Exporting Fakes?

North Korean Clinics Hawk Questionable Medical Care to Tanzania

Situated on the eastern coast of central Africa, Dar es Salaam is the largest city in Tanzania and the country’s main commercial hub. At the end of 2015—just days before the New Year—a reporter from RFA’s Korean Service visited an outdoor market in Dar es Salaam’s Kariakoo ward with the help of a local guide, seeking out a clinic run by doctors sent to Tanzania from North Korea. As the reporter climbed the stairs of an old building located on the edge of the bustling marketplace, a small room appeared at the end of the second floor hallway. Marked only with a piece of paper at the entrance which read “Korean Medical Clinic” in English, the room housed a group of North Korean healthcare workers providing treatment to local residents.

The Kariakoo Clinic Billboard

Dimly lit with a florescent lamp and sporting only a fan despite the muggy heat, the room was decorated with a few potted plants and contained five or six chairs for people waiting to receive medical care. A large table with an ancient television sat in the middle of the room, playing an endless loop of North Korean TV dramas. When greeted in Korean, a receptionist in her mid-50s responds cautiously from her seat behind a desk. The reporter complains of pain in his arm and is told to wait while the receptionist enters an adjoining room. After a short time, she returns and suggests the reporter visit another Korean clinic.

“I am sorry, but the doctors are not here and we cannot provide any treatments without them,” she says. “There is another Korean clinic nearby. They will take good care of you.”

A doctor could be seen inside the room, and several patients had entered and exited since the reporter’s arrival, suggesting the staff were reluctant to treat him because he spoke to the receptionist using a South Korean dialect.

Massage treatment

The Ubungo Clinic

After being refused treatment at the clinic in Kariakoo, the RFA reporter traveled to Dar es Salaam’s Ubungo ward to investigate another North Korean clinic, established in September 2015. Situated in a quiet area of the city, the neatly painted building seemed more like a fancy restaurant than a medical facility. A woman who appeared to be a receptionist and a male doctor scrutinized the RFA reporter at the doorway before agreeing to let him enter, when a local guide explained that he was not South Korean. The reporter spoke in English to the guide, who translated to the North Korean clinic workers using Swahili—the official language of Tanzania. However, the staff members remained wary and demanded his nationality, questioning whether he was Canadian. Once the staff agreed to treat the reporter, he was led along the first floor of the clinic, where he observed two examination rooms, each with one male doctor and female nurse.

The reporter was led to one of the rooms, where a female nurse in her mid-30s asked him for his personal information and recorded his weight, height, blood pressure, and blood sugar level. The room lacked both an air conditioner and a fan, and dust blew in through the screen on an open window, coating the equipment with fine silt. The nurse draped a cloth over a cot and instructed the reporter to lie down, at which point a male doctor who appeared to be in his mid-30s inspected his arm for a while before applying a “low-frequency therapeutic device” made in China, which the medical worker explained is for “relaxing tightened muscles.” The doctor then explained that this treatment method was based on the “Eastern Medicine tradition of North Korea.”

“Do you understand the treatment of Eastern Medicine? Acupuncture and so forth,” he asked the reporter, as a television blared North Korean broadcasting programs in the background.

A local high school student lay in a nearby cot extending a “thumbs up,” as if to express his satisfaction with the treatment he was receiving. When the “low-frequency” treatment was over, the doctor pounded the reporter’s body with an electronic massager and the nurse handed him several pills wrapped in paper. The cost of the treatment was 50,000 Tanzanian shillings, or about U.S. $23—around one-fourth of a local worker’s wages.

Currency earners

According to sources, a total of twelve North Korean clinics have been operating in Dar es Salaam since 1991 in the city’s Magomeni, Temeke, Kariakoo, and Ubungo wards. The number of medical staff dispatched to the clinics has grown from 20 in 2009 to around 100 last year, the sources said. Most of the North Korean clinics provide treatment between the hours of 8:00 a.m. and 6:00 p.m.—and often throughout the night in the case of emergencies—without closing for holidays or during the weekend. One local source, who spoke to RFA on condition of anonymity, said clinics were earning U.S. $1-1.3 million per year and were sending around 90 percent of the money back home to the regime in North Korea. The source said that at least two teams of medical staff are dispatched to each clinic in Tanzania to monitor each other’s work, and cited applications for employment visas from North Korea that show the monthly wage of clinicians is around U.S. $200. He said medical staff consist mostly of married couples who spend three to four years in Tanzania at a time, leaving their children behind in North Korea, and typically extend the length of their work abroad after the term has expired.

Health risks

While profits earned from running clinics in Tanzania are largely used to support a regime in North Korea that has done little to improve the living standards of its own people, sources told RFA that the treatment provided by medical staff is also putting the health of Tanzanians at serious risk. North Korean medical workers are often unable to properly diagnose local residents’ conditions because they speak neither English nor Swahili, the sources said. Additionally, the sourcing, ingredients, and directions for use of the medicine prescribed by the clinics is left unclear.

Following a call for testing from local media in Tanzania, a February 2015 analysis of drugs prescribed by North Korean clinics found traces of mercury, lead, arsenic, and other poisonous heavy metals in the medicine—in some cases as much as 100 times higher than permissible levels. The Tanzania Food and Drugs Authority (TFDA) said at the time that it was planning to inspect North Korean clinics operating in Dar es Salaam following the discovery of irregularities, but according to a report by The Citizen newspaper earlier this month, a crackdown has yet to take place. The Citizen also cited an unnamed South Korean Embassy official as saying that North Korean alternative health clinics were using so-called “Quantum Magnetic Analysers” to falsely diagnose Tanzanians with various medical conditions and urging them to pay for treatment that they didn’t need.

Clinic victim

Gabriel Shayo, a 19-year-old former soccer prodigy who was featured in a May 2015 article by Tanzania’s Swahili-language daily Nipashe about victims of North Korean medical clinics, told RFA that he had sought treatment for a hacking cough and chest pain on the recommendation of a neighbor. While at first his condition seemed to improve, Shayo said that after more than a month of taking the medication prescribed to him by the clinic, his symptoms remained. His parents said that they were not only instructed to continue giving their son the medicine, but were coerced into buying expensive herbal treatments that they had never heard of.

“They told us that they would give us the entire amount of the medication if we paid the whole amount of the cost up front, but we could only afford to give them half,” Shayo’s mother told RFA. “Then they came out with a root of some sort and told us to boil it and give him the tea to drink.”

When Shayo’s condition remained the same, the doctor at the North Korean clinic refused to explain what was wrong with him to his parents and urged them to bring more money for additional drugs to treat him.

“The female doctor all of a sudden burst into tears and said, ‘How can I treat your son if you don’t trust me? We are doing our best!’ But our son’s symptoms were getting worse by the day,” Shayo’s father said.

When Shayo began to cough up blood, his parents rushed him to the national hospital and only then realized that their son was suffering from tuberculosis. The young man expressed frustration over his treatment at the clinic, which he said had cost his family its savings and almost cost him his life.

“I want the Korean Clinic to close its doors because they nearly killed me,” he said.

Official ‘ties’

A local reporter who has reported on the conditions of North Korean clinics over the past year told RFA that, according to Tanzanian law, all drugs must be clearly labeled with ingredients and instructions for use in English or Swahili in order to be sold in the country, but medicine prescribed by North Korean medical staff typically displays neither.

“The doctors are diagnosing patients without even using a computer and it is impossible to know which drugs they are prescribing,” said the reporter, who also declined to give his name.

Clinic workers tell patients who have never smoked a cigarette in their life that they are suffering from nicotine poisoning, he said, and sell them expensive drugs by capitalizing on their anxiety. The clinics are also known to use old tire treads as bands to measure patients’ blood pressure, and lack even the most basic medical equipment and services, he added. But even as the list of victims becomes longer and Tanzania’s authorities are flooded with a growing number of complaints, the reporter said he expects little to change because of “ties” between the North Korean regime and local health officials.

“The president [John Magufuli] has a willingness to carry out reforms and the food and drug administration officials are also aware of the seriousness of the problem,” he said. “But because there are ties and connections between the North Korean clinics and Tanzanian officials … it is difficult to resolve the issue.”

Reported by Albert Hong for RFA’s Korean Service. Translated by Min Kyung Kang. Written in English by Joshua Lipes.

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