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