Hospital records from a young North Korean soldier who defected earlier this month offer telling details about health problems in the closed country.
The soldier had both parasitic infections and a dangerous hepatitis infection — conditions that speak to the poor sanitation and rough conditions those in the hermit nation experience on a day-to-day basis.
The most shocking details, perhaps, are the reports of large parasitic worms, some measuring 11 inches, recovered from the 24-year-old’s intestines.
“An estimated five million people in North Korea have intestinal roundworms, that’s 20 percent of the population,” said Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor.
Doctors found the parasites — likely Ascaris roundworms — when repairing intestinal damage from multiple bullet wounds the soldier sustained during his escape. The eggs of these worms are frequently found in the soil, especially in developing countries that use human waste as an inexpensive fertilizer. Once inside the body, these eggs hatch to form larvae, eventually developing into large, mature worms that infect the small intestine. They can reach lengths of more than 13 inches.
But despite the size of these creatures, Ascaris roundworm infections may not be accompanied by noticeable symptoms. However, Hotez said they can lead to malnutrition in those infected. In children, this can lead to developmental delays and short stature.
“Instead of feeding the kid, you’re feeding the worms,” said Hotez. “They rob children of nutrition.”
Multiple large worms in an infected person, however, can also cause intestinal blockages, and these worms can travel to the nearby liver, gallbladder, or pancreas and cause damage and inflammation to these organs as well, Hotez said.
While dramatic in appearance, roundworm infections are easy to treat, generally requiring only a single dose of anti-parasitic medication.
Likewise, another parasitic worm infection the soldier reportedly had, Toxocara, is also fairly easily treated. Toxocara is a parasite similar to Ascaris, though it is normally found in the intestines of dogs and cats; the worms do not usually grow as large in the intestines of humans. The larvae of these parasites often migrate to other organs in the body –- often the liver, brain, lungs and eyes –- causing damage to the affected organs.
But even more problematic than these parasitic infections are reports that the soldier was also infected with hepatitis B, a viral infection of the liver that can lead to life-threatening cirrhosis if untreated.
The soldier is just the latest case report of health problems among hundreds of other refugees and defectors from North Korea. Past reports have shown that many who have successfully fled suffer from these maladies, as well as tuberculosis, a common and frequently difficult to treat lung infection.
Studies comparing North Korean defectors to other refugee populations found they were more likely to be underweight — and another estimated that about one-third of North Korean children under the age of 5 is malnourished. Dental and vision problems, such as cataracts, are also frequently reported.
Though the reclusive nature of the country limits what is known about its active and ongoing health problems, Hotez said these health issues are common to other places in the world that face devastating economic conditions.
“These are not unique to North Korea,” he said. “These are all infections that are extremely common in the poorest parts of Asia. Toxocara is found in poor neighborhoods in the United States, as well.”
Worm eradication programs were successfully implemented in South Korea following the Korean War, Hotez added, and pharmaceutical companies have been willing to donate global supply of anti-parasitic drugs to countries in need.
Other conditions afflicting North Koreans, such as hepatitis B, are completely preventable through vaccination programs.
But North Korea’s tense political and economic relations with other countries makes assessing, and attempting to eradicate, these conditions in the country complicated.