A top World Health Organization (WHO) official recently disclosed how critical the spread of contagious diseases is in North Korea when she revealed, "North Koreans infected with malaria number 300,000." WHO Secretary General Bruntland made the disclosure in a press conference she held in Seoul following a North Korea tour during which she opened the permanent WHO mission in Pyongyang.

"In June communicable diseases raged in Hamgyong and Yanggang provinces of the North, causing a sharp rise in the number of graves in public cemeteries. To prevent this being revealed to the outside world, North Korean authorities are banning the making of mounds over graves, inviting public grievances," alleged a South Korean missionary serving in the northeastern region of China bordering with North Korea.

With the onset in the mid-1990s of the perennial food crisis, acute contagious diseases preying on malnutrition and insanitariness such as cholera, typhoid and paratyphoid also hit the North. Infectious diseases were also a major cause of mass starvation in the North.

Paratyphoid, with a relatively low fatality, becomes substantially fatal when no antibiotics are available. "Paratyphoid can be overcome if one has money to buy antibiotics and nutritious food," reminisced Kim Young-suk (alias), 58, a North Korean emigre in the South who contracted the disease in the North. "Had I had that much money, however, I, to begin with, wouldn't have been infected by the disease." Many paratyphoid patients get too weak to move outside for food and eventually starve to death she added.

Malaria affected military personnel posted near the Demilitarized Zone first and then spread across the country, according to experts in the South. Unlike tropical malaria, the variant prevailing in the North has a low fatality rate, but the patients suffer from a high fever and chills. In South Korea too, 4,400 people, beginning with soldiers manning the Demilitarized Zone and then nearby citizens, were inflected with malaria last year and 2,700 people this year "Given that malaria cases have been reported near the DMZ only in the South, they appear to have been influenced by the disease that occurred in the North," observed an official of the National Institute of Health. The North's Health Ministry reported to an international health agency in 1999 that "malaria patients numbered 100,000."

Tuberculosis is more chronic and serious in the North, which is said to have the highest fatality rate of communicable disease in the world. The Korea Association of Tuberculosis in the South unofficially estimates that the North's tuberculosis fatality rate in 1997 stood at 40-80 persons per 100,000 of the population, nearly 10 times the 7.4 persons in the South. However, the actual fatality rate from tuberculosis should be much higher, according to relief organizations. The Yugene Bell Foundation, engaged in tuberculosis relief in the North, estimates that 1,000,000 North Koreans need imminent tuberculosis treatment. "Supported by volunteers in South Korea and the United States, among other countries, we've provided the North with tuberculosis-related medicine and equipment since 1997, but only about five percent of tuberculosis patients in the North are estimated to have benefited from the relief aid," says the foundation's secretary-general, Cho Il. Unreported patients swarm sanatoriums when news spreads about the arrival of relief medicines. "It is known that nine out of ten tuberculosis patients treated in sanatoriums die in the institutions," Cho added, saying that inmates in over 60 tuberculosis sanatoriums have started to entertain hope of recovery since relief work began to reach the North from outside.

Schools are often closed due to the occurrence of measles, and cholera every year. Even smallpox, said to have been eliminated from the earth 20 years ago, still occurs in some areas of Jagang province, according to officials involved. The status of chronic infectious diseases like hepatitis is reportedly not assessed accurately.

Since infectious diseases in the North have a direct effect on South Korea, positive joint-countermeasures are needed, officials stress.

(Kim Mi-young, miyoung@chosun.com )