NGO TB PROJECT GAINING DPRK BUY-IN

C O N F I D E N T I A L SEOUL 004075 SIPDIS SIPDIS E.O. 12958: DECL: 11/26/2026 TAGS: PREL PREF PGOV KS KN SUBJECT: NGO TB PROJECT GAINING DPRK BUY-IN Classified By: Amb. Alexander Vershbow. Reasons 1.4 (b/d). SUMMARY -------------- ¶1. (C) In a November 24 briefing for the Ambassador, Dr. Stephen Linton, Chairman of the EugeneBell Foundation, described a recent two-week mission in the DPRK to oversee EugeneBell medical assistance programs. He reported on improved access to facilities and increased North Korean receptivity to outside aid, including Korean-language textbooks. Linton also commented on an increase in multi-drug resistant tuberculosis; the difficulties of fundraising without site access for donors; a boom in shoddy construction projects; and the importance of strict oversight over distribution in any NK-based aid projects. Finally, Linton pushed for a USG-supported medical project in the DPRK that would both deliver humanitarian aid and improve U.S.-ROK relations. END SUMMARY. INCREASED ACCESS TO MED FACILITIES -------------- ¶2. (C) Linton led a six-member EugeneBell delegation to visit 19 health care facilities in Chngju, Shinuiju, Kusong, Kwaksan and Pyongyang. The group made additional stops in Yomju and Tongrim counties. The purpose of the twice-yearly visit was to oversee the "Partner Package Program," which assists in the diagnosis and treatment of tuberculosis in local communities. ¶3. (C) After ten years, the North Koreans have bought into EugeneBell systems for delivering and monitoring aid. Linton said that for the first time, DPRK officials allowed EugeneBell representatives to duplicate and bring back patient records, which will greatly improve program documentation. Linton said also that on this trip they were able to distribute Korean language training programs, including textbooks printed in the ROK. In the past, Korean language books were refused or confiscated; in contrast, North Koreans were now enthusiastic about receiving them. It was also surprising that, for the first time, a Foreign Ministry minder did not accompany them, only Ministry of Public Health personnel. ¶4. (C) Linton expressed optimism about the future of the Partner Package Program. Now that preliminary issues of transportation of medical donations, repair of medical equipment, availability of Korean-language training materials, monitoring and documentation have been worked out, many opportunities for future programs have opened up. For example, read-only CD-ROMs could be distributed to hospitals so that doctors could continue their medical education on fundamental topics such as basic sanitation. Linton said there was a real hunger for this type of material. The Korean passion for education was legendary, he said, and "they have the same passion up North." MULTI-DRUG RESISTANT TB PREVALENT -------------- ¶5. (C) Linton said that the EugeneBell team noticed a marked increase in multi-drug resistant (MDR) tuberculosis. As a result, said Linton, care centers are filling up with "therapy failures," who are treated primarily with direct injections, tube-implants and herbal remedies. One care center in Kusong consisted entirely of MDR patients. Also, doctors tended to discharge patients if the patients were feeling better and, reflecting the DPRK's short life-expectancy, looked as if they would live a couple more years. FOOD SUPPLY NOT A CONCERN -------------- ¶6. (C) Linton said that DPRK officials appeared to be confident in their food supply. In fact, officials did not appear particularly concerned about the situation. They said that more outside aid would help, reported Linton, but that they could make it on their own. "And they probably could," he added. VISIT RESTRICTIONS HINDER FUNDRAISING -------------- ¶7. (C) Even though the Package Program appeared to be gaining traction in the DPRK, fundraising to support the program was getting increasingly difficult. The main obstacle was the continued inability of EugeneBell to bring donors (mainly South Korean and American) to North Korea to visit project sites. Projects in the DPRK have turned into video events for the sake of donors. This could not be a long-term substitute for personal visits, he said. Further, the missile and nuclear device tests have made donors even more skittish. MUCH OUTSIDE AID FUNNELED TO SHABBY BUILDINGS -------------- ¶8. (C) Linton commented that much outside funding appeared to be funneled into a "new village movement." Even medical programs were predominantly building programs that amounted to "slipshod construction projects." Buildings seem to be constructed to last about five to ten years. New buildings appeared to lack steel support or any foundation. Linton also noted the apparent diversion of cement. By the time cement arrived at the construction site, it consisted almost entirely of sand and crumbled as soon as it was applied. In addition, Linton said, a huge amount of South Korean cement appeared to be used to merely coat old buildings. STRICT OVERSIGHT OF DISTRIBUTION NECESSARY -------------- ¶9. (C) Any aid that has a hard-currency value would probably not get through to the intended recipients without close monitoring of distribution. For example, the South Koreans want to establish a pill factory in North Korea. If the quality was good, the product would simply be sold and exported in exchange for hard currency. Linton pointed to the Catholic Church's experience of trying to build a church in Pyongyang. The project fell apart, he said, because it "rose above the pay scale" of the intended recipients. Small-scale, "bottom-up" aid, is the most effective, he said. ¶10. (C) Generally, the South Koreans have been happy to work with the North Korean elites. Linton observed that there did not seem to be much passion for ensuring that their donated goods reach the appropriate end users. The nuclear weapons test may not to have triggered fear in the ROK, but it may have indirectly raised the issue of accountability. Until now, the South Koreans have been willing to write off a lot of slippage for the sake of building good will. OPPORTUNITY FOR AMERICAN MEDICAL MISSION -------------- ¶11. (SBU) Linton urged consideration of a joint U.S.-South Korean medical project in partnership with some of the 300 local medical facilities in the DPRK. A project involving even a third of these local facilities would not only deliver vital medical aid or services directly to North Korean people, but it would also benefit U.S.-ROK relations. It has been fifty years since Koreans and Americans have engaged in saving lives together on the Korean Peninsula and South Koreans would be very supportive, he predicted. It would also make a huge difference to involve Korean-Americans. Linton did not think that the DPRK would be averse to Korean-Americans working on humanitarian projects. In fact, the DPRK would be more likely to accept Korean-Americans than ROK citizens. VERSHBOW