The World Health Organization found itself Friday in the strange position of defending North Korea's health care system from an Amnesty International report, three months after WHO's director described medicine in the totalitarian state as the envy of the developing world.To be frank, I had some of the same qualms about the AI report when I read the news articles about it: Interviewing defectors to paint a picture of what is going on inside the DPRK is inherently biased, as the attitudes, geographic location, and living conditions back in North Korea of the people being interviewed are typically, by definition, on the fringe.
WHO spokesman Paul Garwood insisted he wasn't criticizing Amnesty's work, but the public relations flap illustrated an essential quandary for aid groups in unfree states: how to help innocent people without playing into the hands of their leaders.
Amnesty's report on Thursday described North Korea's health care system in shambles, with doctors sometimes performing amputations without anesthesia and working by candlelight in hospitals lacking essential medicine, heat and power. It also raised questions about whether coverage is universal as it - and WHO - claimed, noting most interviewees said they or a family member had given doctors cigarettes, alcohol or money to receive medical care. And those without any of these reported that they could get no health assistance at all.
Garwood said Thursday's report by Amnesty was mainly anecdotal, with stories dating back to 2001, and not up to the U.N. agency's scientific approach to evaluating health care.
Still, the WHO spokesman's words evoke memories of the glowing praise WHO chief Margaret Chan dolloped on NorkHealth last May. Dr Garwood himself seemed well aware of the inherent problems posed by Dr Chan's buoyancy:
The issue is sensitive for WHO because its director-general, Margaret Chan, praised the communist country after a visit in April and described its health care as the "envy" of most developing nations. ...I've worked for bosses who had no clue at all, in the unenviable position of having to explain or defend their words or actions. My heart goes out to the WHO spokespeople when it comes to questions about their boss.
Some groups may fear being expelled from the country if they are openly critical of Pyongyang, which is highly sensitive to outside criticism. Still, Chan's comments were uncommonly ebullient.
Garwood and WHO spokeswoman Fadela Chaib insisted that Amnesty's report was complementary to their boss' observations, and sought to downplay Chan's praise for North Korea. Instead, they focused on the challenges she outlined for North Korea, from poor infrastructure and equipment to malnutrition and an inadequate supply of medicines.
But whereas Chan had noted that North Korea "has no lack of doctors and nurses," Amnesty said some people had to walk two hours to get to a hospital for surgery. Chan cited the government's "notable public health achievements," while Amnesty said health care remained at a low level or was "progressively getting worse."
Asked Friday what countries were envious of North Korea's health, Chaib said she couldn't name any. But she highlighted the importance of maintaining the health body's presence in the country, where officials do their best to save lives despite "persisting challenges."