For South Korea, another threat from the north: malaria

Just south of the heavily fortified inter-Korean border, a surveillance system operates 24 hours a day. Not to detect missiles or troop movements, but to catch malaria-carrying mosquitoes from the north.

Despite its highly advanced health system and decades of effort, South Korea has never managed to be certified malaria-free by the World Health Organization (WHO). That's because of the mosquitoes that thrive on its border with North Korea.

Seoul this year issued its first national malaria alert in its history. Scientists say climate change, which is bringing warmer springs and more rain, will bring more malaria-carrying mosquitoes to the peninsula if the two Koreas do not cooperate against the disease.

A North Korean flag flies in the wind in the village of Gijungdong, North Korea, on July 30, 2024 © AFP – ANTHONY WALLACE

The heart of the problem is the four-kilometer-wide demilitarized zone (DMZ) that runs along the 250-kilometer border. A buffer zone established at the end of the Korean conflict in 1953 to separate the two countries still officially at war.

Densely forested and swampy, infested with minefields, the DMZ has been virtually untouched by human activity for more than 70 years.

It has become a sanctuary for wildlife – migratory birds, deer, reptiles and even Asian black bears – but also a paradise for mosquitoes, which have a range of up to 12 km.

Kim Hyun-woo, a scientist with the Korea Disease Control and Prevention Agency, stands next to a mosquito-detecting device at Dorasan Peace Park in Paju, near the fortified border between North and South Korea, on July 30, 2024 © AFP – ANTHONY WALLACE

The DMZ is home to “many wild animals that serve as blood sources for mosquitoes,” and they also have large areas of stagnant water to lay their eggs, said Kim Hyun-woo, a scientist with the Korea Disease Control and Prevention Agency.

In 1993, South Korea thought it had eradicated malaria, with no local cases reported for a decade. But that year, a soldier serving along the DMZ was infected. Since then, the disease has been on the rise. A total of 747 cases were reported in 2023, compared to 420 in 2022.

– “Republic of diseases” –

“The DMZ is not an area where pests can be effectively controlled,” Kim Dong-gun, a professor of environmental biology at Sahmyook University in Seoul, told AFP.

Kim Dong-gun, a professor of environmental biology, uses a mosquito detection device at Sahmyook University on July 24, 2024 in Seoul, South Korea © AFP – ANTHONY WALLACE

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As the mosquito population grows, soldiers in the border area are getting bitten more, “which leads to continued cases of malaria in the region,” he added.

Seoul has installed 76 mosquito detectors across the country, mainly near the DMZ. From one of them, visited by AFP journalists in the border municipality of Paju, the North Korean flag can be seen flying in the distance.

In North Korea, around 4,500 cases have been recorded by the WHO between 2021 and 2022.

North Korean doctor Choi Jung-hun, who defected to South Korea in 2011 and specialized in infectious diseases while living in North Korea, at the clinic where he now works in South Korea, July 26, 2024 © AFP – ANTHONY WALLACE

“North Korea is a republic of infectious diseases,” Choi Jung-hun, a North Korean doctor who defected to South Korea in 2011, told AFP. He said he had treated many malaria patients during his career in the North, including a soldier who had been stationed near the DMZ.

According to Dr. Choi, a lack of modern medical equipment prevents early and accurate diagnosis of malaria, malnutrition and poor sanitation leave the population vulnerable, and the number of cases could explode after the floods that hit the north of the country this summer.

– Outdated communal toilets –

“North Korea still relies on an outdated communal outdoor toilet system. As a result, when there is a flood, fecal water overflows and all sorts of infectious diseases spread like wildfire,” Dr. Choi said.

Kim Dong-gun, a professor of environmental biology, uses tweezers to sort mosquitoes collected in his lab at Sahmyook University in Seoul on July 24, 2024 in South Korea © AFP – ANTHONY WALLACE

Over the past decade, 90% of South Koreans with malaria have been infected near the DMZ, according to official figures.

Shin Seo-a, 36, contracted malaria in 2022 and does not remember a single mosquito bite.

“I felt like I was being fried in a really hot pan,” she said, describing the unbearable pain and high fever. “I even begged a nurse to knock me out.”

Malaria in the Korean Peninsula is caused by the parasite Plasmodium Vivax, which is said to be less deadly than the Plasmodium Falciparum that is widespread in Africa.

But after malaria, Ms. Shin still contracted non-tuberculous mycobacterium, a lung infection that typically strikes people with weakened immune systems.

A mesh bag, used by the Korea Disease Control and Prevention Agency (KDCA) to trap mosquitoes, placed in a mosquito tracking device at Dorasan Peace Park in Paju, near the fortified border between North Korea and South Korea. South, July 30, 2024 © AFP – ANTHONY WALLACE

“Malaria is truly a terrifying disease,” she says, hoping efforts will be made to eliminate it from her country.

But with North Korea declaring the South its “main enemy,” cutting off all contact with Seoul and repeatedly rejecting offers of foreign humanitarian aid, the prospect of cooperation to eradicate malaria seems remote.

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