Hidden away and forgotten: in South Korea, coronavirus emergency sheds light on how the old, disabled and mentally ill are treated
- South Korea is scrambling to contain a coronavirus outbreak that has infected more than 7,700 people and killed 60 in recent weeks
- A hospital psychiatric ward where seven of the deaths occurred has raised alarm, as details have emerged about how patients have there lived for decades
If it were not for the notoriety of the killer that claimed his life, the 63-year-old man’s death at a rural hospital in South Korea may have gone unnoticed.
After two decades confined to a psychiatric ward, he had no known family, friends or other ties to the outside world – no one to be notified, no one to mourn or claim his ashes. At little more than 40kg (90 pounds) at the time of his passing, the man, whose name has not been disclosed, barely took up any space in this world.
Six others who had been housed alongside him at the psychiatric ward at the private Daenam Hospital in Cheongdo in southeast South Korea, all in their 50s and 60s, also died within days. Out of 102 patients held in the psychiatric ward, 100 had contracted the deadly virus.
People are telling me they haven’t felt this frightened or endangered since the Korean war
Authorities have not determined how the virus made its way into the locked ward, but once it got there, it found easy prey in patients with weakened immune systems living together at close, poorly ventilated quarters.
As South Korea has scrambled to contain a surge of infections that has topped 7,755 and killed 60 in recent weeks, the virus has in particular seeped into the spaces where society’s most frail – the elderly, the mentally ill, the disabled – are gathered or institutionalised.
The virus overtook a group home for the disabled in the small southeastern town of Chilgok, infecting a third of its 69 residents and staff, then another in the nearby city of Daegu, the country’s fourth largest city. Pockets of infections were discovered at convalescent hospitals and at nursing homes for the elderly in Gyeongsan, Bonghwa and Cheongdo.
Elderly-care centres across the country abruptly shut their doors after three of those who frequent one such centre in downtown Seoul tested positive for the virus. They had eaten at its cafeteria and interacted at the centre, a public facility where many senior citizens take regular classes and spend their days.
It is a similar threat to that dawning on the United States, where an unfolding outbreak at a nursing home in a Seattle suburb has killed 19 and infected dozens of others. Nursing homes across the US and the millions who live in them, as well as their relatives, are on edge.
The elderly and those with underlying conditions are particularly vulnerable to the virus, which has killed more than 4,000 worldwide and spread to more than 110,000 people in more than 100 countries.
In China, where the vast majority of the deaths have occurred, doctors reported fatality rates of nearly 15 per cent for those 80 years of age or older, compared to 2.3 per cent overall. Those with existing heart disease, diabetes or respiratory problems have also been several times more likely to die.
Facilities and institutions where the already weakened are living in close quarters are ideal breeding grounds for pathogens in the best of times. But calamities have a way of further exposing a society’s fault lines.
The current outbreak raging across South Korea, some say, is an overdue wake-up call casting light on the country’s reliance on institutionalisation as a way of caring for its most vulnerable, and forcing a reckoning on the conditions in which they are housed.
“It’s not the virus that’s cruel to the weak,” a South Korean newspaper said last week. “It’s our society, civic groups say, that’s shoved them into isolated environments ideal for the virus to thrive.”
The psychiatric ward in the hospital where seven have died and nearly all patients have been infected has raised alarm, as photos and details emerged about how patients have lived for decades with little prospect of healing or leaving.
A task force of physicians at South Korea’s National Medical Centre overseeing the response to the outbreak said the ward had no beds, the patients spending most of their days on thin futons on the floor.
Many of the patients were found to be malnourished, had issues with hygiene, and atrophied muscles from rarely, if ever, having left the hospital for a decade or two, the task force reported last week.
Making matters worse, ventilation was dismal because windows were sealed to prevent suicides.
“It was characteristically a condition for the virus to rapidly spread once it got in,” Lee So-hee, head of psychiatry at the National Medical Centre, said. “Conditions at Cheongdo Daenam Hospital were particularly bad.”
As the extent of the outbreak became apparent, an alliance of advocates for the disabled lodged a petition with the National Human Rights Commission of Korea decrying conditions, saying other locked facilities housing the sick, disabled and mentally ill were themselves ticking time bombs. There were more than 1,500 group homes for the disabled in South Korea as of 2018.
“We need to examine society’s abuse in having branded the mentally disabled as dangerous and locked them up en masse,” the group Solidarity against Disability Discrimination said. “We pray for the deceased, who were only freed of the locked ward in death.”
Those who work with South Korea’s rapidly increasing elderly population – the fastest growing in the world – were also on high alert as infections in the country spiked. Of the fatalities, more than 80 per cent were at least 60 years old.
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Authorities this week discovered a cluster of more than 50 patients and staff infected with the coronavirus at a convalescent hospital in Bonghwa County, a mountainous area in the east of South Korea. The average age of the infected, many of whom are seriously ill – although none have died – is 88.
Chun Yong-man, president of the Korea Association of Senior Welfare Centres, said many of South Korea’s elderly are warehoused in convalescent hospitals focused on medical treatment rather than in nursing homes centred around quality of life. Those hospitals are less regulated and understaffed, making them especially vulnerable to a situation such as the coronavirus epidemic, he said.
“Of course, the care is inadequate and they’re vulnerable to the dangers of a virus like this,” he said. “We’re all on edge.”
Kim Dong-bae, professor emeritus of social work at Yonsei University, said many of South Korea’s elderly were probably suffering from an information gap, being less able to navigate the internet and social media for accurate information about how to keep safe.
“People are telling me they haven’t felt this frightened or endangered since the Korean war,” said Kim, who is 70.
At Seoul’s Jongmyo Park, the usual crowds of elderly people milling about for company, free meals and games of Go had thinned out, but not disappeared. Signs taped to a wall and a pathway said Go games were banned indefinitely as a coronavirus prevention measure; regardless, a half-dozen games were in full swing nearby.
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Kim Young-bae, 84, wearing a flat cap and face mask and enjoying the afternoon sun on a bench in the park, was unfazed. He remembered a time after the war when an illness would hit a village and dozens would die at a time, so much so there wasn’t enough cloth to wrap the bodies.
His wife is refusing to leave their home, terrified of the virus, he said. She has stopped going to the daytime discotheque that is a popular pastime for old people.
“Does it matter whether you die locked up in your home, or walking around?” he asked. “Whenever it is, we all go some time.”
