Staffdel Kirk
Final Report to
Benjamin A. Gilman (R-NY)
International Relations Committee
 U.S. House of Representatives
Mission to North Korea and China
August 11-23, 1998
U.S. House of Representatives

DATE: August 31, 1998

RE:  Mission to North Korea and China, August 11-23, 1998

At your direction, we assembled a team to assess the food situation and other bilateral issues between the United States and North Korea.  The team consisted of Mark Kirk, Majority Counsel, Peter Brookes, Majority Professional Staff Member for East Asia, Maria Pica, Minority Counsel, and Larry Nowels of the Congressional Research Service.

In sum, we found that the severe food shortage in the country continues.  The prospects for the coming October harvest are better than in years past but will not cover North Korea's needs.  The North Korean government has failed to implement any significant reforms that would reverse its severe economic decline.  When Kim Il Sung's son, Kim Jong Il, becomes President on September 9, he will face four stark options:

 1)  Widespread malnutrition,
 2)  Dependence on food aid,
 3)  Economic reform, or
 4)  Any number of irrational or provocative acts including attempting a forced reunification of the peninsula.

Given the growing fatigue of European and Japanese food aid donors, continued dependence on massive food aid deliveries is untenable.  Therefore, Kim Jong Il faces the difficult choice of reforming his country's economy or letting his people starve.  At this time, it is unclear which choice he will make.

During our mission, we were given unprecedented access to remote regions of the country, visiting several kinds of institutions not previously seen by westerners.  We visited 13 major institutions in three remote provinces including: five hospitals, four orphanages, two primary and secondary schools, and two Public Distribution System (PDS) food warehouses.  All of our travels and visits were announced in advance and were fully supervised by government officials.  The United Nations World Food Programme (WFP) provided substantial logistical support to our mission that was essential to its success.

What follows are our principal findings followed by our detailed mission report:

Food Shortage Continues.  After three years, the food shortage in North Korea continues.  During our visit, we found malnourished people and the widespread use of "alternative food" collected from grass, roots and other plants from forests and hillsides.  While government officials and members of the military are well-fed, many other people, especially those over six years of age in northeastern provinces appeared to be suffering from long-term malnutrition.  Reliable sources estimate that of North Korea's 23 million people, between 300,000-800,000 people have died each year (peaking in 1997) as a result of the food shortages.  Other estimates of the death toll by exile groups are much higher.

Food Aid Saves Lives.  WFP and other international assistance, delivered mainly by the U.S. (200,000 mt), China (100,000 mt) and the E.U. (86,000 mt), clearly saves lives.  The international community is feeding nearly every child under the age of seven.  Compared to our visit in August 1997, most of the under seven year old children appear well-fed and healthy.  The delegation saw many malnourished people not covered by international food aid programs,  including children over six and the elderly.  Death rates are highest among these groups.

Prisons for the Hungry.  As North Korea's food crisis deepened, Kim Jong Il issued an order on September 27, 1995 to "protect" people wandering for food by incarcerating them.  Named after the date of this order, these "9.27" prisons represent a new low in the human rights record of a country that is already at the bottom of respect for international human rights.  International organizations must be allowed into these facilities to feed the inmates.
Medical Assistance Saves Lives.  Most hospitals in North Korea lack the most basic supplies, including food, aspirin and X-ray film.  These "hospitals" are really hospices.  Patients are sent home because of the lack of food.  Those who remain are hospitalized for 1-2 months.  The unilateral U.S. donation of $5 million to UNICEF for medical aid clearly has saved thousands of lives through the provision of F-100 high energy milk, BP-5 compressed biscuits, pain relievers and antibiotics.

Unprecedented Access.  The delegation was given unprecedented access during its visits, including:  the denied provinces of Chagang and Ryanggang, orphanages, primary/secondary schools and one unannounced, unscheduled visit to a family.  Unlike our last mission, the team spent 90% of its time in North Korea deployed to the field in some of the most remote parts of the country.  The delegation also requested, but was denied, access to handicapped centers and urban farmer's markets.

Inadequate Monitoring.  The number of food aid monitors in the country has risen from six to over 30, with teams spending most of their time now in the field.  These monitors work not just for the World Food Programme (WFP), but also the U.S. Private Voluntary Organization Consortium (US PVOs) and the E.U.  While their access and tempo of operations is rapidly improving, they are still prevented from conducting any unscheduled, unsupervised visits.  Only three Korean-speaking monitors work in the country.  The delegation did not see or hear reports of any U.S. or WFP food diverted to the military.  It did see food donated by the E.U. loaded on a military truck with military personnel headed towards a province not covered by the E.U. assistance program.

Lack of Economic Reform.  The current government has made no effort to reform the economy, dooming it to further decline.  In our report last year, we recommended modest steps including expanding the private plots and permitting international access and aid to farmers' markets.  None of these steps were taken.  North Korea has never been self-sufficient in food.  Until 1993, it depended on the Soviet bloc.  Without this aid, North Korea has unsuccessfully tried to convert its Soviet-style industrial economy into an agrarian society.  This strategy will not work given the lack of agricultural reform.  When Kim Jong Il becomes President of the DPRK on September 9, he will face four choices: 1) continued food shortages and starvation among vulnerable populations, 2) dependence on massive food aid from the West and China, 3) economic reform, or 4) or any number of irrational or provocative acts including attempting a forced reunification of the peninsula.  Continued dependence on food aid is not a viable option given the "donor fatigue" of the Japanese and E.U.  Therefore, Kim Jong Il will choose between letting his people starve or reforming the economy.  Unfortunately, no one knows which path he will choose.

POW/MIA Cooperation.  The delegation was in North Korea at the same time a Department of Defense POW/Missing Personnel Office (DPMO)/Central Identification Laboratory Hawaii (CILHI) team was conducting a joint field activity in Yongbyon county north of P'yongyang.  The team was looking for the remains of U.S. servicemen lost during the Korean War.  Peter Brookes of the delegation visited the site and reported good cooperation between the U.S. Army and the Korean People's Army (KPA) at the recovery site.

Bilateral Relations.  The North Koreans do not appear to be fully committed to the Four Party Talks.  Their principal goal through the Talks is ostensibly to develop bilateral relations with the U. S.  Though they do see U.S. food donations as a "humanitarian" gesture, it does not appear to be considered as mutually exclusive from other issues and negotiations involving the United States.  For instance, the North Koreans  repeatedly offered to improve progress on the Four Party Talks if the U.S. provides one million metric tons of food (before November) to the DPRK.  The North Koreans also offered to end ballistic missile sales to countries such as Iran if they could be appropriately  compensated for the loss of hard currency income.  They specifically mentioned a figure of $500 million annually.  Both demands are unrealistic.


August 10, 1998

Else Larsen, Head of Office, World Food Programme, Beijing, China

The delegation met with Else Larsen and Viney Jain of the World Food Programme (WFP) office in Beijing, China.  According to WFP, Chinese official food aid deliveries had varied just over 100,000 tons for each year 1996-98:

The Chinese government does not monitor its food aid deliveries to North Korea and it is assumed that a significant quantity of this aid is diverted to feed members of the Communist Party and the military.

WFP estimated that China also sold North Korea between 700-800,000 metric tons of food per year.  WFP wanted to monitor this trade with a suboffice in Northwest China but this proposal was rejected by the Chinese government.  They reported that refugee flows from North Korea had increased along with increasing crime in the region.

WFP Beijing provides all of the administrative support and backstopping for the approximately 30 staff members deployed in North Korea.  The North Koreans give International WFP staff just two month visas which must be extended every other month to accomplish their work.  In the past, some WFP staff disappointed North Korean officials and had to return to China after failing to get their visas extended.

U.S. Embassy Country Team Briefing on Sino-North Korean Relations

A combined inter-agency team briefed the delegation on the state of Sino-North Korean relations.  They noted that relations between China and North Korea became more complicated after China recognized the South Korean government in 1992.  China now sees South Korea as a key economic trading partner and source for investment in China.  Meanwhile, North Korea is increasingly becoming a source for concern and potential instability.

According to the briefers, China has three main objectives in its relations with North Korea:

Stability.  If the North Korean state collapsed, northwest China could potentially become flooded with hundreds of thousands of North Korean refugees.  In U.S. terms, North Korea could become China's Haiti with adverse effects on the economy and stability of Manchuria.  Chinese aid and political support will be used to maintain the North Korean state to prevent such an outcome.

Economic Growth.  With the collapse of the North Korean economy, China has lost a potential trading partner to the south.  If the North Korean economy could grow, it could improve the prospects for the economy of northwest China.

Prevent U.S. Military Presence on the Chinese Border.  Probably the most important objective of China is to prevent a reunification of Korea along the lines of Germany that brings North Korea under U.S. military protection.

Trade statistics show an increasing trade with North Korea, especially in food and fertilizer.  These statistics also show a noticeable decline in exports to support North Korea's industry, including lubricants which have dropped off the trade charts.  North Korea pays for this trade largely through barter deals involving scrap metal, lumber and personal goods sold at the border.
The Chinese are very open about their lack of close relations with the North Koreans.  Unlike the days of Kim Il Sung, Kim Jong Il and his administration seem more anxious to build ties with the U.S. than China.  The North Koreans frequently complain of the presence of the Chinese in the Four-Party Talks, preferring to develop a single, bilateral relationship with the United States.  The Chinese are also open about their ideological differences with North Korea.  They repeat the famous story of a summit between Kim Il Sung and Deng Tsiao Ping in Dalian, China.  Deng noted that the Chinese economy was booming because of a ‘small window opening to the West."  Kim Il Sung reportedly replied that "when you open a window to the West, flies come in."

With regard to refugees from North Korea, the Chinese government officially enforces a bilateral agreement with North Korea to return all illegal immigrants.  The agreement contains no provisions for political asylum.  Occasionally, the government conducts police sweeps for refugees but announces them in advance and catches few refugees.  This prevents the authorities from overly agitating the ethnic Korean community in China which maintains strong links with their relatives across the border.

August 11, 1998

Pyongyang, North Korea

Meeting with the U.S. Private Voluntary Organization (PVO) Consortium on Food Assistance for North Korea.

The delegation met with Henry Lacy, team leader of the U.S. PVO Consortium and other members of his team.  The PVO Consortium is sponsored by the U.S. Agency for International Development (USAID) which designated 75,000 metric tons (mt) of the American 200,000 mt 1998 donation to the WFP program for PVO Food-For-Work (FFW) projects in North Korea.  The Consortium combined the efforts of five groups: CARE, Catholic Relief Services, Amigos Internationales, World Vision and Mercy Corps International for relief feeding using U.S. donated food in North Korea.

Under the WFP umbrella, the PVOs have approved 48 projects and rejected four.  Most of these projects involve repairing coastal sea walls and river embankments.  They issue a worker two kilograms of U.S. food aid per day of work for an average of 70 days.  Under the current plan, the PVO projects will feed 1.2 million workers and their families.

The PVOs were looking forward to the start of a scientific nutritional survey for North Korea that will document nutritional needs.  Last year, the North Korean government prevented the conduct of a scientifically valid survey because it insisted on picking the children and institutions surveyed.  This flawed study showed that 17% of North Korean children suffered from malnutrition.  The expectation is that the government will permit the survey after Kim Jong Il is inaugurated as president of North Korea on September 9.  They suspected that the government is nervous about the study because it will show that many children have suffered from long-term malnutrition that started long before the floods of 1995 that triggered North Korea's first appeal for international aid.

The PVOs expected the North Korean harvest in October to be better than last year.  In general, there had been no flooding and weather had been good.  The bulk of the monitoring work had gone well with teams spending most of their time in the field.  Access was good but the old restraints remained: 1) all visits had to be scheduled far in advance, and 2) all visits were fully escorted by government officials.

Major problems remained in their operations. In sum, they reported the following concerns:

Ghost Workers.  There is a consistent discrepancy between the number of workers fed by a project and the number of workers actually seen at the project site.  Food for a project is generally distributed before a project begins.  For basic road building and dike repair, the PVOs calculate that each person can move one half a cubic meter of rock or soil per day.  Using that rule, they then allocate food for the total number of square meters of material needed and pay the county involved accordingly.  The PVOs report that local authorities make an effort to get large numbers of people to show up on the day monitors arrive with many people doing busy work as the team makes its rounds.  The PVOs also suspect that the Public Distribution System (PDS) authorities maintain two sets of books: one for the international community and one for the party.

Artificial Limitations. The key government agency involved, the "Flood Damage Relief Committee" (FDRC) has only issued three handlers/translators to PVOs, limiting their operations to just three vehicles per day.  The PVOs expect five vehicles shortly and will be severely constrained.  The FDRC also made an effort to expropriate the PVO's vehicles in a series of running bureaucratic attacks that appear likely to continue. While the PVOs plan to distribute food for five months, they were given visas for only two months.  They were also not given multiple entry visas, putting the chance of visiting Beijing for R&R off the table.  The FDRC also tries to prevent the PVOs from working with WFP in a vain attempt to unilaterally create a separate bilateral channel with the U.S., excluding the WFP.

Departing PVOs.  The latest PVO to wrap up operations is the Paris-based Medicine Sans Frontiers that conducted extensive medical treatment operations in the region.  It appears that unless a PVO is prepared to bring significant quantities of commodities into the country, it is not welcome.  Mere training and services are not enough.

The PVOs reported widespread use of Han Che or "alternative" food by needy North Koreans.  Alternative food comes from almost anywhere and can be roots, nuts, grass, pond weed or other semi-edible plants.  It is usually ground up and mixed with real food to extend supplies.  It usually has a very low caloric content and causes diarrhea that can actually worsen a person's health status.

U.N. Agency Coordination Meeting, Pyongyang

The delegation attended a U.N. and PVO coordination meeting, chaired by the WFP, the senior
international donor in North Korea.  These meetings are held weekly and coordinates the activities of the following international organizations operating in North Korea:

– WFP   – UNICEF    – UNDP – WHO
– US PVOs   – World Wide Concern – EU/DG.8 – EU/Eco
– IFRC   – German Ag. Action  – Swiss Disaster Relief
-- Accion Contra la Faim

The group's financial transactions are handled by ING bank who reported that their third director had been fired by the North Koreans.  ING advised its clients to pull all of their funds out of their ING-North Korean accounts immediately.  This will cause international organization great harm in trying to continue operations in North Korea.

The EU expressed a hard line on dealing with the North Koreans.  EU assistance has been cut from recent levels in past years with EU officials of DG.8 (assistance) and Eco (relief) expressing the need for strong conditionality on policy reforms for future aid deliveries to North Korea.  The EU will specifically focus on the following policies:

World Food Programme Monitors

The delegation met with WFP food aid monitors who described their operations.  In total, WFP monitors had access to 168 out of North Korea's 212 counties.  Out of 18.5 million people in the counties served, WFP fed 7.5 million people.  Of the 43 denied counties, 3 million people lived in them with 730,000 potential beneficiaries (i.e. mainly children under the age of seven) lacking any food from WFP.

A standard food aid monitoring visit consisted of;

In general, each monitor made three inspections per week, giving WFP the ability to have its 12 monitors make a total of just over 30 site visits per week.

Aside from the Pyongyang headquarters, WFP has three suboffices: 1) northwest Korea at Sinuiju along the Chinese border, 2) northeast Korea at Chongjin, and 3) on the east coast in North Korea's second largest city of Hamhung.  WFP was also attempting to set up an office in northernmost Korea at Hyesan but had yet to receive permission.

The monitors reported that people do not know who donated the food they are being provided.  While the county officials clearly read the bags that identify the food as American, European or South Korean, the people do not see these food aid bags at the lowest level.

The health status of children covered by the WFP program, age six months to six years, had improved markedly over the last year of feeding.  Attendance had risen from 30% to over 90% with the provision of meals at nurseries and kindergartens.  WFP monitors were just getting access to older kids, over age six, and reported that their health status declined once they left the international feeding program.

Monitors reported that the general distribution of North Korea's domestic harvest through the PDS had collapsed in March or April.  Few families outside the military or party received any food from the government after these months.  The food shortage had hit the young, urban and elderly poor the hardest.  These people depended on jobs at state-owned enterprises that had long since ceased to function.  They had used up their savings and did not have private plots of land to fall back on for supplementary food.

With regard to farmer's markets, the authorities still prevented any access by international observers.    Vegetable and other goods were in supply but inflation was reportedly running at 80-100% per year in the soft currency prices of goods in the North Korean Won.  Lately, cereals had become unavailable, while eggs had recently showed up in some markets.  While government officials told monitors that these markets were open only once every ten days, in reality many markets were open daily with hundreds of individual farmers informally offering their goods each day on the street.

The monitors reported that the records they saw were too accurate, implying that the books had ben reconciled before each visit.  While they had not documented any diversions of food aid, they could document the dramatic effect food aid had on the children under seven who had improved dramatically in health status since feeding began last year.

Monitors reported that officials were too embarrassed to report death rates among children.  There were complaints on the quality of international food aid, especially Chinese aid.  They also reported that double-cropping initiatives, especially with barely, were showing some success.

While the North Koreans discouraged any talk of  "reform," the monitors reported that they were open to new ideas of soil conservation and other techniques to improve their yields.  The key limiting factor was the lack of fertilizer that would doom even the best harvest to falling far below North Korea's domestic needs.

Kim Gye Gwan, Vice Foreign Minister, Ministry of Foreign Affairs

The delegation met with Kim Gye Gwan, North Korea's Vice Minister of Foreign Affairs and head of their delegation to the Four-Party Talks with the U.S., South Korea and China.

Minister Kim thanked the delegation for the U.S. food aid and stated that it had also served as a confidence building measure to build trust between the two sides.  He noted that if the U.S. provided one million metric tons of food, it would lead to the resolution of many pending issues.  This million metric tons had to be delivered before the harvest came in October.  He noted that USAID had "recognized" North Korea's need for 1.9 million metric tons of food and felt the U.S. should meet half of that requirement.

Minister Kim is usually realistic and pragmatic in his dealings but this request showed a stunning ignorance of the politics and technical difficulties the U.S. would face in meeting such a request.  The delegation informed the Minister that his request was totally unrealistic.  Larry Nowels noted that this amount would represent half of all U.S. food aid.  Given the demands of Indonesia and Sudan, this amount for North Korea did not look possible.  If he repeated this request at the Four-Party Talks in New York, Mr. Kirk advised the Minister, "you will fail.  This is not a negotiating position, this is the reality of what the U.S. can and cannot do for North Korea."

Minister Kim noted that the U.S. food aid had arrived "late" (in fact some food was arriving two week later than originally scheduled).  He showed a sophistication with U.S. law, knowing the difference between P.L.-480 Food-for-Peace and Section 416 Wheat Reserve aid.  He made a pitch for the one million metric tons to come from the Section 416 aid but the delegation reminded him that that was unrealistic.

The delegation reminded Minister Kim that while P.L.-480 aid was linked only to the transparency and integrity of the program, other kinds of assistance, specifically Section 416 food, would be clearly linked to progress on peace talks, nuclear compliance and missile non-proliferation.

With regard to concerns about the proliferation of nuclear weapons, Kim said the DPRK has faithfully implemented the Agreed Framework.  According to Kim, "if the U.S. had implemented the Agreement by 50%, the DPRK had implemented it by 200%."  He said the DPRK has completed a full-scale freeze of its nuclear facilities within one month of signing the framework.  More than 8,000 fuel rods had been canned with only 200-300 remaining to be canned.  If progress on canning the remaining rods was delayed, serious technical concerns would inhibit the completion of the canning process.

Minister Kim noted that under the Agreement, the first Light Water Reactor (LWR) should be completed by 2003 and the second by 2004.  Since such projects take 8-10 years to complete, we are already behind in completing these projects as agreed.  Ground breaking for these projects occurred one year late and further delays would harm the confidence built between the DPRK and the U.S.

With regard to Heavy Fuel Oil (HFO), Kim emphasized that this was not "charity oil."  It was provided as compensation for the power that would have come from North Korea's indigenous reactor.  According to Kim, the U.S. should have shipped 500,000 metric tons annually but no shipments had arrived in North Korea since last April.  In a planned economy, North Korea should receive 40,000 tons monthly, not the huge deliveries and dry spells that U.S. oil subjected the DPRK, giving it logistical problems.  Kim said that many agencies blamed the Foreign Ministry and called for an end to the Agreement due to these delays.

With regard to missiles, Kim said the DPRK exported missiles to earn foreign currency.  If the U.S. was concerned with this, these sales could be stopped "through negotiations."  He warned that the development of missiles for national defense was not negotiable but exports were.  Kim wondered if the missile issue was being raised as an excuse to continue sanctions.  He also recalled that the DPRK defections from Egypt caused tensions between the US and DPRK.  He summed up noting that increased food aid deliveries from the U.S. would help build confidence and would improve the chances for success in other negotiations.  He said that the DPRK had never wanted Four-Party Talks.  It wanted a direct dialogue with the U.S.  The DPRK eventually relented and accepted the Four-Party mechanism.  These and other concessions meant that the DPRK was "giving up all of the time."  That had to stop.  If the U.S. did not stop its hostile policy towards the DPRK, then the country would move back to full military activities with new weapons and new tensions.  According to Kim, "people in the DPRK defend their sovereignty as closely as their lives."

With regard to confidence building measures, the delegation noted that North Korea had to get better submarine skippers to prevent the annual North Korean submarine from washing up in South Korea.  The delegation also pushed for the following:

Kim concluded the meeting with a monologue on the role of Kim Jong Il in North Korea's future.  Kim Jong Il's official rise to power began when he was first appointed as a Marshal of the Korean People's Army (KPA), then as General Secretary of the Korean Worker's Party (KWP) and finally "elected" from military district 666 as a Deputy in the Supreme People's Assembly (SPA).  According to Minister Kim, this was an expression of the people's desire to hold him as leader of the country.  We noticed that last year, people referred to him as the "Respected General."  This year some already use his father's title, referring to him not under his old title as "Dear Leader" but now as the "Great Leader."

Minister Kim said that Kim Jong Il's election to the SPA was delayed several years due to the death of his father.  On September 9th, the anniversary of the founding of the DPRK, the country will conduct a massive celebration.  Nearly all expected that Kim Jong Il would take the final title of President by then.  Minister Kim noted the government would announce four major priorities for government action in the following fields:

Kim also stated that party slogans would change from "let us more forward to final victory through arduous march" to "let us move forward to final victory through forced march."  Kim did not define the difference between arduous and forced march or what "final victory" meant.  Later, Mr. Han of the Foreign Ministry opined that "final victory" did not have an ominous meaning (a la Heaven's Gate), but instead meant overcoming North Korea's current economic troubles.  Minister Kim concluded by stating that it was clear that North Korea would not collapse like the Eastern European states did.

Site Visits

August 13, 1998

Ryanggang Province Orphan Center

The Orphanage has been receiving international food aide since July, 1997.  It receives corn, wheat flour, milk and CSB biscuits.  The current food stock was expected to last through the end of August.  The Center is also receiving medicine from UNICEF (vitamins and anti-biotics) and clothing and shoes.  There are 336 orphans in the Center ranging in age from infants to 7 years.

The death rate from malnutrition peaked in 1997 at 140 anddecreased to 12 in 1998.  Once the children leave the Center, they no longer receive international assistance.  Several of the children in the Center were not present during our visit because they were hospitalized for malnutrition, pneumonia and digestive problems.  Children are sent to the Center because their parents have died from a lack of food or they were simply abandoned.

We observed five groups of children.  The first group we saw had 7 very malnourished babies. The average age was 1 month.  The second group had 10 children with an average age of 1 month to 1 year and were very small.  These children had been receiving F100 for one month.  The third group of children averaged 5 years of age.  Several had red hair from malnutrition.  The children in the fourth group were seriously ill from malnutrition.  The final group of children suffered the most.  They were covered with flies and suffered from the severe effects of malnutrition.  One had a brain tumor.  We were told they had little chance of survival.

Hyesan City Hospital No. 1

The hospital was filthy.  It had no water or electricity.  Flies were everywhere.  Sixty percent of the hospital's 120 patients suffered from malnutrition.  Death rates have increased according to the hospital Director.  The hospital has no food for its patients. Adult patients rely on family members to bring them alternative food.  Children are given F-100 and BP-5 biscuits provided by the WFP.

The hospital lacked basic medical supplies such as x-ray film, aspirin, and antibiotics.  It relied solely on international assistance for its medical supplies.  The hospital received 2 shipments of medicine from UNICEF that included emergency kits.  UNICEF also trains doctors on the administration and use of F-100 in Pyongyang during 2-3 training sessions.  The Director informed us that UNICEF was expected to provide further training on August 19 and 20th.  We were also told that the government was promoting higher birth rates.

We visited two pediatric wards and two adult wards.  The children suffered from malnutrition, tuberculosis, and lung and kidney infections.  We saw a "homemade" intravenous fluid (IV) attached to a child that was constructed from an empty glass bottle containing water and sugar.  The IV tube was dirty and yellow.  It was tied to the child's head by a dirty piece of cloth.  The male adult ward had 10 elderly men all suffering from malnutrition.  Four elderly women in the female ward were visibly weak from malnutrition.

Ryanggang Provincial Primary and Secondary Orphans School

Established in October, 1997, the School holds 300 children between the ages of 7 and 17 years.  Thirty percent of the children suffer from malnutrition.  Several children have died from malnutrition and related illnesses.  Food aide from Swiss Disaster Relief (SDR) accounts for 60% of the food supply while the remaining 40% comes from alternative food.  The Director told us that they do not expect to receive further assistance from the Swiss.  The current supply is expected to run out by the end of August.  The School also receives medicine from UNICEF.

The three groups of children we saw shared the following characteristics attributed to long-term malnutrition: 1) low body weight; 2) light hair reddish brown hair; and, 3) stunted growth.  The children had very little energy.  In one case, a little boy could barely sit in his chair.  We were told that many children had trouble learning.  Older children did not have shoes.

Public Distribution Center for Hyesan City

WFP representative, Mahbub Ul Alam, accompanied us to a meeting with the warehouse manager.  The warehouse was guarded by an armed guard.  Food is received from the port and transported by rail or truck to the warehouse.  Five consignment notes accompany each delivery To ensure proper recording, separate notes are provided to:  the issuance point; WFP; the food administration department; the food distribution system; and, to the receiving county.  Once received at the public distribution warehouse, shipments are distributed to kindergartens, nurseries, and orphanages.  Distributions occur 2-3 days within delivery to the warehouse.

During our meeting, it was discovered that the warehouse received 11 tons less than the declared amount by WFP.  There was no explanation for the missing food.  WFP was investigating the shipment.  The last food distribution by WFP was received by the warehouse on July 15.  Distributions to nurseries and kindergartens were complete.

We saw alternative food being produced at the warehouse.  Piles of grass, corn husks and Amaranthus on the floor were ground into "alternative food" for noodles.  Contrary to the state produced video on how to make alternative food, the machinery was old and dirty.

August 14, 1998

Samsu County Central Warehouse

Samsu is completely reliant on assistance from WFP and UNICEF.  The warehouse distributes WFP food aid to 81 nurseries and 42 kindergartens in Samsu.  The last shipment of 45 tons was received on July 12.  Two tons of South Korean wheat flour remained in the warehouse.  We also saw alternative food production in the warehouse.  Once again, production occurred in unsanitary conditions.

The Vice Chairman of the Samsu County Administration Committee reported that no children had died in nurseries and kindergartens in 1998.  However, death rates among children 7 and above had increased.  Those children had no access to medical care and were only receiving F-100 from UNICEF.  The highest death rates in Samsu were among the elderly.

Most of the population in Samsu relies on alternative food.  Low crop yields were attributed to abnormal weather and lack of fertilizer and manpower.  People cannot work in the field because they have no energy.  Samsu received no direct aide from China, right across the border, but barter trade was reported to be occurring.  People were trading herbal grass and medicine for food.

Site visit to home in Komsandong village, Samsu

Local party officials accompanied us to the home of Kim Jong Ok.  Two people lived in the home.  Ms. Ok was preparing alternative food for dinner.  She was able to show us her ration of 300g of flour.  Party officials instructed Ms. Ok on her answers to our questions and she was visibly frightened by the whole experience.
Samsu County Hospital

Sixty-four of the hospital's registered 82 patients suffered from malnutrition and related illnesses.  Patients are normally hospitalized in this dark, damp and dirty hospital for 1-2 months for malnutrition.  A total of 268 people have died in Samsu during the past two years due to malnutrition.  The hospital had no medicine and was in desperate need of antibiotics, fever/pain medicine and vitamins.

International assistance provided the hospital with the only type of "medicine" available to treat patients - F-100 and high protein biscuits.  Biscuits are provided to all patients.  We saw one boy eating a biscuit.  Only third degree malnutrition cases received F-100.  Doctors received training on F-100 administration.  CARITAS also provided the hospital with corn for the elderly.
We visited two children's wards.  One 14-day old baby was being cared for by his visibly malnourished mother.  The female patients hospitalized for malnutrition covered their faces when we walked into the room.  Several of the women had lost their hair or it was discolored due to malnutrition.
August 15, 1998

Huichon City Hospital No. 2, Chagang Province

The food situation for the Hospital's 45 patients was described as critical by Kim In Ho, the Hospital Director.  Despite assistance from WFP, the International Red Cross and Medicines Sans Frontiers, the hospital has been forced to reduce the number of admitted patients due to the food shortage.  The hospital has a policy of turning away patients it cannot feed.  As a result, doctors visit patients at home.  One doctor cares for approximately 120 families.

Children and the elderly are the most malnourished patients.  One 11-year old patient, Kim Uen Bok (see cover photo), weighed only 15 kilograms from eating alternative food.  Several of the children we saw suffered from the long-term effects of malnutrition, including swollen knees and feet, lethargy, and reddish brown hair.  The recurrence rate for patients hospitalized for malnutrition is 70%.

Huichon Nursery School and Orphanage

The School's population has doubled from 1996 to the present.  It is now the home to  135 orphans.  The Director told us that 20 children have died since 1996 due to third degree malnutrition.  Children in the School were orphaned because their parents died during the 1996-1997 floods or from malnutrition.  The School relies on WFP for food.  It only has enough food to last for the next 20 days.  Each child receives 200 grams of either rice or corn flour per day.

The children we saw during our visit had light brown/reddish hair due to malnutrition.  They were also very tired from the lack of food.  Several children also had skin infections and open boils and sores on their heads.

Tongsin County Hospital

The hospital was housed in two temporary facilities because the old building was destroyed by flood damage.  Lack of materials stopped the construction of the new hospital.  Ten out of the 14 patients hospitalized at the site we visited suffered from malnutrition.  One man had lost half his weight from the lack of food.  Several children had extended tummies and were tired.

Patients receive food from both the international community and the Public Distribution System (PDS).  Food received from the public distribution system has decreased from 300 grams in 1997 to 100 grams in 1998.  UNICEF also delivered four shipments of fever/pain medication, antibiotics, vitamins and F-100 to the hospital.  It has sufficient medicine to last until the end of August.  As a result, only serious malnutrition cases are treated in the hospital.  We were told that 200 "simple" malnutrition cases receive treatment at home by hospital doctors.

An average of 100 people died in Tongsin due to malnutrition from 1995-1997.  This year 78 people have died from the lack of food.

Tongsin County Nursery School

All of the 115 children, ranging in ages 2-5, ate at the nursery school.  The children were fed bread, noodles or alternative food.  The Director informed us that the school received corn flour to make the bread and noodles from an international aide source.  She was unable to tell us which country or agency provided the food.

Site visit to home in Tongsin County

This was the only unannounced, unscheduled home visit during our trip.  Accompanied by our handlers and local government officials, we visited the home of Ms. Rim Hung Un.

She and her five-member family ate alternative food and whatever small amounts of corn and beans she managed to grow on her 30 pyong.  One member of her family suffered from malnutrition.  The day we visited, Ms. Un was preparing acorns she had picked in the mountains for dinner.  Ms. Un also had a pig and a pet dog.

August 16, 1998

Provincial Hospital of South Hamgyong Province, Hamhung

Two hundred of the hospital's 320 admitted patients suffered from malnutrition.  The hospital has registered 2,500 patients who receive treatment at home from the hospital's doctors.  These patients either did not have transportation or were too weak to travel to the hospital.  Kim Song Uk, the hospital's Director, told us that the death rate in the Province had increased 10% in 1998.  He estimated that almost 100% of the population suffered from hunger.

The hospital stopped receiving international food aide in April.  Patients are now forced to bring or have family members provide them with food.  In those cases where a patient doesn't have family, the hospital provides porridge made from alternative food.  The hospital has been able to receive oil, pain/fever medicine, antibiotics, and anti-diarrheas from the international community.  The Director was unable to identify which agency provided the medicine.  Doctors received training on surgical techniques and the use of anesthesia from the World Physicians Organization.

During our visit, the delegation saw one 12 year-old patient, Kim Jong Gun, who had been hospitalized for more than one month.  He suffered from malnutrition and his feet were infected.  He told us that his family was unable to bring him food because they lived five days away.  The doctors informed us that Kim was unable to keep down the porridge he was fed by the hospital.  Kim was very, very weak and told us he had a bad headache.

Provincial Orphanage Center of South Hamgyong Province, Hamhung

The orphanage is home to 270 children, ages birth to 4 years.  The children were orphaned after their parents died.  The mothers of four babies we saw died during childbirth.  The mothers were weak from malnutrition.

Approximately 20 children in the orphanage suffered from malnutrition.  The delegation also saw children who suffered from the visible signs of neglect.  Four small children we saw in one room were withdrawn, rocked from side to side in their cribs, and had sores and rashes on their heads.  The room smelled like urine and the floor had iodine stains from the iodine used to treat sores and skin rashes.

The orphanage was well-provided for by the international donor community.  It had received corn, rice, beans, high energy biscuits, edible oil, and canned fish from international sources.  We were told that they had over one month's supply of food in stock.  UNICEF also provided the orphanage with mattresses and blankets.

August 17, 1998

Middle Orphanage School of South Hamgyong Province, Hamhung

The orphanage was established in November, 1997 and is home to 350 children ages seven to 17.  It is already half-way to its capacity of 700 students.  Mun Bo Su, the principal, told us that the number of orphans in the province is increasing.  They will soon be forced to start breaking-up the student population into a nursery, kindergarten, and primary and secondary school.

The international community has provided the orphanage with three shipments of food: rice (11/1/97), corn (6/3/98), and wheat flour (7/5/98).  The principal was unable to tell us which agency sent the food.  He said that they received the food from the PDS.  The delegation saw one dormitory room filled with mattresses and blankets provided by UNICEF.

Approximately 100 children in the orphanage suffer from malnutrition.  The delegation saw three children, two girls suffering from diarrhea due to malnutrition and one boy with a kidney infection.  We were able to observe approximately 50-60 children playing in the court yard.  They looked reasonably well.  Only a few had reddish brown hair.


August 18, 1998

Meeting with Ministry of Foreign Affairs and Chinese Academy of Social Sciences (CASS), Institute of Asia-Pacific Studies

We met with Sun Yuxi, Counselor to the Ministry, and Piao Jian Yi and Han Zhenshe of CASS.  The Chinese want to maintain their "traditional friendship" with the DPRK.  The parameters of this friendship are to: 1) maintain good relations and open communications between the two countries, including support for the Four-Party talks; 2) provide assistance; and, 3) encourage dialogue between the DPRK and ROK.  Political power in the DPRK is relatively stable according to Yuxi.

The Chinese government has extended an open invitation to Kim Jong Il to visit China.  The invitation has not been accepted nor have the Chinese, much to their chagrin, received an invitation for the September 9th celebrations in Pyongyang.  Yuxi stated that Kim's reluctance to travel outside of the DPRK may be based on either health reasons, concentration on domestic affairs, or the fear that any departure may create a power vacuum.  He noted that while Kim Il Sung enjoyed "several pillars of support," e.g., the military, his own political theories, and popular support, Kim Jong Il has nothing but the military.

The Chinese have noted some economic changes in the DPRK, such as the Rajin-Sonbon Special Economic Zone.  They are uncertain, however, about whether these developments indicate policy changes or result from the desire to attract more assistance.  Small trading occurs across the DPRK-China border and there are increased numbers of people begging for food.
Yuxi stated that, despite improved crop projections for this year, the DPRK still needs food aide as well as fertilizer and crude oil.  Yuxi rejected the characterization of China as the "swing donor" to the DPRK stating that Chinese aide to the DPRK is given according to an assistance plan.  There are no plans for more aid to the DPRK this year given the domestic impact of the floods in China.  He stated that continued assistance to the DPRK is vital.  It lessens their feelings of isolation and promotes peace and stability in the region.
August 19, 1998

Meeting with Chinese Institute of Contemporary Int'l Relations (CICIR)

We spoke with Yu Mei Hua (Senior Research Fellow), Li Jun (Assistant Research Fellow), and Zheng Jusheng (FISS Researcher).  This group offered a more optimistic view of the economic situation in the DPRK.  Hua visited the DPRK five times within the last 10 years. He stated that the economic situation is slightly better in 1998 than it has been in the past two years.  Hua reported that the government is now encouraging farmers markets, small businesses, the development of small to mid-size power plants, and promoting flexible agricultural policies in rural areas.  The economic forecast for the DPRK should improve if the weather remains stable.

Hua stated that he saw people selling food and small electrical appliances in the farmer's market he visited in Pyongyang in March, 1998.  He stated that individuals set prices, but that the government strictly regulated the areas in which vendors sold their goods.  Vendors are mostly women and the elderly.  People also engaged in barter trade at the market Hua visited.  Previously, the market had been open only once every five or 10 days, but was now open every day.

While recognizing that some change will be required, Hua was unable to predict whether this gradual liberalization could continue.  He stated that while Kim Il Sung had more influence and status, Kim Jong Il has been involved in state affairs since the early 1990s and is now in control of the military.  A group of young cadres is now emerging and military hard-liners no longer have as strong of a role as they did in the past according to Hua.  Further, the Kim Jong Il is not held responsible for the current economic crisis.  Rather, the blame is placed on the weather, the collapse of the Soviet Union, U.S. sanctions and the confrontation with the ROK.

Jusheng agreed that the DPRK is not on the brink of collapse.  Rapid economic reform, however, is not a viable option given the fact that Kim Jong Il will inherit his position and undertaking reforms during periods of hardship would lead to political instability.  He predicted that reform would be brought about through slight adjustments in the economy and the agricultural sector.  The primary objective of the DPRK, according to Jusheng, is to normalize relations with the U.S.  The DPRK is using the Four-Party Talks as the vehicle for normalizing relations and obtaining more food aide.  He attributed the DPRK's military posturing as a defensive measure and an attempt to gain the upper hand in negotiations.

China will continue giving the DPRK assistance, according to Jusheng, for humanitarian reasons and to decrease the likelihood of a greater influx of food refugees.  Jusheng described China's policy towards the DPRK as a delicate effort to encourage gradual economic reform and remove the DPRK's reliance on the "military card" in response to perceived outside pressure.  It is an effort that seeks to promote regional stability and peaceful reunification.
August 20, 1998

Meeting with Chinese Institute for International Studies (CIIS)

We met with Yu Shaohua, a Korea expert at CIIS.  Shaohua stated that the consensus emerging in Chinese institutes is that the DPRK is politically stable.  This stability is attributed to Kim Jong Il's: 1) ability to avoid mistakes in domestic/foreign policy; 2) domestic support; 3) increased contacts with regional neighbors; and, 4) decreasing fear of the ROK.  Shaohua indicated that the DPRK's primary goal in is to solve its economic problems while maintaining its self-respect and dignity as a nation.  Despite this year's anticipated harvest, she predicted that the DPRK's economic difficulties because they are reluctant to reform the economy.

Shaohua indicated that the DPRK's primary negotiating tactic is brinkmanship.  The international community, however, is becoming much more adept at this style and no longer over-reacts to DPRK threats to renew its nuclear program.

Shaohua made several observations about the DPRK and its relationship with China.  First, she noted while China's new policies have impacted the amount of aide to the DPRK, it still remains one of China's largest aide recipients.  Second, additional assistance to the DPRK is provided through border trade and "friendship transactions."  And, third both countries work towards maintaining their "traditional friendship."  She noted that China doesn't use aide as a political tool and that currently only China has provided the DPRK with low cost crude oil.

Changes in economic policy will not occur quickly in the DPRK.  The government stands as a counterweight to any change in policy.  Shaohua rejected the development of a "grey market" in the DPRK despite the presence of a nascent market economy, such as the exchange of gifts for favors and farmers markets.  She stated that unlike China, where economic reform came from the government to the people, change in the DPRK is occurring in the opposite direction leaving the government the ability to quash anything it views as dangerous.  Small economic changes in the DPRK are not openings or indicators of reform, according to Shaohua, rather they are more realistically described as survival measures.

August 21, 1998

Yanbian Korean Autonomous Prefecture

Venerable Pomnyun, Executive Secretary, Korean Buddhist Sharing Movement (KBSM), Yanji, China

The delegation met with a Buddhist monk, the Venerable Pomnyun, who serves as the Executive Secretary of the South Korean Buddhist Sharing Movement (KBSM) and is the leading expert on North Korean refugee reporting in China.  Since September of 1997, the KBSM has conducted 1,019 interviews of North Korean refugees hiding in China.  His reports form the largest data base of what is happening in North Korea outside of the North Korean government's control.

According to Pomnyun, his organization has now interviewed over 1,500 refugees.  The average morality rate the refugees report on their immediate family members is 27% since August of 1995.  Pomnyun and his staff of ethnic Korean Chinese citizens regularly patrol the North Korean border looking for refugees who have recently crossed the river into China.  These refugees are mainly concentrated in the Changbai mountain region which is remote and runs along a largely uncontrolled border.  The activities of the KBSM are not officially sanctioned by the Chinese government who regularly interrogates interviewers.

Pomnyun estimates that there are between 100,000 to 300,000 North Korean refugees in China.  Most of these refugees are concentrated in the Yanbian Korean Autonomous Prefecture of China where half of the two million inhabitants are ethnic Koreans.  Most of the refugees have crossed into China in 1997 and 1998 with numbers peaking in 1997.  In the capital of Yanbian Prefecture, Yanji, there are dozens of North Korean children begging for food and hiding from the authorities.  Ethnic Koreans take pity on these children while ethnic Chinese generally help the authorities find and repatriate these children.

According to Pomnyun, roughly 90% of North Korean refugees crossing the border are caught and repatriated by the Chinese border police and local citizens.  If refugees manage to make it to the capital of Yanji, only 10-15% are arrested and repatriated.  Many refugees have relatives in China who protect them.  Most refugees are women and children who have come to China in search of food.  Most of the women remain in China only a short time and then return to North Korean with whatever food they can carry.

It appeared to Pomnyun, the Chinese authorities were building more facilities to handle North Korean refugees.  One such facility was being constructed in Changbai, across the river from Hyesan, North Korea.  He estimated that approximately 70 refugees were repatriated daily from China.

Each repatriated refugee is incarcerated in a "9.27" internment camp by North Korean authorities.  These camps are called "9.27" camps because they were established by an executive
order of Kim JongIl on September 27, 1995.  The order was issued for the "protection of those who are wandering for food."  The people wandering for food (especially children) are nicknamed "Flower Swallows" (Kot-jebi) by the North Korean people.  According to the KBSM, every city and county in North Korea has a 9.27 facility to incarcerate internally displaced persons and refugees who are caught wandering for food.  He specifically identified four facilities in Hyesan, Hamhung, Hungnam and Chongjin (see Annex II).

Stays by people locked in 9.27 prisons average one month while the wanderer is returned to their home city or county.  Many people try to escape or to bribe guards.  Many are also released if they behave well.  Prisoners are given water and corn powder made of ground corn cobs.  Camps range in size from 200-700 inmates.

These facilities are part of the government's program of "arduous march."  Pomnyun reported one refugee who stated that he had read a KWP document, dated August 15, 1997, that stated that 28% of the city of Hoeryong had been "sacrificed" for the arduous march.  The report appeared credible and would march reports of death rates from other exiles for this remote part of North Korea.

Senior Col. Chung, Commander of Police, Yanbian Korean Autonomous Prefecture, Yanji, China

The delegation met with Senior Col. Chung, Commander of the Police in Yanbian Prefecture.  Chung reported that only 200 North Koreans cross the border into China each year.  All of them are immediately arrested and returned per a bilateral agreement with North Korea.  The agreement had no provisions for political asylum.  Chung reported that refugees generally came in search of food and committed very few criminal acts while in China.  For short visits, many North Koreans were allowed into Yanbian as long as they returned quickly to their homes.
Cao Zhi Zhong, Assistant Manager, Yanbian Foreign Economic & Trade Company

The delegation met with the assistant manager on the largest Chinese foreign trade company dealing with North Korea (YFETC).  YFETC enjoyed certain benefits in trading North Korean goods since they entered China with only half the tariff charges of other country's goods.  The major products from North Korea included seafood and light industrial products.  China bartered grain and medicines.  While food exports are totally controlled by the government of China, this policy is relaxed when it comes to North Korea.  Up to 30,000 mt of grains can be shipped to North Korea without the approval of the central government.  Volumes of trade were low:

The total value of trade between the two countries was estimated at $150 million last year.

Annex 1

Estimating the Death Toll

Estimating the death toll of the North Korean food shortage is guess work at best.  Without a scientific nutritional survey and census, anecdotal information and exile interviews are all we can use to assess the toll.

Previous groups have made estimates.  Of North Korea's 22.5 million people, the KBSM estimated that up to five million people have died, using the 27% mortality figure that came from exile interviews. Other groups estimated lower figures - World Vision estimated three million died while the Council on Foreign Relations estimated at least two million died.

We have chosen to be cautious.  After traveling the breadth of North Korea, we are convinced that many people are dying of malnutrition in North Korea.  The food shortage does not affect elite groups in the country like party members, military personnel and certain government officials.  Exile data and our travels indicated that the food shortage is falling hardest on the very young, elderly and urban workers not connected to the Party, government or military.

The following is one method of estimating the death toll in North Korea:
The food shortage appears to have hit hardest in 1997, before international food aid deliveries cut morality among the most vulnerable groups: the very young.  Therefore, we gave a range of estimates, from 300,000 to 800,000 dying per year , peaking in 1997.  That would put the total dead from the North Korean food shortage at between 900,000 to 2.4 million between 1995 and 1998.