North Korea is sending most of its reserve medicines to the capital Pyongyang, leaving rural citizens in the lurch, with many turning to alternatives and counterfeits, as the country copes with waves of COVID-19 cases.
After two years of denying the pandemic had penetrated its closed borders, North Korea in May declared a “maximum emergency” and acknowledged the virus had begun to spread among participants of a large-scale military parade the previous month.
Medicine to treat the disease is in short supply and the stocks that are available are getting sent to Pyongyang, home of the country’s wealthiest and most privileged citizens. The drug shortage has left an opening for a black market of unproven traditional medicine to emerge, with some citizens offering dried deer blood as a COVID remedy. Counterfeit versions of fever reducers like aspirin and acetaminophen are also on the rise, sources said.
“All pharmacies are open 24 hours a day in this maximum emergency, but there is a huge difference between Pyongyang and the provincial areas, so people out here are really dissatisfied,” a resident of the northwestern province of North Pyongan told RFA on condition of anonymity for security reasons.
“Expectations were high as the central quarantine command had intensive discussions where they agreed to quickly distribute the reserve stocks of medicines for the emergency, but we were greatly disappointed when that medicine was given to people in Pyongyang and to the military,” he said.
In the city of Sinuiju, which lies across the Yalu River border from China, no one can find even basic medicines like fever reducers and painkillers, the source said.
“Reserve medicines were supplied in very small amounts to hospitals, and pharmacy shelves are empty,” he said.
“At least some pharmacies in Sinuiju are stocked with herbal medicines used as a cold medicine, but county-level pharmacies are completely empty. However, the pharmacies are ordered to be open 24 hours a day unconditionally,” he said, adding that salespeople and security guards are sitting around at the pharmacies day and night, even if they have nothing to sell.
In the city of Chongjin in northeastern province of North Hamgyong, patients complaining of a high fever and cough have increased, a resident there told RFA on condition of anonymity to speak freely.
North Korea lacks adequate testing capabilities to confirm coronavirus cases but has been tracking numbers of patients reporting “fever.”
“An acquaintance who is a doctor at a provincial hospital told me that even when patients with coronavirus symptoms come to the hospital, they are unable to receive the proper treatment because there is no medicine,” said the second source.
“According to my acquaintance, medicines are normally supplied to hospitals and pharmacies in Pyongyang, and patients with fever in Pyongyang are receiving intensive treatment at quarantine facilities. But even though pharmacies in Chongjin are open 24 hours a day, but there is no medicine or only herbal medicines whose efficacy has not been verified. So it is not helpful to patients at all,” he said.
“They complain saying, ‘Are Pyongyangers the only citizens of the state? Is it okay for us in the provinces to just die?’” the source said.
To deal with the shortage of medicine in the provinces, people are turning to the black market, where unproven traditional remedies like deer blood are sold.
In Pyongysong, South Pyongan province, north of Pyongyang, people are illegally selling deer blood from their homes, touting its medicinal properties as effective against COVID-19, a resident there told RFA on condition of anonymity for safety reasons.
“The types of deer blood traded on the black market are raw blood and dried blood powder. Raw blood in a tiny penicillin bottle is 10,000 won [about US$1.80], and powdered blood in a penicillin bottle is 5,000 won [about US$0.90],” she said.
“If you catch a deer, you can drain its blood. Then you put the blood in a plastic bag,” she said. “Raw blood spoils, so it’s hard to sell. So, people dry the blood and sell it. When a deer gives birth, there is placenta coming out. They also dry it and sell it as a treatment for coronavirus.”
The deer blood remedy is available in North Pyongan as well, a resident there, who declined to be named for safety reasons, told RFA.
She said that rather than catching the deer in the wild, the workers on a deer farm that supplies meat and other byproducts for Kim Jong Un, his family, and other high-ranking officials, are illicitly selling the blood on the black market.
“The musk or placenta of deer are vacuum packed and usually sent to the Central Committee, but the people who work there are secretly selling it.”
Counterfeit medicines that look like the real thing but have no effect at all are also being sold. Fakes have made their way to the local marketplaces in Chongjin, a source there told RFA on condition of anonymity for security reasons.
“The authorities are making a fuss saying they are responding to coronavirus by releasing the national reserve medicines, but there’s still a shortage here so counterfeiters are taking advantage of this opportunity,” the second Chongjin source told RFA.
“A few days ago, the head of the neighborhood watch unit circulated a notice from the district to each household. The notice warns of the fake drugs out in circulation. There are many people around me who bought fake medicines and suffered from taking them,” the second Chongjin source said.
“There are various types of counterfeit medicines, such as antipyretic analgesics such as aspirin and acetaminophen [Tylenol], and multivitamins, which are frequently sought by people to treat coronavirus infection. A friend from my workplace had a fever, so he bought acetaminophen at the market and took it for two days. But it was fake and didn’t work at all,” the second Chongjin source said.
The counterfeit was indistinguishable from the real deal, according to the second Chongjin resident.
“I saw the fake medicine that my friend bought. The packaging looked quite real. It appears to have been made using a pharmaceutical factory facility, with foreign characters engraved on one side of the pill. I’ve heard that medicine dealers bribe pharmaceutical factory officials and rent factory equipment at night to make fake medicines secretly.”
Traveling merchants bring the fakes to distant parts of the country where they know there is a shortage, a resident of Taehongdan county, in the northern province of Ryanggang, told RFA on condition of anonymity to speak freely.
“Last week, some people in my neighborhood bought aspirin and other meds from a travelling merchant who visited our village. One of the people with cold symptoms took the medicine, but it did not work. So he showed the aspirin and multivitamins he bought to the doctor,” the Ryanggang source said.
“The doctor tested it by biting a pill and burning it. He then said the multivitamins tasted wrong and the aspirin was too hard, so it seems as if the medicines were fakes made of wheat flour.”
Though North Korea has acknowledged that the virus is spreading inside the country, it has only reported a handful of confirmed COVID-19 cases. Data published on the Johns Hopkins University Coronavirus Resource Center showed North Korea with only one confirmed COVID-19 case and six deaths as of Tuesday evening.
The country is, however, keeping track of numbers of people who exhibit symptoms of COVID-19.
About 3.6 million people have been hit by outbreaks of fever, 69 of whom have died, according to data based on the most recent reports from North Korean state media published by 38 North. Around 3.5 million are reported to have made recoveries, while around 182,900 are undergoing treatment.
The state-run Korea Central News Agency reported Sunday that the country’s powerful Political Bureau positively evaluated the national pandemic response, saying the pandemic situation was “being controlled and improved across the country.”
Translated by Claire Lee and Leejin J. Chung. Written in English by Eugene Whong.