NORTH KOREAN REFUGEES: DEALING WITH PSYCHOLOGICAL

UNCLAS SEOUL 003538 SIPDIS SIPDIS E.O. 12958: N/A TAGS: PHUM PREF PREL KS KN SUBJECT: NORTH KOREAN REFUGEES: DEALING WITH PSYCHOLOGICAL TROUBLES (PART II) REF: SEOUL 3531 ¶1. (SBU) This cable is the second in a two-part series about psychological issues that North Korean defectors are facing. ¶2. (SBU) SUMMARY: A small group of doctors, politicians and academics in South Korea are working to bring North Korean defector's psychological challenges, including Post-Traumatic Stress Disorder (PTSD),to the forefront but there is still much progress to be made and many social factors to overcome. Some of the initial signs of concern among resettled North Koreans include turning to crime, prostitution and even suicide as a result of their psychological troubles. NGOs are understaffed and overworked and lack fundamental training needed to adequately handle the unique cases presented by North Korean refugees. This is an area where U.S. assistance could help, see para. 14 END SUMMARY. -------------- ...IN SOUTH KOREA -------------- ¶3. (SBU) Not long after arriving in the South, many defectors report that guilt begins to set in because of family members that they have left behind in North Korea, some of whom are likely to be sent to labor camps as a result of the defector's flight from the DPRK. As ONE response to these emotional stresses, an increasing number of defectors immediately contract human smugglers to bring their family members out of North Korea. Although some have seen very quick results with family members arriving in the South in just a matter of weeks after securing a broker, others are frustrated by the long wait as various delays prevent the timely departure of their family members from third countries. Coupled with their own internal demons, most defectors face additional hardships in the form of social discrimination, prejudice, unemployment and economic instability. -------------- EXPLOITATION AND HARDSHIPS -------------- ¶4. (SBU) Professor Ahn Hun-nie at the psychology department at Busan National University took it a step further and posited a connection between stress and outward actions. She reported that the symptoms of PTSD very often appear as personality or behavior quirks, such as being short-tempered, which makes the underlying trauma harder to diagnose. ¶5. (SBU) There are media reports in South Korea that resettled North Koreans are resorting to illegal activities, including prostitution, as a way to make a living. According to National Assembly Representative Ahn Myoung-ock, herself a physician (Ob/Gyn) who has worked with defectors, this willingness is linked to the trauma they experienced in China and other third countries as they made their way to the South. Someone who has been exploited in the past is more likely to be exploited again in the future. As noted in reftel, North Korean refugees in China are often willing to do whatever it takes to survive, knowing that if they are ever caught and sent back to North Korea, they are certain to face severe, possibly deadly, punishment. ¶6. (SBU) Even for those who come to the South and try to assimilate into South Korean society, there are a number of social barriers that add stress and anxiety to the process. A growing number of poor South Koreans are upset that the Korean government appears to be doing more to help refugees than they are doing to help the indigenous poor. North Korean defectors' difficulties in assimilating seem stark when compared to the success of ethnic Korean Chinese (who receive no financial support from the ROK government) to assimilate into society, learn to save money and maintain a steady jobs -- all areas that North Korean defectors have trouble with. Dr. Jeon explained a North Korean's upbringing as ONE in which social status dominates his or her entire life. One's excellence in work, attitude or effort has almost no effect on the success of his or her life. When this same thinking is introduced into the highly competitive and work-driven culture of the South, there is bound to be a serious clash of cultures. This is especially true for a smaller minority of North Korean defectors who held positions of authority or respect in North Korea and who are now considered third-class citizens in the South. -------------- HANAWON -------------- ¶7. (SBU) All North Korean refugees arriving in South Korea are required to spend eight weeks of orientation at the government-run resettlement facility called Hanawon (literally the place of "oneness") where instructors attempt to bridge the social/political/economic gap in thinking and practice between the North and South. At present, the orientation lasts for eight weeks (280 hours of instruction) although just a year ago, the program lasted for ten weeks. The time at Hanawon has continued to decrease in recent years as the number of refugees has risen sharply and expansion projects to accommodate the increased demand at the facility have yet to be completed. ¶8. (SBU) Doctors at Hanawon provide services in internal medicine, oriental medicine and dentistry. Although there is also a psychologist who provides limited counseling services, the Hanawon Director said that they are in need of a licensed psychiatrist to better treat trauma victims. Under the current curriculum, refugees at Hanawon receive 27 hours of "psychological stabilization and healthcare education" compared to 32 hours preparing to receive their driver's license. -------------- ROKG EFFORTS TO HELP VICTIMS -------------- ¶9. (SBU) Despite the best efforts of the staff at Hanawon to prepare the resettled North Koreans for life in the South, there is only so much time to provide support and counseling during the eight-week stay. Representative Ahn has been a vocal advocate for doing more to help North Korean refugees who have been resettled to the South. Rep. Ahn is sponsoring a bill that would require the Ministry of Unification (the Ministry responsible for Hanawon) and the Ministry of HEALTH and Welfare (MOHW) to screen all arriving refugees to identify those who need additional psychological or medical assistance. Those identified as needing help would be referred to free services that could be offered either at public or military hospitals. According to Rep. Ahn, the Ministry of Unification and the MOHW do not have a good working relationship which has prevented the effective integration of psychological assistance in the current resettlement scheme. ¶10. (SBU) Rep. Ahn said that part of the resettlement package provided to North Koreans in the South is free HEALTH care for at least two years. Despite the free availability of health services, many are hesitant to seek out psychological help due to the social stigma associated with mental disorders, she added. ¶11. (SBU) Yonsei University Professor Dr. Jeon Woo-taek found that in the rehabilitation process of refugees, mental HEALTH is key to their successful adaptation and settlement. Jeon's ongoing research on the subject is aimed at providing data for the subsequent development of a government mental HEALTH support program for North Korean defectors living in South Korea. Such a program is required to help refugees successfully adapt themselves to their new environment, Jeon said. -------------- WHAT ARE NGOS DOING TO HELP? -------------- ¶12. (SBU) NK Database President Yoon Yeo-sang told poloff that before 2006, the ROKG did not have a plan to provide psychological support for North Korean defectors after they left Hanawon. In light of this gap in services, several NGOs and church groups stepped in with varied results. Starting in 2006, the ROKG's Ministry of Unification decided to financially support four NGOs that provide psychological support for defectors, ONE of these being NK Database. Two of the other NGOs are located within Seoul and the third is in Taegu. NK Database focuses predominantly on victims of post-traumatic stress disorder (PTSD) while the other three groups spend more time on psychological issues relating to life in South Korea. ¶13. (SBU) Yoon said that recently his organization has also seen an increase in the number of teenagers and younger children seeking psychological support, regardless of whether they suffer from PTSD. In general, defectors are looking for help to come to grips with the life they lived in North Korea and to get help with adjusting to their new life in South Korea. Also, vast differences in society and family between the North and the South contribute to ongoing levels of high stress for many defectors. ¶14. (SBU) Yoon estimated that 20-30 percent of defectors seek out some form of counseling. But this number is misleading because many hesitate to ask for help noting there is a stigma associated with psychological counseling. To better address the growing number of younger defectors who face mental challenges, Yoon advocates teachers and parents taking a more proactive approach in encouraging defectors to seek out counseling. ¶15. (SBU) Yoon said that ONE of the major challenges in helping defectors with mental issues was a general lack of medical specialists (psychologists and psychiatrists). In the ROK, there were only a few professional counselors trained specifically to deal with PTSD sufferers, Yoon lamented. Despite his best efforts to recruit trained personnel, Yoon's staff of counselors only consists of three people. NK Database is reaching out to U.S. organizations in the hopes of identifying groups that can provide training and certification for Korean counselors. Yoon is not only concerned about the PTSD victims, but also for the overworked or "burned out" counselors and their exposure to "second-hand trauma" as they internalize some of the trauma that their patients recount to them during counseling sessions. -------------- COMMENT -------------- ¶16. (SBU) At a minimum, North Koreans who resettle in the South are faced with challenges in almost every aspect of their life: social, cultural, financial, HEALTH and welfare. While they struggle to make ends meet in the South, they must also come to terms with their past and the traumatic events that have shaped their life. For its part, the South Korean government needs to broaden the psychological services available to the refugees and create a stronger safety net for the refugees once they depart Hanawon. The tougher challenge is to change the minds of the South Korean people to be more accepting and tolerant of their "brothers and sisters" from the North. Experts warn that failure to adequately address all of these issues will only further isolate these people from mainstream society at a time when the number of defectors arriving from the North is steadily rising. VERSHBOW