DATE=5/3/99
TYPE=BACKGROUND REPORT
NUMBER=5-43295
TITLE=NORTH KOREA- TUBERCULOSIS
BYLINE=STEPHANIE MANN
DATELINE=WASHINGTON
CONTENT=
VOICED AT:
INTRO: WITH NORTH KOREA EXPERIENCING ITS FOURTH-YEAR OF FAMINE,
OBSERVERS SAY DISEASE IS A PROBLEM THAT IS GROWING WITH
MALNUTRITION. V-O-A'S STEPHANIE MANN REPORTS ONE ILLNESS THAT IS
NOT OBVIOUSLY LINKED TO FAMINE, BUT IS A DIRECT OUTCOME OF IT, IS
TUBERCULOSIS.
TEXT: TUBERCULOSIS IS AN INFECTIOUS DISEASE CAUSED BY BACTERIA
BREATHED INTO THE LUNGS. IN MANY PEOPLE, THE IMMUNE SYSTEM CAN
STOP THE INFECTION AND THE PATIENTS RECOVER. BUT, FOR PEOPLE
WHOSE IMMUNE SYSTEMS ARE WEAKENED BY MALNUTRITION, THE INFECTION
CAN SPREAD THROUGH THE BODY'S LYMPHATIC SYSTEM AND THE
BLOODSTREAM AND CAN BE FATAL.
IN MOST DEVELOPED COUNTRIES, VACCINATIONS HAVE PREVENTED THE
SPREAD OF TUBERCULOSIS -- ALSO CALLED T-B. BUT IN POORER
COUNTRIES, T-B STILL REMAINS A SERIOUS PROBLEM.
IN NORTH KOREA, THE EXTENT OF TUBERCULOSIS IS NOT KNOWN, BECAUSE
THE GOVERNMENT DOES NOT PROVIDE SUCH STATISTICS. STEPHEN LINTON,
THE HEAD OF AN AMERICAN ORGANIZATION THAT PROVIDES MEDICINE AND
MEDICAL EQUIPMENT TO NORTH KOREA, SAYS HE EXPECTS THE NUMBERS OF
NORTH KOREANS DYING FROM T-B TO INCREASE.
// LINTON ACT ONE //
THEY CAN ONLY GROW AS LONG AS THERE IS A FOOD SHORTAGE,
BECAUSE TUBERCULOSIS IS A DISEASE THAT IS DIRECTLY
LINKED TO MALNUTRITION. IT IS THE COMPROMISED IMMUNE
SYSTEM THAT MAKES PEOPLE PARTICULARLY SUSCEPTIBLE TO
TUBERCULOSIS. AND SO, THE NUMBERS CAN BE EXPECTED TO
GROW UNTIL THE FOOD SITUATION IS IMPROVED.
// END ACT //
MR. LINTON SAYS ABOUT HALF THE PEOPLE WITH TUBERCULOSIS GET WELL
ON THEIR OWN. OF THE REST, HE SAYS, HALF DO NOT GET PROPER
TREATMENT AND DIE AND THE OTHERS DEVELOP CHRONIC T-B. IF THOSE
WITH CHRONIC T-B ARE NOT TREATED OR ISOLATED FROM THE GENERAL
PUBLIC, HE SAYS THEY INFECT OTHER PEOPLE.
// LINTON ACT TWO //
WHAT WE ARE SEEING IN NORTH KOREA IS AN INABILITY TO
TREAT THE DISEASE -- WHICH MAKES PEOPLE VERY RELUCTANT
TO COME IN FOR TREATMENT, WHICH MEANS THAT THEY ARE MUCH
MORE LIKELY TO INFECT THEIR FAMILY MEMBERS -- AND WHEN
PEOPLE DO COME IN FOR TREATMENT, A LACK OF RESOURCES IN
HOW TO TREAT THEM.
// END ACT //
THE EUGENE BELL FOUNDATION IS A SMALL NOT-FOR-PROFIT U-S
ORGANIZATION THAT PROVIDES MEDICINE AND DIAGNOSTIC EQUIPMENT TO
13 HOSPITALS AND 60 TUBERCULOSIS SANITARIUMS IN NORTH KOREA.
FOUNDATION CHAIRMAN STEPHEN LINTON TRAVELS TO THE COUNTRY
REGULARLY TO OVERSEE DELIVERIES, AND SAYS HIS GROUP GETS A GOOD
ACCOUNTING OF ITS DONATIONS AND THE RESULTS THEY ACHIEVE.
// OPT // LINTON ACT THREE //
WE HAVE BEEN ABLE TO SEND ENOUGH TUBERCULOSIS MEDICATION
TO TREAT ALMOST 10-THOUSAND PATIENTS. AND WHILE THAT
DOES NOT SOUND LIKE A LOT, AT ABOUT 65 (TO) 70-DOLLARS A
PATIENT, IT IS A GOOD BIT OF INVESTMENT, ESPECIALLY
BECAUSE YOU DO NOT GET DONATIONS OF TUBERCULOSIS
MEDICATION. YOU REALLY HAVE TO GO OUT AND PURCHASE IT.
// END ACT // END OPT //
THE EUGENE BELL FOUNDATION HAS ALSO GIVEN NORTH KOREA MOBILE
X-RAY CLINICS TO TEST PEOPLE FOR T-B, AND GREENHOUSES SO T-B
SANITARIUMS CAN GROW VEGETABLES FOR THEIR PATIENTS IN THE WINTER.
MR. LINTON SAYS BECAUSE OF ITS SEVERE ECONOMIC SITUATION, NORTH
KOREA LACKS ENOUGH MEDICINE TO TREAT TUBERCULOSIS PATIENTS AND
LACKS X-RAY FILM USED IN DETECTING THE DISEASE. THEREFORE, HE
SAYS, NORTH KOREA RELIES ON METHODS THAT HE DESCRIBES AS TRAGIC
WHEN VIEWED FROM THE OUTSIDE.
// LINTON ACT FOUR //
NORTH KOREANS ARE DIAGNOSED WITH TUBERCULOSIS WITH A
PROCESS CALLED DIRECT FLUOROSCOPY, WHICH MEANS THAT THE
PATIENT IS PLACED BETWEEN THE DOCTOR AND A RADIATION
SOURCE AND IN A DIM ROOM. AND THE RADIATION IS THEN
SHOT THROUGH THE PATIENT INTO A FLUOROSCOPY SCREEN IN
FRONT OF THE DOCTOR'S FACE.
// END ACT //
THIS METHOD EXPOSES DOCTORS TO MASSIVE DOSES OF RADIATION, BUT
MR. LINTON SAYS THEY HAVE NO CHOICE BECAUSE THEY HAVE NO X-RAY
FILM AND MUST SEE THEIR PATIENTS' LUNGS IN REAL TIME. HE SAYS
NORTH KOREA ALSO TRIES TO CUT COSTS BY STRETCHING THE USE OF
MEDICINES, BECAUSE WHEN TAKEN BY MOUTH ONLY 80-PERCENT OF THE
MEDICINE IS DIGESTED.
// LINTON ACT FIVE //
ONE WAY TO EXTEND OR TO USE MEDICINE TO TREAT MORE THAN
THE USUAL NUMBER OF PATIENTS WHO COULD BE TREATED IS TO
TRY DIRECT INJECTIONS. AND THE NORTH KOREANS HAVE BEEN
INJECTING TUBERCULOSIS MEDICINE INTO PEOPLE'S LUNGS WITH
VERY LONG HYPODERMIC NEEDLES WHICH IS AN EXTREMELY
PAINFUL PROCESS. // OPT // THEY HAVE ALSO EXPERIMENTED
WITH INSERTING OR FIXING A TUBE DOWN THE TRACHEA INTO
THE LUNGS AND DRIPPING MEDICINE INTO THE LUNGS ON A
DAILY BASIS, WHICH IS A LITTLE BIT EASIER ON THE
PATIENT, BUT THE POTENTIAL FOR SECONDARY INFECTIONS AND
PNEUMONIA ... IS JUST AMAZING. // END OPT //
// END ACT //
MR. LINTON SAYS HIS IS ONE OF THE FEW GROUPS HELPING TO BATTLE
TUBERCULOSIS IN NORTH KOREA. MOST LARGE ORGANIZATIONS, SUCH AS
THE WORLD HEALTH ORGANIZATION, REQUIRE SURVEYS AND ASSESSMENTS
BEFORE THEY COMMIT AN INVESTMENT. THE EUGENE BELL FOUNDATION
DOES NOT DEMAND THAT KIND OF INFORMATION, WHICH HE SAYS NORTH
KOREA WOULD NOT BE WILLING TO GIVE.
MR. LINTON SAYS ANOTHER REASON MORE ORGANIZATIONS ARE NOT
INVOLVED IS THAT THE DISEASE IS NOT -- IN HIS WORDS -- TELEGENIC.
TUBERCULOSIS IS A SLOW-DEVELOPING DISEASE, IT DOES NOT DISFIGURE
ITS VICTIMS AND IT DOES NOT USUALLY AFFECT CHILDREN, MAKING IT
HARD TO RAISE MONEY FOR T-B PROGRAMS BECAUSE IT DOES NOT USUALLY
ATTRACT MUCH ATTENTION FROM NEWS MEDIA.
IF PATIENTS GET THE STANDARD TREATMENT OF FOUR DRUGS TAKEN IN A
CERTAIN SEQUENCE OVER A SIX-MONTH PERIOD OF TIME, MR. LINTON SAYS
THERE IS AN 85 TO 90-PERCENT CHANCE OF COMPLETE RECOVERY. BUT HE
SAYS AS LONG AS NORTH KOREA'S FOOD SHORTAGE CONTINUES AND AS LONG
AS THE COUNTRY IS DEPENDENT ON MEDICINE FROM THE OUTSIDE, THE T-B
PROBLEM WILL GROW. (SIGNED)
NEB/SMN/RAE
03-May-99 11:23 AM EDT (1523 UTC)
NNNN
Source: Voice of America
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