North Korea is facing its toughest trade shutdown in years, but an unusual string of medical devices — namely, pacemakers and prosthetics — still managed to cross the border in November, according to new Russian Federal Customs Service (FCS) data.

Overall, exports of Russian goods and imports of North Korean goods have almost completely dried up, with values down 87% and 96% respectively year-over-year.

In November, Russia exported $229,075 worth of goods to the DPRK, all of which were medical supplies. “Antisera and other blood fractions” — basically, antibody-rich blood from people who have survived diseases — made up the greatest portion