In April this year, U.S. President Donald Trump announced his North Korea policy, summarizing it as “maximum pressure and engagement.” It means the U.S. will apply the maximum level of pressure and engagement on North Korea by using economic sanctions and diplomatic means to induce the North to give up its nuclear and missile development, while still leaving the door to negotiations open. Under this policy, the U.S. has so far put pressure on Pyongyang in various ways, imposing its own sanctions on the North and urging the international community to join the sanctions. Here is Professor Kim Yong-hyun from the North Korean Studies Department at Dongguk University to evaluate Washington’s North Korea policy over the last seven months.

Previously, Trump made aggressive comments like “totally destroying” North Korea and “fire and fury.” But in the process, he still mentioned dialogue as well. For the most part, his North Korea policy in the last seven months has been characterized by “pressure,” drawing a strong backlash from North Korea. The two sides have been confrontational toward each other, intensifying their hardline position.

Top officials in the U.S. administration have unleashed strong rhetoric against North Korea thus far. Trump, in particular, exchanged a bitter war of words with North Korean leader Kim Jong-un through social networking sites like Twitter, raising concerns over a possible war on the Korean Peninsula. The U.S. has consistently placed unprecedentedly strong pressure on the North through the U.N. Security Council or its own measures. The Treasury Department has taken several sanction measures against Pyongyang, while the State Department re-designated North Korea as a state sponsor of terrorism on November 20, nine years after the nation was removed from the terrorism blacklist. The following day, the U.S. announced sanctions on one individual, 13 organizations and 20 ships with the purpose of blocking money from flowing into North Korea to fund its nuclear and missile development. Experts are saying that Washington’s “maximum pressure” is gaining traction again.

The re-listing of North Korea as a state sponsor of terrorism is aimed at generating the effect of “maximum pressure.” But the recent situation is a little different from the time when North Korea was put on the list of state sponsors of terrorism in 1988 for its bombing of a South Korean airliner. At that time, the U.S. was expected to continue to put strong pressure on the North. This time around though, North Korea could be removed from the list as long as the nation comes to the dialogue table. In other words, North Korea’s reinstatement on the U.S.’ list of terror sponsors has the purpose of prompting the North to halt its nuclear activities.

Not only using economic pressure, the U.S. has also engaged in a diplomatic war to isolate North Korea from the international community. The State Department said on November 21 that about 20 countries joined the campaign of placing economic and diplomatic pressure on North Korea, separately from the U.N.-level sanctions. Five countries such as Mexico, Peru, Kuwait, Spain and Italy have actually expelled their North Korean ambassadors, while Portugal severed its ties with North Korea. And Sudan cut its trade relation with North Korea as the first African country to do so.

I would say it is more about psychological and symbolic pressure on North Korea. It is true that the pressure by some 20 countries is giving Pyongyang a hard time. But most importantly, we have to see how actively and extensively China will join and implement the international sanctions. At present, the international pressure is significant as it is tightening the noose around the North psychologically.

The U.N. Security Council adopted two strong resolutions against North Korea, one in August and the other in September, in response to the nation’s intercontinental ballistic missile, or ICBM, launches and sixth nuclear test. It took only one month and a week, respectively, to adopt the resolutions, reflecting that the international community is joining efforts to pressure North Korea. What grabs the attention the most is a change in China. North Korea’s exports to China in October amounted to 90 million US dollars, representing a 62-percent decrease from the same period of last year, when they were tallied at 238 million dollars. Bilateral trade volume in October was 330 million dollars, the lowest level since February. While China has made it clear that it is opposed to Washington’s move to return North Korea to the list of state sponsors of terrorism, China’s state-owned airliner has suspended flights between Beijing and Pyongyang. China has also decided to temporarily shut down a bridge that links the North Korean border city of Sinuiju with the Chinese city of Dandong.

China has clarified its position that it is also joining sanctions on North Korea to cooperate with the international community as one of the G2 nations. It is also cracking down on illegal trade in areas bordering North Korea to heighten the effect of pressure. Apparently, China is putting more pressure on the North than in the past, in consideration of cooperation with the international community, especially with the U.S. But China doesn’t want to go as far as to suffocate North Korea through continued pressure. That’s why China finds itself in a tricky position.

There was less of a fiery response from North Korea in regards to Washington’s decision to add the North again to its list of states sponsoring terrorism. A spokesman of North Korea’s Foreign Ministry said that the U.S. would be held entirely accountable for all the consequences to be entailed by its impudent provocation to North Korea. The remarks were made during a question and answer session with a reporter from the Korean Central News Agency on November 22. Moreover, Pyongyang had refrained from additional provocations for 75 days since its test-launch of a Hwasong-12 intermediate-range ballistic missile on September 15. Given that, it was speculated that North Korea was in the cooling-off process before turning the situation around. And on early Wednesday morning, the North chose to launch a provocation yet again by firing a ballistic missile.

The latest provocation is seen as North Korea’s resistance to Washington’s decision to re-designate it as a state sponsor of terrorism. As Chinese special envoy Song Tao’s recent visit to North Korea proved to be fruitless, the North chose to confront the U.S. for now. Pyongyang is displaying a brinkmanship tactic to demonstrate its presence and to show that it will never yield to sanctions and pressure from the U.S. and the international community.

The South Korean government has strongly condemned Pyongyang’s long-range ballistic missile launch and urged it to stop all actions that would escalate tension further. The U.S. government has defined the missile launch as a provocation that threatens international stability. Trump responded that the launch would not change the U.S. approach to its North Korea policy, stressing that the U.S. would take care of the matter and it was a situation that the U.S. would handle. The American president’s remarks are interpreted as his intention to continue to put the highest level of economic and diplomatic pressure on the North.

The U.S. will likely make a strong response to North Korea’s recent provocation and slap even tougher sanctions on the North through cooperation with the international community. But with the PyeongChang Winter Olympics drawing nearer, heightening military tension on the Korean Peninsula will place a great burden on the U.S. Washington is expected to put pressure on North Korea in the short term, while making efforts to persuade it to refrain from making additional provocations in cooperation with China and the international community.

The international community is concerned about North Korea’s armed provocations, subsequent sanctions by the U.S. and the international community, and again the communist regime’s additional provocations.

[Interview] Institute Dedicated to Research on Integrating Nursing Education in Two Koreas

South Korean nurses and nursing professors and nurses from North Korea are attending a seminar organized by the Unification Nursing Institute. Let’s hear from Kim Hee-sook, the head of the institute and professor at the Nursing Department of Dongnam Health University, to explain this institute in more detail.

The institute is dedicated to the studies of health and medical treatment, as well as nursing education, in North Korea, and of ways to integrate nursing education systems in South and North Korea. Members of the institute also examine the health conditions and problems of the 30-thousand North Korean defectors who have resettled in South Korea and discuss ways to promote their health. In preparation for inter-Korean exchanges and the future unification of Korea, nurses and nursing professors from both South and North Korea get together here to do research on nursing education that should be conducted before and after unification.

The institute was set up in March with those purposes Ms. Kim just explained. It would be important to figure out the differences in health and medical treatment in South and North Korea and find an ideal way to integrate the relevant systems after unification, not only from a humanitarian perspective but also in terms of social integration in a post-unification era. It is said that the role of North Korean nurses, unlike their counterparts in the South, is to simply assist doctors. It is hardly a surprise that their training process is rather short and the education course is not professional. Here is Roh Gi-ok, the head of the publishing department at the institute and nursing professor at Konyang University.

South Korea adopted nursing science from the West, while North Korea did not. North Korean nurses learn a bit about Oriental medicine. The medical terms and textbooks they use are starkly different from ours. Nursing students in North Korea only read one big book, as far as I know. In South Korea, nursing students learn subjects like “Adult Nursing” and “Women’s Nursing,” while nursing education in the North is conducted in accordance with departments at hospitals such as obstetrics and gynecology, internal medicine and surgery. In a word, the nursing curricula in North Korea are designed to nurture assistants of medical doctors.

A North Korean defector named Eom Geun-young dreamed of becoming a nurse in her home country and finally realized her dream in South Korea. Currently, she is working on a master’s degree in medical cooperation after unification. She explains that there are big differences between South and North Korea in terms of what nurses do.

I grew up in a coal-mining village in North Korea. In the North, if a father is a laborer working in a coal mine, his children should also do the same job. But I wanted to be a nurse because I thought nurses would wear pretty clothes and work comfortably. To me, nurses looked very nice. So in South Korea, I never hesitated to go to a nursing school. While practicing at local hospitals in South Korea, I realized that nurses here were very different from those in North Korea. One of my best friends in the North was a nurse. I remember visiting her hospital. There, nurses gave injections, dressed in gowns and wore makeup. That’s all they did.

Clearly, the concept of nursing science and what nurses really do are different in South and North Korea. That’s why North Korean defectors who choose to go to nursing schools or study healthcare often have a hard time in catching up with their studies, with some even dropping out of school. To assist those students in their studies and resettlement, the institute is offering a mentoring program, which is drawing a positive response from the students. Let’s hear from Seo Im-seon, a nursing professor at Baekseok Culture University.

My student is a sophomore at a nursing school. She is studying basic subjects before participating in the practice session, but she really has a hard time studying. It must be difficult for her to study English terms and understand the principles of the subject. I met her about eight times during the summer vacation to help her with her studies. Team assignments seemed to be particularly challenging for her. She said her basic knowledge was so poor that it took 12 hours for her to complete an assignment, although it took only one or two hours for her South Korean classmates to finish the same project. Fortunately, this mentoring program proved of great help for her. I expect programs like this will be implemented more actively to help many more students complete their studies successfully.

The institute has hosted academic gatherings and seminars every month to deal with the themes of the medical system in North Korea and the resettlement examples of North Korean defectors who became nurses here. It also examines the health conditions of North Korean defectors to develop and operate programs to promote their health. Here’s Cho Mi-gyeong, the head of the External Affairs Department of the institute and nursing professor at Eulji University.

Many North Korean newcomers suffer from diseases or traumatic stress they developed in the course of defecting to South Korea via a third country. In North Korea, some had painful experiences of witnessing people dying, being shot, or being taken to unknown places. Here in South Korea, they may forget about the horrible experiences in three to seven years, since they are too busy earning a living. But I’d say the experiences are being suppressed deep down in their hearts, rather than being forgotten. I’m afraid that they might cause social problems later. We want to provide useful health information tailored to individual newcomers by creating videos and smartphone apps they can use.

The institute plans to present a vision for integrating nursing education in South and North Korea through extensive research and various academic activities. Here again is Ms. Roh. The institute has just started carrying out its activities, which will hopefully lay the groundwork for integrating health and medical systems in South and North Korea.