The recent deaths of infants caused by medical mishaps at Ewha Womans University Medical Center were a warning to improve medical infrastructure and take better care of newborns and premature babies.

However, not only infrastructure but the entire medical system of Korea has a structural problem that hinders newborns from getting quality medical care, an expert said.

Choe Byung-ho, president of the Korean Society of Pediatric Gastroenterology, Hepatology, and Nutrition (KSPGHN), said in an interview with Korea Biomedical Review that Korea lags far behind advanced countries in workforce and equipment at neonatal intensive care units (NICUs) and pediatric intensive care units (PICUs).

“Unless the government takes initiatives to enhance the medical service system and infrastructure for critical pediatric patients, including newborns, we cannot solve this problem,” Choe said.

The pediatric gastroenterologist, who also serves as a professor of pediatrics at Kyungpook National University’s School of Medicine, said the government also needs to fight childhood obesity, which has rapidly grown over the past decade, as well as to support patients with rare pediatric diseases.

Choe said the KSPGHN would take aggressive actions to reduce the financial burdens on low-income households suffering from childhood obesity and rare diseases. At the same time, the government should provide much more policy support in the two areas, he said.

Choe Byung-ho, president of the Korean Society of Pediatric Gastroenterology, Hepatology, and Nutrition (KSPGHN)

Question: Experts say Korean children are at “excessive” level in nutrition. Indeed, childhood obesity has gone up, and many worry about this trend. Do you agree?

Answer: Obesity in Korean children has doubled in the last 10 years. Such fast growth is unprecedented in the world. The U.S. Kaiser Research Center released a shocking report that the average of life expectancy of children might be 20 years shorter than their parents due to obesity. What’s worse is that there are more Korean children with metabolic syndrome than their U.S. counterparts, according to a local study.

If we don’t do something, 10 or 20 years later, half of the children’s population could become obese. Currently, the obesity rate of the disabled and low-income earners is quickly rising. More than half of childhood obesity leads to adult obesity and early development of diseases such as hypertension, diabetes, heart disease, stroke, dyslipidemia, arteriosclerosis and fatty liver. We need measures to prevent this.

In fact, we’re already late in managing childhood obesity. We should promote a national campaign to prevent obesity through public commercials. We should ban advertisements of unhealthy foods for young children and adolescents.

I think city and province officials and doctors’ associations should work together to provide a regular education program to prevent students from getting overweight, to enhance school’s sports activities, and to provide nutritionally balanced foods only at schools.

Q: What do advanced nations do to curb childhood obesity?

A: Many advanced countries spend about 7 percent of the public healthcare expenses on obesity. In the U.S. where the obese population is large, the costs for obesity account for more than 25 percent of the total state expenditure for healthcare. In Europe, TV commercials of junk foods are banned, and people pay obesity tax for purchasing carbonated drinks. The entire world is trying to prevent an obesity-led economic crisis.

Q: Besides your policy suggestions for obesity, can you tell us how we should improve medical service for premature babies, newborns, and children with rare pediatric diseases?

A: Pediatric rare diseases are still excluded from the national health insurance policy. For example, gastrointestinal ulcers or gastric bleeding are very rare in newborns or infants, but if they have them, the diseases are life-threatening most of the time. However, due to the name of the disease, it is classified as a mild symptom, which makes the medical payment quite burdensome for the guardians.

Crohn’s disease in children is more likely to be severe than that in adults. The short-bowel syndrome is not covered by the health insurance, either. If the patient does not need a transplant of the small intestine, we can use intravenous nutritional injections at home for several years and help the patient eat himself or herself. But the total parenteral nutrition (TPN) at home requires moving next to the hospital. If not, the patient needs to be hospitalized for several years to get treatment. Moreover, the short-bowel syndrome is not classified as a rare disease in Korea.

Q: The KSPGHN needs to meet government officials to talk about better policies. Do you have any plan to do so?

A: We will try to revise the medical system to help the marginalized patients with severe symptoms and those with rare diseases who need liver and small intestine transplants.

We will also work with related government agencies to improve policies for enhancing breastfeeding, nutritional support for patients with acute pediatric diseases and reducing obesity and metabolic syndrome among young people.

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