Archive for the ‘Pediatrics’ Category

More Help Needed to Improve NK’s Public Health

Wednesday, May 23rd, 2007

Korea Times
Lee Jin-woo

A middle-aged American doctor who grew up in South Korea has stressed that it’s time to move on to helping North Korea with public health issues.

“North Korea’s food situation is at least better. We need to move on to public health issues including rebuilding the North’s nine provincial and 200 county hospitals,” John A. Linton of Yonsei University’s Severance Hospital in Seoul told The Korea Times in an interview on Monday. The 47-year-old doctor heads the hospital’s international health care center.

Linton, who is well-known for his Korean name Yin Yo-han and thick South Jeolla Province accent, proposed a three-stage medical support program for North Korea from the South Korean government.

“Number one, we need to help them with a vaccination program, which should be followed by supplies of diagnostic equipment,” he said. “The final stage should be an exchange of doctors between the two Koreas.”

He said North Korean doctors need basic diagnostic equipment _ ultrasound and x-ray machines, and clinical pathology supplies _ as well as more operating theaters.

“You have to have a healthy population in the North, for them to survive and become competitive enough to receive economic finance and business opportunities.”

He hoped that large-scale medical support to the North on a regular basis would be discussed during ministerial talks between the two Koreas in the near future.

“Nobody can argue with health care,” he said. “North Korea has been an enemy, but now at the same time they are brothers. Even if they are an enemy, you must help them.”

Linton, who visited the North 17 times between 1997 and 2003 to help eradicate tuberculosis in the Stalinist state, said it should be South Korea, not the United Nations or the World Health Organization (WHO), that needs to take the lead in helping the North.

“You have to be very, very careful with the U.N. and WHO. They treat the two Koreas as two separate countries differently,” he said. “Eventually policy should be looking towards unification. South Koreans should take the lead.”

Asked whether he is a big fan of South Korea’s engagement policy toward Pyongyang, dubbed the `Sunshine policy,’ he said he supports it wholeheartedly. Linton, however, emphasized the need to guarantee transparency in the process.

“We should not encourage some of the North Korean leadership as middle management is very corrupt. We should not reward corrupt people there. That’s not for us that’s for North Korea.”

His dedication toward helping the North was initiated by his mother, who worked to eradicate tuberculosis in Suncheon in South Jeolla Province for some 40 years. She decided to donate ambulances to North Korea in 1997.

“When we got there in Pyongyang, we suddenly received a special request from North Korea asking for assistance treating TB throughout the whole country,” he said. “We visited the entire country while helping them fight TB.”

In his autobiography published last year, Linton recalled his unforgettable experiences as an interpreter during the bloody Kwangju pro-democracy movement in May 1980.

He served as a translator to people who occupied the provincial capital against the then military regime led by former President Chun Doo-hwan.

“Immediately following this experience, I was labeled as an insurgent ,” he said. “The American embassy in Seoul asked me to leave Korea, just for translating for three to four hours for reporters.”

He said his experience in Kwangju changed his personal life and made him understand what injustice is and how dangerous newspapers are.

He said such a great sacrifice should never ever happen again on the Korean Peninsula.


NKorea food crisis complicated by politics: WFP

Tuesday, May 22nd, 2007

Philippe Agret

After being ravaged by famine in the 1990s, North Korea again faces serious food shortages, with a UN official based here saying that politics are making things worse.

On the road from the capital Pyongyang to Kaesong in the south, every hill lot is developed for agriculture, with all farm work done by hand.

But only 17 percent of the land in North Korea is arable, one of the lowest ratios in the world, according to the UN’s World Food Programme (WFP).

“North Korea is suffering a chronic food shortage due to structural problems and limited food imports and food aid,” said Jean-Pierre de Margerie, the WFP’s representative in the communist state.

He lamented the international community’s lack of commitment to North Korea amid the deadlock in six-nation talks on disarming Pyongyang, and what some consider to be “hidden sanctions” linking a large part of aid to politics.

“There is no evidence that holding back food or humanitarian aid destined to civilian populations would have an impact on the government or its behaviour,” he said.

North Korea’s worst period came from 1995 to 1999 when drought, flooding and the disappearance of Soviet aid led to a famine that killed between 800,000 and two million people, according to independent estimates.

The scars of the famine still run deep, with a 2004 United Nations study finding that 37 percent of North Korean children suffered chronic malnutrition.

Some experts use the term “7, 8, 9, 10” — as an adult, a seven-year-old born during the famine will be eight kilograms (18 pounds) lighter, stand nine inches (23 centimeters) shorter and live 10 years less than a South Korean of the same age.

The groups most at risk are young children and women who are pregnant or breastfeeding.

After a record harvest in 2005, 2006 was “very difficult” due to heavy floods in the summer and a dramatic drop in food aid and food imports; 2007 could also be dire, de Margerie warned.

Amid the international furore over Pyongyang’s nuclear and missile tests last year, China reduced its aid by half and        South Korea temporarily halted shipments.

Seoul has since resumed fertiliser aid and promised to provide 400,000 tons of rice to North Korea starting in late May.

But the food aid is linked to political conditions, such as Pyongyang shutting its nuclear reactor in line with a multilateral disarmament deal reached in February.

The impoverished country faces a shortfall of one million tons of food this year, or 20 percent of its needs, according to the WFP and the UN’s Food and Agriculture Organisation.

Up to one third of North Korea’s 23 million people may need assistance ahead of the next harvest, warns the WFP.

So is there a danger of another famine?

“No, not yet,” said de Margerie. “But if the trend continues, pockets of severe malnutrition could develop.”

In Pyongyang, not everyone is pessimistic as there is a lack of reliable agricultural data. Some observers say the problems lie in the distribution system and access to food, rather than in actual production.

North Korea’s leaders — whose ruling motto is “juche,” or self-reliance — say they have made food security their priority, but Pyongyang has nonetheless relied on foreign help.

The WFP has collected two billion dollars in 10 years, supplying four million tons of food between 1995 and 2005 that assisted one-third of North Korea in its biggest operation at the time.

Since 2001, multilateral aid from the WFP has been gradually replaced by assistance from China and South Korea. While bilateral aid goes to the government and may be distributed to the elite, the WFP says it closely monitors its aid so that it reaches those most in need.

This year, donor countries have promised only 12,000 tons of food.

The WFP has received only 20 percent of the financing for its programme up to March 2008, assisting three percent of the population, or 600,000 people, instead of the initial objective of reaching nearly two million North Koreans.

De Margerie says he hopes the international community will set aside political concerns to focus on the human tragedy unfolding in North Korea.

“You only see negative images of North Korea. But it has a human face,” he stressed.

“An eight-month-old child or pregnant woman does not engage in politics. It’s the most vulnerable in the civilian population who pay the price.”


Kim Jong Il Gets the Gifts, and All North Korea Ends Up Paying

Wednesday, May 16th, 2007

Bradley Martin

For decades, tourists visiting North Korea have been brought to a 200-room, 70,000-square-meter palace completed in 1978 that displays presents to Kim Il Sung, the “Great Leader,” who died in 1994.

Starting with Joseph Stalin’s 1945 gift of a bulletproof railway carriage, the items include a stuffed bird from American evangelist Billy Graham and a piece of the Berlin Wall donated by a German writer.

These days most visiting foreign dignitaries bring gifts for Kim’s eldest son and successor, Kim Jong Il, 65. The junior Kim’s loot is housed in a 20,000-square-meter (215,278-square- foot) annex that was completed in 1996 — a time when a famine was starving tens of thousands of North Koreans.

Why would the country have spent vast sums on four-ton bronze doors and polished marble floors? “Our people couldn’t display all these precious gifts in a poor palace,” says tour guide Hong Myong Gun. “So we built this palace with our best.”

The gifts in the windowless “International Friendship Exhibition” at Mt. Myohyang, a two-hour drive north of the capital, Pyongyang, range from the trivial to the grandiose.

Cable News Network founder Ted Turner donated paperweights with the CNN logo. A tribal chief in Nigeria offered a throne featuring carved lions, with matching crown and walking stick. Romanian communist dictator Nicolae Ceausescu brought the stuffed head of a bear he had hunted and killed.

Giving and Receiving

In Asia, the protocol of gift-giving has been well established since Chinese emperors began expecting visitors to bear tribute. The Chinese know how to give as well as to receive: Pride of place in the exhibit goes to one of their presents, a life-sized wax figure of Kim Il Sung standing on a three-dimensional representation of a lake shore.

Reverent music, calculated to induce bowing, plays in the background of the posthumous gift, the final exhibit viewed by visitors to the hall.

The elder Kim’s title of President for Eternity makes him the world’s only dead head of state, and Hong says he continues to receive gifts. As of last year, his presents numbered 221,411.

“No other president could draw so many presents, so our people live in pride,” she says. “Except for this place, where can you see such a sight?”

The annex for Kim Jong Il, whose titles include secretary general of the Workers’ Party and chairman of the Military Commission, houses 55,423 additional presents, Hong says. As with his father’s gifts, most of them were never used but were immediately donated to the exhibition.

A Dynasty Sedan

Some highlights in the annex: a 1998 luxury sedan from the founder of South Korea’s Hyundai group — the model named, appropriately enough, Dynasty — and two roomfuls of carved, gilded furniture from South Korea’s Ace Bed Co.

From time to time, groups of uniformed soldiers troop past to see the gifts. A high percentage of them are five feet tall or shorter. In the 1990s, North Korea reduced the minimum height for military service to 148 centimeters (4 foot 9 inches) from 150 centimeters and the minimum weight to 43 kilograms (95 pounds) from 48 kilograms, according to South Korea’s National Intelligence Service.

A 2004 World Food Program nutritional survey found that 37 percent of North Korean children suffered chronic malnutrition. The state “bears central responsibility” for the shrinking of North Koreans, says Marcus Noland of Washington’s Peterson Institute for International Economics, co-author of a new book about the famine.

Freeing Up Foreign Exchange

“As aid began arriving, the North Koreans cut commercial food imports, freeing up foreign exchange,” Noland said in an e-mail exchange.

The saved money was used to purchase surplus military aircraft from Kazakhstan and to build monuments “to the recently departed Great Leader Kim Il Sung and his son,” Noland says. If the regime had maintained the rate of commercial food imports during the 1990s, using aid as a supplement instead of a substitute, he says, “the famine could have been avoided.”

Noland estimates the death toll at 600,000 to 1 million; others have said as many as 4 million people may have died.

Tour guide Hong, 27, places the blame elsewhere. “From 1993 to 2000 our people suffered from countless natural disasters and also from other pressure in the economic field owing to the U.S. aggressors,” she says, referring to sanctions. Even during such hardships, she says, constructing the annex with the best materials was “the greatest desire of our people.”

As she speaks, there is a brief power blackout, a frequent occurrence in the energy-short country. When the lights come back on, Hong continues.

“Our people are very grateful because the Great Leader Kim Jong Il sent all the gifts here for the people to look at freely,” she says. “It was our duty to preserve them and show them to the new generation.”


Distributions Increased in South Hamkyung To Boost Birthrate

Wednesday, May 9th, 2007

Daily NK
Han Young Jin
“If you have a second child, your rations become equivalent to a family of 4”…citizens respond apath 
North Korean authorities have been scrutinizing over the decreasing number of birthrates by young couples and as a result have proposed to increase the amount of rations to families having children.

If a couple gives birth to a second child in the district of Hamheung, South Hamkyung, the whole family will receive 6 months worth of distributions, a source informed. If a third child is born, the rations increase all the more.

After giving birth to a child in a hospital, a married woman from Hamheung can obtain a birth certificate, which is then submitted to the local district office, to receive distributions equivalent to a family of 4. These proposals resemble policies implemented by local district offices in South Korea.

Though Hamheung city has made efforts to increase the birthrate with distributions, the people’s response is all but cold, the source said. How many people would really have a second child just to scavenge off a few months worth of distributions.

One of the main reasons that the birthrate is decreasing in North Korea is due to the fact that women are avoiding giving birth, informed the source.

The source said, “Nowadays, North Korean women engage in businesses and are the breadwinners of the family. They are not satisfied with just having children and bringing them up” and added, “Everyone knows that it is hard enough to live and even harder if you have a lot of children.”

North Korea’s birthrate has continued to decline since the late 1990’s. The average birthrate in North Korea in 1993 was 2.1 births per family and in 2002, 2.04. Comparatively, in South Korea the birthrate per family in 1970 was 4.53 and 1.19 in 2003. Within a period of 33 years, the number of childbirths per family had reduced to 3.34 persons.

In an interview with the Jochongryeon last December, Kang Nam Il, head of the North Korea Population Research Center said, “The decrease of birthrates in our country (North Korea) is no different to that of other nations” and remarked, “Women want to have 2 children, though in the cities women have either 1 or 2 children.”

The source said, “There may be slight differences in each district. Nonetheless, most of the larger cities have adopted this proposal” and added, “This policy was implemented as North Korean authorities are finding it difficult to reach the quota for conscription and the number of students enrolling in schools.”


Family Planning Campaign

Monday, January 22nd, 2007

Korea Times
Andrei Lankov

Old-style Communism had no doubt about the birthrate. Its approach to fertility was simple and straightforward: the higher, the better. There could be no such a thing as too many soldiers or too many workers.

Thus, Communist states went to great lengths to stimulate the birth rate. Of course, material incentives of all kinds were used widely: an additional tax levied on childless people, heavily subsidized kindergartens and creches, long maternity leaves.

Large families enjoyed special access to goods and services, a significant privilege in an economy based on distribution, and plagued by scarcity.

The material incentives were augmented by intense propaganda.

In the USSR from 1944, a mother who raised more than seven children was decorated with a special order and provided with many privileges. The caveat was that it was not enough to just give birth seven times: the decoration could only take place when the youngest of the seven children reached the age of one year.

The same approach was adopted by North Korea in the early stages of its history. Any other policy would be strange: the country suffered huge population losses in 1945-1953, partially due to the war and partially due to the large-scale migration to the South.

The population was believed to be 9.3 million in 1946, but by 1953 it had declined to 8.3 million.

In 1966 the fertility rate in North Korea reached the very high level of 6.5 children per woman. This was higher than the fertility rate in the South where it had already begun to decline, not least due to a government- sponsored campaign.

But then something happened. Around 1970, fertility rates nose-dived in the North, supplying one of the most dramatic reductions in the world’s demographic history. They dropped to 4.5 in 1974 and then to 3.5 in 1976. The crude birth rate, measured in the number of live births per 1000, declined from 35 in 1970 to 18 in 1976, thus halving in merely seven years.

All these figures are quite reliable since demographic statistics are probably the only kind of North Korean statistics decently known to the outside world. We know this through a blunder by the North Korean authorities who, in the early 1990s, invited a group of foreign experts on demographics to the country and provided them with full access to the relevant data. This was done to get their advice on the forthcoming population census.

To make sure that the foreigners would not create any harm, the data was slightly doctored, but the North Korean officials obviously did not realize that demographic data is, by its very nature, remarkably consistent, so an expert can easily reconstruct missing sections. When they understood their mistakes, the authorities tried to prevent the data from being published, but it was too late.

This statistics which became available in the 1990s confirmed what was long suspected: in the early 1970s, North Korea waged a highly intensive and highly successful family planning campaign. The information about this campaign has filtered out through defectors, but few if any experts understood how dramatic and decisive it actually was.

In the early 1970s, abortions were legalized and education about contraceptive procedures became obligatory in all kinds of health centers. Despite increasing difficulties with all kinds of goods, the contraceptive devices were widely manufactured and freely distributed.

The three-child family was proclaimed an ideal, and from 1978 the desirable number of children was further cut to two.

Around the same time, the marriage age was increased dramatically. The legal marriage age remained the same, but the public North Korean laws are not necessarily written to be followed.

The actual life of the country is determined by instructions, of which the instructions by the Great Leader himself are by far most important. And the Great Leader said in 1971, and said in no uncertain terms, that the youth should be sacrificed for the sake of revolution, not for raising families. In his wisdom he said that a good time to marry would be when a woman reached 28 and a man reached 30. Needless to say, a wish of the Great Leader became instantly the law of the land.

But it was never stated that all these measures were aimed at curbing birth rates. This was the major peculiarity of the entire campaign: in spite of its huge scale, it remained essentially secret. Perhaps, the North was unique in being the world’s only state which was in position to wage an invisible campaign of this kind.

The existence of very efficient and non-transparent channels of influence created such a unique opportunity: orders could be transmitted through party bureaucracy to every family without attracting anybody’s attention, while incentives could be distributed and punishment could be inflicted without much noise.

It is not clear what made Pyongyang undertake such a dramatic reversal of its earlier policies. From the officially published documents of the 1970s it seems that Kim Il-sung began to worry whether grain production was growing fast enough. Perhaps, it was decided to curb population growth because the government was not sure whether it would be able to feed more mouths in the future.

Perhaps, the impact of the intense South Korean family planning campaign was also felt in the North. Unlike lesser beings, North Koreans leaders have always been careful readers of the South Korean press, and they often imitated their adversaries in everything from dress fashions to ideological trends.

Finally, the changing mood of the developing world may have played a role. The early 1970s was the period when developing countries came to see population growth as a problem rather than an opportunity.

At any rate, the program was remarkably successful. Nothing like it could happen these days, when Pyongyang is gradually loosing its ability to monitor and direct all activities of its subjects. The days of Stalinism with North Korean characteristics are long gone.


S. Korea Investigating Aid to North

Monday, January 22nd, 2007

Donga (Hat Tip DPRK Studies)

It is expected that the government’s aid to North Korea will be affected as the international community has decided to investigate the general situation of aid projects using U.N. funding including the United Nations Development Program (UNDP). So far, the government and private groups supporting North Korea have often used international organizations as a means to give humanitarian aid to the North, as such aid through the World Health Organization (WHO), United Nations Children’s Fund (UNICEF), World Food Programme (WFP) and others are less influenced by the inter-Korean relations.

Last year, the government and private organizations didn’t provide previously planned corn aid to the North in the aftermath of North Korea’s missile and nuclear tests. However, they spent 5.912 billion won in malaria preventive measures and infant and child support.

In 2005, they sent products worth 25.773 billion won in food aid and quarantine measures against malaria. Besides, they provided goods worth 2.254 billion won in aid and preventive measures against malaria with the North in 2004, and offered North Korea goods worth 20.303 billion won in corn, malaria preventive measures, and vaccine and immunizing agents in 2003.

The total sum Korea spent on the North in humanitarian assistance over the last 10 years (from 1995 to 2004) amounts to $119.43 million, 7.99 percent of the total U.N. financial aid of $1.49 billion to North Korea. During the period, apart from world organizations, the government gave the North $1.16 billion in financial support.

A government official said, “The government’s support for North Korea through international groups is its obligation as a responsible member of the international community,” and added, “Assistance for North Korea through world organizations is for humanitarian purposes, and as far as I know, there is no possibility for misappropriating funds since the aid is being carried out based on a principle of providing 100 percent goods.”

However, contrary to the above government’s official statement, the government seems rather perplexed at the suspicion that its aid through world organizations was diverted to be used for the North’s nuclear development program. The government has used world organizations as an indirect route for its aid toward North Korea because it was worried about getting embroiled in accusations that it is being too lenient on North Korea.

Unification Minister Lee Jae-Jeong also said in his inaugural speech that even humanitarian aid should be divided into emergency aid, assistance in loan form and aid for development, and that emergency aid should continue under any circumstances in order to emphasize the continuation of government’s support for North Korea through world organizations.

Minister Lee has so far expressed regret to the WFP over the suspension of food aid to the North and emergency relief aid for North Korea’s catastrophic flood damage. Another government official stated, The “UNDP seems to have nothing to do with humanitarian aid since it is aid for the development of North Korea. Still, it will still affect the government’s humanitarian assistance program for the North in the future.”

Meanwhile, it was revealed that the government is investing in the Tumen River Area Development Programme (TRADP) the government has been participating in since 1995 under the auspices of the UNDP. An official at the Ministry of Finance and Economy noted, “This year, the government will pay $181,000 for the operating expenses of the TRADP office.”


DPRK population statistics

Friday, August 18th, 2006

The Daily NK compared pupoluation statistics from the Population Resource Bureau.

Here are the statistics on North Korea.

Here are the statistics on South Korea.

Here is the story:

North Korea’s infant mortality reaches 21 for every 1000 due to the country’s poor medical system.

A non-profit demographic institute Population Research Bureau (PRB) reported on Thursday that, as of mid-2006, North Korea’s population is approximately 23.1 million and it is expected to increase to 25.8 million in 2025 and 26.4 million, an increase of 14% from now, in 2050.

North Korea’s birth rate is 16 per 1000 people and death rate is 7 for every thousand, and the natural population increase is 0.9%.

North Korea’s infant mortality (21 for every 1000), which is far higher than that of South Korea (5 for every 1000), implies the North’s weak health care system. The average life expectancy is 71 years, 68 for men and 73 for women. Urban population rate is 60 percent.

According to the report, this year’s world population is 6.55 billion and expected to reach 7.94 billion in 2025 and 9.24 billion, 41 percent more than now, in 2050.

Meanwhile, the primary reason for North Korean infants’ death is respiratory infection and diarrhea. And a third of total North Korean infants are suffering serious malnutrition.


Is whooping cough on the upswing?

Sunday, July 23rd, 2006

From the Daily NK:

NK Whooping Cough…Infant Deaths Helpless

It has recently been confirmed that some children have died of ‘whooping cough’, an acute respiratory epidemic, in Hamhung and Chongjin. In Chongjin, children under 12 are restricted from taking long-trips.

Among North Koreans who have visited areas surrounding Yanbian, rumor has it that “Since this spring, the number of coughing children has increased”, yet this was the first time that a death from a respiratory epidemic was confirmed.

“In Hamhung, some infants have died”

On the 12th, Park Chul Man (pseudonym, 62, Hamhung) who came into China via Tumen said that, “Since mid-April, wooping cough has increased among preschool children, and since June, some infants have died. In Hamhung and Chongjin, all children from infancy to elementary school-age are restricted from going on long trips”.

Kang Sun Mi (pseudonym, 59, Sariwon), from Yanji said that, “Across areas of Hwanghae province, many children suffer from whooping cough”. Kim added that, “children with the illness are confined to preschools, or elementary schools, and their parents bring medicine and food to them daily”.

Whooping cough is an acute respiratory disease to which infants below 5 years old are particularly vulnerable. Throughout the world, 40,000 people die from it annually. After an incubation period of 1 to 3 weeks, children develop a high fever, a runny nose, and continue to cough and tear”.

According to a WTO report, amongst poor countries. wooping cough accounts for 15% of total annual deaths, with the highest death rate recorded in children under 6 years old. The side effects from high fever are usually brain damage and liver failure.

According to Kang, the parents of the sick children take care of all the children confinded to preschools, or elementary schools.

Kang said that, “Because there is no medicine or doctors, it was decided that the should parents do all the nursing work”.

Except for in Pyongyang, the preventive inoculation system is totally destroyed

According to witnesses, since 2002, the preventive inoculation system has been completely destroyed, except for some operation in Pyongyang.

Kim, a defector doctor living in Longjing, explaiend that, “Til 2001, some medicine sent from the U.N. and other sources abroad had been available in Hwamkyung province. However, recently all the medicine goes into Jangmadang to be sold. It is impossible for poor parents to get their children inoculated”.

Kim added that, “the fact that Children over 10 years old have come down with whopping cough shows that the preventive inoculation system in the North is completely dysfunctional”.

According to the UNFPA, the 2004 infant death rate in North Korea is 58 out of 1,000 infants, which is ten times as high as that of South Korea (5.3 out of 1,000 infants).

In 2000, UNICEF reported that, “92.4% of North Korean children under 5 years old were inoculated with DPT to prevent whooping cough, tetanus and diphtheria”.


Triplets rounded up?

Thursday, March 9th, 2006

From the Times of London:
Michael Sheridan

ALL baby triplets in North Korea are being removed from their parents and placed in bleak state orphanages where they are fed by foreign aid.

The policy has prompted concern among diplomats and aid officials, who have witnessed sets of babies kept in special “triplet rooms” in orphanages across the country.

“There is no doubt that the policy is compulsory and universal,” said a seasoned diplomatic visitor to North Korea who has seen the rooms. He said he had not noticed family members visiting the children in his many calls at the orphanages. Conditions when foreigners are allowed to enter appear to be spartan but clean, according to several witnesses.

Food supplies to orphanages are a priority for both the United Nations relief agencies and the North Korean authorities. Local officials have assured inquirers that the babies are being given privileges to relieve their parents of the anxiety of feeding three mouths while the impoverished Stalinist nation endures an eighth year of food shortages.

But diplomatic experts who understand the Korean language and culture cast doubt on the official explanation.

They believe the true reason is linked to some of the most bizarre aspects of Kim Jong-il’s dictatorship. The number three is auspicious in Korean mysticism and triplets are revered for exceptional good fortune. Some believe they may be destined for power and great achievements, which would account for the regime’s desire to keep them under observation.

Diplomats and international aid officials also doubt that poverty is the explanation, because not even triplets born to high-ranking party members are exempt. “It may be officially atheistic and Stalinist but essentially North Korea operates a state religion infused with superstition, astrology and a personality cult which glorifies Kim as a unique individual,” said the veteran diplomat. “You don’t take any chances with rivals in that system.”

Power conferred by blood descent is also important in Korea’s Confucian tradition. The North Korean capital, Pyongyang, was rebuilt by its communist rulers along principles of Chinese geomancy, with “power lines” linking the purported birthplace of the previous dictator, Kim Il-sung, with the purported tomb of Tangun, founder of the Korean race. As heir to the world’s only communist dynasty, the younger Kim exploits every such tradition to exalt himself, while keeping a careful watch on his clan network of intermarried army and party men.

Children of the elite are usually taken from their parents by the age of two and placed in party-controlled schools to break family bonds and to consecrate their devotion to Kim. Foreign observers believe the triplets are kept together and transferred to these schools when old enough.

The segregation of triplets has provoked debate among UN aid agencies and non-governmental organisations delivering help to North Korea.

Although there appear to be no reasons to fear for the physical safety of the triplets, regular visitors to North Korean orphanages report desperate scenes of isolation and sadness.

On a recent visit a member of a foreign delegation entered a room to see infants placed several to a cot, all rocking backwards and forwards.

“Our people were stunned into silence,” the delegate said. A paediatrician outside North Korea who assessed evidence collected on the visit diagnosed severe emotional trauma.

Witnesses said they had noticed better nursing attention and care for triplets in the special rooms. “But none of those infants knows what affection is,” said one visitor. “Our staff try to cuddle them for a few minutes but then, of course, we have to leave.”

Up to 300 sets of triplets a year are believed to be born in North Korea. In an official statement to the UN Human Rights Commission in Geneva, North Korea said: “Triplets are supplied by the state free of charge with clothing, bedding, a one-year supply of dairy products and a pre-school subsidy, and special medical workers take charge of such mothers and children and care for their health.”

The UN’s World Food Programme has reported a sharp improvement in children’s health in North Korea thanks to foreign aid. Since 1998 cases of acute malnutrition in children under seven have fallen from 16% to 9%, and the number of underweight children has decreased from 61% to 21%.

As tension mounts between North Korea and the United States over Pyongyang’s nuclear programme, however, aid officials fear that any military clash could put at risk their ability to feed the children.

There is little doubt of the regime’s cold-hearted approach to paediatrics. In 1998, Médecins sans Frontières pulled out of North Korea, alleging that aid agencies were denied access to so-called 9-27 camps in which sick and disabled children had been dumped under a decree issued by Kim to “normalise” the country.

UN agencies are still arguing for access to closed districts in the northeast of the country, where prison camps and military facilities are located.


North Korea’s stunted policy stunts children

Tuesday, March 15th, 2005

Asia Times
Aidan Foster-Carter
March 15, 2005

It’s a cliche to complain how little we really know about North Korea. Hard facts, and especially figures, are indeed hard – as in hard to come by.

In some fields this is perfectly true. The military, obviously. Does North Korean leader Kim Jong-il have the bomb or bombs? How many? Where is he hiding them? All countries keep that kind of information secret.

But no other nation in the world fails to publish any regular statistics about its economy. This 40-year silence should temper hype about market reforms. Without numbers, neither local enterprises nor external donors or (they wish) investors can do more than gamble in the dark. They really do need to know. Providing accurate numbers is a basic prerequisite of being a modern state.

Yet North Korea possesses a Central Bureau of Statistics (CBS), and it is not idle. No doubt the Dear Leader demands economic data – for his eyes only. But in some fields, the CBS does publish its work. One example was North Korea’s 1993 census, its first ever.

More recently the CBS has worked with international aid agencies to collect information that the latter need in a key area: hunger and its human consequences. The latest fruits of such cooperation have just been published in the “DPRK 2004 Nutrition Assessment Survey”, a joint product of the Central Bureau of Statistics and North Korea’s Institute of Child Nutrition (ICN), with financial and technical help from United Nations Children’s Fund (UNICEF) and the United Nations World Food Program (WFP). The two chief consultants were from Australia and Vietnam, so this was a regional Asian effort. It follows earlier surveys carried out at two-year intervals, in 1998, 2000 and 2002.

It was the WFP that released this report, at a press conference in Beijing on March 7. It is in fact dated November 2004; the survey itself was carried out in October. The delay wasn’t explained. Perhaps the lag was attributable to translation time and to make sure it was fit for publication generally.

I’m often critical of North Korea, so all the more reason to give credit when it’s due. This is an impressive, highly professional report comprising 104 pages, five chapters, 46 tables, 24 figures. The sample was 4,800 children, ages up to six, and 2,109 mothers of children under two, drawn evenly from seven of North Korea’s nine provinces plus the capital, Pyongyang.

Having taught social science research methods in a former life, I get a kick out of reading about random and cluster sampling (sad, I know). Then I pinch myself. This is North Korea. An official document! All these numbers! And on a potentially very sensitive subject, too.

For what this survey measures, with grim precision, is what years of hunger have done to the bodies of small children – and I do mean small – and their mothers in North Korea.

To be technical, there are three main criteria:

*Underweight (for age) is self-explanatory;
*Stunting, low height for age, signals chronic malnutrition;
*Wasting, worst of all, is low weight relative to height, indicating acute malnutrition. Each of these categories is sub-divided into mild and severe cases. For the mothers, a fourth measure was used: MUAC (mid-upper arm circumference). Less than 22.5 centimeters means they aren’t eating enough.

So how are Juche’s (juche is the policy of self-reliance) children faring? The WFP’s press release tried to look on the bright side. Since the last survey in 2002, the proportion of young children chronically malnourished (stunted) is down from 42% to 37%. Acute malnutrition (wasting) eased from 9% to 7%. But those underweight rose from 21% to 23% – though for children under the age of two, those most at risk, this fell from 25% to 21%. One in five children had diarrhea, and one in eight showed symptoms of acute respiratory infection. But mothers have made no progress: a third were anemic and malnourished, the same figure as two years ago. Vitamin A deficiency is common.

Much depends on where people are living. Things are less bad in Pyongyang and in the southwestern Hwanghae farming region than in bleak northeasterly Hamgyong and Ryanggang provinces. Ryanggangites get to eat meat, fish or eggs just once every three weeks on average. Chagang in the far mid-north is bleaker still, but North Korea doesn’t allow access to this area – probably because of military bases located there. Thus, no survey was conducted in Chagang, which means no food aid either; the WFP is strict about that – surveys first.

Even at the national level, the few slight improvements offer scant comfort. The more than one-third (37%) of North Korean’s under six who are stunted – and especially the one in eight (12%) who are severely stunted – will grow up stunted and stay that way. Even once Korea is reunified politically, they will stand out physically: dwarfed by their Southern peers.

Seoul, meanwhile, has different – nay, opposite – child health issues. With uncanny timing, the very same day as the WFP released its survey on the North, education officials in the Southern capital reported that one in 10 schoolchildren in Seoul is overweight. Obesity rates are growing fast, too. As the old adage has it, the rich slim while the poor starve.

Back in the North, the WFP doesn’t appear to be leaving any time soon. Richard Ragan, head of the program’s Pyongyang office – and an American, to boot – said he hopes the agency will shut up shop one day, once the government and the private sector can stand on their own feet.

But for now, one anniversary a proud North Korea won’t be celebrating, is that this year marks a whole decade since it first, reluctantly, asked the WFP and other agencies for help coping with flood and famine. While the worst of the famine has eased, food self-sufficiency – in a country so mountainous that this is a ludicrous goal anyway – looks as remote as ever.

So still, in 2005, the WFP has extended the begging bowl for Kim Jong-il – whose own priorities evidently lie elsewhere. Ever prickly Pyongyang has bitten the kind hand trying to feed it, forbidding UN agencies to launch their usual formal consolidated aid appeal this year. Nonetheless the WFP is seeking $202 million with which to buy 504,000 tonnes of food, mainly grains.

And no wonder. In January North Korea cut its Public Distribution System (PDS) rations to starvation level: 250 grams of cereal per person per day, the lowest in five years. Such cutbacks don’t usually happen until March, when last year’s crop typically runs out. This is all the more odd, since 2004’s autumn harvest is thought to have been the best in years.

Luckily, the WFP currently has enough stocks – as it did not, in the recent past – to feed all of its target group: a staggering 6.5 million North Koreans, or nearly one-third of the entire population. The main categories within this group are 2.7 million children from birth to the age of 10 and 2.15 million people in food or work programs. Other beneficiaries include 900,000 elderly, 300,000 pregnant women and nursing mothers, and 350,000 in low-income households. The latter are a new category: victims of the post-2002 reforms that have seen inequalities widen, even as the state retreats ever further from providing any help to the millions of citizens whom its disastrous past and half-baked present policies have starved and stunted.

That’s my take, not the WFP’s. Diplomacy precludes any such critique from a UN body. Yet the raw data, the results – written indelibly on the bodies of innocent children, marked for life – are there for all to see. It’s ironic, but the same regime that branded this suffering on its people is at least now registering and owning up to the outcome: collating and publishing these damning data, putting its name to the survey, and signing off on it. That’s a start.

Where his statisticians boldly go, will the Dear Leader follow? It’s so simple. Ditch nukes; watch aid explode instead. Let the children eat, and grow. If not, what future is there?