MEDICAL ASSISTANCE TO NORTH KOREA: NGO

C O N F I D E N T I A L SEOUL 000662 SIPDIS SIPDIS NSC FOR DENNIS WILDER, RICHARD MILES, KURT TONG E.O. 12958: DECL: 03/07/2017 TAGS: PGOV PREL EAID KN SUBJECT: MEDICAL ASSISTANCE TO NORTH KOREA: NGO EUGENEBELL'S VIEWPOINT Classified By: POL M/C Joseph Y. Yun. Reasons 1.4 (b/d) -------------- SUMMARY -------------- ¶1. (C) Chairman of the EugeneBell Foundation Stephen Linton, whose Seoul-based organization has provided over USD 25 million worth of medical and other assistance to North Korea since 1995, said that: -- experience had taught him that the best way to provide such aid was in the form of integrated "packages," such as medicines, equipment and documentation needed to treat tuberculosis patients at a particular hospital; -- electrical systems at hospitals are extremely primitive both in terms of electrical supply and faulty wiring, so that EugeneBell insists that its donated equipment connect only to the small generators it also donates; -- the DPRK government would be particularly attracted to medical assistance that includes "rolling stock" such as ambulances and any equipment perceived as high-tech, but that medicines or vaccines would hold little appeal, since they are available from UN organizations or the ROKG. End Summary. -------------- PACKAGES OF ASSISTANCE -------------- ¶2. (U) The EugeneBell Foundation has provided over USD 25 million in assistance, mostly medical, to the DPRK since it was established in 1995: USD 10 million in infectious disease (tubercolosis and hepatitis B) medicine, diagnostic assistance and equipment; USD 8 million in other medical assistance; USD 4 million in food assistance; and almost USD 1 million in agricultural assistance. Funds come from donations as well as from the ROKG (USD 4 million during 2000-2005). The Foundation's staff makes frequent visits to the DPRK and has developed extensive contacts in rural areas. Chairman Stephen Linton told us during a March 5 meeting that his organization has worked with 46 hospitals and tubercolosis clinics in four areas: North and South Pyongan Provinces, Pyongyang City, and Nampo City, covering one-third of North Korea's population. ¶3. (C) Linton said he had learned from experience to provide aid in integrated "packages" whose components work together, such as a complete kit that will allow a local hospital to provide diagnosis and treatment for tuberculosis. If part of the kit is stolen, the treatment will not work, so officials are motivated to protect it (and many potential thieves are scared to go near TB hospitals lest they get infected). Medicine or equipment provided in bulk, he says, gets siphoned off at each stage, much of it resold in China or elsewhere. Over time, Linton said he has learned that working directly with local officials -- who are eager to upgrade their hospitals and very resentful of what they see as the Pyongyang-centric central government -- is far better than relying on the central government's Public Health Ministry, which sees offers of medical assistance in terms of potential cash benefits. One had to be aware that local officials, too, see medical aid in terms of its potential economic benefits. For example, EugeneBell provides each of the hospitals it assists with a small truck to pick up donated equipment; these trucks are clearly rented out or used elsewhere since they end up with high mileage. He cautioned that nationwide monitoring of any assistance program to the DPRK would be difficult, noting that North Korea's farthest northeastern province of North Hamgyong was three days drive each way from the Pyongyang area. ¶4. (C) Having focused primarily on tuberculosis and hepatitis B treatment to date, the Foundation is proposing a broader program of "community health" assistance to local hospitals that would require hospital staff to complete a Korean-language study module before qualifying for a "children's care package" or "maternal and infant care package." Linton said that most of the 400-500 local hospitals currently can do little more than provide emergency surgery (usually without anesthetics),and have few beds and little capacity to care for patients. -------------- ELECTRICITY IS A PROBLEM -------------- ¶5. (C) Linton said that EugeneBell provides small five-horsepower (3,700 watt) diesel-fueled electrical generators as part of its packages to local hospitals. Because hospital electrical power from the DPRK grid is available only sporadically (often only two hours per day, making reliable refrigeration impossible),is of bad quality (fluctuating between 40-55 cycles/second, which ruins equipment),and because of faulty wiring and circuits, the Foundation insists that its donated equipment operate only when connected to these generators. The generators are also a robust model that is capable of operating on the very low-quality diesel fuel available in North Korea. ¶6. (C) Linton said that he had been in touch with USAID about the possibility of providing larger 50 kilowatt or 150 kilowatt diesel generators to operate ten entire hospitals where the Foundation already has projects ongoing. The proposal also calls for voltage stabilization equipment and rewiring of key circuits. Linton suggested that these larger generators would also require a reliable supply of good diesel fuel -- which tends to be unavailable in the DPRK. -------------- AID THAT WOULD APPEAL TO DPRK GOVERNMENT -------------- ¶7. (C) Linton volunteered that the DPRK government is focusing on receiving heavy fuel oil (HFO) in exchange for implementing the February 13 agreement because officials most want fuel: if they cannot refine HFO for use in vehicles, they can at least barter it to China in exchange for diesel fuel. That said, the DPRK government could also be interested in medical aid that had a "rolling stock" aspect, such as ambulances, or in any medical equipment that appears to be high-tech. In that context, he said that DPRK officials might like the idea of solar panels to provide electricity to hospitals. Solar energy has potential in the North because hydorelectric power is available in parts of the country in the cloudy/rainy summer, whereas the winter tends to be clear. ¶8. (C) Asked if the DPRK would be receptive to receiving antibiotics, vaccines or other basic medicines, Linton said he doubted it, because such supplies are readily available from UN agencies or from the ROKG, and their end-use is usually poorly monitored, which is the way officials like it. He said his foundation once proposed a country-wide vaccination program for DPRK elementary-school students, because 98 percent of children attend school, but the DPRK government refused the program because officials wanted to continue receiving (salable) medicines and refrigeration equipment from UNICEF's Global Alliance for Vaccines and Immunization. VERSHBOW