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SEOUL�Health care workers in the world�s last Stalinist state are turning to prescription and sick-note scams to make enough money to buy food, a North Korean defector told RFA�s Korean service.

�A doctor cannot afford even one kilogram of food at the market on his salary,� a North Korean doctor, now living in South Korea, said. �Salaries are provided by the government on a certain national level, but the real distribution of necessities takes place at the market. So the salary does not mean anything to most North Koreans.�

�A salary itself is a ridiculous amount to make a living without bribery. What North Koreans care about is whether they can get some food, not money,� said the doctor, who preferred to be identified only by his surname Lee.

He said many doctors and nurses turned to prescription rackets when food shortages began in order to make enough money to eat. �Since the medical service is provided free in North Korea, people can receive medicine from pharmacies at no charge. But there are no medicines in the pharmacies these days, so doctors� prescriptions are meaningless.�

�In the past, expensive medicines were available at large clinics or hospitals. And doctors worked with nurses to issue fake prescriptions for fake patients and sell the medicine on the black market. That way, doctors could buy at least one kilogram of food. But there is no more medicine in North Korea and the prescription scam doesn�t work any more.�

Now, he said, doctors are increasingly using sick notes to earn extra income. These must be presented for absence from work and can prove valuable in the pursuit of freedom.

�Those who receive sick notes do not have to go to work... The workplace issues a permit to stay home. So North Koreans began to take advantage of sick notes to escape from work and from the control of the government, even if they are not sick,� Lee said.

But when famine hit North Korea in the mid-1990s, even doctors took to wandering and begging for food. �All the doctors had to cut down trees wearing backpacks and begging for rice... Being a doctor meant nothing,� Lee said.

Lee said the medical facilities in North Korea�now struggling with thousands of casualties from an explosion at a railway station�are outdated and poor.

�All the medical facility problems can be boiled down to money. The nation provides nothing, but patients need to receive proper operations. Doctors have to use electrical heaters in operating rooms, and when the electricity is out, doctors use coal to warm up the room. South Korean people probably think it is very primitive,� Lee said.

Lee said most doctors were unable to practice their profession even if they succeeded in resettling in South Korea, as South Korean authorities recognize only those doctors who managed to bring their licenses with them.

�If they do not bring licenses to South Korea, they must go back to school and get the degree again,� Lee said. But he added that mistrust among ordinary South Koreans for a North Korean qualification was still high. �Let�s say I earned a license and set up a clinic. Who is going to come to my clinic?� #####


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