December 13, 1999
The following is a shortened version of the Dorothy and David
Lam Lecture given by Erich and Marilyn Weingartner on Friday, 15th October, 1999
at the Centre for Asia-Pacific Initiatives, University of Victoria, British
Columbia. Erich and Marilyn Weingartner lived and worked in Pyongyang, DPR
Korea, from May 1997 to July 1999.
Erich was founding Head of the Food Aid Liaison Unit (FALU) of the United
Nations World Food Programme (WFP). He was the first NGO representative
(and first Canadian) to achieve resident status in the DPRK. He built up a
program of non-governmental humanitarian assistance, which in the two years of
his tenure topped 100,000 metric tons of food, agricultural and medical inputs,
at a value exceeding US$30 million.
Marilyn, a health care professional, worked first as a consultant at the United
Nations Children's Fund (UNICEF), then at WFP as Health and Hospital Unit
Medical Assistant. She guided a program of upgrading
pharmaceutical production facilities, supplying medical raw materials for the
Pyongyang Pharmaceutical Factory, and imported medicines for hospitals, clinics
and children's institutions throughout the DPRK. She
led one of the teams participating in the WFP/UNICEF/EU nutritional survey of
1998 and initiated an educational program to highlight the nutritional
requirements of pregnant women and nursing mothers.
Both Erich and Marilyn travelled in all provinces of the DPRK, visiting ports,
rail yards, warehouses, nurseries, kindergartens, boarding schools, orphanages,
hospitals, factories, farms and many family homes, both in rural and urban
settings.
December 13, 1999
I. Witnessed realities
1. Roads
The roads themselves are an important source of information. A major part of our two years in North Korea was spent
travelling around the country.
There are two main highways:
- a modern north-south superhighway - the so-called "Reunification Highway" - on the western side, running from Kaesong to Hyangsan, and
- a concrete-covered east-west highway from the port of Nampo via Pyongyang to the port of Wonsan
In the remainder of country, road conditions are very poor. The main south-north highway on the East Coast is in such poor condition that a
trip by Land Cruiser from Pyongyang to Chongjin (on the north-east coast)
- a distance of just under 800 km - takes a minimum of three days hard driving.
What can one see on the roads?
- Vehicles are in disrepair - many of them stopped on the side of the road. Most of the vehicles one sees are very old trucks kept running
with homemade spare parts. Other trucks have been altered to run on methane gas produced by burning cornhusks or any other combustible
material. Rusting and decaying buses and trains can be seen with windows either missing or patched up with plastic and tape, or pieces of glass
held together by nuts and bolts.
- People on the move - on foot, carrying heavy loads or pushing two-wheeled carts. Every functioning vehicle is loaded to the brim with
people of all ages, often on top of a full load of cargo of every description from logs to lentils.
- Bicycles have increased explosively - with a corresponding number of road accidents involving bicycles. This is a relatively recent
phenomenon. Kim Il Sung had banned bicycles during his lifetime, since he did not wish Korean roads to become as cluttered as those in China.
- There are an increasing number of farmer's markets and street vendors in evidence. Of course, foreigners are not allowed to visit them, buy
from them or take pictures of them. We used to see them off the beaten path, under bridges or behind walls. Increasingly they are visible out
in the open, especially after the revision of the Constitution in September 1998. One can often see small stalls along the highway or on
the main roads of cities, selling everything from fruit in season, to home-baked goods, to hand-made household supplies and even furniture.
- Workers are abundant in fields and on road repair. Military, industrial and office workers are mobilized for rice transplanting in the
spring and harvesting in the fall. Since most roads are made of dirt and gravel, repair crews are a constant presence, especially during the rainy
season and in the winter snows. All roadwork is done by hand. On
high mountain roads, workers camp overnight because there is not enough fuel to bring them home each night.
- Women are a major labour force in all areas of work - agriculture, road repair, construction, guard duty and law enforcement, carrying and
pushing heavy loads. Since water supply has suffered from energy shortages, one can see women washing the laundry in whatever water source
is available: rivers, lakes, streams, ponds and even ditches.
The roads also reveal the depressed nature of industrial areas, the abandoned and partly dismantled factories, and other signs of reduced
industrial activity. Industrial towns and neighbourhoods are depressingly drab. Worker's homes in self-constructed apartment
buildings are in a state of disrepair, with inadequate sanitary
facilities.
There is a lack of power generation, not to speak of the antiquated and deteriorating electrical circuits and inefficient wiring. The UNDP
estimates that of the coal-generated thermal as well as hydroelectric power generated by the DPRK, a full 30 percent is lost to the grid! To
increase the production of energy for small communities, the Government has instituted a program to build small-scale power generators that can
be seen on rivers and streams throughout the country.
Roads also reveal the ecological consequences of deforestation. Cold climate and low energy resources means people resort to cutting down
forests for heating and cooking fuel. In the border provinces with China, lumber has been a lucrative commodity for barter trade, often wood
for food. Denuded hillsides increase soil erosion, change weather patterns, and enhance the negative effects of both drought and flooding.
2. Agriculture
It is not a secret that the DPRK has had chronically low yields in its agriculture, and can no longer meet the food needs of its population.
There is a considerable debate among experts as to whether the DPRK was
ever really food self-sufficient and if so, whether it can be so again. The problems are numerous:
- It is a mountainous country, with only 20 percent arable land.
- State policy has promoted unsustainable monoculture, with a concentration on rice production.
- An over-reliance on chemical fertilizers in the past has exhausted the soil. Lack of raw materials has brought fertilizer factories almost to a
standstill. Farmers now rely on composting - including human waste - and
on fertilizer supplied by humanitarian agencies. These inputs bring the total supply to only a third of what is needed.
- There is insufficient fungicide and pesticide to combat plant disease and infestation.
- Farm machinery, which was available in former years, stands idle for lack of gasoline and spare parts. On one farm, we were told that out of
15 tractors only five were operational. Farming has again become highly
labour-intensive, with draft animals used for ploughing and transport.
- To compensate for low agricultural and industrial production, the Government has permitted farming on steep hillsides, an unsustainable
practice that creates further environmental problems. These lands are often made available to industrial workers as a means of survival.
All farming in the DPRK is collective (Koreans prefer the word "cooperative"). As in other societies that instituted collective
farming methods, individual motivation is often a problem. The Government seems
to have recognized this. In addition to traditional motivational campaigns, the Government has recently increased the allotment of
privately cultivated land, so-called "kitchen gardens." These
have proved to be a lifesaver for those who have access to such land. Experience has shown that these small-scale gardens - 60 square metres on
average - usually out-produce yields generated by collective lands. They constitute the major part of food available in farmer's markets.
Most nurseries, kindergartens and orphanages now grow their own food, and aid agencies (mostly NGOs) have helped them to extend the growing season
by building greenhouses.
Other ways in which food production has been enhanced:
- Rehabilitation of farm lands, reservoirs, embankments - sometimes with the help of food-for-work schemes supplied by agencies like the WFP;
- A programme of double cropping promoted by the UNDP - primarily winter wheat, spring barley, and - most recently - potatoes;
- Crop rotation and import of hybrid seeds;
- Small animal husbandry - goats, rabbits, chickens, dogs, pigs;
- The digging of ponds for aquaculture.
Despite these measures, it is clear that the DPRK has no food reserves and continues its precarious dependence on the weather and foreign aid. This is underlined by the results of twice-yearly crop assessments
carried out by the FAO and WFP since 1995.
The 1999 crop assessment figures are as follows:
Total utilization: 4,765,000 mt
Total availability: 3,472,000 mt
Import requirement: 1,293,000 mt
Expected food aid: 370,000 mt
Commercial import (est.): 300,000 mt
Uncovered deficit: 623,000 mt
It should be noted that except for localized weather damage, this year, as also last year, was as "normal" a crop year as one can expect on
the Korean peninsula. These figures can therefore be taken as an indication
that agricultural recovery will be an extended project. It is an indication that we are facing a long-term, chronic humanitarian crisis in
North Korea.
Who are the people most at risk? In the order of urgency, they are children, the elderly, pregnant and nursing women, people in large
families, and industrial workers.
3. Nurseries and Kindergartens
The DPRK has a system of day care that any nation could be proud of. All children have access to these institutions, and most attend them -
provided there is food available. Before WFP targeted nurseries and
kindergartens in 1997, attendance rates were around 30 percent. This climbed to almost full attendance as soon as food started to arrive.
Children's institutions have dedicated and caring staff. We heard stories of nurses taking orphaned infants into their homes at night,
despite food shortages in their own families. Staff is often absent working in fields or gathering wild foods in forests for the children in
their care.
Water and sanitation is a problem everywhere. Children's institutions complain about a lack of soap and access to clean water, contributing to
recurring diarrhoea. Skin rashes, symptom of vitamin deficiencies, are a common sight. In crowded, under-heated conditions, respiratory
infections spread quickly among children of all ages.
Children seen by us were generally thin, with a low level of energy and activity. Caregivers explain that children used to be much livelier
"before the floods." Children seemed healthier this year than
the two previous years, but appearances can be deceptive in the absence of a nutritional survey.
4. Nutritional Survey
Marilyn took part in such a survey in September-October 1998. It was the first nation-wide survey of its kind, conducted with scientific rigour.
Participating in the data collection were UNICEF, WFP, and the European
Commission. On the Korean side, the Flood Damage Rehabilitation Committee (FDRC) had oversight and the Korean Institute of Child
Nutrition took the measurements.
The survey covered children from 6 months to 7 years of age in eight provinces and three municipalities. In all, 1800 households were
visited, chosen to be statistically representative of 70 percent of Korean families.
The main task was to measure the height and weight of the children. However, UNICEF conducted a concurrent Multiple Indicator Cluster Survey
(MICS), which also collected data on iron deficiency anemia, the diet of children, childbirth and breastfeeding practices, immunization histories,
water and sanitation services and access to education.
The findings surprised even the Government, which took 6 months to come to its own revised conclusions. Acute malnutrition was found to be at 16
percent, chronic malnutrition as high as 62 percent. Although the latter statistic figured prominently in the media, the more significant
statistic is actually the 16 percent acute malnutrition. This is the highest rate in East Asia, surpassed in all of Asia only by India and
Bangladesh, at 18 percent.
What is the difference in the two measurements?
Chronic malnutrition - also known as "stunting" - is measured by comparing the height with the age of the child. Stunting is the result
of long-term under- or malnourishment. 62 percent of Korean children were found shorter than expected for their age. Obviously, this
measurement can vary for reasons other than nutrition. Nevertheless, the number does indicate that malnutrition has afflicted North Korean
children for longer than the four years since the floods.
Acute malnutrition - also known as "wasting" - is measured by
comparing weight with height. Whether stunted or not, a child with a certain
height is expected to weigh enough to sustain the normal functioning of its body. If the weight is too low, it means the child is not currently
getting enough to eat.
Although 16 percent global malnutrition is grave enough, the breakdown of this figure is even more revealing. Between the ages of 12 and 24
months, a full 30 percent - that is, one out of three children - were
malnourished. This is the age when crucial brain functions and motor skills develop and the immune system matures. Although otherwise healthy
adults can survive short-term food shortages undamaged, malnutrition at
this age can lead to permanent disabilities.
Furthermore, 18 percent of children less than 12 months were malnourished. This indicates nutritional problems during pregnancy and
breastfeeding. The mothers of these children most likely suffered low weight gain during pregnancy and delivered low birth weight babies. Such
children are unlikely to "catch up" to their peers' development.
The drama of this survey becomes clear if one considers the burden placed upon North Korean society if a significant percentage of the next
generation fails to develop their physical and mental potential.
5. Causes of malnutrition
Considering the significant amounts of food aid which has gone into the DPRK over the past 4 years, most of it targeted to the children covered
by this survey, why does malnutrition continue at these levels? This question haunts humanitarian workers because of suspicions surrounding
the diversion of aid. It also embarrasses the Government, making them nervous enough to postpone this year's survey indefinitely.
To be fair, there are plenty of reasons other than the diversion of food aid to explain these findings. As UNICEF continues to insist, lack of
food is not the only cause of malnutrition.
To begin with, as the Canadian food guide illustrates admirably, the body needs different kinds of food in appropriate quantities. The WFP food
basket stipulates that at least three types of food must be supplied:
cereals, pulses (beans) and oil. Most food deliveries to the DPRK have consisted of cereals like corn and wheat. Oil and pulses are more
expensive, and therefore less popular with donors, who like to maximize the tonnage of their shipments.
Add to this the sub-standard water quality available to most children in the
DPRK, leading to recurrent diarrhea. Diarrhea is also caused by the consumption of so-called "alternative food" such as grasses, leaves,
acorns, tree bark and the like. Children with diarrhoea cannot absorb the nutrients in food quickly enough before it leaves the body.
North Korea has cold winters like Canada, and - thanks to the fuel shortage - a lot less heat. Under-heated institutions and homes mean
that children use the energy in food to keep their bodies warm, rather than to build up their tissue. Weakened bodies fall victim to recurrent
infections - respiratory ailments in winter, diarrhoea in summer. Again, the body uses food to fight infection, thus prolonging malnutrition.
Since most families as such have not benefited from international food aid, the needs of pregnant and
breastfeeding mothers have not been taken care of. The Nutritional Survey has focused attention to this target
group, but donations have not kept pace with the needs. Even when these women do receive food, they have a tendency to share it with the rest of
the family, thus diluting the effect.
Finally, it should be recognized that North Korean health care providers were unprepared for dealing with malnutrition. After the Korean War,
malnutrition was eliminated in the DPRK. Few believed that such
knowledge would again become necessary. Medical schools did not keep up with research into the treatment of malnutrition until it was too late.
There is an urgent need to upgrade training and increase numbers of
competent caregivers.
6. Hospitals
The DPRK has built a great number of hospitals in all parts of the country at city, county, district and ri levels. Unfortunately, many
buildings are old and cold. The lack of heating keeps patients away in the winter; food shortages keep patients away any time of the year. When
food is available, occupancy rates soar. It should be noted that mothers usually stay in hospital with their sick children. They too must be fed
by the hospital.
There is a shortage of medical supplies, which has forced hospitals into increased reliance on traditional "Koryo" medicine. Hospitals
usually have a Koryo-medicine-making unit with qualified pharmacists who grow
their own herbs in hospital gardens. They report that some 70 percent of medicines currently used are
homemade herbal remedies.
Hospital staff (doctors, nurses, midwives, pharmacists) are well-trained and dedicated, but facilities such as operating rooms, delivery rooms,
instruments and laboratory equipment are in a sorry state of affairs.
Outdated technology used is some 15 to 30 years behind the times. The absence of
anaesthetics and antibiotics makes every operation a painful, life-threatening event. Still, health care workers do what they can with
preventive medicine, using teaching aids drawn by hand on hospital walls.
Because of lack of supplies, immunization programmes - which used to be some of the best in the world - have been neglected in recent years. WHO
has warned of re-emerging diseases like tuberculosis, measles and even
cholera. The DPRK is unprepared for the extent of the looming crisis. To remedy this situation, the
International Federation of Red Cross and Red Crescent Societies (IFRC) has launched disaster preparedness
programmes. UNICEF and WHO are involved in countrywide immunization of children.
II. Has anything changed?
We are frequently asked the question whether anything has changed during the two years we worked in the DPRK. Is there any hope of a turn-around? It is a difficult question, because changes in the DPRK are usually
invisible to foreign eyes. Small changes may harbour great significance. On sunny days when the air is clear, we may detect numerous positive
signs:
- There has been some agricultural recovery; some innovations and adjustments in agricultural policy; the success of double-cropping; an
increase in small animal husbandry and greenhouses. There are more markets, more bicycles, more vehicles;
- There has been some reforestation; some energy improvement. This spring there was a cosmetic clean-up and beautification campaign;
- Children on the whole seem somewhat better, at least compared to the ones we saw when we started in 1997;
- Government normalization has provided some stability; the working environment for humanitarian agencies has improved; there is better
monitoring access, increased direct access to line ministries and research institutes. Government seems to have come to recognize the
importance of NGO contributions (although the concept of NGO is still a mystery to them);
- There has been mutual learning between government counterparts and humanitarian agencies; there is formal recognition by Government that
this is a complex emergency requiring long-term solutions; Government has
followed up the nutrition survey by emphasizing rehabilitation, prevention and skills upgrading;
- Relations have also been strengthened at Provincial and County levels; numerous workshops and round tables have been conducted by international
agencies at provincial and local levels, attended by local officials and
experts;
- The international community has been allowed to create and rehabilitate production facilities - e.g. food production facilities like noodle and
CSB factories, and pharmaceutical production from donated raw materials.
Despite these positive signs, the outlook is generally gloomy. Although humanitarian aid is urgently needed, most of the agencies operating in
the DPRK now agree that it is not the solution. Food shortages are
expected to continue despite massive input by the WFP and other agencies. Agricultural uncertainty will continue even if the UNDP succeeds in
funding the roundtable process for Agricultural Rehabilitation and
Environmental Protection. Medical crises will not only continue but increase despite the efforts of WHO, IFRC and UNICEF.
Economic recovery is vital, but industry is not recovering quickly enough. Apart from some South Korean industries, few foreign companies
seek investment opportunities, despite the creation of special economic
zones like the Rajin Sonbong area, and a multi-national Tumen River Development Project that promises to provide appropriate communication
infrastructure in the nearby border region.
The DPRK has developed an unhealthy dependence on international aid at a point in time when donor fatigue has set in. It is increasingly
difficult to raise the requisite funds to sustain the current level of aid.
Humanitarian aid cannot, finally, solve the intractable political problems in the region, which lie at the root of the difficulties.
Unless there is real movement in the 4-power process, the north-south talks, and other fora of negotiation involving North Korea, humanitarian
aid will continue to be held captive to political exigencies.
What needs to happen?
Humanitarian aid needs to be accompanied by greater effort at seeking solutions to underlying problems. In addition to humanitarian
assistance, the DPRK needs massive economic assistance in order to recover from its current crisis. This presupposes an end to isolation
and a building of confidence between the DPRK and potential trading partners. The recent partial lifting of US sanctions is commendable in
this respect.
There is an urgent need to end military confrontation on the Korean peninsula and hasten reconciliation between North and South Korea. This,
more than anything else, would open the gates to real assistance and recovery. This presupposes positive results in the ongoing peace
process.
We must remember, however, that Korea is only one element in the geopolitical scenario affecting peace and justice in all of northeast
Asia. The interests of the USA, China, Japan and Russia all have a direct impact on what happens on the Korean peninsula. Koreans have been
a pawn of regional powers throughout history, and harbour deep suspicions of non-Korean motivations - even those of humanitarian agencies.
The North Korean authorities see the South Korean "sunshine policy"
and USA's "constructive engagement" strategy as a more gentle, but
therefore even more dangerous, intrusion intended to undermine the North Korean people's resolve. They warn of "yellow winds", which blow
through their defences and infect those who are not vigilant.
We already read you a quote by Kim Il Sung. Here is one by his son, Kim Jong Il:
"Through their ideological and cultural infiltration into other countries, the imperialists are working ceaselessly to infect people with
ideological diseases, disintegrate those countries from within and then put them under their domination and control."
Considering what we said at the beginning of this lecture - that the current crisis threatens to undermine the ideological foundations of the
system - this perception is understandable. The USA is by far the largest donor of humanitarian aid and the ROK is by far the largest
trading partner of the DPRK. If North Korean citizens continue to eat from bags of maize, wheat and corn-soya blend imprinted with the American
flag, can they help but wonder why their government is trusting its worst enemy to feed them?
To maintain the status quo under such circumstances requires greater control mechanisms. The changes implemented under the revised
Constitution last year seem to strengthen the military vis-a-vis the Korean Workers Party. Since the title "President" has now been
awarded to deceased leader Kim Il Sung for eternity, the highest post in the land
- appropriated by his son Kim Jong Il - is Chairman of the National Defense Committee, a committee in which the military has the most
prominent profile.
But how does one maintain military control when economic control has been lost? The DPRK finds itself in a "Catch 22" situation: tighten
control, increase belligerence, and lose the aid; OR: accept the aid, make
friends, and lose control? One can well imagine the intense internal debates between the military hard-liners and the civilian technocrats. It is within tensions like these that creative solutions are sometimes
forged and disaster is averted - OR all creativity is stifled and disaster becomes inevitable.
Which of the two it will be is anybody's guess. But the way in which the outside world reacts to North Korean provocations and initiatives is
bound to influence their internal policy decisions. For this reason, we are pleased with the conciliatory tone of the report of William Perry, US
North Korea Policy Coordinator. The new policy has already reaped its first reward: the DPRK agreed not to test-fire its Taepodong II long-range missile this summer.
Canada - with our close relationship to both the USA and the ROK - is in an excellent position to play a much more proactive "honest broker"
role than we have done in the past. South Korea has indicated that it would
welcome Canadian involvement, and North Korea has informally expressed interest in senior-level conversations with Canada.
To conclude,
Aid is not the answer to North Korea's problems. However, aid provides a window of opportunity. Aid gives us the access, which allows us to
understand better, to identify the real issues.
Aid helps to open doors, to build relationships and thereby to build mutual confidence. We might call it "peace-building by example."
Aid provides a breathing space, a time frame within which longer-range solutions can be devised and tested.
Aid prepares the runway for a "soft landing."