North Koreans are reportedly refusing to use Chinese medicine because they fear the products might be unsafe in light of a major scandal in China involving the manufacturing of faulty vaccines, a report revealed on Wednesday.

Radio Free Asia reported that North Koreans are well aware of the scandal surrounding substandard vaccines distributed to hundreds of thousands of children in China, which was merely the latest and most outrageous in a series of Chinese pharmaceutical debacles. The news appears to have been spread by North Korean businessmen returning from trips to China.

“Many patients and their families who used to buy Chinese medicine now seriously question whether they should keep using it or not. North Korean residents who have heard that China often has trouble with fake medicines now distrust the Chinese medicines available in local markets, which may also be fake,” a source in Pyongyang told RFA.

This is all the more remarkable because, as the source pointed out, sanctions against North Korea’s nuclear missile program have made other medicines harder to obtain. Even when the medicines themselves are permitted as imports under U.N. sanctions, financing for shipments from sources other than China can be difficult to arrange.

North Korea itself has a negligible pharmaceutical industry. Pyongyang buys a lot of biotech equipment, but the products created with that equipment are not intended to make people feel better.

RFA’s source said wealthy North Koreans are flocking south of the DMZ to buy South Korean medicine from grocery stores along the border and arranging bulk shipments of South Korean pharmaceuticals to rich North Korean enclaves, but that alternative is not available to the vast majority of the communist state’s impoverished peasants.

“For ordinary North Korean residents, these medicines are just a ‘pie in the sky,’” the source said.

The Chinese vaccine scandal is a big story because the public is increasingly outspoken in criticizing President Xi Jinping’s government, and even the president-for-life himself, rather than accepting a few corporate scalps and writing the debacle off as another bit of capitalist corruption.

China’s Food and Drug Administration tried to restore public confidence on Tuesday by claiming the substandard vaccines were the result of a minor industrial accident that could not have been prevented. The public reacted with even greater outrage, accusing the regulatory agency of careless neglect at best, and participating in a cover-up at worst.

Chinese parents are turning to alternative sources of vaccines most readily available through French and British imports in Hong Kong. Next to North Koreans turning up their noses at Chinese medicine, Chinese parents streaming into semi-autonomous Hong Kong for vaccinations is the last thing Xi’s regime wanted to see.

India on Thursday banned the import of rabies vaccine from China’s Changsheng Biotechnology, the company at the center of the vaccine scandal. The head of India’s drug regulatory agency said a complete recall of Changsheng rabies vaccines might soon follow.