A/HRC/25/CRP.1 patients may access hospitals for free, medical equipment and medication are unavailable to the masses and must be bought on the private market by those who can afford them.422 • A former nurse at a county hospital in North Hamgyong Province, the northernmost region of the country to which many of lower songbun have been banished, told the Commission: “Working conditions were difficult. There was always a shortage of medicine. It was distributed from high levels at the national level down to the county, and misappropriated by officials who sold it on the black market [for money]. Consequently, doctors did not have medicines to use and could only write prescriptions. A more alarming side-effect of the misappropriation of medicines was the sale of dangerous ‘knock-offs’ that flooded the markets. Entrepreneurs mixed liquid antibiotics with fuel and mixed pills with flour to make more money. As a result, many people presented to hospital with infections and problems from using knock-off antibiotics. It was well known in the medical profession that bottles, lids and labels from the Suncheon factory for antibiotics were regularly stolen for the containment and sale of knock-off antibiotics. Although patients can technically go to the hospital at any time of day, the staff are rarely there after lunch as they had to engage in other business to make money to feed their families, or shop and do household chores”. The witness further explained that the dire situation in regional hospitals is known to party officials: “Party staff carry out nominal inspections of the hospitals each year. They are fully aware of the deficiencies of the hospital and the health situation of the community, but are bribed by the head of the hospital not to report the conditions. Staff are also expected to give money so a party could be put on for the visiting officials. Bribery and corruption are the norm in the DPRK. The officials are also the ones siphoning off the supplies, so they are more than aware of the situation. Party officials always given priority in the hospital, treated in separate rooms; they have no interest in how the rest of the population is suffering.”423 345. Women are particularly disadvantaged by the lack of access to health care. Tests for female diseases or screening for breast cancer do not exist. A survey recently conducted with women in the ROK originally from the DPRK found that almost half of the women surveyed did not see a doctor throughout their pregnancy and almost half delivered their babies at home regardless of whether they were from a major city or village. Women also reported that the death of the mother or baby during or after childbirth was not uncommon.424 Maternal mortality rates almost doubled in the decade from 1993 to 2003, largely due to inadequacies in emergency obstetric care.425 The maternal mortality rate in 2010 was estimated to be 81/100,000 live births.426 5. Principal findings of the commission 346. The Democratic People’s Republic of Korea has presented itself to the world as a state where equality, non-discrimination and equal rights in all fields have been fully implemented.427 In reality, the Commission finds that the DPRK is a rigidly stratified 422 423 424 425 426 427 TSH051, TSH004. TSH051. Citizen’s Alliance for North Korean Human Rights, “Status of Women’s Rights in the Context of Socio-Economic Changes in the DPRK”, p. 37. UNICEF, “2003 Country report”, pp. 47-50. WHO, UNICEF, UNFPA and The World Bank Estimates, “Trends in Maternal Mortality: 1990 to 2010”, 2012. The State report for the DPRK’s first Universal Periodic Review in 2009 stated the following: “In the DPRK, equality is fully ensured based on unity and cooperation between persons. No citizen is 97