Source: World Health Organization
Date: 27 Apr 2004

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Health update on the Ryongchon train explosion

The explosion at Ryongchon has resulted in the death of at least 160 people, of which 76 were children. Many of these
children were attending the nearby primary school when the explosion occurred.
Due to damage to the Ryongchon County hospital, the injured requiring hospitalization have been referred to four hospitals
in Sinuju, the provincial capital of North Pyongan province, about 20 kilometers from Ryongchon.

More than 1300 people are reported injured, and 370 have been admitted to hospital, about two-thirds of them children. In
the last two days, four of these patients have died, and WHO estimates that 15% remain in critical condition.

According to the WHO Representative in Pyongyang, who visited the hospitals today, the majority of injuries are to the
face and head, with cuts from glass, bruises and burns. Around 90 patients have eye injuries, the majority due to glass
penetrating one, and in some cases, both eyes. Multiple injuries with fractures, open and closed head injuries and
internal injuries were also commonly seen. About one quarter of the patients have less serious injuries, and these people
could be discharged in the coming week.

Considering the circumstances, medical treatment is reported as reasonable. Medicines and medical supplies, including
intravenous fluids, antibiotics and analgesics provided by the

Ministry of Public Health, the World Health Organization and other international agencies, were available in each of the
hospitals.

There are shortages however of certain commodities and medicines such as different eye preparations, topical creams and
sterile vaseline compresses for burns as well as a lack of some antibiotics. At the request of authorities, WHO will
provide some of these supplies along with surgical instruments. WHO has also ordered additional eye medicines and
equipment to treat the large number of eye injuries, and stands by to assist with more as required.

Some patients have presented with respiratory symptoms, although so far none severe. It is important to systematically
register these as part of the strengthening of disease surveillance after the disaster, in particular because of the
possible toxic impact of ammonium nitrate from the explosion. WHO's discussed these points with with health authorities in
Ryongchon.

As people get better and are discharged, WHO considers that follow-up counseling and community outreach programmes will be
important, especially considering the number of children affected.

WHO response summary

WHO has been part of an international delegation which has traveled twice to the explosion site and to hospitals. Last
weekend, WHO delivered medical supplies and equipment valued at about US$100,000 to Ryongchon and Sinuju. These supplies
were transported from existing stocks in Pyongyang. This week, the government of Japan is providing ten Basic Health Kits
and burn dressing kits. The total cost of this donation is also valued at US$100,000. These supplies will begin reaching
DPR Korea by Thursday, 29 April.

Ryongchon

In Ryongchon itself, temporary shelters with tents have now been established. Many people are still on the move within the
town with their belongings. Work has also started with repair of houses.

The county hospital, about 1.5-2 km from the explosion site, had all its windows broken, and has not been functioning
since the explosion. Some temporary plastic sheets are now covering windows on the first floor, and the hospital will open
for out-patients today. One polyclinic was totally destroyed by the explosion and the Hygiene and Anti-epidemic station
and medical ware house was partially damaged. It is important to restore normal health services in Ryongchon as soon as
possible.

For more information contact: Christine McNab, WHO Geneva, +41 79 254 6815 Or Dr Eigil Sorensen, WHO Representative,
Pyongyang, DPRK - 850-2-381 7914