North Korea

North Koreans in Russia received scant medical care during pandemic


Workers can’t afford medical checkups, so serious diseases are only found after it’s too late.

North Koreans in Russia received scant medical care during pandemic

North Korean and Russian flags are seen at the Vostochny cosmodrome outside the city of Tsiolkovsky, in the far eastern Amur region of Russia, Sept. 13, 2023.

North Korean workers in Russia who contracted serious diseases during the COVID-19 pandemic were unable to receive proper medical treatment, nor were they able to return to North Korea, according to an internal document seen by Radio Free Asia.

The three-page document, titled ‘Status of Patients at the First Construction Company in Khabarovsk, Russia’, was written around February 2022, and recorded the details of several medical issues of North Koreans sent to the Russian far eastern city to earn foreign cash for the government. 

It says that out of 58 employees belonging to the company, 54 are laborers, and eight of them have ‘lost the ability to work due to medical evaluation by the health institution in their country of residence.’

It specifically stated that there was one patient each with stomach cancer, lymphatic cancer, cirrhosis of the liver, emphysema, problems with the intervertebral disc, two patients with heart disease, and one patient with an indeterminate diagnosis.

Choi Jeong-hoon, a senior researcher at the Public Policy Research Institute at Korea University in Seoul, who worked as a doctor in North Korea, reviewed the document and confirmed that it appears to have been written by a North Korean resident, as the disease names and other names used North Korean spelling and spacing.

Sacrificing health

One construction worker in his 40s, who had been working in Khabarovsk since 2014 came down with lymphatic cancer in 2021, the document said. When doctors recommended treatment at an oncology hospital he refused because he did not have enough money to pay for it. 

The worker continued on at the construction site until he could no longer eat properly. He took many rounds of medications but never recovered.

Another worker, in his 50s, who had been working in Russia from Pyongyang in 2015. In 2021 he was diagnosed with stage 4 stomach cancer. 

The document said that the company is ‘administering immunotherapy on its own,’ and said the patient himself was responsible for his worsening condition.

“The patient’s basic needs are stabilization of life and dietary treatment,” the document said. “But as the patient continues to worry, his condition continues to worsen, and he is currently unable to eat and is in pain.”

Another worker in his 50s is said to have missed treatments for pulmonary emphysema.

The document said he developed symptoms of illness such as “shortness of breath, mild fever, and loss of appetite” eight months after being dispatched to Russia in January 2020, and was diagnosed with pulmonary emphysema in the spring of 2021.

While he was not receiving proper treatment, the emphysema, which was originally 3.5 centimeters in size, grew to 5 centimeters in January 2022, in just one year. Surgery to remove it would cost 320,000 rubles (US$3,345).

More dispatched?

UN sanctions mandate that all North Korean workers abroad were supposed to have been repatriated by the end of 2019, but Pyongyang has been able to get around this by dispatching workers under non-working visas, and then putting them to work anyway.

Estimates suggest that there are thousands of North Korean workers in the Russian Far East alone.

The recent summit between North Korean leader Kim Jong Un and Russian President Vladimir Putin has resulted in closer relations between Moscow and Pyongyang, possibly paving the way for an increase in North Korean dispatched workers in Russia. 

The document clearly reveals that North Korea is sending workers overseas while failing to properly guarantee their basic human rights and healthcare, a local source in Khabarovsk, who requested anonymity for personal safety, told RFA Korean.

“Before the pandemic, patients diagnosed with serious illness and unable to work were sent back to North Korea within a month,” he said. “But this was not possible during the pandemic, with the transportation blocked due to the border closure.’

Angry reactions

Professor Kang Dongwan, a professor at Dong-A University in Busan, South Korea, visited the Russian far eastern city of Vladivostok last April to directly observe the lives of North Korean workers. He said that there were some angry reactions to the authorities’ neglect.

“During the pandemic, there were cases of coronavirus and even deaths. However, the North Korean authorities gave instructions to handle the response to COVID-19 on their own and did not provide any support for treatment or vaccines,” said Kang. 

“In the end, there was a lot of awareness that ‘the country we trusted in has abandoned us,’ and that’s why the overseas workers felt uneasy,” he said.

Kang said that the workers put in 16 hours of backbreaking labor per day at the construction sites, and some even worked at night.

“Their environment is so bad that some workers have removed their own teeth because they cannot go to the dentist due to status issues and treatment costs.”

Surgery nearly impossible

North Korea sometimes dispatches doctors with the workers, but they are usually not equipped to handle serious illnesses, said Choi Jeong-hoon, a senior researcher at the Public Policy Research Institute at Korea University in Seoul, who worked as a doctor in North Korea.

“Patients with serious illnesses are left without proper treatment, which only makes their illnesses grow worse,” said Choi. 

Illnesses requiring surgery are impossible to treat with the dispatched doctors, he said.

He explained that sometimes doctors are dispatched with workers, but this is only a formality. It is impossible to treat serious illnesses other than colds or indigestion or to perform surgery.

After reading the report about the patient with stage 4 stomach cancer, Choi said it is unlikely that he is still alive, because without proper treatment, it is typical that patients will live between six months and a year.

“Since he cannot eat, he might suffer from malnutrition and will not live long,” said Choi. “Medicines are of low quality, and even if there are medicines, the officials get to use them first. They say, “The workers should earn money and buy it on their own.”

Meager earnings

But earning enough money for their own treatment is almost impossible.

While each worker is paid a salary far higher than what they could earn doing the same job in North Korea, most of their earnings are given to the North Korean government. The workers are allowed to keep only 10-20%, or a few hundred dollars per month. 

A hospital bill for a serious disease could cost as much as US$5,000-6,000.

Receiving regular health checkups is also costly, Kang said. With no checkups during their deployment, serious diseases like cancer are usually not discovered until the last stage, he said.

“Given the rapid increase in the number of patients with diseases, expenditure of funds is currently being raised as the biggest problem,” the First Construction Company’s document said.

It was “the company’s opinion that the implementation of the national plan has been hindered since January of this year” due to the need to spend hundreds of thousands of rubles for treatment.

The document also cited a lack of connection with anyone in North Korea since the beginning of 2022 as a major reason many of its issues were not being resolved.

Translated by Claire Shinyoung Oh Lee. Edited by Eugene Whong and Malcolm Foster.

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