Tuberculosis work in the Democratic People's Republic of Korea is not easy. Access is limited to two visits per year, telephone and fax communications are difficult (we do not have access to email) and the hope of having an office in-country is still a distant dream. It has taken years to perfect an assistance program that meets these challenges. Our office in Seoul deserves most of the credit for this tedious and exacting work. Not surprising, despite our best preparations, things do not always go smooth on our visits to North Korea.
The first few days did not look promising. Our visit had been delayed too long, until the weather turned cold, and our first few site visits on Wednesday were disappointing. Although everything had arrived safely, their paperwork was a disappointment and to make matters worse they had not followed through with the recommendations we had made on our previous visit. Consequently we were unprepared for what we found at Sadong TB Care Center, one of the medical facilities selected for treating people with multi-drug resistant tuberculosis, people who require expensive second-line medications because they do not respond to regular tuberculosis medications. Little did we know that our entire program was about to take a big step forward.
When we arrived at Sadong, we were met by a large crowd of people. The news had spread about the effectiveness of the MDR TB medications we have been providing through our pilot MDR TB treatment program and they were anxious to be tested for the disease. Many were very ill, having failed the six-eighth month course of tuberculosis treatment two, three, four and even five times. They were desperate to get into the program. By the end of the day we had collected more test samples than we had expected to collect during our entire visit.
I will never forget the image of anxious patients pressing in on every side, anxious for a chance to be treated with life-saving medications. At every place we stopped to collect samples for testing, we were met by crowds of people, many who had traveled long distances over unpaved roads to get there. The weather turned bitterly cold and some of the testing sites were located deep in the countryside, miles from the main roads. Nevertheless the people came by the hundreds to wait all day in the biting wind for a chance to join our program. By the time we left North Korea our MDR TB program had doubled.
Long hours working outside and long miles of travel left us little time for reflecting on the future. But as the time for our departure grew nearer, the hard realities we would face when we returned home began to sink in. Our neat little pilot project was in the process of turning into a national MDR TB program. Where on earth would we find the funds to treat all these people? Clearly, unless we find major funding for MDR TB medications, most of EugeneBell's budget next year will have to go for MDR TB. But will that be enough? How many more people will crowd our testing sites next spring?
These are hard, difficult questions that EugeneBell will have to face in the months that follow. Thankfully we will not have to face these challenges alone. Every time we have come to a major turning point God, through our generous supporters has provided the means to meet them. That is why I wanted to thank you once again for your faithful support. We look forward to giving you the next update on this exciting new chapter of the work we are doing together for people in need in North Korea.
Sincerely,
Stephen W. Linton, Ph. D.
Eugene Bell Foundation
12 Medical Treatment Centers Visited
Wednesday (November 25th)
(South Pyongan Province Children's TB Ward Center)
Several months after our spring visit, we came back to the Children's TB Ward and found that the number of child-patients had greatly increased. The fact that young children had to be hospitalized in cold weather under difficult circumstances was a concern. Fortunately, EugeneBell's new aid package for the South Pyongan Province Children'sTB Ward provided basic equipment and supplies to assist the children. We conferred with caregivers on how to further develop the treatment program for child TB patients.
Thursday(November 26th)
Bukchang County Tuberculosis Care Center
The Bukchang County Tuberculosis Care Center, which is located near a coal mine, does not have many patients because of the region's harsh weather and isolation. However, through EugeneBell's assistance over several years, this care center has developed a well-organized system for treating patients, despite many challenges. The dedicated medical staff is a real inspiration to our delegations.
Friday (November 27th)
Sadong District Tuberculosis Care Center
When we arrived at the Sadong District Tuberculosis Care Center, designated as the Pyongyang area multi-drug resistant treatment center, hundreds of patients were waiting for our delegation. These patients had heard the news of EugeneBell's MDR-TB program and had traveled long distances with the hope of getting into the program. We were also happy to see that many of our patients currently undergoing MDR-TB treatment showed signs of significant improvement. These patients, who had noticeably brighter complexions and evident gains in weight, warmly greeted the delegation.
Saturday (November 28th)
Mundok County Tuberculosis Care Center
The patients at this care center gave EugeneBell's delegation a particularly warm reception. The staff and patients had taken good care of donated materials. We were especially impressed by how they had modified the greenhouses sent by EugeneBell to suite the region's climate. The greenhouses were full of vegetables that provide patients with better nutrition during the winter season. The patients were delighted to receive not only medications but also care packages of winter clothing.
Tuesday (December 1st)
Ryonggang County Tuberculosis Care Center
According to sputum sample test results from last spring, some of the Ryonggang County Tuberculosis Center's medical staff were unfortunately diagnosed as positive for MDR-TB. EugeneBell was able to deliver individually prescribed medications to these caregivers as well as patients, one of whom was the recently retired Nampo City TB Treatment Center's director Dr. Song-Hee Kim. Her sputum test last spring confirmed she was positive for MDR-TB so she came to receive medications at Ryonggang County Care Center, where the delegation had an emotional reunion with her. We grieved that the director of a tuberculosis care center had now become a patient, but Song-Hee inspired us with her firm determination to face treatment with a positive attitude. We had a very busy schedule that day because all of the patients in nearby Daean County Tuberculosis Care Center also came to Ryonggang County Tuberculosis Center to give sputum samples.
Wednesday (December 2nd)
Kwaksan Tuberculosis Hospital
When the EugeneBell delegation arrived at the Kwaksan Tuberculosis Hospital, once more a crowd of patients were waiting for the delegation despite the cold weather. A majority of these patients had failed tuberculosis treatment several times and were discouraged because the proper treatment for them was unavailable. After hearing about EugeneBell's MDR-TB program, these patients, some of whom were parents holding their children's hands, had traveled long distances to come here. The patients knew they would have to wait six months after giving their sputum samples to receive individually prescribed medications, but they came anyway, knowing this was their last chance for life. It will be a challenge for EugeneBell to raise the funds needed to treat all of them with expensive secondary medications.
Thursday (December 3rd)
Anju City People's Hospital
EugeneBell's child health care assistance program is offered through the Anju City People's Hospital. On this visit, we stopped by Cheongcheogang School (a local elementary school) and watched children being given basic health examinations. Part of the children's check-ups included eye examinations. Glasses were made up on the spot for children who needed them using ophthalmological equipment provided through the program. The children receiving glasses were delighted to find they could see so much better.
Sunchon City People's Hospital
The newly appointed director of Sunchon City People's Hospital was delighted that a EugeneBell donor had provided nutritional supplements, including soybeans, for hospitalized mothers receiving post-natal care. We discussed with the director how to improve the program in the coming year including the possibility of providing nutritional support for malnourished children.
Friday (December 4th)
Dongdaewon District Tuberculosis Care Center
Ms. Sarah Carpenter, a teacher at Seoul Foreign School that provides support to Dongdaewon District Tuberculosis Care Center, had an emotional meeting with the caregivers she had only seen in pictures. Sarah hung beautiful paper cranes that Seoul Foreign School students had made around the patients' and staff members' necks. As a representative of the staff and students of Seoul Foreign, she delivered a message of warm encouragement to the patients and caregivers.
Saturday (December 5th)
Ryongsong District Tuberculosis Care Center
Ryongsong District Tuberculosis Care Center inspired EugeneBell to start its MDR-TB treatment program. Dr. Kim Chun-Ae, the center's medical director, is widely known for her compassion and skill as a physician. When she noticed that more and more patients were not responding to treatment with regular tuberculosis medications, she asked EugeneBell if alternative medications were available. Under Dr. Kim's leadership, the Ryongsong District Tuberculosis Care Center has now become a model treatment center for MDR-TB.
Monday (December 7th)
Pyongsong City Tuberculosis Care Center
Director Sun-Ae Lee, who has become a good friend, gave us a warm welcome. Director Lee has been very supportive of EugeneBell's MDR-TB program.