Nobody seems to care for Korea’s caregivers

A 70-year-old caregiver, surnamed Kim, is responsible for a six-bed ward at a nursing hospital in Hwaseong, Gyeonggi. She is an ethnic Korean of Chinese nationality, known in Korea as joseonjok, from Changchun, the capital city of China’s Jilin Province.

Kim wakes up at 5 a.m. Unforeseeable circumstances make the job a challenge.

“A patient suffering from dementia went to the bathroom more than 10 times overnight,” said Kim.

After Kim changes diapers for all six patients in the ward, she gives them breakfast: a liquid formula administered via a tube running through the nose.

Kim then empties the trash cans. While cleaning the room, a patient makes a gurgling sound. She brings a suction hose and sucks out the patient’s phlegm.

Each time the hose sucks a yellow batch of the sticky liquid, the bed rocks as the patient twists their body.

While this is happening, another patient keeps falling from their bed.

A scene such as this is normal as problems continuously occur for Kim while taking care of the patients.

“In some nursing hospitals, a caregiver would have to take care of 10 patients,” said Kim.

In a report submitted to the Korean Convalescent Hospital Association (KCHA) by a research team at the Korea University School of Law in August 2018, a caregiver working at a nursing hospital takes care of eight patients on average.

According to the KCHA, there are 1,560 nursing hospitals in Korea, and 34.7 percent of the caregivers are ethnic Koreans of Chinese nationality.

When all caregivers in the country are considered, including those at nursing homes and large hospitals, the percentage of caregivers who are joseonjok is estimated to be as high as 80 percent.

“Currently, about 180,000 to 200,000 caregivers are working in Korea,” said a person working for a caregiver union under the Korean Public Service and Transport Workers’ Union.

“And of them, we estimate about 70 to 80 percent of the caregivers are ethnic Koreans of Chinese nationality.” That’s at least 120,000 people.

“Of the 64 caregivers dispatched to the Seoul Metropolitan Government’s Boramae Medical Center, 53 are ethnic Koreans of Chinese nationality,“ said the head of an association for caregivers that mainly recruits joseonjok.

This means 83 percent of the caregivers at Boramae Medical Center are ethnic Koreans of Chinese nationality.

A petition on the Blue House website calling for improvements to the caregiver system was posted by a nurse working at a nursing hospital.

The nurse claimed that “caregivers work without basic medical checkups, and most of them start work right after the association for caregivers brings them from the airport.”

No qualifications are needed in order to become a caregiver.

Most nursing hospitals or ordinary hospitals recruit their caregivers indirectly through associations for caregivers or recruitment agencies.

People can become caregivers by paying a fee ranging from 60,000 won ($51) to 100,000 won to an association for caregivers and find work.

Guardians are complaining about the services they receive in contrast to the amount they pay to caregivers. Guardians pay 2 million won to 3 million won a month to caregivers.

However, problems occur because of the lack of training and language differences.

Though these joseonjok can communicate in Korean, the vocabulary and the accents are different.

“When I first came to Korea, there was a time when I almost gave a patient the wrong pill because I was not used to the language,” said a caregiver who is an ethnic Korean of Chinese nationality.

There is little formal education for caregivers.

“Associations that offer systematic training are rare,” said a Korean caregiver at Seoul National University Hospital. “Especially, there are many cases where all the training that caregivers who are joseonjok get is from following their predecessors.”

“Associations are exclusively responsible for the training that the caregivers get,” said a medical worker at Seoul National University Hospital. “The hospital does not get involved with the matter.”

Caregivers visit customers directly and offer their services. Because they are compensated directly by the patients or their guardians, caregivers do not pay taxes and are not eligible for state insurance coverage.

“Caregivers are not covered by long-term care insurance,” said Kim Yu-hwi, a doctor of philosophy at Gachon University’s Inequality and Social Policy Institution. “Because it is outside the policy, the working conditions are harsh and the wages are low, so Koreans avoid the job and joseonjok take the work.”

It is hard for caregivers, especially those who come from other countries, to appeal when they lose their jobs or are not paid for their services.

“When I dozed for a moment after a patient made me lose sleep all day, I was fired immediately,” said a 57-year-old caregiver who is an ethnic Korean of Chinese nationality from Shenzhen, China.

In another hospital, a caregiver brought a black plastic bag to the restroom to secretly wash her clothes.

Because she goes home only once or twice a month, if she does not do her laundry at the hospital, she cannot wash her clothes.

She is also an ethnic Korean of Chinese nationality.

After the caregiver finishes washing her clothes, she hides them under a bed or inside a drawer.

At 1 p.m., caregivers who are joseonjok eat lunch, mostly instant cup noodles or vegetables. Caregivers mostly eat food that last for a long time and are convenient to prepare.

There is a cafeteria for employees that offer meals costing 4,800 won.

If a caregiver eats all three meals at the cafeteria, they will have to spend 16 percent of their daily wage.

The caregivers at this particular hospital receive 90,000 won per day.

When they pay 80,000 won each month to the association for caregivers that they are affiliated with and pay for occupational health and safety insurance, caregivers are left with a little over 2 million won each month.

Sometimes things can go out of hand for caregivers, especially when they come from another country.

A caregiver living in Incheon said she was threatened by a patient’s guardian at a large hospital in Dobong District, northern Seoul.

The guardian, who did not pay the caregiver, came to her drunk one time.

“Let’s go to the basement,” said the guardian. When the caregiver refused, the guardian raised his hand. The incident ended after the police were called.

“We don’t know whether we should call the police,” said the caregiver. “[Korea] is different from China.”

Another caregiver from Yantai, northeast China, said she was sexually harassed by patients.

She said there were occasions where patients suffering from dementia would demand sexual services.

When she refused, a patient hit her with his cane. The caregiver said she had to hide on the veranda.

Some associations for caregivers are more like recruitment agencies. It is rare for them to mediate for caregivers when problems occur.

Joseonjok are in the dark when it comes to Korean affairs, so they do not request help from labor unions.

“No one contacts us, even if we want to help ethnic Koreans of Chinese nationality,” said an employee who works for a branch of a union for caregivers. “It’s hard for us to even grasp the situation.”

“We must improve the quality of caregiving,” said Ryu Si-won, a professor at Inje University Graduate School of Public Health.

BY KANG HONG-JUN, JEONG MI-RI AND JUNG MYUNG-SUK [jung.myungsuk@joongang.co.kr]