A North Korean soldier was shot six times by his former comrades as he attempted to make an escape through the Korean Demilitarized Zone and defect to the South. While recovering from his injuries in a South Korean hospital, doctors discovered his intestines were riddled with large and unusual parasites, providing a rare insight into the nutrition, health, and everyday life of North Koreans.

“In my over 20-year-long career as a surgeon, I have only seen something like this in a textbook,” lead surgeon Lee Cook-jong said in a press briefing on Wednesday, Reuters reports.

An article in the Korea Biomedical Review (KBR) explains that the soldier underwent two rounds of surgery at Ajou University hospital. The operations involved removing a bullet lodged in the abdominal wall and managing the "enormous number" of parasites including roundworms in his gut, the longest of which was was 27 centimeters (11 inches).

“We are struggling with treatment as we found a large number of parasites in the soldier’s stomach, invading and eating into the wounded areas,” added Lee, according to KBR. “We have also discovered a parasite never seen in Koreans before. It is making the situation worse and causing tremendous complications.”

The massive infection is most likely linked to the low levels of hygiene found in the hermit kingdom. The worms were most likely contracted by eating vegetables fertilized with human feces, the doctors believe. There are many ways to safely use manure to fertilize fields, however, it appears that North Korea doesn’t use these practices. 

International sanctions, droughts, and disastrous internal management mean food shortages are a big problem in North Korea. Up to 70 percent of the population live on food aid and eat a dangerously unvaried diet. Micronutrient deficiencies, particularly in iron, zinc, vitamin A, and iodine, are therefore common. Inside the soldier's gut, they also found corn, a staple grain of the North Korean diet.

In the DPRK, young men must serve compulsory military service for 10 years and women for seven. A further 4-5 percent of North Korea’s 24 million people serve on active military duty, and another 30 percent are assigned to a reserve or paramilitary unit, according to the US Office of Secretary of Defense. This means the soldier’s body is representative of many North Koreans and potentially insightful for researchers hoping to learn about the wider health of the country.

“I don’t know what is happening in North Korea, but I found many parasites when examining other defectors,” added Professor Seo Min. “In one case, we found 30 types of roundworms in a female defector. The parasite infection problem seems to be serious even if it does not represent the entire North Korean population.”