North Korea: The Humanitarian Situation and Refugees

MSF Testimony Delivered to the House Committee on International Relations Subcommittee on East Asia and the Pacific in Washington, D.C. by Sophie Delaunay, Regional Coordinator for North Korea, MSF

Mr. Chairman, thank you very much for giving me the opportunity to testify before you in the name of Médecins Sans Frontières/Doctors Without Borders (MSF), and share with you our experience and understanding of the crisis affecting North Koreans in need of food assistance inside the Democratic People's Republic of Korea (DPRK) as well as of the plight of North Korean refugees in China.

MSF operated inside North Korea from 1995 to 1998. During this time, MSF attempted to supply drugs and provide medical training for approximately 1100 health centers, and to run 60 therapeutic feeding centers for malnourished children in three provinces of the country. Convinced that, despite the best efforts of our field teams, our aid was not reaching those most in need of aid as intended, MSF made the painful decision to withdraw from North Korea in September 1998. Since then, MSF has remained deeply concerned about the situation inside North Korea and explored alternative ways to reach the most needy.

MSF derives its current understanding of the humanitarian situation in North Korea from the following sources:

• North Korean refugees in China
• North Korean defectors in third countries
• Aid workers providing cross-border assistance

Today, I would like to address two fundamental concerns regarding the disastrous humanitarian situation of the North Korean people.

• The lack of access of the most vulnerable populations in North Korea to international aid
• The lack of protection and assistance for North Korean refugees

Lack of Access of the Most Vulnerable Populations Inside North Korea To International Aid

In October 2001, I described to a 40 year-old North Korean refugee how MSF used to provide aid in North Korea. After listening to my explanation, he smiled at me and said, "You cannot reach people like this… You can't reach the common people."

His comment illustrates the striking discrepancy in information between aid agencies present in North Korea and aid workers assisting North Korean refugees about whether aid is reaching its intended targets. This has been a characteristic of the North Korean crisis for the past 7 years. MSF itself experienced such a divergence when in 1998, the extent of the famine described by the refugees that MSF met on the Chinese border could not be observed by its teams operating in the DPRK. This was due to the restrictions imposed by the North Korean government on the ability of aid organizations to independently assess humanitarian needs.

To this day, the vast majority of refugees who MSF has interviewed say they have never received food aid. This includes those belonging to the target beneficiaries of the United Nations program. Anyone who has sat and talked with these refugees would find it difficult to believe the assurances of the World Food Program (WFP), which is reporting that aid is saving millions of lives, and that they have access to the people and know where the aid is going.

North Korea has been one of the largest recipient of food aid in the world for a number of years, yet it is still a great challenge for vulnerable populations to access food. Despite increased border controls, some North Koreans, mostly from the northern provinces, continue to cross into China in search of the means to survive. According to the refugees MSF has interviewed, the food situation remains critical for most of the ordinary people in North Korea. In their own words, after a decade-long food shortage in the country, those who remain are the survivors and only the strongest have learned to cope.

Even population groups such as children, pregnant women, and the elderly, who are specifically targeted by the WFP for assistance, are being denied food distribution. In February 2002, an MSF team met with 12 North Korean children between the ages of 6 and 15 who had recently arrived in China. None of them had ever received food at primary school. According to them, pupils have to bring their own lunch from home. Children are often unable to attend school because they are simply too weak or too busy providing for their own sustenance. The same month, a woman from Hyesan told us that, as a pregnant woman she was not entitled to any aid from the government. She was one month from delivery and was forced to cross the border at night in sub-zero temperatures to get some help. Several elderly people who MSF interviewed, who belonged to the WFP target population, said they also did not benefit from any assistance.

Testimonies from refugees and aid workers who are carrying out cross-border assistance largely deny that farmers are better off and can benefit from the crops they grow. A bad harvest combined with a required quota deducted by the government does not leave much for the rural populations to rely on. Despite the irregular functioning of the Public Distribution System in urban areas, it seems that cities offer survival alternatives that cannot be found in rural areas, including widespread black markets.

For MSF, the testimonies of North Korean refugees raise serious questions about the way humanitarian assistance is delivered in North Korea. From our point of view, two major weaknesses in the relief programs favor exclusion of vulnerable populations from the aid system. Those weaknesses are:

• The use of the Public Distribution System (PDS) to channel food aid; and,
• The quality of monitoring food aid.

The Public Distribution System

In North Korean society, the three class labels—"core," "wavering," and "hostile"—continue to be used to prioritize access to jobs, region of residence, and entitlement to items distributed through the Public Distribution System (PDS). Everyone in North Korea, with the exception of cooperative farmers, depends on the PDS for the basic food rations they require for survival. Therefore, vulnerability and need have more to do with political and social standing than age and gender, the criteria used by aid organizations to define target beneficiaries.

As early as 1998, MSF denounced the fact that any assistance channeled through the PDS was discriminatory by nature. By using the PDS as the distribution channel for assistance, organizations are collaborating in organized government discrimination of its own citizens based on politics instead of needs.

"Last time I received food from the PDS was in 1997, only once that year. I received according to my ration ticket. Everyone has different amounts," testified a 20 year-old man from Hoeryong city last October.

According to individuals we interviewed, ordinary urban residents cannot rely on the PDS for their survival and are forced to find alternative ways to obtain food. Erratic for years, the PDS came to a virtual standstill in the late 90's with meager distribution on major national holidays.

The Quality of Monitoring Food Aid

After 7 years of massive international assistance to North Korea, monitoring conditions remain unacceptable. North Korea still does not provide the complete list of beneficiary institutions and WFP teams are still barred from making spot checks. Random access for assessment purposes appears to be impossible, calling into question the transparency of field inspections. Some refugees have witnessed UN visits and their testimonies raise questions over the way field inspections are organized, if not staged, by the North Korean partners.

From its experience and understanding of the North Korean system, MSF would like to reiterate that access by the population to the aid it needs can only be improved if there are independent needs assessments, independent distribution mechanisms, and independent monitoring by operating agencies.

The Lack of Protection and Assistance for North Korean Refugees

Once outside North Korea, challenges remain for North Koreans seeking refuge outside their country. Most North Korean refugees do not even contemplate reaching South Korea. Instead, they cross the border into China in search of food for their families, or a temporary job that will allow them to buy medicines or other essential goods needed at home. These refugees live in a precarious situation in China and are in urgent need of assistance. Considered illegal migrants by the Chinese authorities, they live in hiding and face the risk of being arrested at any time, forcefully repatriated, and subject to severe repercussions in North Korea. Border rules posted along the Tumen River in Chinese and Korean stipulate that, "It is forbidden to financially help, allow to stay, harbor, or aid in the settlement of people from the neighboring country who have crossed the border illegally."

Fines and rewards¹ discouraging Chinese citizens from assisting North Korean refugees and recent arrests of NGO workers illustrate how impossible it is to adequately provide effective humanitarian assistance.² Only a handful of refugees manage to reach a third country, where they continue to face the risk of being arrested anytime as illegal migrants during their 3-to-4-month screening process. Up to now, none of the 1988 North Korean defectors who have been resettled in South Korea have been granted refugee status.

Numerous discussions between MSF and the United Nations High Commissioner for Refugees (UNHCR) about the need for protection have not proved fruitful. In July 2001, MSF called on the Chinese authorities to cease forced repatriations and allow humanitarian assistance for the refugees. These calls have gone unanswered. The ongoing repression of North Korean refugees and of those who assist them limits the scope of any humanitarian operation on the Sino-Korean border. There may soon be no more refugees to tell you about North Korea.

Conclusion

The need for assistance to the North Korean people is widely acknowledged. Testimonies of North Korean refugees confirm that despite massive international relief going into the country, a significant segment of the population remains in a precarious food situation. These testimonies also suggest that humanitarian assistance is not primarily directed at, nor reaching, the most vulnerable populations.

MSF expresses its grave concern over the endless suffering of the North Korean people and urges aid agencies operating inside North Korea to improve their monitoring and be responsible for the populations they are entrusted to assist. A second concern addresses the dire plight of North Koreans seeking refuge in China. Médecins Sans Frontières urges UNHCR and the Chinese government to open a dialogue leading to ensuring protection of North Korean refugees in China, and to authorizing the provision of emergency assistance to the refugee population.

Thank you for your attention.

Additional Testimonies of North Korean Refugees

1. Statements Regarding Reasons for Crossing the Border

Man, 35, from Hoeryong city, North Hamkyong Province. Interview conducted in October 2001:
"There are rich people in North Korea too. People who are poor, who just eat corn, come here [to China]. The rich, who have the rice, they don't need to come here. For them, we are bad, traitors."

Boy, 18, from Sampong city, Musan county, North Hamkyong Province. Interview conducted in July 2001:
"I came to China in June 2001 because I had nothing to eat, my mother died and my father is sick."

Peasant, 40, from Onsong county, North Hamkyong Province. Interview conducted in April 2001:
"Me and my wife came to China because we were starving."

Women, 43, from Aoji coal mine, Eundok county, North Hamkyong Province. Interview conducted in April 2001:
"We have the choice between dying from starvation or dying in the hands of the police after being arrested. Anyhow we may die so we come to China, at least we can please our stomach there."

"If somebody has a high position in North Korea, he does not have any problem. If I was in a high position, I would not need to come to China."

2. Statements Regarding Pregnant Women's Access to Aid

Pregnant women, 31, from Hyesan county, Ryanggang Province. Interview conducted in February 2002:
"I am pregnant and I will deliver next month. As a pregnant woman I am not entitled to any aid from the government. No pregnant women ever receive any. Until the end of the 80s, pregnant women would receive food during their hospitalization."

Women suffering from tuberculosis, 33, from Chongjin city, North Hamkyong Province. Interview conducted in February 2002:
"Pregnant women do not benefit from government care. Well so they say but… when the third child is born, a 300 g ration of food is distributed in his name. After that there is nothing for the child nor for the mother."

3. Statements Regarding Elderly Access to Aid

Man, retired from the Workers Party, 50, from Aoji coal mine, Eundok county, North Hamkyong Province. Interview conducted in April 2001:
"After I retired, me and my wife have not got any income. We don't ask too much, not even rice. But even corn soup we cannot always have."

Retired couple from the Workers Party, 60 & 61, from Obong city, Eundok county, North Hamkyong Province. Interview conducted in February 2001:
"When you're over 61 years old you're unable to work because of the age limit. But right now in North Korea, they write the [retirement] annuity on a piece of paper. With that you can get 600 g of rice for one day but it is only a piece of paper, and I never receive anything, and I cannot eat the paper, we are not goats. I never get any distribution nor any grant and I never receive a wage. If people in the coal mines don't receive any food, how can old people like us receive any?"

4. Statements Regarding Food Availability for Farmers

Couple of farmers, 49 and 45, from Eundok county, North Hamkyong Province. Interview conducted in October 2001:
"We came to China because we were in difficulties so we came here to get some help. We had a bad harvest, no PDS, it's hard to get food, so we came here along."

Peasant, 40, from Onsong county, North Hamkyong Province. Interview conducted in April 2001:
"Before we used to receive some distribution of crops, but nowadays there are not enough crops. Although we plant crops for the year it is not even enough for peasants. On the top of that we have to provide crops to the workers office. There are only 3 to 4 months a year when we have enough crops to eat. Most of the crops are provided to the army base."

Farmer, 40, from Onsong county, North Hamkyong Province. Interview conducted in February 2001:
"Once they tax everything there is not much left for us to eat."

Retired couple from the Worker's Party, 60 & 61, from Obong city, Eundok county, North Hamkyong Province. Interview conducted in February 2001:
"Right now farmers cannot even produce enough food for themselves. There are several reasons why; there isn't any fertilizer and farmers don't have energy to work because they don't have anything to eat."

Pregnant women, 31, from Hyesan county, Ryanggang Province. Interview conducted in February 2002:
"People living in the cities are always better off than those from the countryside. In the city, they can always manage to beg. In the countryside, there is nothing but the grass for the rabbits."

5. Statements Regarding the Functioning of the PDS

Couple of farmers, 49 and 45, from Eundok county, North Hamkyong Province. Interview conducted in October 2001:
"The PDS stopped in '95-'96 but we still have to keep workin.g"

Man, 23, from Musan county, North Hamkyong Province. Interview conducted in July 2001:
"In North Korea the only source of food is PDS, if there is no food ration, there is no other source of food. But you know, since I began to have hair on my head, I have never seen food ration on a regular basis, so it was erratic already after my birth and PDS has always been a major problem for the people."

Woman, 50, from Sampong district, Onsong county, North Hamkyong Province. Interview conducted in April 2001:
"The government does not supply any food to the population nowadays, and says to them that 'although we only have water and fresh air, we have to keep our ideology.' They just leave on corn soup in my hometown. They get the corn from merchants from Chongjin who make profit out of it."

Woman, 50, from Sampong district, Onsong county, North Hamkyong Province. Interview conducted in April 2001:
"In 1997, on April 15, Kim Il Sung's birthday, I received 3 kg of corn from the US. Every family also got 10 kg of potatoes from China on October 10th, 1998 for the Worker's Party foundation day. Besides those two cases, we did not get anymore from the PDS. And the government announced to citizens that no more food would be provided so they should not expect anything from the government and that everybody had to manage their life by themselves."

Woman, 30, from Aoji, Eudok county, North Hamkyong Province. Interview conducted in April 2001:
"Since 1995 I have only received food from PDS once or twice a year for Kim Il Sung's and Kim Jung Il's birthdays."

Retired couple from the Worker's Party, 60 & 61, from Obong city, Eundok county, North Hamkyong Province. Interview conducted in February 2001:
"We just receive food from PDS for anniversaries in January1, February 16, April 15, a ration for 3 days."

Man, 35, from Aoji, Eundok county, North Hamkyong Province. Interview conducted in February 2001:
"I gave up my job in the 7.7 fertilizer factory because there wasn't any food distribution."

Pregnant woman, 31, from Hyesan, Ryanggang Province. Interview conducted in February 2002:
"In theory the PDS should distribute 800g/day/person. But since the 80's, the rations have officially been reduced to 4-5 months. Even though it is fixed like that, the PDS is corrupted and this quantity has not been provided. We receive much less than that. The decrease in rations is always justified by the need to help the army or because the agricultural program did not succeed."

6. Statements Regarding Visits of UN Inspectors

Man, 23, from Musan county, North Hamkyong Province. Interview conducted in July 2001:
"I have seen some foreign guys from the UN traveling around. I don't know what they are doing but when they are traveling, just around this time, government suddenly becomes very busy, you know, try to find those undernourished boys and children … They keep them away, you know, those undernourished children, at some place…Perhaps they were expecting that these UN guys visit welfare facilities inspection, so they want to be prepared for it."

Man, 19, from Hamheung city, South Hamkyong Province. Interview conducted in February 2001:
"Last year I saw UN guys coming to Musan to assess flood damage. The government dug up the river and the streets to make it look more damaged, in order to get more rice. The UN investigators came back to Musan a number of times."

7. Statements Regarding Forced Repatriation and Related Punishment in North Korea

Boy, 16, from North Pyongan Province. Interview conducted in July 2001:B"I was arrested a few month ago in China, put in jail, then sent to North Korea where I was kept in a childrens camp in Heoryong. I escaped again to come back to China."

Man, 23, from Musan county, North Hamkyong Province. Interview conducted in July 2001:
"I was detained in a Chinese detention center in Hunchun in January 2000 then sent back to North Korea with another group of North Koreans. We were handcuffed until we reached Saepiol and then we were blindfolded and taken to a camp. I learned from my cellmates later on that we were in Chongjin. In the camp it was very hard and I have been tortured, but after I mentioned my aunt was working in the North Korean anti South Korean intelligence, I was released."

Woman, 50, from Sampong district, Onsong county, North Hamkyong Province. Interview conducted in April 2001:
"My son was already arrested and repatriated 3 times from China, therefore he will stay in jail for 5 years. Citizens know that if they are caught leaving the country, the first time they have to stay in jail one year, the second time 3 years. I myself was arrested for leaving the country without permission last year in July. I was taken to Chongjin city jail where I only stayed one month because it was too crowded and there was not enough space in the jail. There were 120 males and 178 females there, all of them had been arrested for escaping the country."

8. Statements Regarding the Manipulation of Foreign Aid

Man, 23, from Musan county, North Hamkyong Province. Interview conducted in July 2001:
"The rice and corn in the market are in foreign packages, it is the food that arrives in Korea from good people like you. Then those bastards of senior party members are taking them into their home and their big bellies, but since they cannot sell the things themselves at the market, then they send their wife to do the job. I can precisely tell you that the things are from foreign countries because I often go to the port in Chongjin. A lot of cereals are being unloaded there. We saw all kinds of grains and foreign ships. And sometimes we see the American flag and the package label. So I can precisely say where the cereals we find in the market come from."

Woman, 50, from Sampong district, Onsong county, North Hamkyong Province. Interview conducted in April 2001:
"Citizens know that a lot of relief supply is coming to North Korea from other countries. We have heard about it. But most of the time we never got any of those supplies, so we think that the government keeps for themselves."

Man, 20, from Chongjin city, North Hamkyong Province. Interview conducted in April 2001:
"I have been to the black market recently, I have seen bags of corn there. It had a US flag on the top and it was written that it was a gift from the US."

Mine worker, 46, from Saepiol county, North Hamkyong Province. Interview conducted in February 2001:
"We heard that soldiers in the army still eat 3 meals a day, 2 meals of rice and one meal of porridge. To the army, the food goes to the army. The rice is used to make oil and turned into gunpowder. From what I heard, the army base has about 80-90% go to the army and the rest is sent to the people. At the army factory they use glutinous rice powder to make gunpowder. Or the glutinous rice or corn or peas can be used to produce oil. Or candy powder can be used as well."

Man, 36, from Rason, Eundok county, North Hamkyong Province. Interview conducted in February 2001:
"If you listen to the [South Korean] radio it says how much rice is brought into the country from South Korea, Japan and America. 500,000 tons came into Nampo harbor and other places. But in reality the amount of our ration is one or two days worth, sometimes a week worth. After that there is no more. So I start to wonder if we really got that rice and if the South Korean radio is lying. I think about that sometimes: if the rice came in, why is no one giving it to the people?"

1. Fines: 5000 to 10000 Rmb for helping NK refugees. Rewards: 30 RMB for denouncing shelter; 50 Rmb for denouncing a refugee; 100 Rmb for taking a refugee to the Chinese police station. Based on information collected by an aid worker at the border in July 2001. ( 8 Rmb = US $1)
2. 1) On April 20, 2001, the Chinese government arrested, detained and harshly treated four members of the NGO Good Friends and their translator 2) Chun Ki-won, 46, a South Korean missionary helping North Korean defectors in China has been under custody by Chinese security authorities since he was caught at the end of 2001 3) Rev. Choi Bong Il, 46, was arrested on April 15, 2002 by Yanji Police for his relations with a group of defectors.