Introduction
Nearly all parts of the world have experienced crises in healthcare systems. In both developing and developed countries, healthcare systems are stretching their limits to meet the demands of their populations. Accordingly, one of the most precarious challenges these care systems continue to face is a dearth of health professionals (Ferrell, 2010). In the developed world, healthcare systems intermittently experience a deficit of nurses, physicians, and health practitioners. Probably, the Democratic People’s Republic of Korea – precisely known as North Korea is among the highly centralized socialist states in the world today (Demick, 2010). No doubt, North Korea is arguably one of the poorest nations in the world by current standards. The country depends heavily on foreign aid from other nations and other agencies such as the United Nations (Holtz, 2008). Despite these challenges, the Democratic People’s Republic of Korea maintains one of the robust healthcare systems in the world and devotes significant resources to healthcare research and healthcare development programs. This paper examines the status of the healthcare system in North Korea within the premise of its geography, population, government, economy, and state of health. Under the last parameter, the treatise will scrutinize the prevalence of diseases, violence, accidents, and mortality rates. In doing so, the paper takes a deep look at culture and traditional medicine, healthcare system and delivery, healthcare priorities, and nursing implications among other things.
Location/Geography
The geographical positioning of North Korea is to the North of Asia on the Northern hemisphere of the Korean Peninsula. The country shares a common border with South Korea, China, and Russia. By expanse, North Korea covers a landmass of 120,550 square kilometers with 1,673 kilometers of land border and 2,495 kilometers coastline (North Korea’s crumbling health system in dire need of aid, 2010). North Korea capital city is Pyongyang, located in the western region of the country. Besides, the country has other major cities such as Hungnam, Namp’o, and Ch’ongjin.
Population
The statistics on the people of North Korea, according to Pallagst (2011), could be rare and somewhat undependable. By the turn of the new millennium, North Korea’s populace was put at approximately 21.7 million; it had a growth rate of one percent. During the same period, the birthrate snowballed to a high of 20.43 per 1,000 households with a death rate of 6.88 per 1,000 households (Pallagst, 2011). The uncharacteristic rise in the levels of healthcare provision in the region was responsible for the population growth rate as the death toll decreased exponentially. Markedly, life expectancy in North Korea is not conducive, and nearly 70 percent of the population falls between the age of 15 and 64, while only six percent of the population is over 65 years (North Korea’s crumbling health system in dire need of aid, 2010).
Government
North Korea is among the nations considered to have the most undemocratic governments on earth today (Pallagst, 2011). To date, North Korea is considered one of the most dangerous and volatile states that continue to jeopardize the regional stability in East Asia and the entire peace in the world. The volatility of the state of the nation, especially in its nuclear program continues to put North Korea in a precarious situation with the United States, Europe, and the United Nations’ Security Council. Owing to the widespread suspicion put on North Korea, the North Korean health system has always fallen short of the care threshold by global standards. With little or no commitment to foreign nations and non-governmental agencies, North Korea healthcare continues to retard as other nations in the region progresses (Pallagst, 2011). The nature of the volatility of the government has been magnificent over the years as evidenced in the nation’s perennial nuclear production program.
Economy
North Korea is a central-based economy, and there is a limitation to market allocation schemes. However, North Korea has repeatedly stepped up efforts to decentralize its economy. For instance, as of 2013, the nation’s capital embarked on a centrally planned economy that is slowly taking root in North Korea. Today, North Korea relies on non-pecuniary incentives in many sectors of the economy that includes healthcare and education among others. As at now, the North Korea’s Gross Domestic Product (GDP) rates at 1,800.00 USD as per the 2011 grid.
State of health
Although life expectancy continues to increase, North Korea equally continues to face a number of vital healthcare concerns. Chronic diseases in North Korea, as Postmus (2013) notes, account for nearly all the deadly diseases that consume lives in great numbers. In the process of dealing with the environmental menace, the health structure in North Korea has always focused mainly on treatment – a concern that has given little priority on disease prevention. In North Korea, chronic ailments are among the major concerns that rest at around 24 percent of the diseases prevalent in the region (Health at a glance, 2011). Apart from the ailments caused by environmental pollution, nearly 33 percent of the adult population smoke, thus worsening the state of health with increased prevalent of expiratory diseases across the ages. While the prevalence of the Human Immunodeficiency Virus and Aids are not very high, there have been reported deaths from the aids scourge among the youthful populations in North Korea. With these, North Korea population continues to experience a growing number of infections, much of which is chronic in nature (Health at a glance, 2011). While this concern permeates the healthcare system in North Korea, healthcare professionals and health researchers tend to dwell on curative measures rather than preventive – a situation that is driven by financial constrains within the healthcare institutions. Incidences of violence, ranging from domestic violence, sexual assault, and stalking, trafficking, recidivism, children, and women molestation to armed conflict permeate the North Korean society, and, in many cases, these have ended in death and human miseries (Postmus, 2013). Consequently, these incidences have augmented the mortality rates in North Korea, thus encumbering heavily on the healthcare system.
Culture/traditional medicine, healthcare system and delivery in North Korea
The North Korean society incorporates both the traditional and complementary medicines as necessary tools for empowering the populations and enriching the healthcare capacity and quality in healthcare provision (Shahzad & Farnaz, 2013). Moreover, the North Korean society believes that incorporating these traditional medicines into the nation’s healthcare mainstream guarantees a more comprehensive approach to care provision, while preserving its cultural diversity to facilitate human development. Therefore, despite the tremendous gains made by modern medicine, the North Korean society recognizes the efficacy of traditional herbs and treatment practices that have been in existence over time. Despite the society’s appreciation of traditional medicine, there has been a growing public awareness upped by medical researches on the benefits of modern scientific treatment in hospitals (Shahzad & Farnaz, 2013). Notably, the concerns raised largely by the authorities in North Korea owing to the society’s inclination on traditional medicine are the common challenges emanating from regulatory status, the efficacy assessments, quality control, educational standards, and ecological obligation among other things.
Healthcare system and delivery
North Korea is probably among the growing economies in Asia today. The need for a universal health insurance has been on the rise alongside the need for a robust economy. For a decade now, North Korea has gone through a rigorous health insurance baked by the government (Branigan, 2014). Previously, the intervention by the International Monetary Fund had been characterized by disruptions while the national health insurance (NHI) went through deficits in management. The state of healthcare system in North Korea has been wanting, and the government’s achievement over the past one decade in realizing tangible objectives for its people is still a mirage (Postmus, 2013). The NHI was a big success initially extended to every citizen in 1989, though it realized very little progress after the nation ran into financial deficit during the recession. In the decades that followed, the International Monetary Fund intervened in the North Korean fiscal crisis, thus rejuvenating the NHI’s program of boosting healthcare (North Korea’s crumbling health system in dire need of aid, 2010). The boost in the healthcare system has witnessed many developments currently with decreased death rate, increased life expectancy, and affordable care system.
Health priorities
The compulsory National Health Insurance (NHI), for example, makes healthcare provision in North Korea affordable to every household regardless of their economic status. This provision, according to Barrett (2011), makes every citizen eligible for the robust national healthcare program. The foreigners living in the country are also eligible for the National Healthcare Insurance (NHI), which adequately enables them receive equal medical benefits and care services available in the country. Arguably, despite the state of national economy, healthcare service is highly competitive in public hospitals, oriental care institutions, as well as private hospitals (Ferrell, 2010). Sadly, the healthcare structure in the Democratic People’s Republic of Korea has been under adequate stress owing to substantial deficit in resources.
Nursing implications
The world over, the supply of trained nurses and skilled-care facilitators is pathetic with shifts in workforce competencies (Holtz, 2008). In North Korea, it is believed that the current developments in the health sector will undoubtedly create a surge in professional nurses to alleviate the current shortages in care facilities. However, it is equally feared that as the economic hardship hits, a large number of Korean nurses might be relieved of their duties leading to yet another period of shortage of professionals in nursing (Pittman, 2013). However, should the situation remain, the healthcare insurance cover that has lately received emphasis may likely increase the need for skilled nurses to deliver on various care provisions in the region. According to Demick (2010), the shifts in the North Korean nursing labor market continue to affect the nursing workforce, creating greater implications on the North Korean healthcare structure.
Conclusion
Virtually all nations of the world have had difficult experiences with their healthcare systems. In much of the developing world, this experience continues to land populations into jeopardy that culminates into mortalities and human suffering. North Korea being one of the developing nations is no exception. The care system in the region has been grappling with challenges such as incapacity by the state to guarantee effective healthcare, shortage of nurses, physicians, as well as the prevalence of chronic diseases among other things.
References
Barrett, J. (2011). The North Korean Healthcare System: On the fine line between resilience and vulnerability. Web.
Branigan, T. (2014). North Korean health system crumbling as shortages and sanctions bite. Web.
Demick, B. (2010). North Korea’s healthcare is a horror, report says. Web.
Ferrell, B. (2010). Oxford textbook of palliative nursing (3rd ed.). New York: Oxford University Press.
Health at a glance. (2011). Web.
Holtz, C. (2008). Global health care: Issues and policies. Sudbury, MA: Bartlett and Jones Publishers.
North Korea’s crumbling health system in dire need of aid. (2010). Web.
Pallagst, K. (2011). Shrinking cities: International perspectives and policy implications. London: Routledge.
Pittman, P. (2013). Nursing Workforce Education, Migration and the Quality of Health Care. Disclosures. International Journal of Quality Health Care, 25(4), 349-351.
Postmus, J. (2013). Sexual violence and abuse an encyclopedia of prevention, impacts, and recovery. Santa Barbara, Calif.: Abc-Clio.
Shahzad, H. & Farnaz, M. (2013). Integration of complementary and traditional medicines in public health care systems: Challenges and methodology. Journal of Medicinal Plant Research, 7(40), 2952-2959.