September 13, 2014:   Years of economic decline, growing corruption and persistent government mismanagement have created a health crises in North Korea. This is the main reason so many young males are physically unfit for military service. The health problems arise in many different ways. For example electricity shortages, especially in the warm weather months, plus years of not being able to afford maintenance on water and sanitation systems has led to a sharp increase in diseases of the digestive tract. Hemorrhagic colitis, an often fatal disease of the intestines, is more common and many victims cannot afford the antibiotics that can cure it. The public health system rarely has antibiotics and patients must supply their own, if they can afford it. The corruption has led to the appearance of a lot of counterfeit (and ineffective) medicines, especially antibiotics. The result of all this is that in some parts of the country as many as 20 percent of the population comes down with intestinal diseases and there have been many deaths. The government won’t say how many, or discuss the situation much at all.

The economic collapse of the last two decades gets worse in ways that are obvious. Electricity shortages are more frequent. The national currency (the won) is increasingly ignored, mainly because of continued inflation. The government keeps printing money, not obtaining it via taxation. This is how you cause inflation, and the government feels it has no choice. The people have, in effect, gone on the dollar standard, with the won-dollar exchange rate determining what the won is really worth. In 2011 it was worth 1,500 won to the dollar and now it is over 8,000 won to the dollar.  China is still the source of a lot of goods, and those suppliers want Chinese currency, dollars, or won at the current dollar exchange rate, plus a little extra because of the unpredictability of what will go wrong next in North Korea. So if you need effective medicine you need money. Not North Korean cash, but foreign currency (American and Chinese preferred).

Hunger is growing, and more people are selling what they own to buy increasingly expensive food. More people are eating corn instead of rice. Starvation deaths are not a major source of deaths yet, but malnutrition is a growing public health problem, and increasingly obvious.  This can be seen in pictures of young troops. They are smaller than previous generations of soldiers. Public order is breaking down in more obvious ways. Anti-government graffiti is more common, in addition to illegal drug sales and efforts to use bribes or deceit to avoid military service. Government employees are increasingly demanding bribes just to do their jobs.

Even well off people living in the capital are suffering from the gradual deterioration of everything. For example, apartment buildings put up in the last decade in the capital suffered from cheap materials, sloppy work and poor quality control. Once such high rise, occupied but still under construction, collapsed earlier in 2014. In many other recently built apartment towers the heating and sanitation systems are failing making the buildings uninhabitable in the cold weather. There is no money or material available for repairs. The shoddy housing even shows up on military bases and is another reasons for the troops to be surly and undisciplined.