Return to *North Korean Studies*
Update 12 Jul 2001.
URGENT NEEDS IN HEALTH, NUTRITION AND WATER & SANITATION SECTORS
The Joongang Ilbo 13 July 2001
Longest spring drought in 80 years
Whole population of 22 million affected by acute shortages in food and healthcare
DPRK reports increased mortality amongst infants and children under-five
Less than one-third of Emergency Appeal requirements funded
1. EMERGENCY OVERVIEW AND RECENT DEVELOPMENTS
Food shortages due to worst drought in 80 years
After enduring the coldest winter in 50 years, DPRK experienced its worst spring drought in 80 years with no significant rainfall in more than three months. An inter-agency assessment of the grain producing areas found that spring crops of wheat, barley and potato have been severely affected. The unprecedented dry spell is also likely to bring adverse consequences on the main harvest of rice and maize in October. It is expected that the country will not be able to meet its projected grain production targets this year. The food deficit of 1.8 million tonnes is contributing to an acute food shortage not seen since 1997.
Increased child deaths
As DPRK comes out of international isolation, officials reveal that conditions for survival and development for DPRK's most vulnerable population remain precarious. DPRK Deputy Foreign Minister at a UNICEF conference on children in Beijing in May, presented a report stating that famine and economic collapse cut the life expectancy of its population (22.6 million) by more than six years in the 1990s. The under-five mortality rate for children rose during those years from 27 deaths per 1,000 to 48 per 1,000 live births. Infant mortality rose from 14 to 23 per 1,000 live births. Meanwhile, the per capita gross national product dropped from US$ 991 to US$ 457 in the same period.
Economic recovery remains slow contributing to acute power shortages and affecting essential services such as the cold chain for Expanded Programme on Immunisation (EPI) and water pumping systems. Inadequate electricity and safe water continue to expose children to risks of infections. UNICEF's access remains unchanged - 161 counties in six provinces and all children's residential institutions nationwide.
Continued improvement in relations with international community: relations with EU established but rapprochement with Republic of Korea (ROK) and US stalls
The European Union (EU) undertook a landmark visit to Pyongyang early May. The high level delegation was headed by the Swedish Prime Minister. The establishment of diplomatic relations between the EU and the country is expected to facilitate the EU's efforts in supporting reconciliation in the Korean Peninsula and assisting in economic reforms, including support to alleviate the acute food and health problems. Only two members of the EU's 15 member States, France and Ireland, have yet to open diplomatic relations with North Korea.
While significant progress has been made at all levels after the historic inter-Korean summit in June 2000, the new US administration's current policy review toward DPRK has however adversely affected the pace of rapprochement with ROK. Until the outcomes of the US policy review are known, several initiatives by the DPRK Government have been put on hold or delayed. These include DPRK leader Kim Jong Il's reciprocal visit to ROK, cancellation of cabinet-level meetings with the South, construction of a rail link across the demilitarized zone (DMZ), establishment of industrial complex in Kaesong as well as other areas of cooperation with the South. Joint ventures in information technology, however, are evident and are actively being established, owing to Kim Jong Il's call for 'new thinking and new ideas' in his New Year's address. Chronic shortage of energy and electricity remain the major constraint for investors.
Despite the slowdown in rapprochement with ROK, a third round of family reunions was held in late February this year for 100 people from each side. Mail was exchanged across the DMZ for the first time for a selected 600 people.
2. UNICEF RESPONSE: ACTIVITIES, ACHIEVEMENTS AND CONSTRAINTS
Vitamin A and de-worming campaign
DPRK observed the first round of vitamin A campaign for 2001 on 22 May. The nationwide campaign focused on 2.1 million children of 6-59 months. For the first time, the vitamin A campaign was combined with deworming. All children between 1 and 5 years of age were targeted to receive one de-worming tablet (Mebendazole), a contribution from the ROK National Committee for UNICEF. Eleven observation teams, who visited many immunisation posts in the country, included staff from UNICEF, WHO, WFP and IFRC. A representative from the German Embassy also joined the team. A good turnout was reported from all the visited immunisation posts. Coverage figures are expected from the Government soon.
EPI national plan/Global Alliance for Vaccination Initiative (GAVI) funding
First drafts of the five-year EPI national plan of action, hepatitis B plan of action and a revised application for GAVI funding are expected to be ready soon. A WHO consultant is helping to prepare these documents. The working group meeting attended by WHO, UNICEF and the Ministry of Public Health (MoPH) jointly reviewed and agreed on objectives for routine immunisation coverage, polio eradication and measles control.
Inter-country training course on Integrated Management of Childhood Illnesses (IMCI)
A four-member DPRK team participated in the WHO-organised inter-country training course on IMCI in Java, Indonesia, 4-15 June. UNICEF health project officer accompanied the Government delegation. The training linked home management of childhood illnesses with first level care management as well as with referral levels. The illnesses being studied in depth included diarrhoea, acute respiratory infections, measles, malaria and malnutrition. Country-level implementation will include the following: establishment of a working group on IMCI, adaptation of manuals from generic to country-specific and national lower-level training. An early implementation phase will be carried out in selected districts to be followed by an expansion phase.
Maternal and Neonatal Tetanus (MNT) elimination workshop
A DPRK delegation participated in the joint WHO/UNICEF Maternal and Neonatal Tetanus (MNT) elimination workshop on June 20-22 at WHO office in Manila, Philippines. The workshop aimed to provide technical update and familiarise participants to take steps to achieve MNT elimination. The workshop focused on eight countries in the East Asia and Pacific region and empower the country team to gain knowledge on how to develop a plan of action to achieve MNT elimination by 2005.
Fifth East Asia and Pacific Ministerial Consultation
A four-member delegation led by the Vice Minister of Foreign Affairs represented DPRK in the Fifth East Asia and Pacific Ministerial Consultation 'Shaping the Future Agenda for Children', held on May 12-14. The Vice-Minister announced DPRK's accession to the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) and committed his country to prepare a new National Programme of Action for Children, emphasising on the work to improve quality of education. He further added that DPRK would continue to increase investment for children through appropriate policies and institutional mechanisms.
The DPRK delegation stated that combined impact of disintegration of socialist markets, economic sanctions and natural calamities have cut the life expectancy by more than six years during the 1990s. Death rates for infants and young children climbed while incomes fell by almost half.
Study visit to Cambodia UNICEF facilitated the visit of a two-member DPRK delegation to Cambodia on a week mission to learn on decentralised planning from the Cambodia experience. The team, accompanied by the UNICEF Programme Co-ordinator, visited project sites under the UNICEF-supported Community Action for Child Rights programme and the UNDP-supported commune planning process. The experience gained by the delegation will assist Government/UNICEF co-operation in community level programme activities starting this year. The team also took the opportunity to look at UNICEF assistance to Cambodia in particular, assisted education and nutrition projects. The team visited the Government printing and distribution house, cluster schools, health centres and gained experience in monitoring and evaluation activities.
Global Information System (GIS) and ChildInfo training workshop
UNICEF is supporting the Central Bureau of Statistics to organise a GIS and ChildInfo training on July 2-7 for 20 Government counterparts at the MoPH, Ministry of Education (MoE), Ministry of City Management (MoCM), State Planning Committee (SPC) and the Central Bureau of Statistics (CBS). Three external trainers from the region have been engaged to conduct this hands-on training. ChildInfo is a comprehensive database on the situation of children and women used by UNICEF, Government and other partners for planning and advocacy. The training will support the establishment of ChildInfo with mapping in Government ministries. The database will contain multiple sources of national and sub-national information for better targeting of resources for children, including analyses on the trends and contrasts of key child development indicators.
Facts for Life editions being distributed
Additional 35,000 copies of the Facts for Life Korean version have been printed for nationwide distribution. Some 25,000 copies are being distributed through the MoE; 5,000 through Children's Aid Direct; 2,000 through German Agro Action and 2,000 through IFRC.
Key observations from field visits
Key observations from the field visits undertaken by UNICEF project officers in May are as below (North Hamgyong and Ryanggang provinces):
Diarrhoea and Acute Respiratory Infections (ARI) are still the most common diseases reported.
Less cases of acute malnutrition were reported compared to last year.
Most institutions visited confirmed receipt of essential drug kits.
There are requests for more multivitamins.
Immunisation activities seem to be on schedule. Temperature monitoring was largely accomplished, but cold chain monitoring needs to be improved.
Antenatal care was provided at county and ri-levels, but essential preventive services such as urine and blood tests are reportedly not carried out due to a lack of equipment.
3. APPEAL REQUIREMENTS AND RECEIPTS
UNICEF DPRK appealed for US$ 10.5 million to cover implementation costs of the 2001 Emergency Programme. The table and graph below show the current funding status of the Appeal, by sector. Though the water and sanitation sector is one of the priority areas, it remains poorly funded at 18% of requirement.
The following table and graph indicates the contributions received for the Appeal, by donor. As indicated, largest contributions to DPRK Emergency Programme have been received from Italy (US$ 900,000), followed by Denmark (US$ 592,400) and Norway (US$ 548,250).
4. IMPACT OF UNDER-FUNDING AND CURRENT PRIORITIES
Strong donor support to alleviate DPRK's chronic food crisis is gratefully acknowledged. However, additional resources are urgently required to improve delivery of basic social services that remain severely depleted at all levels. With less than one-third of CAP 2001 funded, UNICEF DPRK is seeking funds for its emergency projects in health, nutrition and Water and Environmental Sanitation (WES) activities. Under-funding will prevent UNICEF from meeting requirements, such as vaccines and essential drugs to prevent and treat common childhood illnesses, both a consequence and a cause of malnutrition. Some 62% of children under 7 years of age in DPRK are already weakened by years of malnutrition. Their uncertain future calls for immediate humanitarian support by donors to save lives, diminish their risk of disease and acute malnutrition. Therefore, health, nutrition, and water and sanitation are indicated as the priority areas for funding. The table below outlines the urgent priority requirements.