North Korea’s long-delayed Pyongyang General Hospital project, billed as the country’s first “modern” public hospital, has shown new signs of construction activity in recent weeks after leader Kim Jong Un said that it should open by the end of the year.

NK Pro analysis of Planet Labs satellite imagery shows the hospital’s rooftop helipad was erased and then resurfaced in the weeks since mid-October, while temporary project administration-related structures outside the west entrance were removed earlier this month.

Construction on the large hospital, located on the Taedong River in central Pyongyang, appeared mostly finished by its original deadline for opening of Oct. 2020, but the project was delayed and largely ignored in state media in the four years since.

This was likely due to problems acquiring sufficient medical equipment, whose shipment to North Korea is prohibited under U.N. sanctions. Pyongyang was found to be shopping for expensive foreign-made medical machinery in 2020.

Kim Jong Un expressed renewed hopes in January for finally opening the hospital, suggesting at a Supreme People’s Assembly session that it would be “completed and start its operation … this year.”

He then reportedly secured help in acquiring medical equipment from Russian leader Vladimir Putin during their summit in June, possibly for the Pyongyang General Hospital or another new hospital.

In a possibly related move, Russian Deputy Health Minister Sergey Glagolev arrived in Pyongyang on Sunday for continuing bilateral talks on trade and economic cooperation.

State media has not mentioned the project since February, when it said Cabinet Premier Kim Tok Hun inspected supplies of equipment and called for the hospital’s opening “as early as possible.”

The groundbreaking ceremony took place in March 2020, when Kim Jong Un presented it as urgently needed due to the pandemic and the overall outdated state of the country’s medical facilities.

Satellite imagery in the coming weeks will reveal whether the new activities are part of plans to open soon, as additional similar structures will also need to be removed and the general area cleaned up and repaved.

Meanwhile, Kim also said in January that a “modern hospital” would be built this year in Kangwon Province, while he declared in August that “large-scale modern hospitals” would be added to the list of facilities that must be built in 20 counties and cities per year for the next decade under the “20×10” rural development plan.

A major new construction project that kicked off earlier this year next to the Wonsan-Kalma tourist beach resort zone on the east coast may be the Kangwon hospital project, but Planet Labs imagery shows work appeared to stop around August and appears far from finished.

Edited by Alannah Hill