A slow silent famine

Jang Ryon Hwa is worried about her two-year-old daughter, Rang Myong Hui. The little girl suffers from malnutrition, and three months ago began to have digestive problems. She has bald patches on her head and scab marks on her thin arms and legs. Her mother was pregnant with her when the first food shortages hit, after the 1995 floods. “She has never had enough to eat, but her condition deteriorated this year,” says her mother.

There are thousands of children like Rang Myong in the Democratic People’s Republic of Korea (DPRK), commonly referred to as North Korea. They were born malnourished and have known only hunger in their short lives, their physical and mental development forever affected.

The misery and poverty has touched all levels of society. Although some suffer more than others, the general nutritional status of the population has been declining for years. Food rations distributed by the government have fallen gradually from 700 grams per person per day two years ago to 130 grams today. And even that is not always possible.

The same story is repeated throughout the country. Agricultural production is either reduced or has come to a standstill. Food is harvested manually, as the farming equipment stands idle due to lack of fuel and spare parts. Less industry, less agriculture, less fishing — these are all symptoms of an economy in ruins, ex-acerbated by two consecutive years of flooding which destroyed the infrastructure, coal mines and arable lands.

Politics and food aid

International aid agencies, denied access to certain areas in the country, are unable to conduct reliable surveys on the extent of the disaster. Although they never doubted that the situation was extremely serious, agencies spoke with less conviction than usual, wondering what was disguised, what was set up and what was true. It reached a point this summer when delegations from different agencies who had visited the country were issuing conflicting reports. Some stated that the worst was over and the country would pull through the crisis, while others claimed malnutrition among children to be as high as 30 to 50 per cent.

To compound relief efforts, political manoeuvring entered the fray. En-couraged by the response to the first international appeal after the floods in 1995 (and again in 1996), the International Federation launched its third appeal in November 1996. This time, though, donor support was replaced by doubt, hesitation and reluctance. It did not help that the DPRK itself stated food aid as a precondition for participating in peace negotiations. Nor did it make it any easier for aid agencies to convince donors that food and politics should not be mixed.

Watching the situation deteriorate, the Federation was faced with a dilemma: ring the alarm bells and talk about an impending mass starvation, while having considerable difficulty raising funds for its relief operations to assist 139,000 flood victims. A breakthrough came following talks in China in May of this year between the two National Societies on the Korean peninsula. Overcoming the political barriers between their respective countries, South Korea agreed to donate food and the DPRK allowed the expansion of distribution of relief to 740,000 people.

With the increased scope of the relief programme, both the Federation and the DPRK Red Cross faced new challenges. The most immediate concern was to set up an independent distribution network for the DPRK Red Cross. This was achieved through the work of the international relief department and over 3,500 volunteers. The distribution network is the largest and only independent relief operation in the country to date.

Following the appeal, the Federation also incorporated programmes to address the underlying problems made evident by the famine — health care and disaster preparedness. A health programme is under way to provide essential drugs and medical equipment to over 106 hospitals and 343 clinics in 19 different districts. The empty clinics and hospitals graphically revealed the weaknesses inherent in the medical community and their capacity to treat malnutrition and other illnesses. In some places, consultations had dropped to 25 per cent of the previous level. Additionally, a three-year disaster preparedness programme has been launched, with the Federation assisting the DPRK Red Cross to increase its ability to respond effectively and to mitigate the risks of natural disasters before they occur.

Lost Childhood

Huichon was one of the worst-affected areas during the floods. In the paediatric ward of the concrete hospital in the centre of the town, 50 out of 75 children are suffering from malnutrition. Three-year-old Li Chol Nam sits listlessly on a small bed, staring into space, his feet curled under him. He suffered from third-degree malnutrition, the most serious. Children under the age of three are attended by their mothers who move into the hospital with them, older children are attended by nurses. Li Chol is the youngest of three siblings. His mother died of malnutrition a month ago. When he came to the hospital, he only weighed five kilograms. He is now six kilograms, but should weigh 15 to 16 according to Dr Chagi Chol, the assistant director.

Children like Li Chol normally stay in the hospital just over one month. When they leave, they have not fully recovered, but are in stable condition.

“That is all we can do. Traditional medicine, which is all we have, cannot reverse their condition,” says Dr Chagi.

Meanwhile Li Chol sits without moving, holding a rattle in his hand.

Worse to come

During the summer, it seemed as if the famine would not develop into mass starvation and that the impending catastrophe would be averted. This was partly thanks to the contributions of the United Nations World Food Programme and the Federation, as well as the enormous interest and goodwill of the world media which highlighted the conditions in DPRK despite being prevented from entering the country. Having a place on the world agenda brought hope. There was brief optimism that the situation could be redressed with a good harvest in October, although no one believed it would be enough to feed everyone for a full year.

But there were no rains in July and August and tidal waves destroyed areas previously considered in good condition. Optimism faded. With dim prospects for the harvest and 50 per cent less livestock from the previous year, life is becoming even more difficult. Surviving a summer with small rations of food has been tough. As winter approaches with little heating and less food available than ever, the famine may neither be slow nor silent.