Academic journal article North Korean Review

Nutrition and Health in North Korea: What's New, What's Changed and Why It Matters 1

Academic journal article North Korean Review

Nutrition and Health in North Korea: What's New, What's Changed and Why It Matters 1

Article excerpt

Introduction

The North Korean famine of the mid-1990s is well-known and well-researched in terms of causation, processes, outcomes and consequences.2 Much less is known, however, about the changing health and nutritional status of the population since the famine and, indeed, the dominant perspective is that nothing much has changed in the DPRK.3 Yet, despite a precarious economy, the end of systematic government provision of food to the population, and a decline in assistance from international organizations after 2001, the data shows that by the mid-2010s, national levels of severe wasting, an indication of famine-like conditions in the population, were lower than in other low income countries globally and on a par with those prevailing in other developing countries in East Asia and the Pacific. Poverty and ill-health remained-as shown especially in terms of maternal health and infant mortality- but the incidence of malaria sharply declined and although the incidence of tuberculosis was up, the numbers of fatalities from both malaria and TB fell substantially.4 The incidence of deaths from vaccine-preventable disease fell. By 2013, the major killers in North Korea were non-communicable diseases including cancers and cardiovascular diseases, which are commonly understood as diseases of wealthy countries.5

This article proceeds by outlining the sources and types of data; it then charts changes in food availability and patterns of accessibility in the post-famine period before showing changes in the nutritional and health status of the population in aggregate, national terms with some disaggregation of the data by gender and age. It proceeds by offering comparative analysis between the DPRK and other poor countries, other Asian countries and near neighbors in East Asia. The analysis shows that indications of poverty and ill-health among the population remained worrying but that post-famine DPRK is far from the outlier state that is commonly presented in scholarly, policy and global media analysis.6

Data

This research is founded on underutilized primary sources, mainly from international organizations (IOs), including UNICEF, WHO, WFP and FAO; the DPRK, ROK and United States government agencies; NGOs; and it makes some use of analysis based on defector interviews.

International humanitarian agencies became resident in the DPRK in response to the health and food emergency of the 1990s. They provided food and heath assistance but they also, as in every other health emergency in the world in which they are involved, sought to measure nutritional and health status and to report their findings to donors and the DPRK government. The two main objectives of such reporting were to generate funding for humanitarian assistance and to provide an informational base to help shape policies to prevent a recurrence of humanitarian crisis.

Much of the data is in the areas of agriculture, health, and nutrition, as these are the core sectors in which the humanitarian agencies operate in the DPRK. The data is both quantitative and qualitative. It is not comprehensive but it is, perhaps surprisingly, extensive and sufficient to allow for a more profound knowledge of the well-being of the population than was hitherto possible prior to the advent of resident international organizations in the DPRK.

Disaggregated data by gender, age and geographical location became available as the mandate was to target the most vulnerable groups and women, especially mothers, children and the elderly were prioritized for assistance as were those living in the more remote and poorer areas of the country. Nutritional, health, agricultural and educational data was, therefore, routinely collected and analyzed at provincial level, and often at county level. Since much of the data was collected to help fulfill the mission of the humanitarian organizations, rather than for generic, national statistical purposes, the empirical data is fairly rich for women and young children but is relatively sparse for adult males and adolescents of both sexes. …

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