By Josh Smith and Heekyong Yang
SEOUL (Reuters) - A defector’s treatment for critical injuries suffered during a dramatic dash from North Korea has highlighted a shortage of South Korean trauma doctors and again underscored Seoul's lack of preparedness in the event of hostilities with Pyongyang.
The defector, identified only by his family name of Oh, was shot at least four times by his former comrades during his daring escape into South Korea last week.
American military helicopters flew the wounded soldier not to one of the many hospitals in Seoul, closer to the border, but to the Ajou University trauma centre an hour south of the capital.
The centre, and its lead surgeon John Cook-Jong Lee, have been thrust into the spotlight amid a push for more trauma facilities and specialist doctors in a country still technically at war and where preventable trauma death rates are already amongst the highest in the OECD.
An official at South Korea's Ministry of Health said more than 30 percent of people who suffered fatal trauma injuries last year could have survived if they had access to proper, timely treatment. That's far higher than the 10 to 15 percent in places such as the United States and Japan.
"Although 133 surgeons are currently entitled to perform trauma surgery, I highly doubt that all of them can actually perform," said Park Chan-yong, general affairs manager of the Korean Society of Traumatology. "Many of them just gained the rights, but never had practiced this kind of surgery."
By Friday, attention sparked by the defector's case had prompted nearly 200,000 South Koreans to join a petition asking the presidential Blue House to boost funding for Lee’s trauma centre, one of just nine in the country.
"THERE IS NO HOPE"
During increased tensions this year with heavily armed North Korea, Seoul has faced criticism over a lack of preparation for major emergencies, with many bomb shelters, for example, laying forgotten and unstocked with food or water.
The government has launched programs to raise awareness, but public emergency drills often fail to attract much response.
Despite the apparent need for specialists, Lee said he has faced "ignorance," including from some doctors who complained he was showing off with new techniques, since returning from training in the United States in 2003.
"I had to explain whenever I met new doctors here, what a trauma surgeon was. Every day," he said.
Often, trauma medicine is not seen as attractive or lucrative as other fields, said Park.
"Residents and medical students avoid coming to traumatology, because there is no hope and no dream."
The South Korean government says it recognises the problem, and in 2014 set a goal of lowering its rate of preventable trauma fatalities to levels closer to those of other OECD countries by 2020.
But with a shortage of funding, only half of a planned 17 regional trauma centres have been built so far, a health ministry official said.
Germany, for example, has less than twice the population of South Korea, but 10 times as many operational trauma centres.
MADE TO WAIT
South Korea's strict gun control laws also mean there are far fewer gunshot wounds like those suffered by the defector. Between January 2012 and August 2017, 31 people were killed and 51 wounded by guns, according to the police.
In comparison, in the United States, where Lee trained, more than 33,000 people die from gunshot wounds every year, according to annual averages of government data.
However, the kinds of industrial accidents and car crashes commonly seen in South Korea can cause equally bad injuries, Lee said.
"In South Korea, roughly speaking, more than 90 percent of trauma victims are brought to the hospital in less than an hour," Lee said. "However, frequently, they are put in emergency rooms for a while, sometime for hours, to get proper care."
Lee has made a name for himself and the Ajou trauma centre, in part by cultivating a close relationship with the American and South Korean militaries, making it an obvious choice for the defector's treatment.
Lee said his fascination with the American medical evacuation crews and the techniques he learned in the United States have led him to push for a series of new additions at the trauma centre, including a recently completed roof-top helipad with flashing neon messages in English for American pilots.
U.S. military air crews, however, have yet to obtain Pentagon permission to use the new helipad, Lee said.
The arrival of the North Korean defector has brought Lee a new round of criticism for appearing to seek attention, including from one lawmaker, a charge he says is unfounded.
But it has also highlighted the need for more funding for his centre and more trauma facilities in South Korea.
"To those who get only 10, 20 minutes of sleep while working to save emergency room patients, to those who only get to go home once a week or not even that – we should not be criticizing them but rather, discuss how to resolve problems within the system," the petition submitted to the Blue House said.
(Additional reporting by Christine Kim and Haejin Choi; Editing by Lincoln Feast)