Monday, July 3, 2017

Unification Could Bring Health Crisis to Korea

I hear so little talk of reunification so when I saw this article posted in the Korea University Hospital, I was a little taken aback. Wow, proof that there is some preparation for a united North and South Korea again. Preparation on a medical level ... very interesting.

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(THE KOREA TIMEs, Apr 4, 2017)
by Jung Min-ho, Kim Eil-chul 

Imagine hundreds of thousands of North Korean refugees are crossing the border into South Korea after their regime suddenly collapses. What would be the most urgent issue for the unified Korea?


Surveys show that most South Koreans believe the cost of unification is the biggest concern. However, according to Kim Young-hoon, former president of Korea University Anam Hospital, money may just be a secondary issue.

"President Park Geun-hye said unification would bring a bonanza, but it could instead bring a health crisis, if we are unprepared," Kim said. "Unification could bring along many lethal, infectious diseases that we are not ready to cope with. The worst part is that we know very little about such risks."

Some health risks are obvious, he said. For example, North Korea has about 110,000 tuberculosis (TB) patients, 5,000 of whom died in 2014 alone, according to the World Health Organization (WHO).

"More worryingly, many of TB cases in North Korea are multi-drug resistant. This means we don't have any way to cure the highly contagious infection," Kim said.

Even today, South Korea, the fourth-largest economy in Asia, is struggling with its own fight against TB. According to the WHO, the country has the highest TB incidence rate among members of the Organization for Economic Cooperation and Development.

"So if you think that South Korea is capable of coping effectively with a huge influx of TB patients from the North, you may be mistaken," Kim said. "Look at how one patient infected with the Middle East Respiratory Syndrome last year shook the entire nation."

"And TB is just one of the many health risk factors of unification."

The health risks of unification may be even bigger for North Koreans, who have lived behind the walls of the world's most isolated state for more than 60 years. Most of them may not be immune to the diseases that would not affect people in the rest of the world. "For now, we just don't know much," he said.


/Courtesy of Korea University Anam Hospital
The poor overall health status of North Koreans may also bring down that of South Koreans altogether after unification. According to a report published in 2014 by the state-run Korea Institute for Health and Social Affairs, the average lifespan of North Koreans is 69.5 years, much shorter than the 81 years for South Koreans. In terms of medical standards, experts believe the rich South is 30 to 50 years ahead of the impoverished North.

During his 2014-2015 term at Korea University Anam Hospital, Kim thought the health risks of unification are a serious issue to be addressed. Thus, he created a graduate program to study the health and medical implications of Korean unification, making Korea University the first college to have such a program in Korea. The program will launch in September.

"Some of the program lectures will be open to the public, and I also plan to financially support students in the program as much as possible," he said.

He also created the Inter-Korea Foundation for Health and Medical Education last year under the Ministry of Unification, which will support professors and students in the program.

The foundation has already begun to review medical journals and data from North Korea in an attempt to understand the diagnosis and treatment of different kinds of diseases there in comparison with South Korea. "We are trying to find out, for example, what types of cardiac disorders are common in the state and how they are treated with very limited resources," Kim said.

The foundation will also collaborate with experts to study the health of North Korean refugees in South Korea.

"The foundation and experts are documenting the health status and determinants of North Korean refugees. By doing so, they can try to understand how their health status changes as they adapt to the Westernized lifestyle of South Korea," he said.

Through a cohort study involving about 1,000 North Koreans, researchers at the foundation have already produced some meaningful results. For instance, he noted, the researchers found that North Koreans have a higher risk of developing diabetes, as they will take in much more nutrition when they settle in the South.

One of the courses of the program aims to unify the medical terms of the two states. Many terms used in the North are Korean and Russian, while those used in the South are mainly English.

"Many South Korean organizations have tried to improve the health of North Koreans by giving them medical devices and drugs, but there has been no solid system that can be helpful in the long term," Kim said.

"Not just as preparation for unification. I also hope that our effort can contribute to bringing the two sides closer on their way to the ultimate unification."


Kim Young-hoon, who served as the president of Korea University Anam Hospital, now leads the Arrhythmia Center at the hospital. He is one of the most renowned arrhythmia experts in the country.
/Courtesy of Korea University Anam Hospital
Fixing hearts that have lost their rhythm

Arrhythmia is a condition in which the heart beats either too fast, too slow, too early or irregularly. It occurs when the electrical impulses to the heart that coordinate heartbeats are not working properly.

Arrhythmia is the cause of most sudden cardiac deaths. Atrial fibrillation, which can lead to blood clots, stroke, heart failure and other heart-related complications, is the most common type of arrhythmia.

Arrhythmia affects millions of people worldwide, including about 2 to 3 percent of the total population of Europe and North America, and according to the Korean Society of Cardiology, 800,000 to 1 million in Korea as well.

Kim, who now leads the Arrhythmia Center at Korea University Anam Hospital, is one of the most renowned arrhythmia experts in the country.

In 1998, when atrial fibrillation was largely considered impossible to treat, Kim implemented radio frequency catheter ablation, a minimally invasive procedure, in which thin wires called catheters are inserted into a vein to destroy the heart tissues that signal abnormal electrical impulses.

Since then, he has successfully performed the procedure on more than 2,500 patients, dispelling initial concerns about the method's efficacy and safety. Kim said none of his patients has died as a result of the procedure.

"About 95 percent of atrial fibrillation cases can be cured completely with the procedure," he said. "After that, patients just have to take medications."

Having published more than 140 articles about arrhythmia in reputable journals in Korea and abroad, Kim has become well-respected among many experts in the field.

Dailian University in China is one of the many institutions that have asked him to share his know-how about arrhythmia treatment, especially about radio frequency catheter ablation. In 2012, he agreed to do so at the school for five years. Some doctors from Japan, Hong Kong and Indonesia have also visited his hospital in Korea to learn from him.

His research team is now working to develop better ways to treat arrhythmia, in cooperation with experts at world-renowned medical institutions, including Harvard Medical School.

Remembering Rosetta Sherwood Hall

The alumnus of Korea University College of Medicine expressed his affection for his school during the interview, saying his last goal is to revive the spirit of Rosetta Sherwood Hall, an American medical missionary who established the Joseon Women's Medical Training Institute, the predecessor of the medical college, in 1928.

"About a hundred years ago, she risked her life to come here to deliver one message: the importance of helping those in need. I think everyone here needs to take that message seriously and act accordingly. When we do, I have no doubt that the school will change in remarkable ways," Kim said.

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