Cost of military exemption for tuberculosis jumps fivefold in North Korea

People want to avoid enlistment as they fear being shipped off to Russia to fight in war with Ukraine.

Read a version of this story in Korean

Bribing one’s way out of military service in North Korea has gotten more difficult these days.

The cost of fake tuberculosis certificates has jumped fivefold due to increased demand from families who want to avoid having their young men sent to Russia to fight in its war with Ukraine, residents in the northeast Asian country told Radio Free Asia.

“Until last year, most medical certificates for military exemption cost around US$100,” a resident of the northern province of Ryanggang told RFA Korean on condition of anonymity for safety reasons.

“But the price of a tuberculosis certificate has risen to $500, making it difficult for residents who are eligible for military service to afford it.”

In North Korea, every man must serve 10 years in the military and every woman must serve seven, but those with means can use their wealth to buy their way out.

Young people sign petitions to join, or return to, the army, at an undisclosed location in North Korea, in this undated photo released Oct. 16, 2024.
north-korea-enlistment-age-increase-01 Young people sign petitions to join, or return to, the army, at an undisclosed location in North Korea, in this undated photo released Oct. 16, 2024. (KCNA via Reuters)

The going rate to bribe hospital officials for a tuberculosis diagnosis has risen from US$100 to $500. With the certificate, the would-be soldier can avoid conscription until the next time they are up for tuberculosis tests, which is usually once per year.

What was once an enormous sum that most people -- who, according to South Korean outlet NK News make between $1 to $3 per month at their government assigned jobs -- would never be able to afford, has now become painfully expensive even for some wealthier families.


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North Korea’s military isn’t just about military training. Soldiers are often tapped for free labor on farms, construction sites or government projects.

With North Korea now participating in Russia’s war with Ukraine, soldier’s lives are at risk, so the stakes have risen and so has the cost of avoiding conscription.

According to the Pentagon and South Korean intelligence, North Korea has sent 12,000 soldiers to Russia to fight against Ukraine, but Pyongyang and Moscow have not openly acknowledged it.

However, most people in North Korea are aware, because news of the situation has spread by word of mouth, and according to the resident, is a major concern for families with military-age children.

“There is an underlying fear that if their sons join the military and are sent to Russia, the parents will never see them again alive,” she said.

With news about the war spreading, people are trying to raise money in any way they can so they can buy medical exemption certificates, a resident of the northwestern province of North Pyongan told RFA on condition of anonymity for personal safety.

“They are selling their properties and borrowing money, but the price of tuberculosis diagnosis certificates continues to rise, so some residents are giving up,” he said.

The authorities in North Pyongan appear to be fighting back against the fake certificates by forcing military-eligible citizens to test for tuberculosis every three months instead of once per year, he said.

“The cost of the certificates is so high and they have to get tested more often, so now they have no choice but to enlist.”

Translated by Claire S. Lee. Edited by Eugene Whong and Malcolm Foster.