China. This involves dangerous border crossings into countries like Mongolia or Thailand. Once they arrive, they turn themselves in to the authorities, and are handed over to the South Korean embassy, which arranges for them to be taken to Seoul.
Those who make it this far are sent to a place named Hanawon for three months. Hanawon serves as both an educational institution, teaching North Koreans how to use ATM machines for instance, and as a place of interrogation—South Korean agents want to be satisfied a particular defector is not a spy before letting him or her loose in South Korea.
As mentioned, North Korea’s harsh economic reality has historically been the main reason for defection. These days, however, there are many for whom this is not the case. I know of one defector, for instance, who made the move after becoming captivated by South Korean drama shows, fashion, and pop music. Another simply says, “I couldn’t develop myself in North Korea.” In the DPRK, you cannot simply do whatever you want with your life, unless you have a lot of money and/or connections.
Once in South Korea, however, many defectors have a rude awakening. They arrive in a country that seems more selfish than the one they came from; they find that their education is useless to employers; and they suffer discrimination from South Koreans, who see them as either pitiful, suspicious, or exotic. That said, there are relatively few who want to go back home, despite the obvious pain of being separated from family and friends.
There is another option, though. Some move on again, to a third country. The UK is the most popular option, with 1,000 North Koreans living there. Most live in London, which compared to Seoul is a multicultural Mecca where even those with the most exotic origin can find a degree of acceptance.
One of those people is Ji-min Kang. Ji-min is outspoken and eloquent on all matters related to defection, and as such, we asked him to contribute most of the essays in this chapter.
Why do North Koreans defect? And how difficult is it?
DT: Defection became a major issue in the mid-1990s, due to the famine. People simply left North Korea because they were starving. Today, there are almost as many reasons for defection as there are defectors. It is getting harder to leave, though. One of the major changes from the Kim Jong Il to the Kim Jong Un era is increased border security.
/> Cho Ui-seong:
One reason travel is so attractive is that you can always return to where you came from. But this is not the case with defecting from North Korea. Rather, it is a sad experience. So why do people make this painful, scary, tough, dangerous choice?
Since defection became a thing, it has occurred for various reasons, depending on the situation in North Korea, the methods and intensity of state control, and the changing mentality of North Koreans.
Those who came down to South Korea, who were once known as “soldier defectors,” started to be called talbukja [“person who has escaped the North”] from the mid-1990s, during the period of extreme food shortages. Before then, most people who defected did so for political reasons; but following the famine, most people left to escape starvation.
Due to the collapse of Eastern European socialism, the death of Kim Il Sung, repeated natural disasters, and the economic blockade from the West, the North Korean authorities lost the ability to enforce border control. Even if they had, they wouldn’t have been able to stop the irresistible force [drawing people away from North Korea]. This sums up the way people thought at the time: “Instead of staying here and starving to death, I’d rather get shot crossing the river.” This attitude, and the authorities’ poor border security, led many people to leave, and the number of those ending up in South Korea was not insignificant.
The authorities gradually realized the seriousness of the situation and in the 2000s began to tighten the border and mete out strict punishment to those attempting to defect. They also conducted public executions by firing squad to create an atmosphere of fear, and began monitoring the families of defectors.
People were learning how to live without government rations, and this made them think twice about defection. But defection couldn’t be stopped completely. Meanwhile, news from the families of defectors and those who had been caught in China and repatriated began to spread, even to regions far from the border. Stories of the material wealth of other countries and how people there were free of starvation began to shake North Koreans—a people who had believed their country had one of the best standards of living in the world—to the core. This pushed more people to the border, to the Yalu and Tumen Rivers.