Tuesday, February 1, 2022

Kim Jong-un's First Decade in Power - Building Paradise

The city of Samjiyon after reconstruction. Image: KNCA, December 2019.

Introduction 

After the Korean War, North Korea had to be entirely rebuilt. Very few buildings, bridges, railways, or factories survived those three years. With substantial aid from the Soviet Union, East Germany, Czechoslovakia, and China Kim Il-sung managed to rebuild most of the country by the mid-1960s and North Korea’s economy outpaced that of South Korea until ca. 1973.

Reforming the economy along socialist lines, introducing Stalinist architecture, and mobilizing millions really did mean that “socialist construction” was more than a mere slogan. And for many, who had for centuries lived in abject poverty, a paradise of sorts did arise in the beginning. But far from being a true socialist and self-sufficient state, North Korea relied on massive amounts of aid and imports at below-market prices, so-called “friendship prices”, from the Communist Bloc. New bureaucracies and elite classes (built upon the Songbun class system) also meant that the people were never on an equal footing, despite the official Party line.

After the collapse of the Soviet Union and the famine, Kim Jong-il struggled but failed to pull the country out of its economic decline. A mix of economic reforms, market activities, and growing illegal trade did mean that things slowly improved; however, economic conditions still have yet to fully recover from the famine years.

Every year, the leadership and the Workers’ Party of Korea offers new economic agendas and promises new successes toward the construction of a socialist paradise – a paradise that ever seems just out of reach. However, Kim Jong-un has taken the task about as seriously as one can, considering the huge expenditures on the military and the political and ideological constraints that exist.

Kim Jong-un appears to have recognized the economic drag the Songun Policy was causing through mismanagement and inefficient resource allocation, and also paid attention to the threats the state faced by ever-growing market-based activities and decided to take a different approach than Kim Jong-il.

He certainly wanted to complete the nuclear program as it practically guarantees regime survival, but there also needed to be economic growth and reforms. Not “reform” in the sense of opening up to the world and scrapping the centrally planned economy, but reform as in renovating the existing system to become more efficient, to seek new ways to evade sanctions, and help the government reign in market activity outside of its purview.

In 2013, Kim began to move away from Songun and toward a policy that had been promoted by Kim Il-sung called Byungjin (parallel development). Kim Jong-un’s iteration of Byungjin prioritizes both nuclear development and economic development, and theoretically, not one over the other. The economic development portion is focused on light and medium industry, tourism, science and technology, transportation, and energy, whereas under Kim Jong-il’s Songun, he had wanted to maintain an economic focus on heavy industry to support military requirements; often neglecting the rest of the economy and preventing any meaningful rise in people’s living standards.

The topic of living standards has been something Kim Jong-un hasn’t ignored. During the 2013 WPK meeting in which he promulgated his ideas for Byungjin, Kim stressed that it would lead to a “strong and prosperous nation where the people can enjoy the wealth and splendor of socialism.”

While weapons’ development certainly hasn’t taken a back seat, the number of major construction projects skyrocketed after Kim’s ascent to power. Touching every sector of the economy and culture, the proliferation of new projects has changed the face of the country, as Kim has staked a considerable part of his legitimacy on domestic policies and the economy.

Whether or not these projects are merely shallow attempts at propaganda wins or will make a fundamental difference in people's lives and the economy is largely up for debate as it will take more than concrete and steel to cause the fundamental reforms needed for lasting economic growth.

 

Tourism

Chair lift at the Masikryong Ski Resort. Image credit: Uri Tours, Jan. 28, 2014. CC SA 2.0.

Early on in his rule, Kim Jong-un made tourism a key aspect of his economic plan. With the ultimate goal of welcoming over two million foreign visitors by 2020 and increasing domestic tourism as well, Kim was looking forward to turning North Korea into a regional tourist destination – with all the cash tourists bring along with it. To help accomplish this, the government embarked on several high-profile construction projects.

The first was to continue work that began with Kim Jong-il, modernizing the Pyongyang-Sunan International Airport and adding a new terminal. The work, which began in 2011, carried on until 2015. The new terminal is six times larger than the old one, but tellingly, the airport’s fuel center was not enlarged. With only a few international flights into Pyongyang each week, exactly how and why thousands of new passengers would flock to the country remained unsolved.

To drive up interest in visiting the country, in 2013 Kim ordered the construction of the Masikryong Ski Resort. At a cost of $35 million and with a capacity to handle 70,000 visitors a year, it opened that same year and was North Korea’s first ski resort open to the general public. Two others had earlier been constructed in the Mt. Paektu region, but they were only available to the country’s elite and special guests.

Following Masikryong, a smaller ski facility was constructed in Kanggye-ri in 2017. The country’s oldest ski facility, in Samjiyon, was modernized in 2018 and another nearby facility that was constructed in 2001 (Pukphothae-san) was likewise renovated and may now be opened to a larger segment of the population; although, it hasn’t been mentioned by state media.

 

Waterparks were constructed in several major cities, with Pyongyang’s Munsu Waterpark boasting 14 waterslides spread out over 15 hectares. Kim Jong-un also oversaw the opening of the Rungra amusement park and directed the construction of numerous athletic facilities.

But perhaps the largest tourism-related project in the country’s history was the reconstruction of the Wonsan (Kalma) International Airport and the construction of the Wonsan Resort.

Converting the military-use Wonsan airport into a dual-use international airport for tourists and the air force began in 2013. The old 2,400-meter runway was replaced by two runways of 3,100 and 3,500 meters, and a modern terminal was constructed along with helicopter facilities.

The renovation cost between $150-200 million but its only major use thus far has been as the host airport for KPA Air Force airshows and to provide service to occasional passengers from intra-DPRK flights and government officials.

Kim Jong-un has taken a special interest in Wonsan as it’s home to his favorite seaside villa. Back in 2013 he expressed disappointment over the lack of recreational opportunities in the region and ordered that the area become a “world-class” tourism destination. These desires became the Wonsan-Kalma Tourist Zone.

Work along the beach didn’t begin until 2018 when nearly 5 km of beachfront property suddenly sprang to life all at once with construction equipment and workers. Kim has visited the area on multiple occasions and has offered specific criticism along the way. Trying to meet his demands added to the complexity of the project that was initially expected to open in April 2019. That deadline has been moved back several times and the resort, with its hotels, luxury inns, and condos capable of handling thousands of visitors a day is still not completed.

 

Somewhat more successful was the reconstruction of the city of Samjiyon. A major part of Kim’s tourism agenda from 2018-2020, modernizing Samjiyon and the whole Mt. Paektu region held added importance as the mountain is the mythical home of the Korean people and was the alleged headquarters of Kim Il-sung’s guerrilla army who fought against the Japanese during their occupation, and thus, it is the home North Korea’s independence.

The stated goal for the town’s reconstruction was to turn it into a “utopia town under socialism” as it is “the sacred place of the revolution”. The whole transportation corridor from Hyesan to Samjiyon was also modernized. Construction in other towns took place as well, with nearby Phothae also being rebuilt almost entirely. Over 40 km of road, 60 km of rail, and 10 train stations were either rebuilt or newly constructed, and new apartment blocks and houses were built in Wiyon, Junghung, Kasan-ri, Pochon, Thongnam, Poso, and other locales in the region.

Samjiyon and the surrounding villages have a population of 35,000-40,000. Nearly all of the homes have been rebuilt, along with schools, theaters, clinics, and farming facilities. A further thousand homes were reportedly constructed in 2021 as part of the ‘third phase’ of construction.

Kim Jong-un has visited the area at least ten times, underscoring its importance to the leadership. Like his father, he hasn’t indulged in building monuments to himself, but he must maintain the people’s loyalty. By constantly reminding citizens that he is Kim Il-sung’s descendant and that he is investing in the quasi-holy ground around Mt. Paektu, Kim bolsters his own legitimacy and personality cult.

Various proposals to turn the Mt. Paektu region into international biospheres and parks, such as a proposal to turn it into a UNESCO Global Geopark, have also been made over the years. What effect the recent changes to the area and increased population might have on these ideas is unknown, particularly as deforestation continues to threaten the existence of several endangered species that live in the area.

 

Aside from the international situation and the ongoing COVID-19 pandemic, Kim’s plans to turn North Korea into a regional tourism hotspot may run into other more fundamental difficulties. After reviewing satellite imagery, as I wrote for NK News in 2019, I was unable to find adequate water treatment facilities. What little energy infrastructure has been built hardly seems enough for the proposed numbers of visitors during peaks months as well.

Access to Samjiyon is restricted to rail and road, with the risk of power outages interrupting the trip always a possibility. There are also no tour packages that would allow someone to only visit the beaches at Wonsan. If you don’t want to be driven around Pyongyang or visit the DMZ while also going to Wonsan, you’re out of luck.

Limitations on freedom of movement, difficulties in crafting a personalized itinerary, and the prospect of blackouts (or knowing that your waste may be being dumped into the sea), doesn’t make the country a good prospect for mass tourism, even if you solved all of the geopolitical and human rights issues.

 

Foreign tourism has never been a major contributor to the economy. Prior to the Trump administration's ban on US tourism to the country in 2019, it was estimated that only $5 million came from American visitors. To compare to another money-earning ‘enterprise’, in 2020 North Korean hackers stole nearly $400 million worth of cryptocurrencies.

Of course, after a series of high-profile arrests and the tragic death of Otto Warmbier, it became clear that American tourists weren’t the regime’s focus to begin with. And official media has said as much, with the government preferring to focus on drawing in tourists from China, South Korea, and other East Asian countries. However, the tourist destinations that had been completed in time, before COVID disrupted travel around the world, had managed to only moderately improve the numbers of visitors to North Korea with between 250,000 and 350,000 foreign guests making the trip in 2019 depending on the estimates used. Well below the 2 million tourists Kim had wanted by 2020.

 

Two areas that have improved due to the domestic tourism push have been hot springs spas and regional amusement parks.

In October 2019 residents began moving into a new hot springs complex that was constructed in Yangdok. Kim Jong-un has visited the site more than once, taking the opportunity to be photographed with bathing locals. Yangdok also includes a skiing facility, but that was closed down (along with most recreational facilities) in the wake of COVID-19. However, preparations to reopen Yangdok and Masikryong were being made in November 2021.

Efforts to renovate the elite hot springs at Onpho began in late 2018 following Kim Jong-un’s lamentation that the site was in “very bad condition, saying bathtubs for hot spring therapy are dirty, gloomy and unsanitary for their poor management.”

Although, it seems that economic crisis has slowed work on the site, and it has yet to be publicly opened again, even though it has long been a place where the country’s elite (and the Kim family) would visit.

 

As briefly mentioned above, waterparks and other recreational and leisure centers have popped up all over the country. I’ve located 17 soccer fields and stadiums just in Pyongyang that have been constructed or renovated in the last decade, at least 158 ‘Children’s Traffic Parks’ have been constructed since 2017 around the country, open-air theaters have been built in each provincial capital, and waterparks of varying sizes, from Haeju’s 38,000 sq. m. park to Kanggye’s at only around 5,200 sq. m., were also added in each province.

While not tourism in the traditional “let’s go have fun and see the sights” sense, places of pilgrimage geared toward a domestic audience have also seen some improvements. Select museums dedicated to “American atrocities” during the Korean War, like at Sinchon, and some locations dedicated to the Kim family have been modernized. Other improved sites span from the Mt. Paektu region to the International Friendship Exhibition.

On the other hand, North Korea has hundreds of ancient forts, temples, pavilions, and pagodas, exposure to which could enrich the lives of every North Korean (and even help the regime’s propaganda), but most remain out of sight or ignored, left to decay into nothing as the sites promoted by the government are still heavily focused on modern propaganda.

 

Flood Recovery & Afforestation Efforts

Flooding is a perennial problem in North Korea, creating both losses of life and loss of harvests. The country has experienced several severe floods in recent years that together have affected the majority of the country, from the city of Sariwon in the south to Hoeryong in the far northeast.

North Korea’s proactive flood mitigation efforts have largely been pinned on the construction of dams to hold back rivers, but heavy rainfall and narrow river valleys often negate or overwhelm these measures. Dikes and levees have also been notoriously weak, leaving thousands of people and thousands of hectares at risk each year. But it seems that the government is finally taking flooding much more seriously.

For example, the town of Yonsa has experienced two major floods since 2016. After the first one, the riverbanks were washed away taking houses and the local stadium site with the floodwaters. New houses and levees were built but then another flood in 2020 erased the levees and knocked out a bridge.

This 2020 flood was part of a year that saw three typhoons affect the country. Following the flooding, Kim Jong-un began touring the sites from farming villages along the Chaeryong River in North Hwanghae Province to Komdok in the country’s north.

These visits gave Kim the appearance of being a hands-on leader who cared about getting people’s lives back together.

The result, hundreds of new homes were constructed in North Hwanghae and around 2,300 were rebuilt in Komdok (which is now in the process of being totally reconstructed and turned into a more modern mining region).

Flood-related construction can also be seen in Musan, home to the country’s largest iron mine, in Hoeryong (which also suffered heavily during the 2016 flood), Komusan, and up and down the valleys of the Hamgyong provinces. Within North Hwanghae, housing in the small villages around Myosong, Jithap, and Taechong was rebuilt, and a new neighborhood was constructed in Unpha.

It will take another typhoon or flooding event to know if the kilometers of new levees will hold and if the thousands of new homes can stand up to the weather, but 2020 certainly initiated a large number of construction programs in even some of the smallest towns in the country.

Map of deforested areas (red) from 2000-2015. Cropped image from: “Spatiotemporal Patterns of Forest Changes in Korean Peninsula Using Landsat Images During 1990–2015: A Comparative Study of Two Neighboring Countries”, by Dong, Ren, Wang, Q. Yu, Zhu, H. Yu, and Bao. IEEE Access, May 1, 2020. CC 4.0

Flooding isn't the cause of deforestation, but afforestation can certainly help with flooding. The country has struggled with deforestation since the famine and as wood stoves and heating stand in for electricity shortages, and Kim Jong-un has directed several policies toward addressing the issue.

Denuded hillsides can’t absorb as much water and contribute to flooding as well as soil degradation, which makes agriculture more difficult, so planting trees is an integral part of both flood control and increasing crop yields without having to spend huge sums of money.

In 2012 Kim wrote a policy paper “On the revolutionary switch in land management” which discussed forest management and the need for major afforestation efforts. This was followed by a two-day conference on deforestation and soil health in 2013 which dozens of North Korean scientists attended.

These events culminated in the “10-year plan of Forest Restoration” that runs from 2015 to 2024.

He also declared “war” against deforestation and in 2015 North Korea’s Foreign Minister Ri Su Yong told the United Nations that the country aimed to decrease its CO2 emissions by 37%. While it’s unlikely that North Korea’s carbon footprint has declined much (outside of the effects of COVID on the economy), Kim Jong-un has ordered the construction of several tree nurseries and the renovation of forest management stations to combat deforestation.

Afterward, large tree nurseries began to pop up all over the country. They can be found in Kanggye, Rason, Sariwon, Heaju, Pyongyang, Kangdong, Sinuiju, Jungphyong, Wonsan, and Hamhung. Improvements to many of the country’s smaller forestry management stations can also be seen.

In total, Kim’s war on deforestation envisions over a million hectares of new forests with tens of millions of saplings being grown at any given time. To underscore the state’s seriousness, he has visited several of the new nurseries in person.

This initiative faces major odds, however. Around 30% of forest cover was lost between 1990 and 2010 and around 15,000 hectares are further lost each year. Between slash-and-burn agriculture, forest fires, droughts, and damaging insect infestations, just halting deforestation will become a major accomplishment if successful.

 

Powering the Country

North Korea has never had an abundance of electricity, but it had enough to meet its basic needs up until the 1970s. Following the collapse of the Soviet Union and Communist Bloc, North Korea was no longer able to get coal and heavy fuel oil at discounted prices. Additionally, the country lacked the capacity to repair or replace parts in their aging power plants and struggled to keep up with rising energy needs through hydroelectricity.

Compounding the problem is the fact that much of the energy grid infrastructure and design is now 40+ years old. Energy loss through leaks and inefficient designs can cost North Korea up to 30% of its electricity.

The government has made some attempts at increasing generation through traditional thermal power plants, though, Pyongyang’s central plant is far too old to simply be repaired and the country would need considerable foreign assistance to modernize the plant.

Begun under Kim Jong-il in 2010-2011 the Kangdong Thermal Plant was supposed to supply the capital with between 200 and 300 MW of coal-powered electricity. Construction work proceeded after Kim Jong-un took over and by 2013, the cooling tower was being raised and ten apartment buildings for workers and their families were in various states of construction. Work stalled out by 2014, however, and quickly came to an end. Some work finally resumed ca. 2019/2020 and the structural supports for two boilers can now be seen, but the plant is still far from being completed.

Between 2015 and 2018, two new generating units were added to the Pukchang Thermal Plant, which provides energy to the country’s only aluminum plant and is the country’s largest thermal power plant. The completion date is speculated to have been moved up in response to Kim Jong-un’s 2018 New Year’s speech in which he called on the country to “drastically increase thermal power generation”. The expansion added 400 MW of electricity capacity when working at full efficiency.

Additionally, the power plant in Songbon, which had relied on fuel oil, was converted into a typical coal-fired power plant, as the country’s supply of petroleum has been squeezed. Work on the conversion appears to have been completed in 2020.

However, these improvements to fossil fuel power plants haven’t been enough to put an end to blackouts. Lacking the domestic capability to build new fossil fuel power plants, energy policy under Kim Jong-un has instead focused on hydroelectricity and it has slowly begun to look toward solar and wind power as well.

The unreliability of hydroelectricity in North Korea has been an ongoing problem, as droughts are common and water levels can fall below what is needed to turn the turbines. Many of the major dams in the country were also constructed in the early 20th century and are aging, producing less electricity in the process.

To help overcome these problems, dozens of small and medium-sized hydroelectric generators have been constructed in the last decade, and there’s also been a renewed push to install micro-generators in the numerous small streams that cover the country. These micro-generators are only enough to power a house or two but they can be used to run local grain mills or keep the lights on in the local clinic, helping to bring at least some electricity to the smallest communities.

On the larger side of things, the Huichon Dam was finally completed under Kim Jong-un. Kim Jong-il’s anger over years of delays and problems with the dam is one theory as to what caused his heart attack in 2011.

Huichon is the first dam in a series of hydroelectric dams that run along the Chongchon River. Over the course of 65 km, there are twelve dams – eleven were built under Kim Jong-un. Between the main dam and the other smaller ones, the installed generating capacity reaches 400-500 MW, enough to theoretically power almost half a million homes in ideal circumstances. But problems at Huichon continue and with fluctuating water levels, it’s likely the entire system operates at less than 75% capacity.

Other important hydroelectric projects include the Orangchon-Phalhyang Hydroelectric Dam that was completed in 2019 after twenty years of construction, the building of two dams along the Chungman River (in Usi County), the Wonsan Army-People hydroelectric project, and the Paektusan Hero Youth Power Stations – all being completed or initiated by Kim.

The last hydroelectric project I’ll mention is Tanchon. Planning to squeeze electricity out of the Hochon River system in Ryanggang Province dates back to a Japanese plan for the area beginning in 1925. North Korea’s own plans were envisioned by Kim Il-sung, but it wasn’t until 2016 when work began on what is the largest hydroelectric project in the country’s history.

It involves a 60-km-long tunnel that carries water out of the Samsu Reservoir, south (against the direction of the river) to a hydroelectric station in the Worker’s District of Sinhung in South Hamgyong Province. COVID has delayed its completion and only moderate progress has been made since 2019.

 

North Korea has experimented with wind and solar for decades, but only ever at small scales. And while the price of solar panels fell and citizens began to use them on their own, the government was still slow to adopt the new technologies. That’s changed somewhat in the last decade.

Although there still hasn’t been any large-scale production of wind or solar, several small facilities have been constructed and microturbines can be seen at several collective farms. Additionally, North Korean firms have begun to manufacture the turbines domestically instead of relying solely on importing them from China.

Today, experts place solar at providing less than 1% of the nation’s total energy, yet, upwards of 55% of North Korean households rely on solar energy at some level, either using it to power their entire home or by having small panels just to charge cell phones or single appliances. The government has also been adding larger panels to new construction projects and residential towers. These panels can easily be spotted in satellite imagery.

Wind and solar may not yet be enabling factories to run, but they are democratizing electricity in a way that hadn’t existed in the country before. With photovoltaic panels available in the markets, people whose neighborhoods aren’t even connected to the national grid can now keep a light on at night or help their local school run its equipment, all without relying on the central government.


Pyongyang’s Construction Boom

Major areas of new construction and renovation under Kim Jong-un. Image: AccessDPRK.com

Modern Pyongyang has been referred to as Pyongyang 3.0 not only because there’s a third Kim in charge, but because it has gone through three distinct periods of construction and urbanization.

Kim Il-sung’s Pyongyang was the rebuilt showcase capital born out of war. Kim Jong-il’s Pyongyang was crowned by the abandoned Ryugyong Hotel and became a city frozen in time. With few modernization programs, it still stressed the “‘monumentality’ and the reification of state ideology” with little regard for the practical needs of the population.

The city’s main urban area grew from 70 sq. km. in 1984 to over 103 sq. km. by 2017, but the most impressive changes that have occurred involve the mix and density of new buildings in the last decade, not merely outward suburbanization which is something that remains a slow and organized process due to existing administrative barriers.

The skyline of Kim Jong-un’s Pyongyang would be all but unrecognizable to denizens from the 1960s and 70s. During his rule, he has preferred to embark on the monumental, not to the state, but in providing monumental housing projects, monumental recreational facilities, and monumental economic/industrial construction – setting his legitimacy not only in the completion of the country’s nuclear forces but in raising living standards and attempting to pull the country out of the economic quagmire that arose in the 1990s.

A number of housing projects had been initiated under Kim Jong-il, particularly in the Rakrang District on the southern bank of the Taedong River and in Hyongjesan to the north of downtown. These projects involved dozens of buildings and thousands of housing units but were left incomplete. Construction has carried on through the first decade of Kim Jong-un’s rule and they have become part of his ‘grand plan’ to construct over 66,000 new housing units in the capital by 2025. This figure includes 16,000 that were already under construction at the time of his March 2021 announcement and a further 50,000 to be built in several large sections throughout the city.

These new housing projects include a section of high-rise apartments in the Sadong District, new apartments in the Mansu District where the International Taekwondo Federation Headquarters used to be located, and there are plans for more housing in the Mangyongdae District.

As seen in the image above, there have also been numerous individual apartment buildings added in various places along with new factories, schools, and other facilities.

Two other major housing projects that were completed were the Mirae Future Scientists Street along the Taedong River and the Ryomyong New Town. Mirae involved construction along 1.2 km of Mirae Street and consists of some of the tallest buildings in the country including the famous Unha Tower. Completed in 2014, the development consists of 2,500 apartment units for scientists, students, and staff from the Kim Chaek University of Technology.

Following Mirae was the 2017 opening of the Ryomyong New Town. This redevelopment of land along Ryomyong Street by Kim Il-sung University saw the construction of 40 new apartment buildings and the renovation of a further 67 existing buildings of different types. The 2 km-long development stretches from the giant Tower of Immortality to just before the Kamsusan Palace of the Sun.

Kim Il-sung University has also been undergoing an expansion that began in 2014 and has yet to be completed.

A major criticism, however, of these projects has been the speed at which they were constructed. The tallest occupied building in North Korea is the Ryomyong Condominium Building No. 1 which reaches 82 stories. It was built in less than 3 months. Critics note that in the rest of the world, to safely and properly construct a building that tall it would take around 2 years.

Building collapses are not unknown in Pyongyang and land subsidence, a direct hit from a typhoon, or an earthquake could one day topple many of the buildings.

Additionally, with power outages still a recurring event, elevators can be a dangerous proposition, leaving the top floors in many Pyongyang buildings unoccupied or used by the lowest-ranking citizens in the capital. The lack of water pressure and fire suppression systems as a result of energy shortages also makes the higher floors undesirable.

As with all other major towns in the country, a new orphanage was constructed in 2014, the city’s amphitheater was renovated, and multiple soccer fields and stadiums have either been constructed or modernized. In the last decade, the Sunan International Airport was modernized, at least four medical facilities have also been built in Pyongyang, a new civilian airstrip was built along with a VIP heliport, the Victorious Fatherland Liberation War Museum and the Korean Revolution Museum were both enlarged, the Pyongyang Zoo was modernized, and there has been a wide range of factories and workshops constructed covering well over 730,000 sq. meters combined.

 

Updating the Provinces

While Pyongyang did see some new construction under Kim Jong-il, particularly in the last few years of his life, the rest of the country was largely left behind. Under Kim Jong-un, numerous towns and cities of all sizes have experienced some level of modernization and expansion.

Whether in an attempt to prove the successes of the Byungjin Line policy on the national economy or because the government recognized that there was a very real need for modern housing and other facilities throughout the country, dozens of population centers have benefited from new construction.

The cities of Sinuiju, Hwangju, Hamhung, Rason, Kanggye, Nampo, Pyongsong, Sariwon, Kosan, Wonsan, Chongjin, Haeju, and most recently, the Komdok mining region have all seen multiple construction projects ranging from renovating their downtown areas to enlarging factories and building new recreational facilities.

A few specific examples:

Komdok is currently in the middle of being reconstructed almost entirely, with 25,000 new homes planned by 2025 to turn Komdok into “the world’s best mining town”. This is being accomplished through the use of so-called “soldier builders,” who are merely members of the armed forces conscripted into civilian construction projects as a source of free labor – a very common practice in the country.

Sariwon has seen renovations of its downtown area, at least 20 mid-rise apartment buildings have been built, and nearly 13 hectares in the city’s west now hosts nurseries, schools, and recreational facilities.

Like Sariwon, Kanggye is another provincial capital that has seen substantial construction. Its stadium is being renovated, a plaza was added in front of the People’s Palace of Culture, at least 25 new apartment buildings have been constructed, three hydroelectric dams have been built downriver, and as mentioned in the tourism section, Kanggye has a small ski resort and waterpark.

 

Outside of city facelifts, relatively large housing projects have been constructed in Bukchang, Yongbyon, Paekun, Yomju, Tongrim, Chollima, Chunghwa, Songchon, Pyongsan, Hwadae, Tongchon, and Ongjin, just to name a few. Of the examples listed, these residences provide space for as many as 8,200 families.

Children’s nurseries, orphanages, and new schools have been built in each provincial capital. Additionally, the Ministry of Public Health announced as part of their 2016-2020 plan to modernize 200 local hospitals outside of Pyongyang. As many local clinics haven’t been positively identified via satellite, it’s difficult to ascertain whether or not the government has been successful at this, particularly if the changes were all on the interior (new equipment, basic building maintenance, etc.), but we do know that the South Hamgyong Provincial Hospital in Hamhung recently underwent renovations, as did hospitals/clinics in at least Kanggye, Jasong, Samjiyon, in the village of Hunggyesu, Sariwon, Songnim, Nampo, and Haeju.

 

Agriculture and Land Reclamation

During the Communist Bloc era, North Korea could rely on ‘friendship prices’ for just about everything and never managed to develop food independence. Since then, Pyongyang has received nearly a billion dollars worth of food aid from the United States alone since 1995 and it is in greater need today than it has been in several years.

Famine, droughts, floods, and huge levels of mismanagement have all plagued the country’s ability to feed itself. Yet, despite the oft-quoted fact that North Korea only has 17% arable land, it actually has 46% more land dedicated to agriculture than South Korea and yet still produces substantially less food.

It’s within this context and with the memory of famine and belt-tightening that Kim Jong-un came to power proclaiming in 2012 that he would banish hunger once and for all through a ‘scientific approach' to agriculture and by going after corrupt officials.

Fast forward to 2021 and the government tacitly admits it’s failed, telling the people to tighten their belts once again and to be prepared to endure hunger until at least 2025. Although the government is blaming the situation on COVID, North Korea has needed to import food every year under Kim Jong-un and received international food assistance most years.

As such, the food supply has featured heavily in Kim Jong-un’s speeches and policy announcements. And indeed, many changes have been seen. From policy changes allowing farmers to sell more of their surplus produce to letting people have much larger “kitchen gardens”. And while these changes may have had a measurable impact in certain years, it’s clear they haven’t been enough.

In concert with policy changes, Kim has also embarked on several high-profile construction projects aimed at improving food supplies.

The Jangchon Vegetable Farm in Pyongyang has grown substantially since 2013 and is touted as being “a standard of the socialist rural cultural construction”. And in what may be the largest single agricultural project of Kim Jong-un’s rule was the development of the Sepho Tableland. With projects spread across 30 sq. km. the development involved everything from improving livestock grazing and production to increasing crop yields in the area.

Another giant project that has continued to be developed is the enlargement of the Kosan Combined Fruit Farm in Kangwon. The fruit farm occupies more than 3,400 hectares, with hundreds of homes constructed throughout the plain, and was redeveloped to allow for mechanized harvesting. And then there’s the Taedonggang Fruit Farm in Pyongyang that extends for 9 km along the Taedong River.

On the other side of the country, the Jungphyong Vegetable Greenhouse Farm and Tree Nursery was constructed from 2018 to 2020. The 130 hectares worth of greenhouses are meant to provide food during the winter to Chongjin and the surrounding area.

Other large farms have that either been constructed or enlarged during his rule can be found in Rason, Hamhung, Samjiyon, and in Wonsan, where a full 1,000 hectares are currently being converted into greenhouses and related facilities across from the Wonsan Villa. In 2018 there were also 430 hectares of land brought back into cultivation in Mubong, Ryanggang to increase the production of potatoes, one of the regime’s most extolled crops.

And most recently, another large vegetable farm was announced, this time at Ryonpho south of Hamhung. The 100-hectare site will be constructed on the site of another airfield, as was the case with Jungphyong.

However, despite the creation of large ‘modern’ farms and regional experimentations with letting farmers have full control over small plots, food production has still fluctuated year-to-year, as natural disasters and weather changes still play a far greater role in food production than the state’s attempts to control the situation.

 

Beyond trying to boost crops, efforts into livestock have also been made.

As mentioned above, the work at Sepho partially dealt with grazing lands and around half a dozen livestock centers were constructed in the process. Existing poultry farms in Sijuiju and Kusong were remodeled and a new large poultry farm was constructed south of Pyongyang in 2019-2020 at Kwangchon.

In terms of other animals, the Phyongbuk Pig Farm was remodeled in 2020 and in 2021 a new black swan hatchery was established at the Kwangpho Duck Farm in Chongpyong. Fish farms are also an important source of protein, with over 60,000 tons produced each year between fresh and saltwater species.

Several examples of fish farms built in the last decade include the Ongjin Coastal Fish Farm which has been increasingly developed over time and encompasses nearly 3 sq. km, the Monggon Fish Farm was built in 2018, Paechon Fish Farm No. 2 was established in 2017-18, a medium-sized facility was constructed in Hungdok in 2016-17, and others in Hwanggok and Muggye were built in 2016.

Existing fish farms have also been expanded or had improvements made to their facilities such as the Sokmak Salmon Farm, Songdo fish farm in Kaesong, the 22-hectare Poman fish farm, and the Samchon Catfish Farm which can produce 3,000 tons a year.

 

Since the period of Japanese occupation through to today, over 850 sq. km. of land in northern Korea has been reclaimed, either through passive reclamation (letting enclosed areas silt up) or through actively filling tidal flats and river deltas. The state of North Korea took up this process after independence and has laid out multiple ambitious reclamation plans over the decades.

The new areas can be used for everything from rice paddies to salterns to aquaculture (sheltered fish farming) and are intended to make up for the lack of arable land in the country.

Under Kim Jong-un, dozens of plots, large and small, have been walled off from the sea and older projects begun by his predecessors such as the Ryongmae Island Project and Taegye Island Reclamation Project have been allowed to progress. The total area of the new sites, once completed, will add over 160 sq. km. of territory. Kim has said that he wants to add a total of 3,000 sq. km. of reclaimed land. In order to do this, however, the country will have to destroy several whole habitats: tidal flats, marsh and reed lands, and inter-island zones.

Marginal lands behind the West Sea Barrage and within the Kangryŏng Reservoir that was created after the Kangryŏng Bay was dammed in 1984-87 have slowly been turned into farmland, while some of the newer projects begun by Kim Jong-un are so large that they’ll forever change the coastline of the country and can be seen from space.

According to 38 North, twelve major reclamation projects are ongoing, with some having been initiated before Kim Jong-un’s ascent. Some of the ones that were started entirely by Kim Jong-un include projects around Sohae which encompass ~33 sq. km., one near Kwaksan that will encompass 7.2 sq. km., and another between Sinmi Island and Ansan that encompasses over 64 sq. km called the Honggondo Tideland Reclamation Project.

With rising sea levels, it’s unclear what efforts in design and construction have been made to prevent saltwater infiltration and to deal with additional erosion. It’s also unclear if the country will reap more benefits from rice production than they might have through fishing, shellfish production, and other activities had the reclaimed areas been left as tideland and marshes.

 

Transportation

New electric locomotive model by the Kim Jong Thae Electric Locomotive Complex. Image source: Rodong Sinmun, October 2020.

Adequate and modern transportation infrastructure has been lacking for decades. Although North Korea has 7,435 km of railway and 25,554 km of roads, the physical tracks and ties are decades old and most of the railcars are over 30 years old. A lack of sufficient electricity also means that a two-day railway trip using diesel locomotives could take 10 days using electric locomotives, which make up the bulk of North Korean railways, as prolonged electricity cuts can be common.

Efforts have been made to modernize the railcar fleet, with a new electric locomotive design being introduced in 2020, but most of the rail lines and rolling stock remain dated and in need of considerable repair.

The country’s road network is another matter. The lack of paved roads (less than 3% of the total) and winding mountain routes was chosen on purpose by Kim Il-sung to slow any invasion in the event of a second Korean War. Select roads and highways continue to be repaired as needed, particularly within Pyongyang, but new road construction has been rather limited, with major highway projects connecting Wonsan to Hamhung (began in 2012) and Hyangsan to Huichon having been abandoned.

Although Pyongyang is still seeking Chinese and Russian investment in new road construction, there has yet to be any progress on the ground despite various agreements signed years ago with the exception of the New Yalu River Bridge which I discuss later on.

 

However, considerable effort has gone into enlarging and modernizing the country’s main port facilities. As North Korea’s limited foreign trade and fishing fleet are major lifelines, the aging ports needed a facelift to facilitate both legal and illegal trade.

As the country’s primary port, Nampo’s port and oil facilities, in particular, have undergone major improvements.

Constructed on the former site of the Nampo Smeltery, a container port was added in the early 2000s and was later enlarged in 2011-13 to cover 21.3 hectares. A container gantry crane was added in 2019. A small ship repair facility was also built nearby, opening in 2015.

Of larger concern to international sanctions, Nampo’s oil and coal terminals have undergone improvements as well.

North Korea is prohibited from exporting coal yet managed to earn as much as $410 million from coal exports in 2020. Several vessels were also noted to be docking at the coal terminal that year which had seen the construction of a new covered coal bay in 2016.

Nampo’s oil storage capacity has grown considerably. Two new facilities have been constructed since 2016 and 14 new petrochemical storage tanks have been built since 2011, dispersed among the several oil facilities around the city. Foundations for a further 12 tanks also exist.

Many of the tanks are around 23 meters in diameter. If we assume that all 14 new tanks average out to 23 meters in diameter and are a conservative 10 meters tall, that gives an added maximum capacity of 29 million liters of oil. In other words, Nampo alone has added over 187,600 barrels in additional storage capacity under Kim Jong-un.

Other ports and harbors around the country have likewise seen modernization efforts. At Chongjin, the country’s largest fishing harbor, three new storage tanks have been constructed and several buildings within the shipyard, manufacture, and repair complex were completely remodeled beginning in 2018.

The ports and harbors at Changjon, Tongchon, Rangsong-ri, and Muchon-Koam have all seen improvements. At Tanchon, an entirely new harbor was constructed from 2010 to 2012 and has been well maintained ever since. Then there are the facilities in Rason (Rajin-Sonbong) which have undergone small but continual work ever since the creation of the Rason Special Economic Zone in the 1990s.

 

North Korea has 19 road and rail connections with its neighbors. Under Kim Jong-un, ten of them have been modernized and their capacities expanded. The freight regauging yard at the Tumangang Station connecting North Korea and Russia has been in the process of being upgraded, and construction on new customs facilities began back in 2017.

In a process that took a decade to complete, the Wonchong border crossing with China (just up the river from Tumangang) was constructed and provides a 4-lane bridge connection.

The Namyang-Tumen border crossing was completed in 2020 as part of a project that also saw 42 apartment buildings built.

New or enlarged customs facilities have also been constructed at Sambong, Hoeryong, Hyesan, Chunggang, and Manpo. And an entirely new overland border crossing was constructed north of Samjiyon. The single-lane road cuts through the forests before hitting the Chinese border and was established in 2014; although, it is not a regular commercial border crossing and seems to have limited use.

However, North Korea’s most symbolic cross-border connection, the New Yalu River Bridge, still has yet to be opened.

Construction of the newest official Sino-DPRK crossing point began in 2011 and is estimated to have cost $350 million, but due to multiple delays and eventually COVID, the opening has been postponed for years. The bridge wasn’t even connected to the country’s road system until 2021 and none of the customs facilities have been constructed.

 

Mass transit upgrades have also been made in Pyongyang specifically. New subway cars have been introduced and the city has slowly been updating its tram and bus fleet, as some buses from the 1970s can still be found traversing the streets.

Between 44 and 100 Chollima-321 trollies have been manufactured since the refurbishment of the Pyongyang Trolley Bus Factory in 2018 (after getting Kim’s personal approval). Twenty were sent to Wonsan to improve inter-city transportation in anticipation of greater traffic due to the Wonsan Resort, but the majority remain in use in the capital.

And most recently, the city is in the process of building its first subway extension since the primary lines were completed in the 1970s. Based on the visible tunnel excavation points, the subway extension will run for approximately 3.5 km from the current Kwangbok Station to a new station that will be located somewhere near the Mangyongdae Children's Palace. Although planning for the extension goes back many years, active construction along the whole line wasn’t occurring until 2019 and continues through to today.

 

Lastly, a former 30 km-long railway segment from Hyangsan to Unsal is in the process of being reconstructed along with at least one new train station. The line had been decommissioned in the 1990s. This is the longest segment of railway that I am aware of that has either been recommissioned or completely overhauled other than the Hyesan to Samjiyon line.

 

Conclusions

Whether they’re prestige mega-projects or simply new housing to keep up with population growth, construction has been a major theme throughout Kim Jong-un’s first decade.

Over 100,000 housing units have either been constructed or are planned nationwide. Provincial theaters, orphanages, and tree nurseries have popped up with regularity. And, of course, the regime has spent countless millions on military construction as well.

Some of these projects have had real impacts on the people’s lives and fulfills part of the state’s pledge to build a nation for the people. Whether it’s housing, recreation, or water purification sites, one cannot argue that there hasn’t been some improvement. However, Pyongyang continues to misallocate millions on tourist projects that will never draw in millions of visitors and on projects that only have propaganda value, that only serves to divert money away from much more needed infrastructure projects like updating the national power grid or improving water quality.

And despite what could be a billion-dollar construction spree over the last decade, many of the projects appear to be superficial and will have little real impact on the economy so long as North Korea continues to isolate itself and arrest foreigners for things that wouldn’t be criminal in the rest of the world.

At $40 a ticket, most North Koreans can’t afford to go skiing. With precious few international flights to Pyongyang, there’s yet to be a substantial uptick in the number of tourists. And even all of the residential construction comes with caveats. Elevators don’t always work, and water can’t be pumped up to the top floors of the tallest buildings rendering those floors uninhabitable. The lack of electricity also affects everything from mass transit to the ability of hospitals to perform their services.

COVID-19 also set several projects behind from the Wonsan Resort to the Tanchon Hydroelectric Project, hampering associated developments and preventing additional electricity capacity from coming online.

And so, while projects have proliferated to every corner of the country, it is difficult to assess their real impact in this current climate, recalling that other prestige projects in the past actually helped to plunge the country into economic collapse instead of helping.

 

~ ~ ~ ~

 

I have scheduled this project to run through to the end of the year, with a new article coming out roughly every 10 days or so. If you would like to support the project and help me with research costs, please consider supporting AccessDPRK on Patreon. Those supporters donating $15 or more each month will be entitled to a final PDF version of all the articles together that will also have additional information included once the series is finished. They will also receive a Google Earth map related to the events in the series, and can get access to the underlying data behind the supplemental reports.

Supporters at other levels will be sent each new article a day before it’s published and will also receive a mention as seen below.

 

I would like to thank my current Patreon supporters: Amanda O., GreatPoppo, Joel Parish, John Pike, Kbechs87, and Russ Johnson.

--Jacob Bogle, 2/1/2022

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Tuesday, January 18, 2022

Kim Jong-un's First Decade in Power - Health of the Nation

Temperature screening in Pyongyang. Image: KCNA, March 4, 2020.

 

Introduction

While the health of a nation’s leader can have an outsized role on a country, more important to a nation’s strength and wellbeing is the health of the general population. It is from this population that government officials, soldiers, technicians, and farmers are drawn, and if the health of the people is poor, it will be reflected up and down economic, government, and military institutions.

For North Korea, the general state of the healthcare system and the presence of poor health in large segments of society has affected a poorer educational performance, led to higher rates of work-related disability, and has even influenced national security as the military has had to lower recruitment criteria in a reflection of the impacts of long-term malnourishment.

Despite some marginal attempts by Kim Jong-un at improving healthcare (such as the construction of the Pyongyang General Hospital and modernizing the Myohyangsan Medical Equipment Factory) and attempts to improve the food supply, illnesses like tuberculosis still rage through the country and over 42% of the population suffers from undernourishment.

Compounding the problems associated with limited healthcare, food production, and endemic disease has been the arrival of the COVID-19 pandemic and the regime’s response to it. Closing the border has all but ended foreign trade, expelling foreign aid workers has prevented medical and food aid from being distributed, and Kim Jong-un has rejected offers by the international community to provide millions of COVID vaccine doses.

As such, while Kim Jong-un can boast some legitimate accomplishments in other sectors, the efforts to better the health of the people must be seen as a failure.

 

Health of the Nation

The South Hamgyong Provincial Hospital after the 2021 renovation. Image source: KCNA, May 2021.

 

The State shall protect the people’s lives and improve the working people’s health by consolidating and developing the system of universal free medical service and improving the district doctor system and the system of preventative medicine.” - Article 56 of the Democratic Peoples’ Republic of Korea’s constitution, 2016 version. Emphasis added.

  

   On paper, one might suspect that North Korea has a fairly robust healthcare system. With 133 provincial-level hospitals, 1,608 county-level hospitals, and 6,233 primary care clinics, there are almost 37 doctors per 10,000 people: a ratio on par with Australia. However, despite impressive gains in life expectancy and the proliferation of medical clinics into small villages around the country during the 1960s and 1970s, North Korea currently has some of the worst healthcare infrastructure in the world.

Most clinics are capable of diagnosing basic diseases and setting broken bones, but everything from sterile needles to antibiotics and anesthesia is in short supply. In Kim Jong-un’s North Korea, there still remains no national emergency number (like 119 in South Korea or 911 in the U.S.) and patients must arrange transportation directly with their local hospital. As there are not enough ambulances in the country, private taxis may be required or even asking for transport on a passing tractor.

Despite the constitution guaranteeing free healthcare, people are often required to pay for supplies and medicine prior to receiving any care (including emergency care), and there have been reports of patients needing to provide their own blankets as well as meals for the nursing staff and doctors.

Hospitals capable of providing more complicated services are limited to Pyongyang and provincial capitals, but electricity shortages and shortages of everything from IV bags to modern medical beds hamper even these favored institutions.

The constitution’s guarantee of preventative medicine has likewise gone unfilled under the rule of Kim Jong-un.

The rate of smoking among North Korean men has indeed fallen from 59% in 2008 to 46.1% in 2019 according to the World Health Organization, but smoking rates remain above the global average of 36.7%.

An estimated 71,300 North Korean die each year from smoking-related causes. These represent 31% of the total deaths in the country. Although the rate of smoking has gone down, deaths caused by tobacco use are compounded due to a lack of early detection and available treatment options.

To tackle this problem, all three Kim’s have instituted various anti-smoking initiatives, but they have only met with moderate success. Under Kim Jong-un, such initiatives have been seen in 2016 and 2020 which included bans on smoking in certain public buildings.

However, Kim Jong-un continues to smoke in public, undermining efforts to curb smoking among the people.

 

   Tuberculosis isn’t a self-inflicted disease the way lung cancer can be, but it is still an illness that has been controlled in many parts of the world thanks to antibiotics and routine screenings (86% of all new cases can be found in just 30 countries). North Korea has the highest rate of TB among its neighboring countries, and it has been reliant on international aid to keep its spread in check. However, the regime hasn’t always been fully cooperative, and international sanctions have hampered efforts as well.

But while these joint efforts between Pyongyang and NGOs had produced consistent positive results in the decline of TB deaths since 2000, that trend began to reverse in 2016. North Korea’s expulsion of foreign aid workers and border closures in response to COVID-19 also means that the country has been left for over a year with almost no assistance fighting this highly contagious disease.

By December 2020, experts and aid workers who had worked in combating TB in North Korea warned that North Korea would soon run out of the life-saving drug supplies it had acquired in the run-up to the country’s lockdown. One U.S.-based humanitarian official said, "Every untreated TB patient could infect 10 to 15 other people. We could be looking at a much bigger epidemic [in North Korea]”.

Organizations were able to send 918,000 doses of the Bacillus Calmette–Guérin (BCG) vaccine, but the usage rate is over 300,000 doses a year as every newborn is given it. This left North Korea with only a three years’ supply in the best of circumstances.

A further shipment of TB-related treatments was stuck in a Chinese port for months as North Korea worked through their extreme quarantine measures (which extends to both people and products). Lapsed TB treatment plays a role in the development of antibiotic-resistant strains. These ‘super strains’ already account for 21% of new TB cases in North Korea and the country has run out of the drugs needed to fight them.

If Kim Jong-un doesn’t end the lockdowns soon, whatever progress had been made in fighting TB (and drug-resistant TB in particular) could largely be undone. With an estimated 135,000 people currently infected, without treatment, each of those individuals could infect a further 10 to 15 people as stated above.

It must also be said that in the case of North Korea, of five main risk factors, over 65% of TB cases are attributable to undernourishment according to the WHO “Global Tuberculosis Report 2020”; a problem that has only increased due to the extreme nature of the country’s lockdowns.

 

   In terms of being able to provide services and access, North Korea’s healthcare system is deficient in multiple areas.

According to the article “Surgical Diseases in North Korea: An Overview of North Korean Medical Journals” published in the International Journal of Environmental Research and Public Health in 2020, North Korea’s healthcare infrastructure seems to be unable to provide complex surgical procedures like organ transplants.

Based on a review of medical literature from hundreds of DPRK-specific reports, the 2019 study “Systematic review of evidence on public health in the Democratic People’s Republic of Korea” found that cancer screenings appear lacking, particularly for cervical and breast cancers. While both rural and urban women are aware of diseases like cervical cancer, only 6% of women reported having a cervical cytology smear test and 62% of rural women said that travel distances were a barrier to getting screened.

It is this lack of access and loss of faith in the medical system (due to distance, medical costs, and shortages of medicine) that leads many patients to forego visiting hospitals and instead seek medications on the black market and herbal/folk remedies for self-treatment for a wide range of illnesses. 

Unfortunately, this has helped to fuel drug addiction in the country as upwards of 61% of patients end up buying opioids on the black market. Without adequate monitoring, both addiction and physical dependence can quickly develop, leading to a host of other problems.

 

   Attempts to limit or ban drug abuse and alcoholism have occurred for decades. Although drug addiction is not as widespread as some suggest, the lack of proper medicine and treatment options requires that people seek help elsewhere. The state doesn’t help matters by being behind the manufacture of drugs like methamphetamine and heroin. In fact, for a time in the 1990s, most of the methamphetamine being abused in northern China came from North Korea.

Despite crackdowns on domestic drug use, abuses of amphetamines and opioid narcotics remain more than a passing fad among the country’s youth. Occasionally reaching epidemic proportions within the northern provinces of the country, the drugs aren’t merely being used for people to get high, but are used to cope with never-ending demands for labor, long working hours, physical exhaustion, and to try to address health problems like chronic pain from injury, disability, and even end-stage cancers.

As briefly mentioned above, compounding the spread of drug use is also its state-sponsored manufacture. With sanctions cutting into the regime’s finances and China taking a harsher view toward drug sellers, domestic drug sellers and criminal gangs have had to find local buyers for their highly potent drugs.

No proper study has been conducted on drug abuse within the country, and the regime often claims it doesn’t even exist, but the reports from defectors are consistent in that drug abuse exists and has reached what could be described as an epidemic at different points since the 1990s, with drug addiction being almost unheard of prior to the famine.

 

   In the field of mental health, competent institutional support for psychiatric problems is almost completely lacking. While some facilities exist, named No. 49 Hospitals, they are described by defectors as little more than prisons for the mentally unwell.

Words like “psychiatrist” and “mental health” are rarely known of by the average person, and the most common way to address mental illnesses of all sorts, it would seem, is for people to either ignore it or try to treat it (as though it were a regular disease) with herbal medicines.

In general, mental health disorders are simply not recognized as such and there is little in the way of research or treatment. Additionally, people can be accused of anti-state activities because they are non-conforming and don’t simply “snap out of it” after being subjected to greater ideological indoctrination. To summarize defector sentiment about the state of mental health in the country, in North Korea, only the mentally sound exist. A sentiment underpinned by the general view that,psychiatric disorders should not exist in an ideal socialist society.”

Undiagnosed and untreated mental illnesses are also associated with higher rates of suicide, alcohol and drug abuse, and can even express itself through violence in a country where domestic abuse and abuse against women outside the home are already common.

 

   Regarding infant and maternal mortality, North Korea has made continued improvements in infant mortality with the mortality rate per 1,000 live births dropping from 55 deaths per 1,000 in 2000 to just 20 in the year 2020. On the other hand, maternal fatalities are on the rise.

According to the “Report of the detailed findings of the commission of inquiry on human rights in the Democratic People’s Republic of Korea” by the UN Human Rights Council and published in 2014, “almost half of the women surveyed did not see a doctor throughout their pregnancy and almost half delivered their babies at home regardless of whether they were from a major city or village. Women also reported that the death of the mother or baby during or after childbirth was not uncommon. Maternal mortality rates almost doubled in the decade from 1993 to 2003, largely due to inadequacies in emergency obstetric care.  The maternal mortality rate in 2010 was estimated to be 81/100,000 live births.”

Maternal mortality has thankfully dropped from 81 deaths down to 66 deaths per 100,000 live births as of 2014, but it is still six times as high as in South Korea, over twice as high as in China, and higher than Cuba’s, another country who has held on to a strict command economy and has been the subject of sanctions for decades.

In particular, the high level of maternal mortality is due to the fact “that many hospitals were unable to provide adequate obstetrical emergency care such as anticonvulsants, antibiotics, and blood products.” Such inadequacies can be seen throughout the whole of North Korea’s medical system.

 

Dental procedures in Pyongyang. Image: Wikimedia Commons by (Stephan), June 9, 2008. CC 3.0.

 

   Although North Korea’s healthcare system has several severe deficiencies, there are areas in which the system is not only competent but has the resources required to provide care such as in basic dental and eye health, and as mentioned above, the system has been able to make strides in infant mortality.

The problem is that these improvements aren’t equally distributed. The most modern equipment and best medicines are first reserved for a handful of elite hospitals that are allowed to work on Kim Jong-un, the rest are distributed throughout Pyongyang. Finally, the main provincial hospitals can expect to receive occasional modernization efforts; although, medicines are often diverted into the black markets or given to the military.

Kim Jong-un has mentioned healthcare in five of his New Year’s speeches, but they were simply token remarks with the exception of 2018. That year he moderately expounded upon the state’s goals saying the state should “apply the people-oriented character in public health service in a thoroughgoing way, and boost the production of medical equipment and appliances and different kinds of medicines.”

Interestingly, “anti-epidemic” work was expressly mentioned in his 2015 speech, but what concrete measures were implemented is hard to say.

Over the last decade, there have been a few large construction projects related to medical infrastructure. One of the earliest was the opening of a new breast cancer research center at the Pyongyang Maternity Hospital in 2012. Although it is reported to be the cutting-edge research and treatment center for breast cancer in the country, as discussed above, travel difficulties remain a major barrier to accessing treatment. Additionally, as entry into Pyongyang itself is restricted, rural women being able to get emergency treatment is even more precarious.

Following that, the nearby Okryu Children's Hospital was opened in 2013. Billed as the best children’s hospital in North Korea, it is where the bulk of pediatric specialists can be found.

North Korea has a high incidence of cataracts and other eye conditions. To combat this, foreign specialists have been allowed to occasionally enter the country and direct mass evaluations of patients and to conduct procedures. However, in 2016 Kim Jong-un order the construction of the Ryugyong General Ophthalmic Hospital. It is the second of two identified eye-specific hospitals in the capital.

In late 2018 Kim Jong-un ordered the modernization of the Myohyangsan Medical Appliances Factory which he found lacking during a visit that October. The factory is responsible for the manufacture of medical beds, dental chairs, and a wide range of other equipment.

A year later in 2019, a medical oxygen plant was constructed. As we have seen in India and elsewhere during the COVID-19 pandemic, having the capacity to domestically produce enough medical oxygen is an essential part of the medical supply chain and is a requirement for the treatment of scores of diseases.

The most recent major medical construction project has been the Pyongyang General Hospital. Slated for completion in October 2020, it sits unopened today. Causes for the delay have been numerous including poorly manufactured electrical insulators and Pyongyang’s inability to import needed equipment. Located in the heart of Pyongyang, right next to the WPK Founding monument, the hospital must be viewed through the lens of being a personal prestige project for Kim Jong-un and the regime; one that is now 15 months overdue.

A kind of long-distance medical system was also introduced in recent years, with a drive to expand the system in 2021, but accessing it still requires patients to travel to their local clinic or hospital, and as personal computers and smartphones are banned for most of the population, patients can’t directly access the system at home. However, according to senior researcher Kim Young Hui of the Korean Peninsula New Economy Center, this remote medicine system has allowed provincial doctors to learn new skills and improve their treatments as they are monitored by doctors at more advanced medical facilities around the country.

 

   Worker health and safety is another key indicator of a government’s commitment to its people, as well as the strength of workers’ rights and labor laws. In a ‘worker’s paradise’ like North Korea, one would expect that labor laws and safety requirements are rigidly adhered to, with tough repercussions for neglectful managers.

However, as there are no independent labor organizations, lobbying or pressure groups, and no independent enforcement agencies, the North Korean state has a monopoly over the entire labor market and set standards as they see fit, and ignore them with impunity.

The constitution guarantees an eight-hour workday and prohibits child labor, but these regulations are routinely ignored. Grade school students, college students, and soldiers alike are all required to work on farms for portions of each year. Teenagers and the adult population are also often called upon to engage in ‘speed campaigns’ of mass, manual labor to build the regime’s latest megaproject. Hundreds of thousands of others are called to duty to perform mass games and serve in military parades.

The labor activities and the training for things like the mass games and parades place a tremendous burden on the body, with injuries being very common and with participants unable to take time off for sickness, to use the bathroom at will, and are rarely provided with enough calories to meet the increased activity level.

A lack of robust occupational safety regulations means that injuries and disabilities in the mining, timber, and construction industries are common. Repetitive stress injuries and the development of chronic conditions within agriculture (which is still largely a feudal activity involving significant human labor) are also routinely found.

All of this means that North Korea has been ranked by the World Health Organization as having the third-worst worker-related death and injury rate in the world.

Based on the “WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury, 2000–2016” report (published in 2021), North Korea had 76.9 work-related deaths per 100,000 workers in 2016. That's an increase from 56.2 in the year 2000. For comparison, in 2016 South Korea had 20.6 work-related deaths per 100,000 workers, China had 39.7, and the United States had 25.7.

Despite alleged worker protections limiting the workday to eight hours, North Korea also had among the worst rates of “stroke attributable to exposure to long working hours.” Long working hours is defined as more than 55 hours a week. North Korea had 28.1 work-related stroke deaths per 100,000 workers in 2016. South Korea and Japan, both countries well-known for their stressful working conditions and long hours had significantly fewer stroke-death rates at 3.9 and 4.9 respectively.

All of this has a significant impact on the North Korean economy, with the country losing an estimated $1.5 billion each year due to work-related injuries, disabilities, and death.

Although North Korea has enacted numerous domestic laws and multi-year plans stated to protect workers and bolster healthcare, and despite voting in favor of multiple international resolutions calling for improved access to trauma medicine, surgical care, and increasing access to basic medicine in rural areas, the lack of implementation means they currently have not made a measurable impact on people’s lives.

North Korea’s Ministry of Public Health announced in their 2016-2020 plan to modernize 200 local hospitals outside of Pyongyang. Yet, the regime has failed to even complete the flagship project of North Korea’s medical sector, the Pyongyang General Hospital, despite it being slated for completion in October 2020 – let alone hundreds of smaller facilities. And a review of satellite imagery indeed shows only a handful of provincial hospitals that have been upgraded.

Also affecting both civilian workers and those in the military is North Korea’s nuclear program. From mining and milling uranium to producing plutonium and testing the finished bombs, the process is fraught with physical dangers and toxic chemicals. In 2019 I wrote two articles detailing the health consequences of Pyongyang’s nuclear program (Part I, Part II).

In short, pollution leaking into the environment from the mining and milling process affects the drinking and irrigation water for thousands downriver. Former workers of the Pakchon Uranium Concentration Plant and from the Yongbyon Scientific Nuclear Research Center have all reported on a number of diseases consistent with both acute and long-term radiation exposure. And, defectors who lived in the areas downwind of the Punggye-ri Underground Nuclear Test Site have reported spikes in illness following the nuclear tests, describing the illness as the “ghost disease” as it comes and goes (following the tests) and causes its victims to become very weak (also consistent with radiation exposure).

 

An ‘epidemic prevention’ unit took part in the 73rd DPRK Founding Parade on September 9, 2021. Image: KNCA.

 

   The state of health in North Korea is also having substantial impacts on arguably its most important institution, the military.

Around 60% of North Korea’s population are either currently serving in the military, have served, or will end up serving for at least a few years, this makes the health of the military not only a concern to national defense but impacts the broader issue of public health as well.

The health of KPA military personnel received a lot of international attention in 2017 when a soldier defected across the DMZ. He was shot multiple times by fellow DPRK soldiers and required intensive medical care in South Korea. During his treatment, it was revealed that he had large intestinal parasites.

This discovery was not surprising. As many as 47% of North Koreans have helminthiasis, parasitic worm infections. What is surprising is its existence within a soldier who was serving in a relatively elite KPA unit as a frontline soldier of the DMZ.

Food rations in North Korea have long been based on one’s social and political standing, with the military receiving better rations and other supplies as part of the Songun Policy. Thus, one would expect to see fewer infections and other health problems among the military. Yet, this does not seem to be the case ever since the collapse of the economy in the 1990s.

Exposure to these parasites is predominantly due to poor hygiene (only 59% of the population has access to flush toilets), the use of improperly prepared “night soil” (a euphemism for fertilizer made from human waste), and eating food that hasn’t been properly cleaned.

All strata of society, from soldiers to farmers to students, are required to collect night soil and are also required to engage in farming activities. This creates a large level of exposure to parasites and other pathogens.

Chronic parasitic infections are associated with everything from poor cognitive development in children to liver damage. They can also exacerbate malnutrition and make one more susceptible to tuberculosis infections.

Although the levels of malnourishment have fallen since the days of the famine, most soldiers still do not receive their full dietary requirements, leading to soldiers robbing civilians of their food in some instances.

This multigenerational experience of malnutrition has been reflected in the military changing some of its recruitment criteria. Among them, the acceptable shortest height for new recruits was lowered in 2012 to 142 cm (4’ 6”). This change remains today and is not always enforced as the military struggles to maintain recruitment quotas.

Malnourishment and chronic disease can only have one impact – lowering the soldier’s readiness and endurance, regardless of their ideological fervor. Repeated injuries are also common in basic training, while taking part in labor activities, as well as for those who are called up to be part of mass parades. This lack of caring on behalf of the state has been discussed by multiple former KPA defectors, some of whom have taken to YouTube to describe the difficulties associated with military parades.

 

   While the state is ultimately responsible for the general welfare of its people, the inescapable role of international sanctions, levied as a result of North Korea’s nuclear and ballistic missile programs, on the country’s healthcare system cannot be overlooked.

Overbroad sanctions and bureaucracies that move with the speed of pitch have created a complex web of import controls and trade barriers that even make it illegal for North Korea to acquire computer monitors for hospitals and many medicines. Getting specialized equipment into the country is nearly impossible.

In the wake of the COVID-19 pandemic, aid organizations have had to seek exemptions from the United Nations to send even the simplest of medical goods. Gloves, masks, and thermometers are all tightly regulated by international sanctions.

Of course, the regime in Pyongyang has not been helpful in this regard, either. Ignoring their continued development of nuclear bombs which lead to the sanctions being put in place to begin with, Kim Jong-un’s actions to combat COVID-19 can only be seen as criminal.

 

   Kim closed down the country’s borders in January 2020 and put an end to tourism as well. Soon after, foreign diplomats and aid workers were being sent out of the country, group by group. By March 2021, not a single foreign aid worker was left in the country.

This ‘border blockade’ has had multiple effects. It prevents goods and medical supplies from entering the country through legitimate trade and it keeps international groups from being able to bring in and distribute much-needed aid.

The regime’s extreme stance is underpinned by the mistaken belief that the surface of products can be a major source of COVID infections. Everything from visitors to Pyongyang to bus seats has been disinfected more than once, and the government issued shoot-to-kill orders regarding any foreigner who may wash up on their shores (for instance, a wayward fisheries official from South Korea in need of help).

COVID’s threat to North Korea is very real. Although the country is perhaps better equipped than most to enforce local and regional lockdowns to stop any spread of the virus, the country’s medical infrastructure is incapable of dealing with numerous severe cases at once.

To that end, the regime has taken strict measures to quarantine people with COVID-like symptoms and increased legal penalties for those who disobey lockdown orders. North Korea has also tested roughly 50,000 people for COVID-19 and reported zero positive cases. While this has raised a number of doubts (particularly as small outbreaks of COVID-like illnesses have occurred), it does seem that North Korea’s extreme measures have prevented any widespread infection.

However, there have been major consequences to the country’s lockdown measures. Food supplies are running low, people are unable to find daily hygienic items in the marketplace, medications for tuberculosis are running out, and the government can’t import the vast majority of things they need to keep hospitals operating because the border has basically been hermetically sealed.

Although UN medical supplies were sent to North Korea in October 2021, the lack of personnel to distribute the supplies and to independently monitor that distribution means the supplies could easily be diverted elsewhere, as has happened with various other aid and food shipments in the past.

Making matters even worse is Kim Jong-un has the power to end this suffering while also combating the virus. As NK News reported, “North Korea is one of only two countries that has yet to administer any COVID vaccines, despite being promised over 8.12 million doses from COVAX and rejecting another 3 million Sinovac doses.”

Instead, he has taken the opportunities afforded by having a sealed border and almost no foreigners at all in the country for the first time in a generation to crackdown on everything from market activity to going after people wearing skinny jeans (something viewed as being foreign and anti-socialist).

While the war on pants endures, mothers can’t get the help they need during childbirth.

There has been a recent glimmer of hope, however. At least one train has recently been granted permission to enter the country from China to test out North Korea’s new disinfection center at Uiju. If the process goes well, this may open up opportunities for cargo to once again regularly enter the country.

Additionally, the state-party newspaper Rodong Sinmun published on January 10, 2022, that the regime is modifying its anti-epidemic policies to be more “people-oriented”, suggesting that some restrictions may be lightened up. While no specific changes were announced, it is clear that two years of total shutdown have wrecked both the economy and the country’s healthcare system, all without a single COVID case ever (officially) being reported.

 

Conclusions

   The current state of healthcare in North Korea is due to multiple factors. From economic mismanagement to diverting products away from hospitals and clinics to sell for foreign currency to the cumulative effects of years of sanctions. But Kim Jong-un has had a chance to address each one of these major factors and has opted not to.

His anti-pandemic measures have only served to make matters much worse.

The construction and modernization of select medical facilities in the country reflect the regime’s “our way” attitude and are an attempt at self-sufficiency, but the country lacks the indigenous manufacturing capacity to adequately supply itself with even the most basic of supplies. In 2017 the last WHO-certified drug manufacturer in the country was closed down, leaving citizens with only folk remedies and highly dubious “Koryo-medicine cures” made of everything from ginseng to rare earth minerals.

While there have been some statistical improvements, the lack of reliable sources of medicine and equipment, along with constant electricity shortages, has meant that the North Korean healthcare industry is moribund and unable to right itself.

Patients dealing with advanced cancer, mental health problems, or work-related trauma face a medical system that can’t cope due to its inherent structural inefficacies, and that may often actually be detrimental to the patient.

The rapidly declining availability of everything from food to hygienic supplies to antibiotics as a direct result of Pyongyang’s anti-COVID measures does not inspire confidence that the state of North Korean healthcare will improve in the near term, particularly as UN food aid has not been able to enter the country since March 2021 and the regime refuses to accept COVID vaccines that could help them end the lockdown.

And while Kim Jong-un has recently directed that future COVID measures be more tailored and “people-oriented” perhaps hinting at a loosening of some controls, only time will tell if these new policies will have any real impact at all. Currently, all that can be said is that the average North Korean has fewer medical options today than just a few years ago.

 

~ ~ ~ ~

I have scheduled this project to run through to the end of the year, with a new article coming out roughly every 10 days or so. If you would like to support the project and help me with research costs, please consider supporting AccessDPRK on Patreon. Those supporters donating $15 or more each month will be entitled to a final PDF version of all the articles together that will also have additional information included once the series is finished. They will also receive a Google Earth map related to the events in the series, and can get access to the underlying data behind the supplemental reports.

Supporters at other levels will be sent each new article a day before it’s published and will also receive a mention as seen below.

 

I would like to thank my current Patreon supporters: Amanda O., GreatPoppo, Joel Parish, John Pike, Kbechs87, and Russ Johnson.

--Jacob Bogle, 1/17/2022

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Saturday, January 15, 2022

Kim Jong-un's First Decade in Power - Health of the Man

Note: this was originally going to be a single article detailing healthcare in North Korea, with the first half being on the health of Kim Jong-un and the second half focusing on the general state of healthcare and medicine in the country. However, due to length, I have decided to split the article into two separate ones, divided among the same two topics: health of the man and health of the nation. "Health of the Nation" will be published in the upcoming days. 


Sensationalized headline by the celebrity gossip website TMZ repeating totally unfounded claims that Kim Jong-un may have died in April 2020. Image: Screenshot of April 25, 2020 ‘breaking news’ article headline.


Introduction

   The health of a nation’s leader and the health of the population are two factors that can have an outsized role in determining the course of history, yet it is often overlooked. Immediate, visible existential threats like invading armies or economic collapse occupy far more of a government’s attention, while invisible germs or quietly ticking clogged arteries remain out of sight and all too often out of mind.

However, history is filled with the turning tides of war, the rise and fall of empires, and revolutions that are either partially or largely based on matters of health.

U.S president Woodrow Wilson suffered a stroke in 1919 that severely hampered his ability to promote the League of Nations Treaty within the United States, leading to its ultimate failure in the Senate. Without the support of the United States, the weakened League’s ability to enforce its own resolutions and maintain future peace enabled the Italian invasion of Ethiopia, Japan’s invasion of Chinese territories, and eventually lead to the Second World War as Germany began to systematically violate treaties and ignore post-WWI obligations.

Adolf Hitler’s continual drug use after 1941 fueled his innate sense of infallibility and compounded his manic episodes. Coupled with his lack of military knowledge, his addled brain brought about some of the greatest military disasters in history.

 

   While the leaders of North Korea are painted in semi-divine terms by state propaganda, they are, in fact, just men. Kim Il-sung died of heart failure. Kim Jong-il suffered a major stroke and then died of a heart attack three years later.

And even though Kim Jong-un came into power at a young age, his health then as now has been the subject of much discussion and concern. The illness of any leader can cause instability within a country, and as Kim currently lacks any adult heirs, an unpredictable succession could have major consequences both domestically and internationally.

Surgeries, long periods of disappearance, and even rumors of his death have dogged his first ten years in power.

As such, while Kim Jong-un can boast some legitimate accomplishments in other areas, the history of his first decade with regard to his own health can only be given a middling score.


Health of the Man

Kim Jong-un with his walking cane visible in this KCNA image dated Oct. 14, 2014.

   Nearly everyone can find some genetic history of illness in their family. Heart disease, cancer, dementia, these things are common to have in your family. But most people manage to live long, healthy lives regardless and one’s lifestyle plays a huge role in this.

For Kim Jong-un, heart disease runs in his family. It’s also likely that other conditions like high cholesterol and atherosclerosis affected both his father and grandfather, but we have little direct evidence of this.

As a teenager, Kim’s lifestyle would have placed him on a better health footing than genetics may have suggested. He was athletically inclined, loved playing basketball (even had an aggressive streak), and he enjoyed spending time at the family’s seaside villa at Wonsan which offers multiple types of recreation.

But as he got older, he began to put on weight and when he came to power at the age of 27, he may have weighed as much as 90 kg (198 lbs) while being 5’ 7” tall. This would have given him a body-mass index (BMI) of 31, making him clinically obese.

Both his predecessors also put on weight as the years wore on, fueled by extremely rich foods and copious amounts of alcohol.

Kim Jong-il once remarked that he didn’t trust people who wouldn’t get drunk during parties. And he was known to be Hennessy’s largest non-corporate customer, importing $700,000 worth of Paradis cognac in one year alone to keep himself and his friends suitably lubricated.

This raises the specter of alcoholism within the family as well which would compound any predisposition to other illnesses. I don’t mention alcoholism just because Kim Jong-il enjoyed parties, but because his sister (Kim Jong-un’s aunt), Kim Kyong-hui, has struggled with the disease for many years and because alcoholism is known to be common among North Korea’s elite.

There is little to suggest that Kim Jong-un does not enjoy an equally spiritous lifestyle.

Pointing to this is the theory that Kim suffered from gout in the early years of his reign. After being out of the public eye for forty days, Kim Jong-un appeared in public again on Oct. 13, 2014 but needed a walking stick to help him get around.

South Korean intelligence said that he had undergone a procedure on his foot; however, that belies what could have been a more complicated truth.

Media commentators and North Korea watchers speculated that he was more likely suffering from gout, a condition where uric acid builds up in the joints and causes a wide range of painful symptoms. Major contributing causes to gout include having a diet high in fats and sugars, drinking, and smoking.

Gout can also cause tophi, hardened deposits of uric acid on the joints. One place they tend to develop on is the Achilles tendon.

Kim continued to use the cane for three weeks.

Of course, none of this is conclusive that he had gout and it’s never a good idea to do armchair diagnoses, but it is one reasonable possibility to explain why someone with his history and lifestyle would also need a cane for weeks.

What is known without doubt is his family history of heart disease and stroke, and that he is obese, eats an unhealthy diet, smokes, and has a history of minor surgery.

 

   Kim’s smoking is both a family trait and a national pastime. Some 46.1% of North Korean men smoke cigarettes daily, compared to 15.3% in the U.S.

Kim has tried to stop smoking at least twice, in 2016 and in 2020. Each of those years was also times when the regime promoted anti-smoking campaigns. In 2020, Kim actually banned smoking in public places.

The issue of Kim’s smoking even came up during a March 2018 meeting with South Korea National Security Advisor Chung Eui-yong, as Kim’s wife, Ri Sol-ju, said she had been wanting him to stop smoking for years. Unfortunately, smoking can be a very hard habit to break and he is still seen with a lit cigarette in many of the official photographs released by state media.


A portly Kim Jong-un walking around Ryomyong Street in Pyongyang. Image: KCNA, Jan. 26, 2017.

 

   By 2015, his weight had further ballooned, possibly to as high as 130 kg (286 lbs), giving a BMI of nearly 45. This level of weight gain, if the estimates are accurate, would drastically increase his risks for developing diabetes, liver steatosis (fatty liver) – made even worse by drinking alcohol – and would require his heart to work harder, almost certainly leading to heart disease at a younger age.

Making understanding his health situation more difficult is that speculations on the health of the Kim family, replete with lurid tales about their lifestyles, have long been fodder for tabloid writers and intelligence agencies alike. Western reporters often lack translators (or perhaps just the discipline) to correctly divine whether or not a story is coming from a satirical online discussion board or is legitimate breaking news, and foreign intelligence agencies lack the resources required (both human and electronic) to get close to the leadership to validate or refute every rumor that pops up.

South Korean media, in particular, have an unfortunate reputation for getting things wrong when it comes to North Korea or for taking a mere suggestion from an “unnamed intelligence officer” and running with it as though it were the gospel truth.

There have been numerous examples where stories of one or another North Korean official is reported to have been executed – with no substantial evidence, and then the story gets copied and repeated in otherwise legitimate media around the world only to have said official show up days or months later.

And things haven’t been any better regarding reporting on Kim Jong-un. In 2016 a baseless rumor about his death was picked up and reported as fact. Such shocking news caused defense stocks to temporarily rise and the South Korean won to fall.

The fake story even claimed that the Korean Central News Agency had announced the news. All anyone had to do was to check the KCNA website. Absolutely no such official story existed. And yet, by the next day, 115 articles had been written on the topic and it began to make the rounds internationally.

Needless to say, Kim wasn’t dead. But this highlights the dangers of not checking sources first and exchanging one’s journalistic standards to post sensational and clickbait-y stories.

Unfortunately, such lessons never get learned.

 

   In 2020, Kim Jong-un was not seen visiting the Kumsusan Memorial Palace (Kim Il-sung’s and Kim Jong-il’s mausoleum) for the April 15 Day of the Sun ceremony, the country’s most important holiday. It was the first time he missed taking part in the ceremony since coming to power.

Missing such an important event sparked many questions. Soon after, DailyNK reported, based on an unnamed source inside North Korea, that Kim Jong-un had undergone a heart procedure at the exclusive Hyangsan Hospital on April 12 and was recuperating. It gave few other details but was clear in that Kim was stable and resting at one of his villas.

It wasn’t long after this that other reports started claiming he was in critical condition, brain dead, in a coma, and even dead. Many of these false reports claimed to be citing DailyNK, even though nothing in the DailyNK article could be construed to mean he was near death.

This absolute journalistic negligence didn’t even stop when 38 North reported, with clear satellite images to back it up, that Kim Jong-un’s armored train had been sitting at Wonsan Palace since April 21 and reports by others that leisure boats from the palace had been moved around the bay. The combination of evidence made it almost certain that Kim Jong-un was not only alive but had moved from Pyongyang to spend the rest of his recovery time at his favorite residence.

The rumor mill didn’t finally stop until both U.S. and South Korean officials came out and said they agreed with the assessment that he underwent a medical procedure and that he was alive and there were no indications of anything more serious.

Kim finally reappeared in public on May 1 during the official opening of the Sunchon Phosphatic Fertilizer Factory. There was continued speculation about his recovery, but as Jefferey Lewis remarked on Twitter, “Well, I wouldn't say Kim looks healthy, but he definitely doesn't look dead.”

All three Kim’s have disappeared from view on multiple occasions, but those periods don’t always concern ill health. The birth of a new child, taking vacations, or simply needing time to reflect on new policies can drag even the most spotlight-loving dictator away from making daily appearances.

However, there has been one other recent absence that did restart discussions about his health.

 

   After missing for a few weeks, Kim Jong-un oversaw a parade celebrating the country’s 73rd founding anniversary on Sept. 9, 2021. The nighttime parade offered a lot for observers to discuss (like the inclusion of civilian emergency personnel) but it was Kim Jong-un’s physical appearance that also caught attention.

He had lost a noticeable amount of weight and had an overall better look and energy level than in the past. Further appearances substantiated the initial assessment that he had, indeed, lost significant weight.

It was first reported that he may have lost between 10 and 20 kg (22-44 lbs.). More recent images of him at the end of 2021 places the weight loss at the higher end of that estimate and also show that he is managing to keep the weight off for now. Although he would still be considered obese for his height (his thinner weight is still between 117 and 120 kg (258-264 lbs.)), it is a good start.

His mobility and breathing have visibly improved as a result as well.

The weight loss doesn’t only have a positive impact on his health, which seemed to be deteriorating over time. Particularly after the DPRK-US summit process collapsed and as North Korea faces tremendous economic problems due to COVID-19, Kim must be seen as a vigorous leader. His “on the spot guidance” tours, pioneered by Kim Il-sung, are an integral part of his rule, and the only way to keep such an active touring schedule is to maintain a certain level of health.

Additionally, gossip within North Korea by average people about his weight had increased over the course of his first decade. Even though such talk against the “highest dignity” is illegal, gossip, jokes, and criticisms about him routinely spread. In a country of chronically undernourished people and after he raised the specter of additional “belt tightening”, being caricatured as the plump Supreme Leader poses a threat.

These concerns over the people’s opinion of Kim have not just shown up in secret government meetings. State media has publicly addressed his weight loss, implying that Kim was eating less to help the country, harkening back to the days of the famine when Kim Jong-il was reputed to only eat a single bowl of rice a day. So, his thinner look pays both political and health dividends for the leader.

 

   The leaders of North Korea are no different than any other person in their desire to live as long as possible, but they do have far greater resources to apply to accomplishing that. To reach for that goal, a secretive research organization was established during the rule of Kim Il-sung, the Longevity Research Institute, to help keep him happy, healthy and living as long as possible through the use of herbal and folk medicine mixed in with modern medical science (along with practices of questionable ethics and effectiveness).

The Institute continued its activities throughout the life of Kim Jong-il, with 130 doctors and scientists eventually being involved. While there has only been indirect evidence that the Institute is involved in Kim Jong-un’s life, it is likely they’re working hard to keep the third generation of Kim going.

 

   With all of the real (and imagined) health problems Kim Jong-un has faced, governments and pundits around the world have been contemplating his eventual death. What would the aftermath of his sudden death mean? Can there be yet another dynastic succession? What about who controls the nuclear weapons? Who could maintain internal stability?

These and other questions were all raised during his 2020 absence and literally thousands of articles and reports were written to try to answer them.

I myself wrote three. One for AccessDPRK, one as part of a digital symposium by The National Interest, and one discussing the future of the Kim family cult after his death for Asia Times.

The opacity of North Korea’s governing system and a lack of knowledge about any official succession or continuity of government plans renders discussions about Kim Jong-un’s incapacitation or death little more than speculation, but his health must be considered to be part of North Korea’s national security planning. And until his children reach adulthood, there will be an extra layer of doubt and concern over his health and what might happen in the future.


Conclusions

   With no clear heir, the status of Kim Jong-un’s health does become more pressing. Although Kim does not engender the same devotion and loyalty as Kim Il-sung, and although it is unlikely that he has the same level of absolute control over the state as previous generations of Kim have held, Kim Jong-un is still the center spoke for a nuclear-armed nation.

With the family medical history such as it is, his recent weight loss could be the first concrete sign that his health has been precarious, and that he is now taking steps to ensure his survival and the continuance of the regime.

There are also hints that Kim has begun to make subtle reforms to the country’s laws and to the rules of the Workers’ Party that would theoretically enable someone other than him or a direct heir to one day rule the country. These changes may only be temporary steps to shore up the regime in the event of his demise, changes that could be reversed once an official successor is named, but they are nonetheless incredibly important and exhibit a level of foresightedness in the face of his medical history.

To directly address Kim Jong-un’s health, his surgeries point to a relatively young man that may be facing some serious medical issues. His weight loss is a concrete step toward warding off everything from heart disease to diabetes, but he will need to go further still. He must eventually stop smoking and his diet is going to have to change substantially if he wishes to live – healthily – into his 80s.

Another move would be to lower his stress levels. Genuinely placing focus on the people’s health and wellbeing and working to finally solve longstanding issues like food shortages would benefit Kim and the 25 million others living in North Korea. Of course, if history is any guide, this is unlikely.


~ ~ ~ ~

I have scheduled this project to run through to the end of the year, with a new article coming out roughly every 10 days or so. If you would like to support the project and help me with research costs, please consider supporting AccessDPRK on Patreon. Those supporters donating $15 or more each month will be entitled to a final PDF version of all the articles together that will also have additional information included once the series is finished. They will also receive a Google Earth map related to the events in the series, and can get access to the underlying data behind the supplemental reports.

Supporters at other levels will be sent each new article a day before it’s published and will also receive a mention as seen below.

 

I would like to thank my current Patreon supporters: Amanda O., GreatPoppo, Joel Parish, John Pike, Kbechs87, and Russ Johnson.

--Jacob Bogle, 1/15/2022

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Monday, January 3, 2022

AccessDPRK in 2021

This last year marked a milestone for AccessDPRK, and thanks to your continued readership and the support of my Patreon supporters, 2022 will see some great additions to the project.


The biggest event of the year, of course, was the publication of the Phase III map.

The journey that led to the 2021 map began in December 2012, and after 7,000 hours of work, I was finally able to publish the final version of this nationwide map. 

The Free Version contains over 61,000 locations of interest. The Pro Version includes an extra 3,400 locations along with added information on thousands of others. In terms of locating military bases, industrial facilities, and cultural sites, it's the most comprehensive map available to the public...anywhere.


For the AccessDPRK blog, I was able to write 21 articles and analyzed 116 images for those articles. I also started the Kim Jong-un's First Decade in Power biographical series which takes a look at his first decade ruling the country. The series is broken down into twelve topical articles and eight have already been published.

The top 5 articles of the year were:

  1.  What's Inside North Korea?
  2.  Is Wonsan Prison No. 88 Closing?
  3.  What Lies Beneath the Underground Republic
  4.  Border Blockade
  5.  The Unique Buildings of NK's Missile Program
AccessDPRK articles were also cited by Chosun Ilbo, One Earth Future Foundation, i News and various other UK papers.

The blog's 142 articles now contain the equivalent of 937 printed pages of material and include 938 images. I also added 65 images this year through Twitter that are not duplicated in the articles on this blog. In total, I've added nearly 500 Twitter images, providing a very large range of visual material for those interested. 

Web traffic to the site increased by nearly 20% year-over-year. On Twitter, I added 185 new followers and AccessDPRK-related tweets earned 346,000 impressions. The year's most 'popular' tweet was one in response to North Korea's September 2021 cruise missile test and reported range.


As announced at the start of 2021, I also began working on a book. Thanks, in particular, to my Patreon supporters I was able to purchase several books and journal articles to help research for mine. The future book's current layout is broken down into three main sections and will contain seventeen chapters. Of course, this is subject to change.

 
Looking to 2022

The amount of work required to research and write the biographical series necessitated that I largely take a break from other parts of AccessDPRK, but once the series is finished, I will be focused on completing the watershed map and the map of DMZ trenches. I will also work toward editing and publishing the rest of the 31 'city briefs' that I have written on various towns across the country.

Afterward, I would really like to place more focus on research and writing my book. Although that may mean less blog activity, I will still be looking out for new changes in North Korea and if a topic piques my interest, I'll write a post about it. I currently have a list of 20 article ideas & drafts, so there shouldn't be a dramatic decline in regular content output. It just won't be my main focus.


Patreon

I set up a Patreon account in 2020 and have gained some great supporters. Currently, you can help support the project for $3, $5, $10, $15, and $20 monthly, each coming with its own rewards.

I am constantly thinking about new rewards to add, one of them being that I am working on a kind of virtual tour of the country. But you can already get early access to new articles, monthly digests that feature information I haven't discussed publicly, you can have me analyze places you're interested in, and get access to multiple exclusive datasets. Plus, blog and Twitter mentions for any support at $3 or more.

If you believe in sharing facts-based information with the public about all aspects of North Korea (defense, culture, economy), please think about helping out. Every dollar really does help make this possible.

With that, I want to give a huge THANK YOU to my Patreon supporters throughout the year: Amanda O., Anders O., GreatPoppo, Joel Parish, John Pike, Kbechs87, Planefag, Rinmanah, Russ Johnson, and ZS.

Lastly, I want to wish everyone a wonderful upcoming year!


--Jacob Bogle, 1/2/2022
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