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View more articles by Jacob Fromer
Jacob Fromer is NK News's Washington DC correspondent. He previously worked in the U.S. Senate.
China exported at least $50 million worth of medical supplies to North Korea last year, data published by the Chinese General Administration of Customs (GAC) and analyzed by NK News revealed.
The exports — including 65 million syringes, hundreds of thousands of dollars’ worth of antibiotics, and more than 4 million pairs of rubber gloves — came as international aid groups trying to bring their own medical supplies into the DPRK, including some of the very same items China exported, were required to seek permission from the UN first.
UN Security Council (UNSC) sanctions ban a wide range of goods from entering North Korea — a punishment for the country’s nuclear weapons program. The banned goods include medical equipment made of metal.
China has said those sanctions are exacerbating the humanitarian situation in the North.
In December, Beijing and Moscow proposed a draft UN Security Council (UNSC) that would have lifted all sanctions “related to the livelihood of the civilian population of the DPRK.”
“Our proposal to adjust some of the sanctions on the DPRK is to meet the reasonable humanitarian and livelihood needs of the DPRK people in support of the process of political dialogue,” Geng Shuang, a Chinese foreign ministry spokesman, said after the draft was made public.
That same month, however, China exported at least $4 million in medical supplies to North Korea, according to the GAC.
Included in that total were 5.7 million catheters and cannulas, 10 tons of gauze and bandages, and two ultrasound machines worth almost $6,000 each.
Aid workers with extensive experience inside North Korea told NK News that the DPRK’s healthcare system is severely lacking in basic supplies, like sphygmomanometers for measuring blood pressure, and stethoscopes.
According to the GAC, however, last year China exported more than 65,000 stethoscopes and more than 128,000 sphygmomanometers to the North.
Those amounts would likely not come close to supporting all of the country’s medical needs. By some estimates, the country has between 200,000 and 250,000 healthcare workers.
Even the 65 million syringes would not add up to much if divided across North Korea’s population of 25 million: less than three of them per person, on average.
But they were still imported from China at a far higher volume than what aid groups brought in last year, according to UN documentation.
One person working for a humanitarian organization told NK News that even if the North had every basic supplies it needed, the country’s healthcare system would still be plagued by a lack of clean water, consistent electricity, and even heat during the winter.
The UN Security Council explicitly says that its ban on metal goods includes medical supplies like needles and catheters.
The UNSC insists, however, that the sanctions are not intended to restrict humanitarian assistance to the country.
Many larger types of medical equipment, like X-ray machines and ambulances, are also banned — although North Korea has managed to procure at least some modern equipment, including high-end European devices, for its flagship medical facilities in Pyongyang.
Other essential medical equipment, like rubber gloves and antibiotics, are not subject to sanctions.
Last year, 38 humanitarian aid groups received exemptions from the UNSC to bring otherwise banned items into the DPRK.
To receive an exemption, a group has to document what items it plans to bring into the DPRK, how they will get into the country, and how the group will guarantee that they won’t be misused.
In August last year, Médecins Sans Frontières (MSF) — the aid organization also known as Doctors Without Borders — reported every single latex glove and syringe, among many other items, that the group planned to bring into North Korea for a tuberculosis treatment project.
The paperwork for their exemption request was 158 pages long.
One expert told NK News that many humanitarian groups take great care not to inadvertently violate any of the UN rules, and will report every item — sanctioned or not — that they plan to bring into the DPRK.
“To cover their bases, when applying for UN sanctions exemptions many NGOs and international organizations appear to list all of the goods they plan on exporting to North Korea,” said Daniel Wertz, the Program Manager at the National Committee on North Korea (NCNK), a non-governmental organization in Washington.
“If you work for a humanitarian organization active in North Korea, it’s better to play it safe with a comprehensive UN exemption in place than to see a shipment held up by Chinese Customs because of confusion over what items are or aren’t prohibited for export,” he said.
Those items are likely included in the Chinese customs data, one person familiar with customs practices told NK News.
Aid groups are also wary of violating American sanctions on the North — or even just attracting the suspicion of the U.S. Treasury Department.
NK News previously reported that one organization, American Friends Service Committee (AFSC), had been investigated by the Treasury Department in 2018, although no fines were ultimately issued.
A spokesperson for the group told NK News earlier this month that “funds meant for humanitarian support were instead spent on lawyers.”
Through all of this is the fear among many observers that the novel coronavirus, which was first discovered in neighboring China, could eventually break out in North Korea — if it hasn’t already.
Morgan Ortagus, the U.S. State Department spokesperson, said last week in a statement that she was “deeply concerned about the vulnerability of the North Korean people to a coronavirus outbreak.”
“The United States is ready and prepared to expeditiously facilitate the approval of assistance from these organizations,” she said, referring to aid and health groups that work in the North, and likely also to the sanctions wavers that they may need to get approved first.
One person working for a humanitarian organization told NK News that one of the most important devices the DPRK will need for tracking the coronavirus, known as COVID-19, is a supply of thermometers.
China may already have helped give its neighbor a head start: according to the GAC, North Korea imported more than 650,000 of them last year.
Edited by Oliver Hotham