AP Medical Writer
PYONGYANG, North Korea (AP) -- The Man Nyon Pharmacy is lined with rows of colorful packages containing everything from dried bear bile and deer antler elixir to tiger bone paste and ginseng. But the ancient "Koryo" medicine provided at this popular dispensary isn't just for minor aches and pains.
It has been integrated into the health system from the smallest village clinic all the way up to the nicest showcase hospitals in the privileged capital of Pyongyang. Both modern and traditional styles of healing have long been uniquely intertwined nationwide with doctors from both schools working in tandem under one roof.
North Korean physicians say many patients prefer traditional medicine to the Western kind, but it's difficult to determine the true situation in this closed and impoverished society where access is limited. Defectors, foreign aid workers and North Koreans agree that many Western drugs are scarce and say villagers still forage for plants in some areas to make their own herbal concoctions.
With the U.N. Security Council imposing its toughest-ever sanctions following North Korea's third nuclear test in February, patients may become even more dependent on these home-grown remedies in a country of 24 million people where government health spending ranks among the world's lowest.
"Doctors are more interested in Koryo medicine rather than Western medicine because they can get it more easily," said Ri Hye Yong, who manages the frigid concrete pharmacy opened by the government nearly three decades ago. "It's much cheaper."
The latest restrictions are meant to squeeze new young leader Kim Jong Un and the ruling class by clamping down on access to foreign travel and luxury goods. North Korea has responded with tirades that include threatening nuclear attacks against the U.S. and its allies.
The resolution is not supposed to block donor aid to those who need it most, including the two-thirds of the population who don't have enough to eat. But foreign aid workers say years of limitations have created a maze of red tape and approvals needed to ship in medical supplies and equipment. Some countries refuse to process payments for anything involving North Korea because of restrictions placed on banks, while some foreign companies and organizations simply do not want to be involved once they learn where the materials are headed. But once the goods arrive, they say the process becomes fairly simple.
"Even though the imposed sanctions clearly exclude humanitarian assistance, a negative impact on the levels of humanitarian funding has been experienced," the U.N. Resident Coordinator's Office in Pyongyang said in a statement April 29, adding nearly three-quarters of the $147 million needed this year has not been received.
The World Health Organization is lacking an estimated 60 percent of the drugs it needs for at-risk kids and pregnant women, while the U.N. Children's Fund is struggling to get vaccines and medicines to prevent the biggest killer diseases among children, it said.
In addition, the WHO says the process of importing essential equipment and medicine has also grown lengthy at all levels, and those involved have become over cautious in clearing materials to ensure they could not be classified as dual purpose or luxurious items.
International efforts to help boost the country's ability to produce its own vaccines and medicines were earlier affected when some technology and seed microbes were halted over concerns they could potentially be used by Pyongyang for malicious purposes, WHO said.
Despite these challenges, it's difficult to understand the full picture within North Korea where outsiders are banned from traveling freely and data are lacking or unreliable. Suspicion of the outside world is reinforced by huge hospital propaganda paintings depicting Americans and Japanese as the country's "sworn enemies."
Jang Jun Sang, a department director at the Ministry of Public Health, said in an interview in February that sanctions have cut imports of medical equipment and supplies.
But he said North Korea was used to sanctions. "If we receive medical aid, that's good," he said. "But if we don't, that's fine, too. We're not worried."
North Korean factories have limited ability to produce pharmaceuticals, and many rural clinics lack electricity, running water and heating. By the government's own account, more than 80 percent of village clinics suffer from "chronic shortages of medicines and supplies at all levels of the system."
According to defectors such as Kwon Hyo-jin, some drugs are smuggled in from neighboring China and marketed while others are taken from hospitals and sold illegally. All health care is supposed to be free in North Korea.