| Spring 2008 |
SPRING 2008 TRIP REPORT
(May 5-17th)
Highlights
For the past twelve years, the Eugene Bell Foundation has sent medical aid to the Democratic People’s Republic of Korea (North Korea). Initially, these efforts were limited to providing medicines, medical equipment, nutritional and other types of assistance directly to tuberculosis treatment facilities and local hospitals.
Gradually, material assistance has been organized into four distinct programs, two related to the diagnosis and treatment of tuberculosis and two related to community health.
On this visit we were able to make significant progress in all areas, particularly in our new multi-drug resistant tuberculosis program. Agreements reached this spring will now enable EugeneBell to individualize diagnosis and treatment for inpatient tuberculosis care. Four multi-drug resistant centers have been identified where patients will be tested and treated based on their specific medical and material needs. In other words, for the first time, donors will be able to ‘adopt’ individual patients and follow their treatment programs for several years until (hopefully) they are cured and return to their families.
This visit also saw significant progress in our community-based women and children’s programs. As a result of assistance provided last year and this spring, local hospitals enrolled in these programs (presently there are four) will have comprehensive programs for managing the health of pregnant women, their infants, and school-aged children. Care will include health education, physical health exams, tuberculosis screening, vision care and where needed, nutritional support. If successful these programs will be expanded to other communities.
Itinerary
May 7 (Wednesday)
It took almost five hours for EugeneBell’s delegation to drive from Pyongyang to Shinuiju, a city on North Korea’s northwestern border. The delegation’s first stop was the North Pyongan Province Tuberculosis Hospital (located in Shinuiju City).
The North Pyongan Province Tuberculosis Hospital is one of four tuberculosis hospitals where EugeneBell supplies regular tuberculosis medications for TB patients treated as outpatients through local hospitals. After discussions with the hospital staff on a proposed program aimed at early detection of tuberculosis in Shinuiju City and the surrounding area, the delegation drove to the Shinuiju City Tuberculosis Care Center where patients with serious cases of TB are given long-term care.
The Shinuiju City Care Center has received diagnostic, nutritional and treatment support for a decade through EugeneBell. While checking on the most recent shipment of aid, medical professionals on the delegation and care center staff collected sputum samples from patients suspected of having multi-drug resistant tuberculosis. Under our new program, once test results are available, those found to be suffering from this particularly deadly form of the disease will be transferred to the MDR treatment center for North Pyongan Province.
May 8th (Thursday)
Our delegation visited the Yomju County Tuberculosis Care Center that morning. Due to bad weather, we were not able to visit the Yomju TBCC last fall and were glad that sunny weather made it possible for us to cross the high mountain pass to the center without incident. After discussions with the staff, we visited the patients and collected more sputum samples. Overall, we were impressed with the quality of care provided by this center, thanks to continued support through EugeneBell.
When our delegation arrived at Jongju City Care Center, we found that the building program which began last year is almost completed. Patient numbers are still low due to a shortage of housing but, thanks to the one-ton truck and tractor donated through EugeneBell, there is hope to complete new patient wards this year.
May 9th (Friday)
This morning our delegation visited the Gusong City People’s Hospital, one of the local hospitals enrolled in our Mothers and Infants and Children’s Programs. The delegation was able to confirm delivery of the second ‘step’ of support for these programs. After touring the hospital we had extensive discussions with hospital staff and local medical officials on program implementation and documentation. We hope to visit this site again this fall.
In the afternoon we drove to the most remote medical facility supported by EugeneBell, the Gusong City Care Center. The forty-five minute drive to the center ended at the bank of a river that was too deep for our vehicles to cross. Fortunately, considerate care center staff sent an oxcart to help us with the rest of our journey! We had very good meetings with the staff and patients.
May 10th (Saturday)
In the morning we visited the Kwaksan Tuberculosis Hospital, one of the medical facilities chosen for long-term care of multi-drug resistant patients. If all goes according to plan, special wards will be designated so that those diagnosed with MDR TB can be isolated from the other patients and receive special care. We were happy to find that one very sick patient we had visited last fall was still living. We collected numerous sputum samples from her and other patients anxious to be tested for MDR TB.
That afternoon we visited the Hadan Tuberculosis Surgical Hospital, where EugeneBell has delivered several shipments of surgical equipment as well as providing support for regular tuberculosis care. Our delegation was able to witness an operation in progress on a young women suffering from spinal TB. If left untreated, she would be in danger of permanent paralysis. We prayed for her quick recovery.
May 11th (Sunday)
Although we usually try to make Sunday a day of rest, the schedule prepared for us this spring made Sunday one of our busiest. We first stopped by the Anju City People’s Hospital, one of the four medical facilities selected for community-based women and children’s work. We were met by health officials and hospital staff and agreed on a plan to upgrade the program this fall.
That afternoon, we visited the Anju City Tuberculosis Care Center, one of our sites for multi-drug resistant tuberculosis work. During a very emotional visit, we were able to deliver medication to patients who provided sputum samples on our last visit and to take samples from every patient in residence.
May 12th (Monday)
In the morning we visited the Sunchon City People’s Hospital, one of the four sites selected for women and children’s programs. After touring the facility and met with health officials and staff. The subject of our meeting was how to achieve our goal of a community-based program for pregnant women, new mothers, infants and school children. The meeting was followed by a delicious lunch hosted by members of the Vice Director of the People’s Committee. We left for Pyongyang that afternoon hopeful that with the high level of official interest in our programs evidenced on our visit, Sunchon City People’s Hospital would soon be a model center for community health outreach.
May 13th (Tuesday)
Chollima County Hospital was on our schedule for the morning. This local hospital had just received the first shipment of support for women and children’s work. Thanks to generous donors, EugeneBell has been providing tuberculosis treatment and surgical support to the Chollima County Hospital for some time. We are hoping to build on this foundation to encourage this local hospital to expand community outreach designed to identify individuals with medical needs early for more effective treatment.
In the afternoon we visited the Tongdaewon Care Center located near Pyongyang City. This care center has faced many difficulties, including the death of its long-time director last year. Today’s challenge is an increasing numbers of patients who do not respond to regular tuberculosis medications. Once again we were able to have an emotional meeting with patients in the center and collect sputum samples from those suspected of having MDR TB. As soon as results are known, under our new program, those inflicted with this particularly deadly form of tuberculosis will be transferred to the Rongsong District Tuberculosis Care Center for long-term care.
May 14th (Tuesday)
This morning we visited the Pyongyang City Tuberculosis Hospital where a mobile X-ray vehicle donated by EugeneBell has been in operation for a number of years. After discussions with the staff we toured the facilities, including the operating room and patient rooms where we spoke to patients who were recovering from surgery. Tuberculosis can migrate from the lungs to other parts of the body and often settles in the spine, bring paralysis. Pyongyang City Tuberculosis Hospital is anxious to upgrade its surgical ward to provide better care for people suffering from extra-pulmonary tuberculosis.
In the afternoon we visited the Sadong District Care Center where we collected sputum samples from patients suspected of having MDR TB last autumn. Tragically, four of the ten had died. Nevertheless, with the individualized prescriptions that we had brought with us, the six surviving multi-drug resistant patients will now have a chance at life. This heartbreaking visit reminded us of how much we need to expand our new multi-drug resistant tuberculosis program so that people suffering from MDR TB can be diagnosed early and treated before it is too late.
May 15th (Wednesday)
On this our last day for visiting medical facilities this spring, we visited two sites where we hope to develop multi-drug resistant tuberculosis work. The first was the Ryongsong District Tuberculosis Care Center, clearly the best run tuberculosis long-term care facility in the country. This care center is unique as it has been supported by EugeneBell since it was first established. Under energetic leadership from staff and local medical officials, Ryongsong District Care Center provides a model level of patient care. Here we found that all but one of the patients who had provided sputum samples on our previous visit had survived. Their eagerness to begin treatment with the individualized medication kits we brought was inspiring. We were able to collect samples from every patient in residence at the center and hope to bring back even more MDR medicine this fall.
In the afternoon we visited the Nampo City Tuberculosis Care Center, a facility that has received a steady stream of support through EugeneBell for almost ten years, thanks to generous donors in the United States. This care center has also been designated as a potential center for MDR TB work for people from the Nampo City area. On this visit we again collected samples from every patient in residence. Nampo City Care Center also has a children’s ward with sixteen young tuberculosis patients in residents. On this visit we were able to enroll these children in our program for children with TB.
May 16th (Wednesday)
As is customary, our final full day was taken up with meetings with health officials and a little sightseeing for members on the delegation who were visiting the Democratic People’s Republic of Korea for the first time. In our discussions we reflected on how much easier this visit had been when compared to last fall and made plans for the future.
May 17th (Thursday)
Early that morning our delegation bid an emotional goodbye to those who had accompanied our delegation for almost two weeks of non-stop visits to various medical facilities enrolled in EugeneBell’s support programs. Though anxious to get back, we were sad to part with those who had worked so hard to make our visit a success but also eager to share our experiences with those who sacrifice so much to make EugeneBell programs possible.
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| Meeting with staff from North Pyongyang TB hospital in front of a EugeneBell medical examination veh |
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| Reaching out to a patient receiving treatment at Yeomju TB Care Center |
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| Using an oxcart to cross a river leading to Gusong City TB Care Center |
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| An operation in progress on a young woman suffering from spinal TB at Hadan People's Hospital |
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| Patients with their package of MDR-TB medicine at Anju Care Center |
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| Mother and infant grateful for their Maternal and Infant Care Package at Sunchon People's Hospital |
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| Dr. Linton gives a speech about MDR-TB to patients at the Dongdaewon TB Care Center |
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