August Rush: Voice in the Wilderness

I eventually had to stop applying for English teaching jobs – at least temporarily. After several days of problems mid-August I’d ended up with a sore throat so bad that it somehow managed to spread as far as my shoulders. That was a new experience. After two hospital visits where I’d been unsuccessfully treated for some kind of chest infection, I went to a specialist ENT hospital to be quickly diagnosed with tonsillitis, and it wasn’t long before I had a second opinion from another specialist confirming this.

I lost my voice almost completely just three days after my web development job interview, and I really don’t know how I managed to get through that in the first place. I was really under the weather around that time, but I don’t think it particularly impacted my unsuccessful interview, which I think I largely failed on my own merits.

Still, it’s no fun being in an interview thinking that you’d talk more if you felt you were physically able to. I’d gone to the local pharmacist with the notion of buying something to get me through it but the best she could offer were some kind of cough sweets that I’d had before and lack the edge necessary to actually do anything. This seems to be a bit of an underlying theme with me in Korea – the kind of powerful over-the-counter medications we get in England either aren’t available here or actually seem to be illegal (like ‘Vicks’ for example, which I’ve gathered is banned in Korea as well as Japan). Maybe the medical profession just wants you to go to the hospital instead, but it's a pity.

My voice came back and then went again the next week, so I had to accept that not only was I not getting better, but also that it was clearly absurd to be trying to get interviews for teaching jobs when there seemed no prospect of being able to speak at them, unless I could pioneer an entirely new category of occupation here – that of the English-teaching mime. And just to put the icing on the cake, the many medications I was put on caused such intense drowsiness I was even unable to stay awake at my desk. Not that they warned me I’d be practically losing consciousness when I took them – it needed a visit to another pharmacist armed with the pills for them to confirm that yes, in fact that might happen.

But I was not a good patient, and not just because of the language barrier. I heard the same phrase from each doctor - “the most important thing you can do is rest”. In Korea. Right. Seriously. It isn’t that kind of culture here and I’m not sure Koreans even know how to. And in that respect, I’m just like them – perhaps I’ve found my spiritual home.

A further complication arose when my ENT doctor went away for a conference. I don’t know what it is about Korean doctors, but they often seem to be away from their jobs, on holiday, stuck in traffic, or on strike. Maybe I’m just unlucky but I seem to be forever hospital-hopping these days, although at least Korea is a country which actively supports that. Perhaps it has to.

So I finished up in a rather dingy little clinic with a singular aged doctor - but my wife assured me that he was ‘famous’ locally, which is presumably why he didn’t feel the need to trouble himself with details like décor and the customary young women on reception, instead apparently opting to employ their mother, who also transpired to double up as the ass-injection nurse. But by this time I didn’t really care about the image of the place because I was beginning to think my tonsils and I were not destined to be ending the year together.

The old doctor did give me some new pills - and they seemed to work more effectively than anything I'd had before. A few days later, my sore throat returned and voice went again, but this time, as it's the Chuseok holiday period, I'm just going to have to live with it. Hospitals everywhere, but no cure in sight.

Busan e-FM Week 17: Health

About 'Open Mike in Busan'

Introduction

Sometimes it feels like I’ve visited a lot of hospitals and dentists while I’ve been here, so today I’m talking about some of my health-related experiences in Korea.

The first hospital by comparison

My first experience was only two weeks after coming here, but it was for my brother-in-law, not me. He wasn’t feeling well, so we decided to take him to a hospital. That was a big surprise in itself, because in England you have to phone for an appointment with your doctor, and then you maybe get one with seven days. So often you think there’s no point, because by the time you see the doctor, you’ll probably be feeling better, whereas in Korea you just go straight there. I know Koreans must take this for granted, but for me it was amazing.

What’s more, British doctors have offices, but there’s generally nothing to treat you there – it isn’t a hospital. You might get a prescription for drugs, but if you need further diagnosis like an x-ray, or treatment, you’ll have to join a waiting list for an appointment at the main city hospital – which is like the large university or government hospitals in Korea. In other words, diagnosis and treatment can be a very slow process in England.

I wonder how quickly they diagnose Meniere’s Disease in Korea?

For example, I became really ill with attacks of dizziness and sickness in the UK six years ago, but I still waited a week for a doctor’s appointment. Then I got some pills for an ear infection I didn’t have, went back a month later and got some more pills, waited a couple of weeks for an x-ray, waited another couple of weeks for the results, and another week for the doctor’s appointment where he told me they couldn’t find anything and I should just wait and see if it got better or worse.

Two months later they agreed to send me for hearing and balance tests, two months after that I actually had those tests, and then I waited another two months for the results. Then I got tired of all this waiting around and paid around 500,000 won [~£282/$460] to see a specialist consultant privately for thirty minutes. He recommended an MRI to look for brain tumours – but because the cost of 1.3 million won [~£733/$1,200] I waited two months to have it done through the national health system [NHS] which was free, and then I waited a long six weeks for the results of that. The results were negative and so I had to wait another five weeks to see the consultant again, and that’s when I was finally diagnosed with Meniere’s Disease.

So it was thirteen months from my first Meniere’s attack in December 2004 to my diagnosis in January 2006. If it had been a brain tumour, the delay might have been the difference between life and death, which really makes you think how good the system is in Korea.

And here’s my first proof

When I developed neck pain a few months after arriving here, I went to a specialised local orthopaedic hospital. Five minutes after arriving I’d already had two x-rays, and five minutes later I was seeing an orthopaedic professor. So after ten minutes I was seeing the kind of professional it had taken me nine months to see in England. Fifteen minutes later I was starting treatment for the problem, and it was really cheap because the whole visit cost 32,000 won – even though I didn’t have national insurance at the time. It would have only been 13,200 if I had.

Treatment differences and a lingering question

The treatment was not really similar to the kind you get in England. I had massage pads put on me which left these large ugly bloody circles on my neck – I’ve never seen anything like that in England – and I even had acupuncture later. All the nurses gather to watch when that happened because they’d never seen a Westerner having acupuncture before. But actually, this was the easy option, because the doctor recommended physiotherapy and acupuncture as the second choice – the first was multiple neck injections and surgery. I wasn’t keen on that, and the doctor laughed because apparently Westerners never are.

I got better despite not opting for the surgery, so how necessary was it? I started off thinking that the Korean health system was great, but I began to see a downside, which is over-treatment – doing tests and getting treatment that maybe isn’t necessary.

In fact, I had more experience with this because I had some chest pains last year, and the professor I ended up seeing recommended a heart CT scan, but later I read that there’s a 1 in 600 chance of that procedure actually causing cancer, and personally I don’t like those odds. I know it’s a risk, but all the other tests seemed to say I was OK, so I decided the CT scan was a step too far. And I got better, so it probably was.

Actually, the interesting thing about that experience was that the professor spoke perfect English, so it was the first time I had a proper conversation about a problem rather than having everything translated through my wife. Language is a big problem when seeing doctors and dentists – it’s quite frustrating.

Dentists and the veneer begins to wear off

The dental system is bad in England as well; I used to have to book appointments up to two months in advance with my dentist. But you tend to have check-ups there every six months, whereas I gather that in Korea people often only go when they have a problem.

I found it’s more high-tech here, so there are screens above the chair where you can see your x-rays, or a video of the work being done, but I was a bit shocked at the lack of glove usage. When I went to the dentist here, I hadn’t expected to end up with a 20-something woman’s unprotected fingers deep in my mouth. And when they found a problem with an existing filling, they said it couldn’t be fixed and I had to have the tooth out. A second dentist said the same. But when I went back to England they fixed it and it’s still fine two years later, so even though treatment is much cheaper here, especially now I have private insurance, maybe you don’t always get better results.

Private insurance or signing your soul away

Even though medical costs seem relatively low here, I still bought private insurance, but it was very complicated to understand. The cost is about the same as in the UK, but I’m only paying for twenty years and then it’s supposed to all be free after that [i.e. pyramid-scheme alert], which sounds like a bad deal for the company. And when I agreed I had to sign around ten documents which were all in Korean and I didn’t understand what I was signing.

But on balance

Generally I’m a big fan of the Korean health system though. Treatment is fast and it’s relatively cheap [although not for everyone]. There are downsides – such as the potential for over-treatment, and the way doctors sometimes go on strike here, which never happens in England, or the way hospitals are closed for long periods over holidays such as Seollal. But I think if British people could experience this system we’d want to switch over to it in the UK immediately. I think it’s one of the best things about Korea, and as someone who’s had a couple of medical problems in the last few years – and now that I also have my son’s health to worry about as well – it’s one of the reasons I really like living here.

Links
Busan e-FM
Inside Out Busan

Air date: 2011-02-16 @ ~19:30

Busan e-FM Week 14: The Baby Experience

About 'Open Mike in Busan'

Introduction

Another important event in my life was the birth of my baby son four months ago. Actually, our plan to have a baby was one of the reasons we returned to Korea.

Hospitals

I though it would be better to have a baby in Korea rather than in England. We have our National Health Service, so the cost is very low, but sometimes the service is quite basic as well. Korea is more expensive, but there are many hospitals and treatment options to choose from. In the city I’m from there’s one really large city hospital which covers everything – including delivering babies – so this means if you choose to have your baby in a hospital rather than a home, that’s where you have to go, whereas in Korea our first task was to choose a hospital.

In a way it wasn’t a difficult choice. There are different options but we wanted to choose one close to our apartment because we don’t have a car, so that really limited our choice. Actually, one of the major differences between England and Korea is the 산후조리원 [sanhujoriwon] system – we don’t have that in my country, we just have midwives who visit new mothers regularly after they’ve given birth. In fact, I know Koreans find this a bit shocking, but the average length of stay in a British hospital for a woman who gives birth is just six hours. So when my wife wanted to stay in the 산후조리원 for two weeks, I was the one who was shocked.

And some more surprises

So at first I thought she’d give birth and come home shortly afterwards. If there are no complications that’s the way it works in England. It’s probably too short really, but then two weeks or more seems very long. Of course, then I learned how there’s a belief in Korea that women’s bodies are ‘shattered’ once they’ve given birth, and they are so delicate they aren’t even allowed to shower or bathe for a week because of the belief that it will leave them vulnerable to the cold in winter.

Looking back, I had a lot of surprises even before our son was born. Normally in England I think a woman only gets two ultrasounds during her pregnancy, if everything seems normal. Here, we went to the hospital every two or three weeks, and had an ultrasound scan every time. And every time they burned the scan to a DVD so we could watch it at home. At least, until about half-way through when the system changed – then they uploaded them to an Internet account instead. So the regular scans were a really positive difference.

Another big surprise was when my wife said “we have to choose whether we want to buy a stem cell package”. That’s not really common in England, so the whole process of going and meeting various stem cell companies at the BEXCO baby fair, and evaluating their packages, was not something I’d expected to be doing.

I didn’t cope well with the language barrier, and it was was of the most frustrating experiences I’ve had in Korea. My wife’s pregnancy didn’t go completely smoothly at first, so every time we saw the doctor I was really desperate to understand what he was saying, but of course, I couldn’t.

The birth

The birth itself was also quite different from what I expected. My wife’s water broke late on Saturday evening, so by the time we got to the maternity room it was 11pm. That’s when I realised that the problem with giving birth in a small hospital – especially at night at the weekend – is that there aren’t many staff around. In fact, until the doctor came at 4.25am, there was only one nurse on duty and that’s the only person we saw – the rest of the floor was deserted, whereas in a large British hospital there are hundreds of doctors, which means that if something unexpected happens, there’s always going to be an appropriate specialist around.

Of course I couldn’t understand what the nurse was talking about, but having said that, at one point towards the end – after the nurse had made a series of calls – I sure she was saying on the phone “where’s the doctor, where’s the doctor?” So it wasn’t a happy experience.

But in the end it all went relatively smoothly. Our son was born at 04.57am, and I cut the umbilical cord – that’s another thing I had to do in Korea that I wasn’t expecting.

No contact rules

Then, after 30 seconds with his mother, he was rushed off to the maternity unit, and that’s the last time she saw him for 24 hours, which also shocked me. And then – this is not so much shocking as annoying – they wouldn’t let me hold my son. I really wanted to hold him, but he’d been rushed off to the maternity unit and the hospital had a ‘no contact’ rule for fathers. When we asked when I could hold him they said “in two weeks when he comes home”. It was a bit upsetting really at the time. In fact, there were really limited visiting times, and when you went the staff would show you your baby for between two to five minutes, then that was it. So in the first two weeks I think I saw my son for a total of 50 minutes despite twice-daily visits to the hospital, and of course there was no physical contact.

So in some ways the hospital was really strict. But in other ways, not so much; they let photographers from an external company into the maternity unit – but just not fathers. In fact the hospital was a bit of a disaster anyway. I was just before Chuseok, so a lot of women had chosen to be induced over the holiday. The hospital had basically taken the business, but then didn’t really have much room for the mothers afterwards. And despite this they gave their cleaning staff the week off, so you can imagine – the place was like hell after a few days. In fact, the woman in the next room had a big plumbing problem in her bathroom, and when she complained to the hospital boss, rather than doing anything about it, he just gave her a tool to fix the problem herself, even though she’d just had an operation.

Baby naming

So we were glad to get home, but it’s not as though the problems stopped there. Then there was the whole baby naming business afterwards.

Naming a fusion baby can be a difficult issue. We decided to compromise by having a Korean first name, and my Western surname. I thought we might be able to choose the Korean name, and I had an idea about naming him after a famous Korean physicist because it’s something to aspire to. But then I learned that what usually happens, is the fortune tellers recommend a list based on the parents’ times of birth and the baby’s. We had to wait until after my wife had left the hospital to consult the fortune tellers – so for the first three weeks of his life he didn’t have a name, which to me seemed really odd.

So my son was named by a fortune teller in the end. A fortune teller my father-in-law knew gave us a recommendation, but it was only one name when I thought we’d have more choices. We went to another fortune teller and got another ten choices, but finally we chose the first one we’d been given. It was a hard process because I wanted it to be a name that would be easily pronounceable for my family back in England, and it had to sound right in English.

Of course, being a former police officer, my father-in-law knows some... interesting people. So I sort of jokingly asked – he’s not a former criminal is he? And sure enough, that is how my father-in-law knew him. So that’s how my son ended up being named by a convicted fraudster. I just have to hope he’s good at reading fortunes.

Links
Busan e-FM
Inside Out Busan

Air date: 2011-01-26 @ ~19:30

Poisoned

Korea has a lot of '빵집', or bakeries - so many in fact that one franchise owner recently felt motivated to go to extraordinary lengths to fight back against a rival located nearby.

It wasn't 'rat bread' that finally gave me my first bout of food poisoning in Korea, but it was bread-related. Korean Mother brought home a bag of various products from a nearby shop. When she does this it usually sets of a frenzy of bread-eating for a couple of days, not particularly because of some desperate desire to eat more Westernised food on my part, but more because she buys so much of it that it's very easy for some of it to go to waste otherwise.

I find the products available in Korean bakeries a constant source of interest - they regularly change and are always inventive. In England, no-one would think to bake peas into an otherwise sickly sweet cream cake, or put tomatoes on top of a birthday cake, but in their apparent never-ending battle to push the boundaries of something new, these are just some of the surprising innovations brought to you by the local bread and pastry researchers here.

The problem with Korean Mother bringing bakery products home with her, aside from the sheer quantity, is the identification issue. Namely, that the products are often placed in anonymous bags which renders the contents on the product contained within a mystery. Usually though, it's fair to bet that anything which seems to be savoury and have contents will have some variation of vegetables, crab and darker mystery-meat.

So when I decided to heat up one of those doughy products with its mystery contents, I thought little of it. But I became sick shortly afterwards, which was surprising because if anything I'd overcooked it due to lingering at my trading desk for a little too long while the microwave was on. That's just the way it goes sometimes, I figured.

What I'd forgotten about in the subsequent fog of illness which enveloped me was that after eating it I'd followed it with half of some sweet bread, which I'd also heated up - though not so much. When I returned to complete the second half of the latter product the morning after I got better, I discovered - with the advantage of daylight - that mixed in with the sweet bean paste and slightly sugary coating were small bits of meat, which I'd merely heated up to room temperature the night I became ill.

Sometimes my struggles with the contents of our fridge and food cupboards come down to my failure to understand the Korean language, but getting food poisoning from a bread-based product has made me realise that there are some things in Korea which are always going to exist to challenge me... although I should also know better by now than to eat my food in the dark here.

They Shoot Horses, Don't They?

When you reach a certain age the Korean Government start to write to you inviting you into a hospital of your choice for an annual medical, which helpfully serves as a reminder that you might have more years behind you than ahead. Generally, it seems like a good thing, because in England people are encouraged to get sick or die before visiting a medical professional; the public health service long since discovered that the longer it can avoid treating sick people, the greater the chance of them expiring before expensive drugs and care need to be employed. In Korea, the Government seems to want to prevent you getting seriously ill in the first place, and I'm sure the private health insurance industry here is grateful for that.

The trip to the hospital got off to a worrying start after discovering an ambulance parked at the entrance bearing the legend “Pusan Mental Hospital”. Just the day before, I'd read about a new law that allegedly enabled the Government to detain foreigners without trial on mental health grounds, in an article which ended with the words of a Korean wife saying "Now I can trick my non-Korean speaking husband into attending the hospital on some pretext, explain some of his habits to the doctors, and get rid of him." Worrying.

Given that the article is a satire, or at least I hope it is because the original news story leaves some room for doubt, I took this as proof that my life may now finally be approaching the point of maximum absurdity it's possible to reach as a private citizen without becoming a government employee. Five minutes later we were filling in the psyche questionnaire.

How many times a week do I get depressed? How many times a week am I sad? Why does the answer scale only go up to four? “Looks like you might be going to see a psychiatrist” quips my wife as she ticks several numerically high boxes. Thanks. Helpful. I don't know, isn't this normal for a foreigner living in Korea? Well, maybe it isn't, but I have no reference point. But I didn't get referred to a psychiatrist, so maybe it is. Or maybe they don't care, I certainly don't – that's the advantage of feeling down that all those happy people don't want to talk about.

So do I want to have a camera stuck down my throat? No... why would I? Honestly, I know network television in South Korea is so apparently awful that even the North Koreans find it stereotypical these days, but what lengths will medical staff go to just to entertain themselves in front of a TV? The procedure requires me to be heavily sedated or unconscious anyway, and I weigh up the obvious advantages of this versus the inherent risks and decide against it. I'll do it when I actually think I have a problem I thought, slipping into exactly the kind of sociological conditioning the British National Health Service works so hard to cultivate. “Yes,” says the nurse detecting my internal dialogue, “I can see that while you're physically ready for it, you're not mentally ready for it”. I don't even know what that means. What does that mean?

Now comes the really hard sell. So my blood is going be tested for thirteen different problems. Would I like to pay extra and be tested for seventy problems instead? It's only 30,000 won extra. This is how it begins. You can even pay extra to receive a forecast for future medical problems based on a range of additional tests, questionnaires and the hospital computer's random number generator. Or you can visit a fortune teller, because it might be cheaper. Buy into enough extra tests and the one problem they are guaranteed to detect is that you are haemorrhaging money. But I paid for the extra blood tests, because I'm intrigued to know the answer to test number 67 – 'percentage of banana concentrate in blood'.

An x-ray to top-up my Korean half-life, an ultrasound to see if I'm still generally sound, an ECG to test my short-circuits, and we're done. As we walk up the stairs from the dungeon of devices, I reflect on the fact that I'm clearly in much better shape than the hospital building, which is six months old and features an alarmingly large crack running down its side.

When we leave they forget to ask us to pay, resulting in two nurses chasing after us outside the building. Perhaps their unwillingness to wait a few days for my return appointment may not bode well for the test results after all.

Multiplicity

A few weeks ago I ran into problems registering my son's name with the local district office, and I said it wasn't likely to be the last time having a multicultural child was going to cause problems in Korea. Well I didn't have to wait long for the next issue to raise its head – our son's health insurance bills have arrived and because his Irish surname takes up four Korean character spaces (it's four Western syllables), there was only one character space for his first name rather than two – so he's lost the last syllable of his name. I should have seen this coming because – with my middle name - only the first syllable of my surname appears on my health registration – and this is how I get called out in the hospitals.

This can't be good because when it comes to dealing with officialdom in any country – and I know Korea isn't different – it's quite important to maintain a consistent identity across systems otherwise computers and bureaucrats start to insist that you are not the same person. And when computers start thinking you are different people, the complications can just multiply. Since my son is more Korean than I am – and he'll have to grow up here - I see how it could be a particularly irritating problem for him.

My wife was not confident of our ability to get them to add the extra syllable to his first name, and neither was I because I kind of knew deep down – speaking as an ex-software designer myself - that some incompetent Korean software designer (I'm beginning to wonder if there is really any other kind) decided there was going to be a five-character limit in the database. Because, you know, Koreans don't have such long names and who else would ever be registered in the Korean health system except people with Korean names? Right? (For more on the Korean IT mentality - read this).

I found my wife's initial reaction very telling - “I feel bad now about giving him a strange name”. And that is the wrong answer. Your first reaction is supposed to be righteous indignation, otherwise you've fallen into their trap.

Korea keeps saying it welcomes a multicultural society so I think it would be better if they started planning for it rather than mysteriously thinking that Korea's future multicultural society will consist of people from lots of different countries all pretending they are Korean. Or does Korea really think all the foreigners are going to change their surnames to Kim? Don't answer that – they probably do.

The Hornet's Nest

Apparently Namhae has killer bees. Or something like that.

Korean Father was out very early in the morning on top of an isolated mountain mowing the grass around his mother's grave, during the last days of the summer's heat. It has to be done otherwise it would become unkempt and that would be disrespectful, and since graveyards in Korea are generally small and don't employ anyone to maintain them, it's a family responsibility. The graves of those with no nearby or surviving relatives can often easily be spotted as isolated patches of chaos in an otherwise ordered scene.

This particular morning Korean Father was stung three times by large hornets. It seems that this is OK as long as they don't get you in the head. Then you die. Really. In fact I understand that earlier this year a forty-two year old farmer died in Namhae after this happened to him, and there have been other deaths and incidents. The fourth sting caught Korean Father right between the eyes. His right eye began to lose focus, his lips numbed, he started to lose movement in his jaw, and his arms and legs weakened. He called a friend who's the head of a health clinic, and he phoned for an ambulance, which had to negotiate its way to the top of the mountain Korean Father had walked up. Fortunately there is a road, of sorts, although it's one of those Korean ones you really don't want to look down over the side of.

Fortunately with rapid treatment Korean Father quickly recovered, unlike some other unfortunate victims, although his face was still swollen days later.

Before city dwellers lull themselves into a false sense of security, according to the JoongAng Daily the Busan Fire Department had to administer first aid to 145 people this year, so clearly it's not an issue just confined to the countryside. And while we have a lot of bees and wasps (hornets) where I'm from, they pale in comparison to the Asian Giant Hornet, which grows up to two inches (50mm) in length, and injects a venom so strong it can dissolve human tissue.

So it seems like this is an important safety tip, beware of Korea's killer hornets...

When the Smoke Clears

I really don't like mosquitoes, the dreaded Korean 'mogi'. Recently I related some of my mogi-chasing stories to someone here and she seemed to think it was more amusing than I did. When I got home, I asked my wife, "what's so funny about that?" She told me that Korean people don't usually bother enough about mosquitoes to spend an hour out of bed in the middle of the night chasing one with a newspaper. OK, that's fair enough, I may be a little crazy. But look at it this way - I'm a completer-finisher*. (*I wish - I'm actually a dangerously high scoring 'shaper').

But am I crazy enough to want to run trucks around crowded streets spraying insecticide at everyone? No - so who are the crazy ones now?

I didn't see this the first time I was here, but this summer one day I noticed a cloud of smoke in the distance. My first thought - that some old Hyundai Accent had finally reached its expiry point - proved incorrect.

It was, I was told, mosquito spraying. I'd heard about this, but thought it was a practice largely consigned to the past. Apparently not, it seemed, as the scene was repeated every couple of weeks thereafter.

It didn't look very healthy either, as the truck in our area dashed around the narrow streets spewing a chemical cloud behind it leaving people nowhere to hide.

Obviously, the insecticide is designed to kill mosquitoes rather than people, but I can't help thinking that it can't be particularly healthy, even if it won't kill you. And will this chemical concoction still be seen as safe in future? There was a time when people thought DDT was fine too.

But what I didn't expect, was to see one of these chemical spraying trucks do a circuit of the local school ground every two weeks, enveloping the children practising football in thick clouds of insecticide.



But perhaps this means if the Korean national team ever have to play a game in fog, they're bound to win.

Maybe it doesn't cause any lasting damage though. My wife used to run through the smoke chasing the trucks down the street because she said it was fun. That was when she was a child by the way, not recently - which would be more disturbing.

Now I'm a parent though, I watch that mosquito truck making its regular rounds of the local school, and think one day that could be my child enveloped in a chemical soup. I'm not really thrilled at the idea.

But does it work? Well, this summer was amazing for three months - I didn't see a single mosquito. But just as I was contemplating the notion that actually, it really does work, I read that the unusual weather this year meant that mosquito numbers were down significantly. However, as the autumn arrived they emerged with a vengeance. The mogi-trucks are still doing their rounds, I suppose they would argue that it would be worse if they didn't. But how can we know?

Horror Hospital

Recently I wrote about some of the problems my wife and I had experienced with the maternity hospital we were in, but things were going to turn out to be worse for other people in what seemed to me like a perfect storm of Korean cultural issues.

The first aspect of Korean culture which differs from my own country lies in the fundamental nature of the birth experience itself. In Korea, women can – within a period of around four weeks - choose when to give birth; they pick a date and then report to the hospital to be induced or – if this is their preferred option, to have a caesarian section to deliver the baby. Now add to this ability to schedule a birth to the Korean thanksgiving holiday of Chuseok, one of those extremely rare times of the year when family might not be out working 12-hours a day, apparently making it a good time to schedule said birth. Next add in the near total contempt some business owners demonstrate for their customers in Korea, nurtured through a pathological pursuit of profit that might even make a financial trader blush. Add a little of the legendary local construction quality on top, and mix all these things together to achieve predictable results.

So this is what happened. A large number of women checked themselves in to have their babies during the Chuseok holiday, and it was probably double what the hospital could cope with. Normally, the recovery area of the maternity hospital, the 'sanhujoriwon' (산후조리원), takes up three floors – over Chuseok, the hospital expanded it to six by commandeering other floors which were not designed for the purpose. Whereas my wife's room was solely for her with en-suite, a desk, a TV and double bed for the husband to sleep in, the Chuseok mothers ended up in shared rooms with four beds and little else. That makes it no better than a bad British experience, and possibly worse because the already seemingly understaffed Korean hospital had not employed extra personnel for the holiday rush. Crucially for the people here though, this was not what they are accustomed to expecting, and it certainly wasn't what they were sold in the brochure.

And it gets worse. I said the hospital hadn't employed any extra staff, but in fact they'd gone the other way. The cleaning staff had the week off. So you have these new mothers, packed into rooms kept at abnormally high temperatures because of the belief here that this is better for their 'shattered' bodies, there's a lot of sweating and a lot of clothes going in the hospital wash baskets. But now nobody is around to clean them, piles of smelly clothes are building up in the corridors, and mothers are running out of clean clothes to wear. You can imagine the situation with bedding, bearing in mind that many of these women have undergone operations or procedures and were still bleeding.

And then there was the woman in the room next to us. Like my wife, she had been lucky enough to have her baby just before Chuseok, so she had a room to herself as she was supposed to. But the bathroom had a drainage problem. It was fitted incorrectly with the drainage grate too high, so after showering water would just collect creating an indoor pool. The room isn't exactly new so presumably it's been like this since it was built two or three years ago. She complained to the Sanhujoriwon Director - he offered her a small tool to push the water uphill into the pipe. She'd just given birth and could hardly walk, but the Samhujoriwon Director apparently thought nothing of her bending over pushing water around the floor. She protested.

Was he embarrassed? Afraid? His response was “If you don't like it, I have plenty of other women who would gladly have your room.” And sadly he was probably right, because when you're packed into a small room with three other women with no facilities whatsoever, you'd certainly see a single room with an inch of standing water in the bathroom as an upgrade. This is not really a good excuse, and it reminds me of the time I found a long black hair baked into my pizza at an expensive restaurant in Busan, and when we complained, the manager looked at us incredulously and said “well, it's only one.” On the face of it, Korea often seems to have a positive customer service culture – but perhaps only because they want to sell you something – once the transactions is done, attitudes can rapidly change – not always, but often enough to make you feel like you're stepping into a minefield every time.

It must have been bad because the husbands got unionised and all went to see the Hospital Director to complain, and by this time you can probably guess how that went. 'If you don't like my hospital, pick another!' I understand that a private Internet forum for mothers in Busan is now buzzing with anger about it, so word of mouth may at least provide a little karmic retribution.

Given the appalling conditions in the lower decks it almost seems churlish to mention another area in which the experience fell below expectations, but I will for completeness. The 'samhujoriwon' experience is about recovery and education, with mothers attending various classes to help them transition from hospital to coping on their own with their babies. There were no classes during Chuseok which meant that of the ten days of activities promised, many women only got seven. It's understandable that this is just bad luck and while I would expect cleaning to continue during the holiday, educational classes are a bit much to ask for. But there certainly won't be any refunds for the women who were short changed in this and other ways during the holidays. By this time, I couldn't say I was surprised.

Can I name and shame the hospital here? Sadly, probably not. The way things seem to work here is that criticising companies in public can easily lead to lawsuits. And in a nutshell, this tells you a lot about reason why the Hospital Director all but laughed in the faces of his patients and their families.

The problems I detail above effected others far more than they effected my wife. We were lucky – if you can call it luck - to have our own room away from some of the horrors. But I asked my wife, in principle rather than with intention, what could we have done to formally complain about the hospital had we suffered like some others had suffered. I was curious. She really wasn't sure, because often it seems people really don't ask those kind of questions here. I had an idea that ultimately, hospitals had to be licensed, and medical companies that ask new mothers to crawl around the bathroom floors of understaffed hospitals in dirty clothes are probably not what the government have in mind when handing out those licenses. So one imagines there must be some mechanism for calling people who run institutions like this to account. But it's not really my problem and it's a given that the Koreans who suffered won't take action either. Nothing will change. Meanwhile the Korean Government will keep talking about their desire to promote medical tourism to Korea within the Asian region, with discounts for properly qualified plumbers, presumably.

Access Denied

Twenty minutes after my son was born, I was finally able to take my first picture of him... through the glass partition of the 'Baby Center'. But that was more than my wife, who despite being awake wasn't able to see him again until 4pm Sunday afternoon - eleven hours after the birth.

I said a mistake was made in those precious few seconds after his birth, and it was that my wife handed our baby back to the impatient staff at their beckoning, and not to me. I would have liked to have held him. But they wanted to take him away and clean him up. It didn't seem unreasonable and I didn't think it was going to have the consequences it did.

Holding the Baby

My only question after taking that first photo was when could I hold my son. The answer wasn't clear, but it certainly became clear over the next 24-hours. I couldn't. The staff were determined in their inflexibility, and I was completely mystified. I couldn't really conceptualise the notion that the staff could refuse me access to my child when both I and my wife wanted me to have that moment. Even though living here has conditioned me to live with the sometimes bizarre cultural mores such as fan death, which people doggedly believe in despite any rational argument to the contrary, this was probably the most surprising cultural difference I'd ever encountered.

When my wife felt better she tackled the staff about the subject. When could I hold my baby for the first time? "In two weeks when you go home." was the rather curt response. And there you have it. The first physical contact I will have with my son won't be for another ten days.

Five Days, 30 Minutes

The visiting times don't help. There are two one-hour visiting sessions and one which lasts 30 minutes at the 'Baby Center'. But that doesn't tell the whole story. What happens is you go, and they place your baby in a crib behind the glass partition, often for around two to three minutes. So five days after the birth I've spent less than half-an-hour with my baby, and of course what I have had has been through that glass partition. Before the birth I didn't know how I'd feel about becoming a father. And now I still don't know, because I don't really feel like one.

Germs and Hygiene

Their reasoning is germs. Fathers are not allowed access to their babies because of germs. I thought this was a little hypocritical of the hospital judging from what I saw of their hygiene standards when my son was born. It didn't really seem to stand up to much rational scrutiny either. Medical staff and mothers were coming in and out of the 'Baby Center' all the time, and they had to put on a gown and wash their hands. I didn't understand why fathers couldn't do the same.

It's also hard to take quite so seriously when you consider that until a few months ago - after we'd chosen this hospital - babies were allowed to stay in the rooms where mothers recuperate for two-to-four weeks after the birth, often with their husbands who stayed with them.

Bubble Boy

If my baby's isolation is rather questionable, mine seems more real. I'm unable to express anything beyond simple concepts in Korean so I have no ability to explain exactly how I feel to any of the medical staff. I know in reality I have no hope of convincing them to change their mind - whatever I have to say about Attachment Theory, my emotional position or basic human rights - but it would at least be a comfort if I could register that intellectual disapproval. I can't and that just adds to my sense of powerlessness.

The truth is that much of my life in Korea comes down to battling the sense of worthlessness which can easily arise from people constantly discussing issues concerning me, and sometimes in front of me, without my input. To an extent that's an inevitable consequence created by the language barrier, but it doesn't make me feel any better. It seems that being dismissed as a non-participant is also the modus operandi at the hospital, except it amplifies my existing sense of living apart from the society I'm supposed to be participating in. The glass wall which divides my son and I serves as a metaphor for my wider experience in Korea.

I feel I've missed out on something important because those first few hours and days are gone now. So to my mind the hospital have taken something from me which I'll never get back. And if anything were to happen without me ever having any physical contact with him I think it would be even more difficult to deal with.

That said, I think I'm getting to a point now where I've gone through disbelief and anger and am arriving at apathy. I'm resigned to not having any real contact with my son until the end of the month. What else can I do? The increasing sense of apathy is better for me than the anger I had before, but I do wonder what a psychologist would make of it - it may not be a healthy emotional start to the bonding process.

Primer

When we signed up this wasn't how the hospital operated and they never said "by the way, we've changed the deal". Once my wife had given birth, and realised they'd changed the way they operated. it wasn't a realistic option to change hospitals so we were stuck with it. I suppose you could argue that it's a breach of contract, but this being Korea there's little to be done about it; consumer rights are comparatively weak here and the law certainly gives the impression of favouring its corporate paymasters. Welcome to Chaebol Country.

If I could go back in time I'd do it differently. So my advice to anyone who finds themselves potentially heading towards the same situation as me here is to think very carefully about what you want out of the experience, and how it's likely to unfold. I wish I'd held my son after he was born and I lost that chance for two weeks. But ultimately it's about more than that. Visiting times are extremely short, my wife doesn't see her baby except when she feeds him which I don't think is emotionally healthy, there may be a worrying lack of emergency backup, and hygiene standards seem questionable at best.

Not all Korean hospitals are going to operate the same way or be the same. Next time - if there is a next time - things have to be different.

Baby

Five days ago my wife gave birth to our first child, a boy. Over the last couple of years, we'd talked about whether it was better to have a baby in England or Korea. I've always been impressed with the Korean health system - yes, it costs money, but it is fast and efficient in comparison to the slow lumbering bureaucracy of the British National Health Service. Korea seemed to be the clear winner. Now I'm no longer sure. I want to document my experience here as a possibly cautionary tale for other people who find themselves in the same position. Had I known a few months ago what I know now, things may have worked out differently.

I'm splitting what I have to say into the before and after - a tale of two halves if you will, and then there may be quite a lot of post-match analysis, so if you don't want to know the result, look away now.

She's Having a Baby

My wife's water broke at 9.35pm on Saturday evening. The hospital said she had time for a shower before checking in. That's important because Koreans firmly believe that women can not take a shower or bath for a week or more after giving birth otherwise it will damage their health for life - after giving birth Korean people's bones are 'brittle'.

An hour later we arrived at the hospital. It's not a huge state-run complex of buildings as you would expect to find in the UK, but rather eleven stories of a very small office block situated on a major road. Like most Korean hospitals, it's specialised - in this case, as a maternity hospital. When we reached the delivery floor, we stepped out of the elevator into a small empty waiting area. I soon discovered that the entire floor was being staffed by one nurse, although since there was only another patient there, who was busy screaming in agony, perhaps that was the appropriate staffing level. The nurse split her time between checking us in and disappearing into the first delivery room to admonish the woman for her behaviour. Really.

Korean Mother was with us, and she went down on the forms as the next-of-kin. My inability to communicate at the level of Korean necessary to deal with a medical emergency made it necessary, but that was to prove only the first of a series of unhappy experiences during the next few hours.

The Red Gloves

The unseen woman gave birth and the baby cried for around a minute before silence descended on the otherwise unoccupied delivery floor. Retrospectively, I see now I should have seen that as a clue, but my head was full of other thoughts. We were in the next door delivery room by now with my wife lying on the bed. The nurse entered with heavily bloodied surgical gloves and much to my shock began adjusting my wife's bed and bedding. Korean hospitals have always seemed to have good hygiene standards so this wasn't what I expected at all. It turned out my wife was already 30% dilated so we were told the baby was likely to come by the morning.

I suppose the room wasn't quite what I expected either. It was very cramped - only wide enough for one person to stand on either side of the bed - and it didn't fit my possibly wrong image of the clinically clean environment I'd expected. It was really just a room, with some rather dingy circa-1970s wallpaper.

I'd chosen to be present in the room during my wife's birth. I don't think this is really negotiable for British people and it would be very unusual if you didn't want to be. I got the impression that Korean men are not so enthusiastic about the idea, and I was told the husband of our neighbour stayed outside for the big moment. But again, the reality was different from my expectations. Korean Mother and I were regularly told to leave by the nurse and the pedometer that I wore eventually told me I'd walked over a kilometre in the corridor outside, partly out of frustration and partly just to keep myself awake. Korean Mother took to crouching by the entrance to the curtain-off delivery room chanting Buddhist mantras over and over.

The Wreck of the Mary Celeste

It was while I was pacing up and down the narrow and claustrophobic corridor of the Mary Celeste Maternity Hospital that I finally started looking at the crib positioned near to the door of my wife's delivery room. A green blanket sat in it and it was stained with blood and other bodily fluids. Another equally stained blanket lay underneath it. I suppose the hospital would argue that they were perfectly clean despite their appearances, but I was so surprised I took a photo of it. Unfortunately, I'd left my DSLR in the maternity room and was only carrying my compact digital camera, which I discovered had developed a fault preventing me from altering its settings, so the noisy picture didn't do the reality of it justice. Anyway, I was rather surprised, and not in a good way.

My wife was determined not to be a screamer so only moaned occasionally, but even after two epidurals she was in considerable pain by 3.30am, which is when apparently to her great surprise the nurse discovered that my wife was 80% dilated, suddenly moving the expected time of arrival up a number of hours. The nurse had now been the only person we'd seen since arriving five hours earlier, but she began making phone calls to a doctor, giving me some comfort that we really weren't the only people in the entire building. But lingering questions remained in my mind - if there was an emergency, how equipped was a small hospital like this to cope with it? How long would it take a crash team to get here? Did they even have one? No, say what you like about British hospitals, at least you probably have every conceivable specialist to hand if there's a problem. I began to think a larger Korean hospital might have been a better plan.

Push Pull

Within half an hour the nurse was giving instructions to push but there was still no sign of the doctor despite a series of phone calls. In my mind I'd editorialised them as increasingly urgent pleas of 'where are you?', but perhaps it wasn't.

Twenty minutes later the nurse, whose attendance throughout the night had been sporadic despite the theoretical one-to-one ratio of nursing care, disappeared, leaving Korean Mother to work with her daughter on the pushing. When the nurse returned, with the doctor, a second nurse, and a large vacuum pump in tow, we were bundled out of the room. I discovered later that the baby had been judged to be stuck, but my language isolation prevented me from understanding what was happening and Korean Mother didn't appear to know either. Her Buddhist chanting became louder which I didn't take as a particularly positive sign. It was a critical time in the delivery, and we were kept outside for twenty minutes, but they hadn't properly closed the curtain to the room, so occasionally I managed to see beyond the medical staff to the horrors that lay beyond. My wife had clearly lost quite a lot of blood. It's hard to know at the time what can be considered normal, so I wasn't especially worried, but later she had to have a transfusion.

30 Seconds Over Tokyo

We were finally called in three minutes before the birth, and for the first time we had to wear gowns - but no masks. Because of the cramped conditions - caused in no small part by the large vacuum pump that was already attached to my wife, I could only stand at the top of the bed, so when the baby came it's the only angle I could see it from. The umbilical cord was clamped and I was given what felt like the world's bluntest scissors to cut it with. Yes, Korean men apparently might sit out the actual delivery, but its normal for them to cut the umbilical cord.

We'd had all these grand plans about taking lots of photos and even filming the moment of birth, but in the reality of the situation it seemed heartless to take pictures like a tourist when my wife needed my full attention. When the birth happened at 4.57am it was so quick that I was taken aback. I didn't understand how rapid the vacuum pump could be, although having seen my baby sucked out of its home head first like that I think I understand why so many people in the modern world have nightmares about being abducted from their beds by aliens. I was quickly conscripted into cutting the cord and then the baby was passed to its mother while I struggled - and failed - with the now certainly faulty camera I had to hand to take a shot. I couldn't reach my DSLR in time. Thirty seconds later the baby was bundled outside by the nurses and I once again tried and failed to take a photo in the corridor despite the protestations of the staff. Blink and you'll miss it. Our baby was hurried away.

In the end, while giving birth is a terribly hard thing to go through, it ended up being comparatively straightforward. The baby was fine and after a couple of days, my wife was much better too. But a mistake was made during that thirty second period and it was going to linger with me and cause a great deal of unhappiness and frustration.

Stem Cell

"We don't have a contingency plan, because it's not likely to happen". - Anonymous Korean Stem Cell Company Representative.

Before we went to the BEXCO Baby Fair, my wife broached the subject of umbilical cord stem cell harvesting with me. Apparently the idea was that if the cells were harvested from the cord blood and stored, our child would potentially have a better chance of recovery from future diseases such as diabetes and blindness, and eventually also problems that would benefit from a regenerative medical solution, once technology allows.

I'd heard about stem cell harvesting, but thought it was a niche activity much more in the realm of fringe science than common reality. As far as I'm aware, it's not a subject which tends to raise itself in my own country for expectant parents, but I should have guessed that in Korea - which has pioneered some stem cell research - the question is much more in the public domain. And the three Korean stem cell harvesting companies with stands at BEXCO only brought me more rapidly to that realisation. This is a big business here.

So during our trip to the Baby Fair we sat down to talk to each company, armed with questions. Apparently this was not the norm for the company representatives we met, who implied that most customers just listen to their extended one-to-one presentations and sign up, quite possibly with the perception that everyone else was doing it, so they should too. It doesn't help that the business is premised on the collective guilt-trip that is doing everything you can as a parent for your baby's future health (the American Academy of Pediatrics in their review of cord blood banking nicely summarised this as "families may be vulnerable to emotional marketing at the time of birth of a child"), and worse that there is more than a small element of naked self-interest, insofar as treatments derived from the stem cells can also be used by the parents for themselves should they need it - in which case the child's guaranteed allocation is supposedly filled from a general stem-cell bank.

To be fair, one of the issues we were concerned with was the financial stability of the companies concerned. There seemed little purpose of going to the expense of putting stem cells in a tissue bank if there was the real risk of the operating company going under and switching the machines off at some point in the future. Since retaining these stem cells is a one-time-only opportunity, the benefits of which may not be called upon for fifty years or more, it stands to be a very long term relationship. I was not encouraged to discover that some companies in the industry had upfront costs but no further maintenance charges, because while it sounds financially attractive, the business model runs the risk of being little more than a stem-cell pyramid scheme which is financially unsustainable in the long term. The companies concerned might argue that all future costs will be absorbed by the upfront charge, but since they can't know what the future cost of electricity, storage and wages will be, any company operating this model might start running a loss on progressively more of their inventory. Such developments have a habit of bringing down companies very quickly. We were also quite inquisitive on what contingency plans existed in the event of extended power outages at the tissue bank. This possibly transpired to be a prescient line of questioning since the particularly hot summer this year is pushing Korea's low electricity reserve margins to the limit and threatening extended blackouts.

To their credit, one of the company representatives we talked to was armed with financial statements allegedly showing their robust financial health, demonstrating that they knew that there was a concern over long-term security of the stem cells in their care. The problem was though that the balance sheet concerned - impressive though it was - belonged to their publicly-listed parent company. Indeed, none of the three companies we talked with were truly independent or integrated operations, but rather financially separated units of larger publicly-traded groups which made it entirely conceivable that they had to be independently viable and may not receive backing from the parent company should the business make losses and become insolvent.

We didn't really make a lot of progress conducting limited due diligence on the companies we were considering entrusting our stem cells to, nor in truth did we expect to, but it wasn't a wasted effort on our part; a couple of companies stated that in the event they could no longer store our cells they would allegedly inform us, but we didn't choose to do business with the company whose representative told us of financial failure "we don't have a contingency plan, because it's not likely to happen"...

In truth, the whole business of harvesting stem cells is little more than a contingency plan - a little insurance and peace of mind if you will. The evidence of the efficacy of treatments is mixed, scientific progress may render the availability of umbilical cord stem cells less relevant, there's currently little evidence that donations from unrelated donors in stem cell banks are any less effective (or ineffective), and the wild claims that are made regarding the treatment of hereditary or genetic conditions such as leukaemia may be wide of the mark - these are pre-existing conditions which may not benefit from the use of stem cells which may carry the same problems.

We signed up anyway, because even if one of the companies we talked to didn't have contingency plans, we wanted to have one for our baby. The cost was 1,300,000 won (£702/$1,115), and the company will liaise with the maternity hospital to take the cord blood and rush it off to the tissue bank as quickly as possible when my wife gives birth. The cost covers the first 20 years of storage rather than it being an open-ended lifetime commitment, after which the company we signed up with "doesn't have a charging policy yet" - this is still a relatively new industry. It may not be ideal, but we tried to chose the company most likely to be around in 20 years. Because the stem cells are not really geographically portable, it also means that should our child need any treatment in future, we will need to return to Korea for it if we aren't living here.

Pong

Normally, I don't really sweat that much, and this may have been the reason why before this summer I've only had around five mosquito bites in Korea. In the last two days, I've been bitten seven times in our apartment, and I have the itchy red spots to prove it.

Having a large apartment can seem like a step up from the 'one-room' place we spent the first fifteen months in, but I discovered it had a downside: the air conditioning unit in the one-room could keep the air cool with only intermittent efforts, but the one in our four-bedroom apartment would need to stay on all the time to have any chance of making a significant difference to the temperature of our office on the other side of the building. The upshot of which is that I'm working in a room which hits 30 degrees and 80% humidity on the bad days, while three computers pump out warm air which has nowhere to go. It's hot, uncomfortable, and apparently it's made me more of a mosquito target.

The question of where the dreaded mosquitoes are actually coming from became a pressing one after their seven-bite feast. Our bed is protected by a large mosquito tent, so it isn't while I sleep. Logically then, it's almost certainly in the office where I've spent almost all my time this week. It wasn't long before careful examination of the large wire gauze cover which prevents insects flying through the otherwise open window (aka 'mogi jang' - 모기장 - mosquito net/bar) revealed it to have four large gaps in the frame where insects can enter the apartment as they wish. One of them is the gap beneath the window and the frame, which might be unavoidable, but the other three are a little inexplicable – they are lozenge-shaped holes which are clearly part of the design of the frame.

Since my wife became pregnant we can't liberally employ mosquito spray wherever we want to as we used to, and truth be told I was never convinced of its efficacy – only a direct hit at close quarters ever seemed to kill, so Korean Mother's strategy of spraying a room heavily and then closing the door for ten minutes before going to bed never seemed like it was going to harm anything apart from the person sleeping inside. I can't spray my office even if my wife isn't in the room now either, since we acquired an aquarium. So I've had to resort to using an insect swatter, which often involves cleaning up blood-splattered walls afterwards.

I hoped technology might come to the rescue, but was disappointed to find that most people on the Korean Internet felt that the kind of electrified lights which I often see in fast-food places back in the UK, but not so much in Korea, don't actually work very well. So we ended up buying an electrified mosquito swatter.

The electrified mosquito swatter seems typical of so much that is sold in Korea. It's made in China, and it's so dangerous that almost two-hundred people were injured by it last year. Shopping forums are full of cautionary tales of the huge sparks which are created and the dangers of it touching yourself or any close family members you'd like to keep. Despite this, the solution is not to ban the product, but rather to offer 100,000,000 won (£53,600/$81,500) of product liability insurance. A Samsung Insurance sticker is therefore attached above the handle for your peace of mind. If that isn't enough, the box has the word 'Safety' written in large letters in the corner, and 'As Seen on TV', though it isn't clear to me whether this was in an advert or a news report.

What kind of design aesthetic should such an apparently dangerous device have? Something that doesn't look attractive to children? No, worryingly it looks like a toy with a tennis racquet shape, a bright orange frame, and a friendly-looking cat face in the middle of the metal strings, inviting you in for a closer look.

The initial test came the day the package arrived. The device is activated with a button which must be held in while hitting the offending mosquito, although apparently it can retain a charge even after it's released. I quickly put the batteries in and pressed it – a loud crack accompanied by large retina-blurring spark immediately jumped off the metal wiring. There was no doubt this was going to be satisfyingly deadly, the only question remained as to who the victim would be. The second loud crack came as I moved the now electrified racquet gently towards the flying insect, which was left motionless in the wiring.

It's easy to be frightened by the rather cavalier attitude to public safety that exists in this country – but the electrified mosquito swatter stands as an example of how it can actually work for you; just because some ajumma set fire to her apartment with one, and just because a young girl put one in her mouth with predictably horrific consequences (yes, both actually happened), apparently nobody is going to stop you from buying it. Which is good if you're careful and responsible, but not so good if you might be Darwin Award material. Later, I'll let you know at a later time which group I fall into. Unless I can't.

Dollhouse

It's been clear to me for some time that the Korean maternity experience differs radically from the British one. One important respect in which this difference manifests itself is postnatal care - it isn't uncommon for a new mother to spend two to four weeks at the hospital's 'sanhujoriwon' (산후조리원') postnatal/postpartum clinic recuperating in Korea. By comparison, the National Health Service hospital in one British city states the average length of stay in their postnatal beds in 2009 was 1.2 days.

I went to the Maternity Hospital with my wife for a scheduled ultrasound, and after the scan we went up several floors to look at the postnatal suite. British hospitals tend to comprise of one or more sprawling low-rise buildings in their own grounds, whereas the smaller more specialised Korean hospitals often tend to occupy office buildings, and are easy to miss amidst all the other explosive activity of a typical Korean street. So stepping out of the elevator on the 8th floor, I expected the usual reception area and office-style rows of corridors leading off to various rooms. Instead there was nothing except a separate glass door, through which one could see an image which very much conveyed the message that you were now leaving the clinically sanitised hospital environment for something less dehumanising - beyond was a lounge with a TV on the wall, some couches with refreshments, and a colourful timetable on the wall with cartoon headlines promising treatments, massages, exercises and other activities. A narrow staircase led upwards to some uncertain destination. It was uncomfortably hot - apparently because of the recommended postnatal recovery temperature, otherwise known as 'slow cook'. It's a traditional Korean belief that new mothers should cover themselves with blankets and keep warm in order to protect them from 'loose bones' - failure to do so results in arthritis and rheumatism in older age.

We had to remove our shoes to proceed, emphasising the notion that we were transcending from a public environment to a domestic one. We were led upstairs, to be shown three types of room in which my wife could stay. The first comprised of a bed, a couch, a large LCD television and a desk with an Internet-connected computer, with a door to a separate private bathroom on one side of the room. The slightly cheaper rooms progressively lost the couch and the desk, so that the most economical option potentially had you surfing the Internet from the heated floor. The difference between the cheapest and most expensive rooms was 150,000 won per week (£87/$130), and the most expensive option was 800,000 won per week (£475/$718). I thought it best to go for the most expensive room, given that they were bigger and carried less risk of going stir crazy, especially considering that the view from most rooms extends approximately three feet out to the side of the next building, hence the prevalence of frosted glass. Also, since husbands are expected to stay overnight with their wives, more space is better, and I'd prefer to sleep on the couch rather than the floor.

I noticed something odd though. We'd looked at three rooms with three rather dazed and disconnected looking occupants, but where were the babies? It transpired they were all three floors below us being cared for. This was not what I had expected - to my mind this was supposed to be an important bonding time between mother and child, yet it seemed that the Korean approach involved separating the two for most of their postnatal stay in the hospital. Yes, when the baby needs feeding the mother is called down immediately to do this, but otherwise mother and baby are not together. As my wife sat discussing room options I was left pondering the Korean method and what they knew that I didn't, given that my initial reaction was that the idea was extraordinarily bad. At least it transpired that our 'sanhujoriwon' was not as strict as the one in Seoul whose head said "Mothers are not allowed to touch or hold other babies, we have strict visiting hours and don't even let the grandparents hold the baby."

We went down to see the newborn baby care facilities. This time on stepping out of the elevator we were confronted by a large artificial tree surrounded by a bench, behind which a glass wall separated this small island of faux-nature with a brightly-lit scene which could easily have been straight from a science-fiction movie. Four rows of perspex baby cots were lined up, ten per row, with three nurses moving around changing and checking the slowly stirring occupants. A separate control-room appeared to be situated off to the right. I felt the brightness was hurting my eyes but perhaps you get used to it. I watched a nurse change a baby. It was quick, functional, and not exactly gentle. The baby started crying, which elicited no reaction whatsoever from its carer - she finished and moved on. This did nothing to convince me that separating mother and baby was a good idea, but I understand that the separation may allow time for the mother to recover from childbirth, and it does provide round-the-clock monitoring and care for the babies.

The whole recovery issue though is an interesting one in Korea. Barring a sudden advancement of science or an unexpected alien abduction I'm never likely to experience childbirth, so I'm not really in a position to comment, but the impression seems to be given here that after giving birth a Korean woman's body is 'shattered', bones are fragile, and generally great care must be taken to bring her back from the brink of existence.

In the UK nobody I knew had stayed in hospital for anything like the extended period that appears to be the norm in Korea, and more than that the impression isn't created that women's bodies are completely broken from the experience to the point at which they should be relieved of any involvement in caring for their babies. It crossed my mind that keeping forty women in hospital at 800,000 won per week is probably a pretty good business, although this isn't to say it's necessarily a bad thing. But assuming there are no complications, my cultural background has clearly conditioned me to expect a much reduced recovery time to the one which my wife was envisaging.

This issue is a potential cultural battle which any sensible Western husband is going to carefully avoid with their Korean wife - so I told my wife it's entirely her decision how long she stays in hospital for. She has to weigh up the advantages of the rest and postnatal care versus the potential loss of immediate bonding, actual quality of care and the formal complaints which have been raised.

A River Runs Through It

A few years ago $900 million was spent creating a 6km recreational space along a stream in central Seoul. I've visited this urban renewal project 'Cheonggyecheon' ('청계천') and it is quite beautiful, although as its Wikipedia page suggests, it has not been universally welcomed.

It's possible that since then Korea has developed an obsession with rivers, streams and even canals, though perhaps it had one even before 'Cheonggyecheon' was completed. There's even a development proposed for our neighbourhood which involves creating an artificial stream with bridges running the length of the district. Everyone, it seems, wants a little bit of 'Cheonggyecheon'.

The Suyeong River ('Suyeongcheon'/수영천') in the Banyeodong area of Busan is not quite so picturesque, but this hasn't stopped part of the area around it being designated as a 'park'. A 'park' elicits certain imagery for an English person. The Victorians, stifled by industrial pollution and in a last gasp of the grandeur of empire, built quite a lot of them, generally squarish in shape, generally complete with ornamental ponds and statues of lions evoking notions of far off conquests and British dominance. These days, except on the sunniest of days, they're primarily the domain of drug-users and knife-wielding youths, and as such, have retained their national metaphor. In Korea, a park is a much more fluid term, seemingly covering almost any public area within a city that hasn't succumbed to urban sprawl. Which usually means they are to be found somewhere it would be too difficult or undesirable to build.

So to call the Banyeodong river development a park by British standards would be a stretch - it is essentially a couple of paths either side of a river nestled between two busy roads, featuring a small recreational area, some public exercise equipment, a vegetable patch, a decaying factory, and a couple of potentially dangerous river crossings.

But you have to take what you can get here I think. I used to enjoy running when I was younger and have often thought about taking it up as part of my efforts to keep fit, but it isn't really safe to go out running alone early in the morning where I'm from, and in Korea, it's a question of finding a place. Like most of Korea, Busan is quite mountainous so the flat areas between the peaks tend to be heavily built up. Running along the main roads never looks healthy because of the heavy traffic fumes, frequency of junctions, people, and motorcyclists treating the pavements/sidewalks as a road. Away from the major roads, there aren't even any pavements so you take your chances with the traffic weaving in and out of the streets. It's not conducive to picking up a sustained pace. So if I sound underwhelmed about the park in Banyeodong, you have to understand it is a small oasis of possibility in an unforgiving urban landscape, and I wish we had something like it near our apartment. Perhaps one day the local government will build a stream for us, as promised.

Winter's Child

It snowed this week in our part of Busan. It was the first time snow had settled on the ground since I've lived here. South Korea hasn't had an easy winter, but this city's location and our location within it - in the south-west by the sea - mean that it usually rains, if anything. The snow still falls on top of the nearby mountains though, which I have an excellent view of from my office window. Annoyingly, it often doesn't stop it from being bitingly cold, but it's nothing compared to Seoul. Our dog was captivated by what he saw out of the window, and outside our building a group of children, whose school was apparently closed by the weather, bravely tried to scrape together enough of the white stuff to build a snowman. I imagine this was their first and last chance of the season, and it was clearly hard work.




I had to go to the maternity hospital with my wife the day of the snowfall, because she had an ultrasound scan scheduled. There was no more than two centimetres of snow beneath our feet, but somehow the main road had become treacherous. When a taxi driver saw us, he apparently knowingly applied the brakes about ten feet away in order to slide to a stop beside us. It was clear that most of the road was ice - there had been no attempt to grit it.

As we skidded our way terrifyingly towards the hospital, it was clear that few drivers were prepared to compromise their driving style to accommodate the dangerous conditions, so regularly changing lane and cutting up people who couldn't necessarily brake effectively was commonplace. The saving grace was that the roads were so jammed with traffic, so nobody was able to go very fast, meaning the hundreds of accidents which doubtless occurred should have been minor.

Our doctor had not made it to the hospital - he was stuck in traffic - but we were able to see another, who at the end of a long conversation I barely understood asked if I had been bored. I'd tried to look attentive while fighting the constant tendency I have in Korea to zone out, but my lack of comprehension had somehow been detected or correctly assumed. It's unfortunate that my Korean ability has not progressed sufficiently, because this is a time when I want to understand every word and subtle nuance of the ongoing diagnoses, but instead all I can do is read the body language for any sudden negative revelation. It's incredibly frustrating.

The hospital gave us a DVD after the ultrasound. We hadn't had one after previous scans but this was a big one which incorporated a '4D' imaging technique which is supposed to be more comprehensive. The DVD contains a software application - Windows only of course - from which it's possible to view the ten minute ultrasound video, still photos and a general yoga video for pregnant women alongside some hospital advertising. We'll take the DVD back with us as the pregnancy progresses and they will continue adding to it until the baby is born. It's all part of the package but it's still a very nice touch. A friend of ours who's also pregnant has chosen a much bigger general hospital - as opposed to a specialised maternity hospital - where they don't do this, which seems a pity. Having the video has enabled us to share it with family back home to make the pregnancy more real to them than it would otherwise be, given the geographical difference.

Everything is fine and we continue along the road of the Korean pregnancy experience.

Crazy Heart

The part can never be well unless the whole is well - Plato

I suffered from chest pains three weeks ago, which was not particularly anything new, but the weakness in my arm and duration of the pain was - so I decided to go to hospital the next day to ensure the problem wasn’t anything serious. Cue the Korean hospital experience:

T+0 We enter the hospital unannounced
T+1 minute, we fill in my details on a form
T+2 My blood pressure is taken
T+3 I see the doctor
T+5 I'm sent for x-rays
T+6 I'm having the x-rays
T+8 I'm seeing the doctor again
T+10 I'm referred to a heart specialist
T+12 We're back out on the street

At twelve minutes from start to finish, it would all be very impressive, and fairly typical of the Korean health experience, if the hospital hadn't been more focused on my lungs and admitted that, despite its size, it lacked the resources to conduct a more thorough heart investigation. Immediately seeing the heart specialist they'd referred me to felt like too much of an escalation, so I decided to try another hospital. I love the freedom of choice here.

The second hospital matched my expectations much more closely. Within fifteen minutes of walking in through the door, I'd seen a doctor, had an ECG plus breathing tube test, and had only been stopped from quickly moving on to a heart ultrasound by the onset of lunch-breaks, which along with potentially being shut at weekends and on holidays, are the one aspect of Korean private hospitals which can be rather disconcerting.

So the ECG was flagged as abnormal, my breathing envelope was too limited, and the heart ultrasound suggested I was suffering from Mitral Valve Prolapse. It didn’t appear to be an immediate cause for concern, but I was referred to a large and effectively Government-backed university hospital to see a professor, and I thought we might as well get it out of the way while we were out.

Pusan National University Hospital (aka 'PNUH') was much more like a British NHS building - a large maze of corridors with worn floors, fixtures and fittings, fading government-issue paint schemes, endless waiting areas, treatment rooms and mini reception desks around which sorry-looking huddled pockets of humanity could be found. While the private hospitals projected a certain ‘can-do’ attitude alongside their modern décor, a certain sense of hopelessness seemed to permeate the atmosphere of the state-backed institution.

It seemed that before I saw the professor, I would have to repeat all the diagnostic tests again, I believe on the grounds that the university hospital could only really verify its own results. Or you might use the word 'trust'. I understood why, although I wasn't particularly happy about repeating the x-rays; while the quantitative and qualitative difference between the Korean health system and the UK's NHS has never ceased to amaze me, it's not to say that every aspect of the Korean system is left unquestioned, and I've pondered the risks of potential over-diagnosis during my time here.

While I was stood at my second x-ray machine of the day, I noticed the display telling me that my full name was now 'MA LEE KEUL'. We'd had a lot of problems trying to spell it out at the hospital's main reception desk. My long Western name is a constant problem in Korea, my surname was gone and now 'Ma-ri-geul' was my full name, apparently.

Although my actual speed of progress through the system was still much faster than the NHS, it seemed I would have to return a week later for an analysis of the results and some more tests with the professor. So last Friday I returned to PNU Hospital, but this time there was more of a buzz in the air. Kim Yuna - a national heroine and feature of every other advert on TV - was skating for gold in Vancouver, and Korea was transfixed. Every TV and monitor seemed to be carrying an Olympic feed, and the huddles of humanity were now to be found gathered around images of this national event.



Typically my time with medical staff follows a well-worn pattern. I brief my wife beforehand, we both enter, she explains the problem, the doctor asks her follow-up questions, sometimes involving me via translation, and after much is said we leave and my wife gives me a very much shorter summary. Probably, that's what all the information boils down to, but the experience is thus oft-rendered into an somewhat dissatisfying abstract, for which I only have myself in the shape of my lack of Korean fluency to blame.

My meeting with the professor took a different turn. After the initial introduction with my wife, the professor turned to me and asked how it would be if she spoke to me in English. That was fine with me though it's not without risk - in my experience sometimes it's better to have people say things in Korean so the full facts can be understood by my wife, rather than have them attempt to do the same in English and have my wife and I only receive a summary of what we might have done in the native tongue. I needn't have worried though, the professor had worked in America and her English ability was very impressive. This meant, for the first time in Korea, that I was able to have a full conversation about a medical issue without feeling that I was losing out on the level of information I would receive in the UK. In fact, it was better than the UK, because the professor actually took the time to explain the various results to me in detail, which the NHS rarely feels motivated to do.

She suggested that I have a CT scan, but since the initial results weren't indicating a problem, I wondered how far I wanted to go - I believed such scans carried an approximate 1-in-2000 risk of actually causing cancer (later, I read this Wall Street Journal article which suggests the figure for heart scans may be as high as approximately 1-in-600), and I'd already had a CT scan last year for back pain. I expressed my reservations and she smiled - she said she knew foreigners were often wary of such things. "Yes, we don't like radiation very much" I replied somewhat unapologetically. I'd had to weigh up the odds and make a snap judgement. It's fair to say I've probably had more than my fair share of medical problems in the last ten years, which have sometimes been investigated at great personal inconvenience and expense to little avail, although we have ruled out serious pathologies as a result. The NHS was never really interested in pursuing diagnosis beyond a certain point - whereas Korea's enthusiasm for medical tests constantly threatens to turn my life into an episode of 'House M.D.', which incidentally - and perhaps not coincidentally - is quite popular here. I'm not a hypochondriac although I don't believe in not properly investigating things - one of our friends here has metastasised cancer because she accepted her doctor's initial assurance that she had nothing to worry about, proving that the health system in Korea doesn't always work. For me, if serious problems can be ruled out after proper investigation I'm happy to live with what I'm left with if - on balance - it seems to represent a lower risk approach than invasive diagnostic procedures or regular radiation exposure.

On the whole, I'm sure that my attitude is not one the Korean medical profession really agrees with, and I regularly feel that I'm slipping into the role of being a strange or awkward foreigner when I express my unwillingness to follow advice or even turn up at a hospital until I've suffered minor problems for an extended period. I suspect that most Koreans display much more reverence towards their doctors, and perhaps we've lost our sense of innocence and trust in the West. But then, the rapidly growing anti-science, anti-intellectual and anti-fact section of American society demonstrates the downside of letting people with limited intelligence and no expertise or understanding in certain areas influence important decisions, and I worry that by Korean standards, I might seem like one of those people too. My degree is in Computer Science, and the few years I spent working for a medical devices company is neither here nor there. The upshot of this is that I second guess my doctors against what I read in Wikipedia, a fact that will possibly always prevent me from seamlessly integrating into this aspect of Korean society no matter how fluent my language abilities eventually become. The professor had strongly implied that whatever tests I'd had done at the private hospitals, the tests I would undergo at the university hospital would be the ones with the correct results - and as far as I believe anything I believed that. I'm not completely distrusting.

In the absence of a CT scan, the professor instead suggested I do a treadmill test, which due to its unscheduled nature, later saw me vigorously sprinting along on the machine in my jeans rather than the shorts which would have been a better option. I was told to stop if I experienced any pain, though my natural bloody-mindedness, coupled with the possibly belatedly important need to not fall into the stereotype of being a weak foreigner in front of the Koreans, meant that only a near-death experience was going to stop me.

After the treadmill I had an ultrasound. Kim Yuna was due to start her routine within twenty minutes and I was concerned the staff would miss the event, but fortunately we finished in time, and the professor invited us to watch the performance with her colleagues. It felt like the Korean equivalent of one of those moments you tell your children about - where were you when Kennedy was shot, where were you when Kim Yuna took the gold? I'm sure it will pass. The hospital seemed to come to a halt - later I read that volume on the stock exchange in Seoul dipped significantly as traders turned their attention away from their trading screens. The atmosphere was tense - quite possibly all across the country - and I felt that Korea had wound itself up to such a point that even I couldn't bear the idea of her making a mistake. So Kim Yuna's performance became my last heart test of the day.

Three weeks ago I visited three hospitals and had a day seemingly full of seeing doctors and having different tests, but the total bill only came to £35 ($53/60,000 won). The total PNU Hospital cost about £170 ($255/290,000 won), which puts the differences into perspective. But with luck, I should be able to reclaim about 90% of that through my medical insurance.

As for me, my problems are intermittent and difficult to diagnose, and I walked away from the hospital with no evidence of anything clinically significant in my results. But it's altered my perspective slightly on the small private hospitals I've previously trustingly frequented, now that I've seen how things are done in the big institutions.