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North Korea: The mystery of its Covid outbreak

The BBC has pieced together information, through conversations with people who have managed to contact those living in North Korea, and by using publicly available resources.

Voices inside North Korea

Kim Hwang-sun was sitting alone in his kitchen in Seoul when his phone rang. It was a Chinese broker with the news he'd been waiting for. His family could talk.

It has been 10 years since Hwang-sun escaped North Korea alone. His two children, grandchildren and his 85-year-old mother are all still there, and he's given up hope of ever getting them out.

These secret phone calls are the only communication he has with them. He knows not to ask too much in case they're being listened to. He keeps his conversations short, never more than five minutes.

Two days earlier, North Korea had announced its first coronavirus case.

Data released by the government, in an unprecedented move, indicates the virus spread quickly to every province in the country.

"They told me that very many people are sick with a fever," says Hwang-sun. "I got the sense it was really bad. They said everyone is walking around asking anyone they meet for medicine. Everyone is looking for something to reduce their fever, but no-one can find anything."

He didn't dare ask how many people were dying. If they were overheard talking about deaths, it could be seen as criticising the government, and he fears his family might be killed.

So far, about 15% of the population has become ill with a "fever" according to the official data. A lack of testing means this is how cases are described.

North Korean leader Kim Jong-un has acknowledged the shortage of medicine, ordering the army to distribute their stockpiles.

Hospitals and pharmacies in North Korea haven't had any medicine for years, says Hwang-sun. Doctors write a prescription, and it is up to the patient to find what they need and buy it, either from someone selling directly from their house, or from a local market.

"If you need anaesthetic for an operation, you have to go to the market to get it and bring it back to the hospital," he says. "But now even the market-sellers don't have anything".

"The government is telling us to boil pine leaves and drink the mixture instead," his family told him. State news reports have also advised gargling salt water to relieve symptoms.

"This is what happens when they have no medicine. They shift to traditional medicine," says Dr Nagi Shafik, who has worked for Unicef in North Korea's villages since 2001. When he was last there, in 2019, medicine was already short. "There was some, but very, very little," he says.

Almost all medicine is imported from China and the last two years of border closures have choked off this supply.

Sokeel Park, from the organisation Liberty in North Korea, helps escapees from the North settle in the South. Those who have spoken to family back home have told him there has been a run on medicine. "What little was left has been bought up, pushing prices sky-high," he says.

Photo: Korean Central Television: Caption: North Korean poster asks: "Comrade, are you keeping to the emergency virus prevention rules?"

Photo: Korean Central Television: Caption: North Korean poster asks: "Comrade, are you keeping to the emergency virus prevention rules?"