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INFO RUEHBK/AMEMBASSY BANGKOK 7036
RUEHBJ/AMEMBASSY BEIJING 3590
RUEHHI/AMEMBASSY HANOI 2165
RUEHMO/AMEMBASSY MOSCOW 8390
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RUEHVN/AMEMBASSY VIENTIANE 1219
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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. 
 
------- 
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