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Tuesday, July 27, 2010


The tragedy in North Korea

With the sinking of the South Korean Navy vessel Cheonan, the missile and nuclear tests and the fire-breathing rhetoric, it is easy to forget that North Korea is also an economic basket case. A nation that once outpaced its southern neighbor in economic development has been teetering on the brink of seeming collapse for years now. A new report on the horrific state of North Korea's health care system is a much-needed corrective to the prevailing image of the reclusive nation and a reminder of the appalling human price of the decisions made by the leadership in Pyongyang. While we cannot ignore the regime's bluster and provocations, we must also remember that millions of North Koreans are victims as well. It is our duty as fellow citizens to help ease their suffering.

In a grim new assessment, Amnesty International concludes that the Pyongyang government has systematically failed to provide its citizens with basic health care. The antiseptic language of the report — "The people of North Korea suffer significant deprivation in their enjoyment of the right to adequate health care" — glosses over an ugly reality. Hospitals are unheated, lack running water and often experience blackouts as a result of energy shortages. There is a chronic shortage of medicines, bandages and sterilized needles. There are cases of doctors being forced to perform amputations without anesthesia.

This sad situation is compounded by "chronic malnutrition" throughout the country. North Korea was hit by a famine in the 1990s that claimed as many as 2 million lives. The hardships continue amid economic mismanagement and a series of natural disasters. According to North Korean government statistics, between 2004 and 2008, the latest year for which data are available, food rations ranged from 150 grams per person per day to 350 grams per person per day. The World Food Program estimates that between 2003 and 2007, less than a quarter of households are on the official food distribution system and only two-thirds of farmers received food rations, and rarely the full entitlement. Half of North Koreans eat just two meals a day; some 9 million people out of a population of 23.7 million were considered to be "food insecure." Earlier this year, (South Korea's) Korea Rural Economic Institute concluded that North Korea's estimated shortfall for 2010 was 1.29 million tons of grain, or nearly four months of food supply.

As a result, 45 percent of all North Korean children under the age of 5 suffer stunted growth because of malnutrition. Nine percent of children under 5 suffer from wasting; 25 percent are underweight, 7 percent severely. The World Food Program estimates that in 2009 one-third of North Korean women were malnourished and anemic. Tuberculosis afflicts at least 5 percent of the population.

North Korea has experienced disasters such as a series of floods and droughts. Food shortages forced North Koreans to forage, denuding the countryside and making it even harder to cultivate agriculture. But the real culprit is economic mismanagement. Government policies have discouraged people from farming and selling to government distributors; the result has been increasingly short food supplies and soaring prices.

The problems are compounded by North Korea's economic isolation. Pyongyang's belligerence, and its disregard for international norms — particularly its nuclear and missile tests — have triggered successive rounds of sanctions. While the sanctions exempt humanitarian aid and have been tailored to avoid imposing hardships on ordinary North Koreans, in fact the termination of much of the country's international exchange, from trade to the suitcases of cash that traveled from Japan to the northern half of the peninsula, has squeezed the economy and most North Koreans have felt the pain. The North Korean economy has contracted three of the last four years — 2008 was the exception — and should shrink again in 2010.

Even aid is circumscribed by the conditions put by Pyongyang on its distribution. Donors fear that their assistance has been diverted or used for political purposes. The North Korean government's refusal to accept monitors has meant that donors are increasingly reluctant to give, and aid organizations have withdrawn their operations. In May, the World Food Program announced that its aid to North Korea — funded at only 10 percent of its target — would run out by the end of June.

Plainly, the first responsibility rests on the shoulders of the North Korean government. It should allow food aid to be distributed in ways that conform to international norms. It should embrace reforms that encourage farmers to grow food rather than hoard it. For their part, the rest of the world must endeavor to ensure that the North Korean people do not suffer for the misdeeds of their leaders. Humanitarian concerns should dominate decision making — by both North Koreans and other nations. That basic principle has been ignored for too long.

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