It is difficult to believe that if, say, the British or French government decided to spend less than a dollar per year per person on the health service in order to increase the army’s size to between three and four million, and to produce yet more nuclear weapons and missiles, all in conditions of food shortage and famine, this would go entirely uncriticized by The Lancet — assuming, of course, that the staff of The Lancet would not be sent immediately to the harshest possible labor camps if they did so.
For a health system to be in disarray, it must once have been in array. Given the difference in the stature — the height — of the people of the two Koreas, which has now persisted for decades, it seems unlikely that the array was ever very great, notwithstanding the propaganda. When I was in North Korea I was shown a gleaming facility that was so obviously a Potemkin hospital — a façade and nothing else — that only a regime with a great deal to hide would have resorted to such an expedient.
Every cloud has a silver lining, however. The Lancet quotes the head of World Health Organization, Dr. Margaret Chan, as saying that the health services of North Korea would be the envy of the developing world. According to the WHO, North Korea has made progress not only in the field of infant and maternal mortality, but in the reduction of deaths during surgery. Since The Lancet goes on to quote, by contrast, the testimony of a man who had his leg amputated without anesthetic for a broken ankle, while being held down by five medical assistants, it is rather alarming to think of what North Korean surgery must have been like before the improvement took place. Only four medical assistants to hold patients down, perhaps?