Cablegate: North Korean Refugees: Dealing with Psychological

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PP RUEHWEB

DE RUEHUL #3538/01 3480634
ZNR UUUUU ZZH
P 140634Z DEC 07
FM AMEMBASSY SEOUL
TO RUEHC/SECSTATE WASHDC PRIORITY 7751
INFO RUEHBK/AMEMBASSY BANGKOK 7036
RUEHBJ/AMEMBASSY BEIJING 3590
RUEHHI/AMEMBASSY HANOI 2165
RUEHMO/AMEMBASSY MOSCOW 8390
RUEHPF/AMEMBASSY PHNOM PENH 0345
RUEHKO/AMEMBASSY TOKYO 3726
RUEHUM/AMEMBASSY ULAANBAATAR 1608
RUEHVN/AMEMBASSY VIENTIANE 1219
RUEHSH/AMCONSUL SHENYANG 3544
RHMFISS/COMUSKOREA J5 SEOUL KOR
RHEHNSC/NSC WASHINGTON DC
RUACAAA/COMUSKOREA INTEL SEOUL KOR
RHMFISS/COMUSKOREA SCJS SEOUL KOR
RHHMUNA/CDR USPACOM HONOLULU HI
RUEKJCS/SECDEF WASHINGTON DC//OSD/ISA/EAP//

UNCLAS SEOUL 003538

SIPDIS

SIPDIS

E.O. 12958: N/A
TAGS: PHUM PREF PREL KS KN
SUBJECT: NORTH KOREAN REFUGEES: DEALING WITH PSYCHOLOGICAL
TROUBLES (PART II)

REF: SEOUL 3531

1. (SBU) This cable is the second in a two-part series about
psychological issues that North Korean defectors are facing.

2. (SBU) SUMMARY: A small group of doctors, politicians and
academics in South Korea are working to bring North Korean
defector's psychological challenges, including Post-Traumatic
Stress Disorder (PTSD), to the forefront but there is still
much progress to be made and many social factors to overcome.
Some of the initial signs of concern among resettled North
Koreans include turning to crime, prostitution and even
suicide as a result of their psychological troubles. NGOs
are understaffed and overworked and lack fundamental training
needed to adequately handle the unique cases presented by
North Korean refugees. This is an area where U.S. assistance
could help, see para. 14 END SUMMARY.

-----------------
...IN SOUTH KOREA
-----------------

3. (SBU) Not long after arriving in the South, many defectors
report that guilt begins to set in because of family members
that they have left behind in North Korea, some of whom are
likely to be sent to labor camps as a result of the
defector's flight from the DPRK. As one response to these
emotional stresses, an increasing number of defectors
immediately contract human smugglers to bring their family
members out of North Korea. Although some have seen very
quick results with family members arriving in the South in
just a matter of weeks after securing a broker, others are
frustrated by the long wait as various delays prevent the
timely departure of their family members from third
countries. Coupled with their own internal demons, most
defectors face additional hardships in the form of social
discrimination, prejudice, unemployment and economic
instability.

--------------------------
EXPLOITATION AND HARDSHIPS
--------------------------

4. (SBU) Professor Ahn Hun-nie at the psychology department
at Busan National University took it a step further and
posited a connection between stress and outward actions. She
reported that the symptoms of PTSD very often appear as
personality or behavior quirks, such as being short-tempered,
which makes the underlying trauma harder to diagnose.

5. (SBU) There are media reports in South Korea that
resettled North Koreans are resorting to illegal activities,
including prostitution, as a way to make a living. According
to National Assembly Representative Ahn Myoung-ock, herself a
physician (Ob/Gyn) who has worked with defectors, this
willingness is linked to the trauma they experienced in China
and other third countries as they made their way to the
South. Someone who has been exploited in the past is more
likely to be exploited again in the future. As noted in
reftel, North Korean refugees in China are often willing to
do whatever it takes to survive, knowing that if they are
ever caught and sent back to North Korea, they are certain to
face severe, possibly deadly, punishment.

6. (SBU) Even for those who come to the South and try to
assimilate into South Korean society, there are a number of
social barriers that add stress and anxiety to the process.
A growing number of poor South Koreans are upset that the
Korean government appears to be doing more to help refugees
than they are doing to help the indigenous poor. North
Korean defectors' difficulties in assimilating seem stark
when compared to the success of ethnic Korean Chinese (who
receive no financial support from the ROK government) to
assimilate into society, learn to save money and maintain a
steady jobs -- all areas that North Korean defectors have
trouble with. Dr. Jeon explained a North Korean's upbringing

as one in which social status dominates his or her entire
life. One's excellence in work, attitude or effort has
almost no effect on the success of his or her life. When
this same thinking is introduced into the highly competitive
and work-driven culture of the South, there is bound to be a
serious clash of cultures. This is especially true for a
smaller minority of North Korean defectors who held positions
of authority or respect in North Korea and who are now
considered third-class citizens in the South.

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HANAWON
-------

7. (SBU) All North Korean refugees arriving in South Korea
are required to spend eight weeks of orientation at the
government-run resettlement facility called Hanawon
(literally the place of "oneness") where instructors attempt
to bridge the social/political/economic gap in thinking and
practice between the North and South. At present, the
orientation lasts for eight weeks (280 hours of instruction)
although just a year ago, the program lasted for ten weeks.
The time at Hanawon has continued to decrease in recent years
as the number of refugees has risen sharply and expansion
projects to accommodate the increased demand at the facility
have yet to be completed.

8. (SBU) Doctors at Hanawon provide services in internal
medicine, oriental medicine and dentistry. Although there is
also a psychologist who provides limited counseling services,
the Hanawon Director said that they are in need of a licensed
psychiatrist to better treat trauma victims. Under the
current curriculum, refugees at Hanawon receive 27 hours of
"psychological stabilization and healthcare education"
compared to 32 hours preparing to receive their driver's
license.

----------------------------
ROKG EFFORTS TO HELP VICTIMS
----------------------------

9. (SBU) Despite the best efforts of the staff at Hanawon to
prepare the resettled North Koreans for life in the South,
there is only so much time to provide support and counseling
during the eight-week stay. Representative Ahn has been a
vocal advocate for doing more to help North Korean refugees
who have been resettled to the South. Rep. Ahn is sponsoring
a bill that would require the Ministry of Unification (the
Ministry responsible for Hanawon) and the Ministry of Health
and Welfare (MOHW) to screen all arriving refugees to
identify those who need additional psychological or medical
assistance. Those identified as needing help would be
referred to free services that could be offered either at
public or military hospitals. According to Rep. Ahn, the
Ministry of Unification and the MOHW do not have a good
working relationship which has prevented the effective
integration of psychological assistance in the current
resettlement scheme.

10. (SBU) Rep. Ahn said that part of the resettlement package
provided to North Koreans in the South is free health care
for at least two years. Despite the free availability of
health services, many are hesitant to seek out psychological
help due to the social stigma associated with mental
disorders, she added.

11. (SBU) Yonsei University Professor Dr. Jeon Woo-taek found
that in the rehabilitation process of refugees, mental health
is key to their successful adaptation and settlement. Jeon's
ongoing research on the subject is aimed at providing data
for the subsequent development of a government mental health
support program for North Korean defectors living in South
Korea. Such a program is required to help refugees
successfully adapt themselves to their new environment, Jeon
said.

----------------------------
WHAT ARE NGOS DOING TO HELP?
----------------------------

12. (SBU) NK Database President Yoon Yeo-sang told poloff
that before 2006, the ROKG did not have a plan to provide
psychological support for North Korean defectors after they
left Hanawon. In light of this gap in services, several NGOs
and church groups stepped in with varied results. Starting
in 2006, the ROKG's Ministry of Unification decided to
financially support four NGOs that provide psychological
support for defectors, one of these being NK Database. Two
of the other NGOs are located within Seoul and the third is
in Taegu. NK Database focuses predominantly on victims of
post-traumatic stress disorder (PTSD) while the other three
groups spend more time on psychological issues relating to
life in South Korea.

13. (SBU) Yoon said that recently his organization has also
seen an increase in the number of teenagers and younger
children seeking psychological support, regardless of whether
they suffer from PTSD. In general, defectors are looking for
help to come to grips with the life they lived in North Korea
and to get help with adjusting to their new life in South
Korea. Also, vast differences in society and family between
the North and the South contribute to ongoing levels of high
stress for many defectors.

14. (SBU) Yoon estimated that 20-30 percent of defectors seek
out some form of counseling. But this number is misleading
because many hesitate to ask for help noting there is a
stigma associated with psychological counseling. To better
address the growing number of younger defectors who face
mental challenges, Yoon advocates teachers and parents taking
a more proactive approach in encouraging defectors to seek
out counseling.

15. (SBU) Yoon said that one of the major challenges in
helping defectors with mental issues was a general lack of
medical specialists (psychologists and psychiatrists). In
the ROK, there were only a few professional counselors
trained specifically to deal with PTSD sufferers, Yoon
lamented. Despite his best efforts to recruit trained
personnel, Yoon's staff of counselors only consists of three
people. NK Database is reaching out to U.S. organizations in
the hopes of identifying groups that can provide training and
certification for Korean counselors. Yoon is not only
concerned about the PTSD victims, but also for the overworked
or "burned out" counselors and their exposure to "second-hand
trauma" as they internalize some of the trauma that their
patients recount to them during counseling sessions.

-------
COMMENT
-------

16. (SBU) At a minimum, North Koreans who resettle in the
South are faced with challenges in almost every aspect of
their life: social, cultural, financial, health and welfare.
While they struggle to make ends meet in the South, they must
also come to terms with their past and the traumatic events
that have shaped their life. For its part, the South Korean
government needs to broaden the psychological services
available to the refugees and create a stronger safety net
for the refugees once they depart Hanawon. The tougher
challenge is to change the minds of the South Korean people
to be more accepting and tolerant of their "brothers and
sisters" from the North. Experts warn that failure to
adequately address all of these issues will only further
isolate these people from mainstream society at a time when
the number of defectors arriving from the North is steadily
rising.
VERSHBOW

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