By Gunnar Westberg

Gunnar Westberg has made a revisit with a small group of doctors to the Democratic Peoples Republic of Korea, DPRK

Already on the train from Beijing towards Pyongyang do I feel a different atmosphere from that at my visit in 2005. The custom officials look briefly at our documents, register and seal our mobile phones as in previous years, but pay no attention to our computers, written material and CD:s. The train is overflowing with packages and trunks, at least some of it smuggled. At the first DPRK stop an expensive new car picks up four big bags from the train. All houses are newly painted, maybe for the benefit of the Dear Leader who passed through in his special train two years ago.

Mobile phones – yes they are here now! Statistics are not available but at least a large minority of the younger people in the street seem to have them. Our guide says that mobile phones are equally common in the rural areas. They can be used only for calls within the country. Considering that you need a permission to travel between the provinces and cities in the country, the mobile phones will be a strong factor in informing and uniting people.

An emergent middle class?

Obviously, the middle class is growing and is becoming more prosperous. A few years ago there were few locals in the better restaurants, mostly foreigners. Today the locals are the majority. There are more bicycles, also in the biking-unfriendly Pyongyang. Bikers often disobey the rule that they should not cross the streets. They do not carry their bikes down and up the stairs at the underpasses and sometimes bike on lanes marked “no bikes”. Pedestrians cross the street most anywhere. The beginning of civil disobedience?

I feel but cannot prove that the body language of people in the streets is more open, more relaxed. Six years ago almost all people I saw walking to work in the morning walked on by one, not speaking, not looking up. Today you often see two or three walking and talking together. Some laughing is heard. Am I imagining?

There are tourists, not a great number, but increasing. There are a few large neon signs advertising new products. Some foreign films are reportedly available on DVD. Still no foreign papers are available. All TV and radio sets are fixed to the DPRK channels. Clothing is better, even the street sweepers are now quite neatly dressed – yes, there are still a large number of persons, mostly women, with brooms sweeping the broad boulevards and even the six-lane road to Nampo.

Will Special Economic Zones bring more openness?

Reportedly there are more businesses with Internet access, especially in the “Special Economic Zones”, such as Rosan. When will there be Internet cafés in Pyongyang? “In just a few years “a young lady guessed. If this turns out to be true, it may spell an end of the isolation of the country and, eventually, a “DPRK spring”. Maybe. With an army of 1.8 million soldiers the ruling nomenclatura has the means to defend its rule.

The country is now gearing up to celebrate the year of Juche 100, one century since the birth of the Great Leader, Kim il Sung. DPRK counts the years since that date. Many housing and other building projects must be finished before the birthday of April 15, and many hydroelectric plants too. That is a tall task, not likely to be completed on time, but likely to cause great celebrations.

Three great problem areas

In addition to the inefficiency in and oppression by the political system, the country has three great problems: The military, energy and food.

The military system takes reportedly 27% of the national product. Even if the soldiers do some productive work the military establishment is an enormous burden, which slows down development. There is a chronic deficit of energy in the form of oil and electricity. The night in DPRK is still dark, as we could see from the train, and more importantly, the supply of electricity to industries, offices, hospitals and homes is unreliable and insufficient. We saw a large surgical operation performed without any other light than that from the windows. When the elevators do not run in the tall buildings with 20 stores or more, the consequences are likely to be frustrating.

Food. Very few tractors moved on the vast fields, maybe because of lack of petrol. Fields were reaped with sickles. On many fields peasants were seen collecting the seeds left the ground, one by one. One party official said that in spite of flooding the harvest was likely to be about average.

Nutrition and health care

The most recent report by the UN Children fund UNICEF, the World Food Program WFP and the World Health Organisation WHO give information on the nutritional and health stats, particularly in the children.

The report is dated March 24 2011 and tells of a situation of severe hardships for large segments of the population. At the time of our visit in October, the end of the harvest season, the situation was probably better. Recent reports from international agencies predict that the coming winter will be worse for food supply than the previous. The resources of the international aid agencies are very insufficient. Starvation is likely to affect children in some orphanages, while malnutrition will become even more widespread in the coming winter than last year among children, elderly and pregnant women.

We saw two orphanages for children below the age of four. The rooms were clean and well kept and the children well dressed, to some extent in clothes donated from abroad. The number of staff was low. The children were clearly understimulated and, especially in one of the two places, severely undernourished and stunted. We left the children with heavy hearts.

We should however remember that one important cause for the poor situation as regards food and energy are the severe sanctions against the country.

President Jimmy Carter, who has paid several visits to DPRK, stated recently: ”One of the most important human rights is to have food to eat, and for South Korea and the US and others to deliberately withhold food aid to the North Korean people is really a human rights violation”.

At present DPRK authorities do accept food aid. Fertilisers and farming equipment are welcomed and would be better than food aid.

Amnesty International reported in 2010 on the deplorable and deteriorating quality of medical care, “The crumbling state of health care in North Korea”. However, even today basic medical care, essential drugs and vaccination seem to be generally available and the health of the children is better than in many poor countries. The level of literacy is among the highest in the world.

Amnesty also reports on the increase in the size and activity in the labour camps and prison camps over the last ten years. The suffering in some of these camps is extreme.

Chances of positive development

Against the background of the reports from Amnesty and the UN organisations, is it realistic to talk about positive changes in the country? Is it not rather so that the increasing middle class and its increasing purchasing power robs the majority of the people of their share of the increase in resources? That may be so, but it is still likely that it is from this educated and increasingly confident middle class that change will be initiated.

Can we hope that the investment by foreign companies, the rising middle class, the increasing openness, the mobile phones and maybe Internet will bring about a development similar to that in China?

The outcome depends on changes in the leadership of the country, of which we understand little. It depends also to a large extent on the attitude of other countries, especially USA, China and South Korea. The naming of DPRK as a member of the Axis of Evil by President Bush in 2002 caused people to rally behind their leaders.

During the last year South Korean and US navy have run provocative military exercises close to disputed boundary waters. These coalition partners have also started the enormous military build-up on the island of Jeju. Whatever the reason may be, these moves support the hawks in the DPRK military, and decreases the chances of a “DPRK spring”.

A peace agreement is possible, if the political will is there. The losers would be the DPRK military and the US military-industrial complex. Not only the people of DPRK but the whole region would gain vastly if this last remnant from the wars of the bloody twentieth century were terminated.

Medical education and professional career

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