In October 2011, Bangkok-based photographer Damir Sagolj traveled with Alertnet, a Thomson Reuters Foundation’s humanitarian news service, and Médecins Sans Frontières to North Korea, at the request of the regime’s Economy and Trade Information Center. After six months on standby, the group was granted a tightly controlled week-long trip into the South Hwanghae region, the country’s rice-bowl, to report on a growing food crisis. They gained access to collective farms, orphanages, hospitals, rural clinics, schools and nurseries rarely or never seen by the media.

In a pediatric hospital in North Korea’s most productive farming province, children lay two to a bed. All showed signs of severe malnutrition: skin infections, patchy hair, and listlessness. “Their mothers have to bring them here on bicycles”, said duty doctor Jang Kum Son in the Yellow Sea port city of Haeju. “We used to have an ambulance but it has broken down completely. One mother traveled 72 kilometers. By the time they get here, it is often too late”.

According to World Food Program (WFP) estimates (March 2011), 6 million North Koreans need food aid and one-third of children are chronically malnourished and/or have stunted growth. In contrast, the United Nations recognizes a food crisis in Somalia affecting 4 million people. North Korea has relied on food aid since the mid-1990s. Critics say Pyongyang spends most of what little hard currency it earns maintaining a million-strong army and developing nuclear weapons and missiles instead of feeding the millions suffering from malnutrition.

A savage winter that froze seeds in the ground hit early crops even before the summer’s floods. The province of South Hwanghae normally produces one-third of the country’s total grain supply, pumping wheat, maize and rice into the Public Distribution System which supplies food to two-thirds of the population.

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Appeals by the regime for massive food aid (the apparent motive for granting access) had gone mostly unanswered by a skeptical international community. Only 30% of a UN food aid target set for North Korea had been met. The USA and South Korea, the two biggest donors before sanctions, had said they would not resume aid until they were satisfied that the military-led communist regime would not divert the aid for its own uses and until progress had been made on disarmament talks.

The image which the regime presented in South Hwanghae was largely one of chronic hunger, dire healthcare, limited access to clean water and a collapsing food-rationing system, all under a controlled economy that has been in crisis for more than twenty years, ever since North Korea was left in isolation after the collapse of the Soviet Union.

In one orphanage in Haeju, 28 children huddled together on the floor of a small clinic, singing "We have nothing to envy, " an anthem to North Korea's longstanding policy of juche (self-reliance) that has made this one of the most closed societies on earth.

Measurements taken of each child's mid-upper arm with color-coded plastic bracelets, a standard test for malnutrition, showed that twelve were in the orange/red danger zones, meaning that some could die without proper treatment. MSF nutrition experts found similar results among children at other institutions, but stressed that the findings were not statistically significant.

At an orphanage in Hwangju town in North Hwanghae province, eleven of the twelve children in the clinic were critically malnourished and appeared to be no more than three or four years old; orphanage staff insisted that they were eight, but severely stunted because of malnutrition. "I've never seen stunting like this before, not ever, not even in Ethiopia”. [Delphine Chedorge, deputy program manager of emergencies, MSF France].

Tim Large, Editor-In-Chief, Thomson Reuters Foundation

Damir Sagolj

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