HPG Working Paper

Famine in North Korea:
humanitarian policy inthe late 1990s
Emma Campbell

December 2015

HPG
Humanitarian
Policy GroupAbout the authors
Dr Emma Campbell is a Visiting Fellow based in the Strategic and Defence Studies Centre, College of the Asiaand the Pacific, Australian National University. She has worked in the field with Médecins Sans Frontières
and as a researcher and editor at the North Korea Database Centre, a Seoul-based NGO specialising in North
Korean human rights and the welfare of North Korean refugees living in South Korea. The author would like tothank Professor Tessa Morris-Suzuki, Dr Jacinta O’Hagan and the anonymous referees for their comments andassistance with this paper.

Humanitarian Policy Group
Overseas Development Institute203 Blackfriars Road
London SE1 8NJ
United Kingdom
Tel. +44 (0) 20 7922 0300
Fax. +44 (0) 20 7922 0399
E-mail: hpgadmin@odi.org
Website: http://www.odi.org/hpg© Overseas Development Institute, 2015
Readers are encouraged to quote or reproduce materials from this publication but, as copyright holders, ODI
requests due acknowledgement and a copy of the publication. This and other HPG Reports are available fromwww.odi.org.uk/hpg.

Contents
1

Introduction

1

2

Aid and division: a history framed by the Cold War

33

The humanitarian response
3.1 Official intransigence
3.2 Access to information
3.3 Linking humanitarian aid and security goals

5
5
7
9

Conclusion: an ‘Arduous March’ for humanitarian actors?

11

Bibliography

13

4

i

ii Famine in North Korea: humanitarian policy in the late 1990s

1 Introduction
The instructors were too hungry to stand andtaught us sitting down. When the classes ended… [students] without money went to the ricepaddies to dig up rice roots to hand in at school.
In summer students scraped off the inner barksof pine trees. When I looked out of the window
during class, I saw lines of death carriages loadedwith corpses passing by. That year, so many
people died of starvation (Ziemek, 2009: 15).
This testimony, from a North Korean refugee who
fled to South Korea, describes her experience of theso-called ‘Arduous March’.1 Throughout the 1990s,
North Korea was gripped by economic crisis, natural
disaster and famine. The causes of the crisis included
the failure of the North’s extreme socialist model, theend of Soviet and Eastern European subsidies after
1990 and the collapse of the Socialist bloc. It also
coincided with the death in 1994 of the country’s
revered leader Kim Il Sung.
Long closed off from countries outside of thesocialist bloc, the crisis led North Korea to issue an
unprecedented request to the international community
for humanitarian assistance. In response, United
Nations organisations, national government agencies,
the International Federation of the Red Cross (IFRC),
NGOs and even private groups and individuals
embarked on large-scale humanitarian activities in the
country. For most organisations this was their firstcontact with North Korea. For others it was theirfirst experience of operations anywhere in Northeast Asia (Flake, 2003; Schloms, 2003). Despite thisconcerted intervention, involving one of the largest
aid operations of the time, the most widely quoted
estimate suggests that between 600,000 and a million
North Koreans died from hunger or disease during thefamine (Haggard and Noland, 2007). Others put the
number of dead as high as 3.5 million.2
1 An earlier version of this paper was delivered at ‘A Global
History of Modern Humanitarian Action: Regional Conferenceon East and Southeast Asia’, co-organised by the Humanitarian
Policy Group and the Institute of South-East Asian Studies(ISEAS), Singapore, 29–30 January 2013.
2 For a full discussion of possible death rates, see Haggard andNoland (2007), pp. 74–76.

The provision of aid to North Korea was controversial
because the catastrophe that faced the country resulted
from government mismanagement and failure, rather
than natural disaster. Moreover, there seemed little
willingness on the part of North Korea to liberalise
its authoritarian regime and move towards the greater
openness and reform unfolding across the former
communist world. It is thus not surprising thatmany donor countries and organisations had serious
reservations about their aid work in the country, andformulating an acceptable humanitarian aid policy
was fraught with difficulty. Donors had a strong desire
to provide humanitarian assistance to the desperateNorth Korean population, while at the same timeensuring that the aid given did not prop up a regime
that was causing the suffering in the first place.
In subsequent analyses of humanitarian operations inNorth Korea, a number of commentators have criticised
the aid community for failing in this core objective.
The economist Nicholas Ebertstadt, for example, wrotethat ‘these clueless programs of humanitarian relief
have been a resounding failure. Or to be a little more
precise: they have done a wonderful job of nourishingand supporting the regime – they have only incidentallyand episodically mitigated the distress of the victims
for which they were intended’ (Eberstadt, 2011). Aidgroups including Médecins Sans Frontières (MSF) andAction Contre la Faim (ACF) have also expressed deep
concern about their humanitarian engagement with
North Korea during this period. Both organisations
eventually withdrew from the country, in part because
they believed that aid was being diverted by thegovernment, and because they believed that aid actors
were being used by the international community toprop up the North Korean regime.
Other analysts, however, have argued that theinternational aid community was right to continue
working in North Korea. Haggard and Noland(2007) criticise those who thought that aid should be
withdrawn in order to hasten the reform or collapseof the North Korean regime, noting that, while pullingout of the North would not have guaranteed the fallof the government, it would certainly have led tohardship for a population in dire need of assistance.

1For Hazel Smith (2005), a former UN representativein the North, food aid not only made a marked
difference to the health and nutrition of the wider
North Korean population, but also led to a positive
shift in attitudes among the North Korean authorities
towards engagement, negotiation and compromise.
Andrew Natsios, the former head of the US Agency
for International Development and World Vision
US, touched on a particularly sensitive aspect of aid
policy when he argued the case for humanitarian aid
to North Korea during the famine on both moral
and pragmatic grounds. In 1997, Natsios wrote that‘even if policy makers are unmoved by the ethicalproblem of using the threat of mass starvation toforce the North to negotiate, they should worry about
the profoundly destabilising effects famine can have’(Natsios, 1997).
This paper – part of the Humanitarian PolicyGroup’s ‘Global History of Modern Humanitarian
Action’ project – draws on these analyses and otherinformation to chart a history of humanitarian aid
during the ‘Arduous March’. It focuses on the role
played by the UN, Western aid agencies and theUnited States, which provided the vast majority of
the funding for UN operations. Alongside publishedaccounts of their role, the paper also uses information
recently released by MSF, MSF and North Korea
1995–1998,3 an interview with a former senior ACF
employee who led a team working inside North
Korea at the time of the famine and an unpublished
ACF press dossier distributed following the NGO’s
withdrawal from the country in 2000.
The paper highlights three predominant themes thatcharacterised the challenges faced by humanitarianagencies working in North Korea over this period: (i)the intransigence of the North Korean authorities; (ii)the availability and accessibility of information for aid
agencies; and (iii) the use of humanitarian aid in theservice of foreign policy goals. In conclusion, the paper
examines the impact of this period on more recent
humanitarian engagement with North Korea. In order
to contextualise the involvement of the international
aid community in North Korea, it will first be useful toreview a history of aid in North Korea prior to the 1990s.

3 The author is grateful to MSF for granting permission to use thisinternal MSF document prior to its publication. The author would
also like to thank Laurence Binet of MSF International andSophie McNamara of MSF Australia for their kind assistancewith accessing the document.

2 Famine in North Korea: humanitarian policy in the late 1990s

2 Aid and division: a history
framed by the Cold War
North Korea is a modern creation. After the withdrawalof the Japanese from the Korean peninsula in 1945,
it was divided at the 38th parallel into two zones:
the south, administered by the United States, and thenorth, administered by the Soviet Union. Regimes
friendly to the respective occupiers were installed –Kim Il Sung became the President of the Democratic
People’s Republic of Korea (DPRK) in the north, andSyngman Rhee became the President of the Republic ofKorea (ROK) in the south. Both the new regimes andthe occupying powers failed to cooperate on a unified
administration for the whole peninsula, and entrencheddivisions on both sides finally led to war in June 1950.
The conflict lasted three years, ending where it began –with the Korean peninsula divided at the 38th parallel.
Over those three brutal years both North and South
Korea were devastated. Around 2.8 million Koreansdied. The majority of casualties were suffered by theNorth, which was left in ruins by bombing ‘that hardlyleft a modern building standing’ (Cumings, 2010).
In the years that followed the war both the North andSouth were faced with the massive challenge of rebuilding
their economies and societies. The prognosis for the
peninsula was grim, but particularly so for the South(Cumings, 1997). Indeed, in the two decades that followed
the division of the peninsula the rate of economic growthin the North outstripped the South (ibid.), despite thefact that the North had suffered disproportionate losses
during the war and much of the peninsula’s productive
agricultural land was in the South (Noland, 2012). The
North, however, had vast coal and mineral resources,
and the remnants of the Japanese colonial era’s heavy
industrial installations. Overcoming its war losses,
North Korea recovered rapidly, establishing a systemable to provide for the basic welfare requirements of its
population. Like many other nations in the Socialist bloc,
however, it did so under a harsh authoritarian politicalsystem (Cumings, 1997; Smith, 2005).
Under Kim Il Sung, North Korea developed an
indigenous ideology, Juche, combining ideas of socialism
and nationalism. Through Juche, North Korea sought

economic self-sufficiency, political sovereignty andmilitary self-reliance (Park, 1987a: 66).4 Juche’s
strong nationalist elements reflected the challenging
historical experiences of the Korean people, including
invasion, colonisation and occupation by foreign
powers (Cumings, 1997). Paradoxically, the ideology
did not preclude the acceptance of foreign aid andtechnology on the path to achieving the goal of national
independence and self-reliance, and aid became an
important element in the country’s reconstruction.
The Cold War defined much of the North’s experienceof aid, whether humanitarian, economic or military. In
the first decade and a half of its existence it received
substantial assistance from China, the Soviet Union andsocialist Eastern European countries (Ha and Jensen,
1987; Chung, 1987). Aid from Eastern Europe was
generally non-military, and included humanitarianand development assistance both during and after the
Korean War. During the war, for example, Poland
offered soap, machine parts and two aircraft for medicaluse (Chun, 1987). In 1953, Romania gave railroad
carriages, fishing boats and oil trucks, and provided
for the construction of a cement plant and an aspirin
factory (ibid.). East Germany provided substantial aid
during and after the war, including clothing, medicine,
blankets and other basic goods, as well as substantial
aid for reconstruction (ibid.). The country also received
huge amounts of economic and military assistance,
mainly from the Soviet Union and China.
From the 1960s onwards, following the Sino-Soviet
split, North Korea attempted to play the role of an‘independent’ socialist nation, refusing to align witheither of the two socialist powers. It used this asleverage to maximise support from both the Soviets
and the Chinese as it sought not only financial aid,
but also military support, oil, petroleum products andtechnology (Ha and Jensen, 1987; Chun, 1987). In thecontext of the Cold War strategic environment, the
4 For a full discussion of Juche and the role of autonomy andself-reliance within it, see Koh (2014).

3

North had much to offer Moscow and Beijing in return.
Aside from moral support in the competition between
the Soviet Union and China, North Korea provided
important coastal access. Influence in the North was
also strategically important, given the US presencein South Korea and the proximity of Japan (Ha andJensen, 1987).
During this period, North Korea was also an aid donor,
as well as an aid recipient. Just as the North’s receipt
of aid had been framed by the Cold War, so its aid andother support was directed by ideological as well as
pragmatic motives. In particular, aid policy was used
as a weapon in the competition between North andSouth Korea for influence in particular countries orregions. In the Middle East and North Africa, North
Korea successfully challenged the South for influence inthe mid-1970s (Moon, 1987). Moral and material aid
to the Arab world included support for the Algerian
independence movement against France, aid to Arabnations in the 1967 and 1973 Arab–Israeli wars andother economic, cultural and scientific agreements withcountries in the Middle East including Egypt, Iran,
Libya and Syria (ibid.). Similar trends were also evident
in Africa and Latin America (Park, 1987b; Lee, 1987).
While there were clearly pragmatic motives for thisaid, it also reflects solidarity with many of the Middle
Eastern movements of the time, which were anticolonial and often socialist in their ideology. In the firsthalf of the 1970s, North Korea established diplomatic
relations with 23 African governments, compared tojust four by the South (Park, 1987b). It is noteworthy
that, as late as 1984, North Korea was providing aid
to South Korea in response to massive flooding. By
this time, however, the South’s economic strength had

surpassed the North’s, and it is likely that the aid was
accepted as a gesture of cooperation, rather than out ofnecessity (Kwak, 1987).
Despite the impressive beginnings of the North
Korean regime, the combination of socialism andautarky made its economic model unsustainable. The
North’s aspirations to self-sufficiency were beset bya fundamental problem. The heavy industrial modelthat had aimed to promote defence and economic
independence in fact relied upon foreign technology andoverseas support. It was heavily dependent on oil, which
had to be imported, and it needed generous financial
terms from sympathetic governments (MacDonald,
1996). The country pursued one of the most extreme
versions of socialism and suffered more than othersocialist bloc members from the systemic deficiencies ofsocialism: allocative waste, poor coordination and thelack of incentives and motivation.
These problems came to a head as the socialist patronson which the North relied began to experience theirown economic decline in the 1970s and 1980s. The
North’s only alternative was trade with the capitalist
bloc, but the North Korean system and its underlying
ideology were not compatible with the liberalinternational financial system. With little of value
to offer by way of international trade, a history ofdefaulting on its debts, a brutal authoritarian regime
and a nascent nuclear programme, few countries werewilling to engage economically. The collapse of thesocialist bloc in the early 1990s dealt a final blow thatsent the North Korean economy into rapid decline,
precipitating the economic crisis and famine that
subsequently overwhelmed the country and its people.

4 Famine in North Korea: humanitarian policy in the late 1990s

3 The humanitarian response
News of a crisis in North Korea started to appear in
the Japanese press in 1992, when the Asahi Shimbun
reported severe food and energy shortages (MorrisSuzuki, 2011). By 1995 the humanitarian situation
was extremely grave. In the summer of that year
North Korea was hit by heavy flooding, made worseby the environmental destruction – deforestation,
man-made soil erosion and the neglect of foodprotection – caused by the North’s failed socialist
industrial model. The flooding is estimated to haveaffected over 5m North Koreans and caused over
$15 billion in damage (Woo-Cumings, 2002). In
response to appeals for international help, including
letters sent directly to aid agencies, including MSFFrance (MSF, 2008), between 1995 and 1999 over
$640m in aid was sent to North Korea (Flake,2003). The United States alone is thought to havegiven between $400m and $540m in food aid
and energy assistance (Flake, 2003, Haggard andNoland, 2007), and by 2005 US assistance totalledover $1bn (Haggard and Noland, 2007).

3.1 Official intransigence
From the very start, as organisations began tonegotiate terms of reference and start up theiroperations, they were faced with deep-set intransigencefrom the North Korean authorities. To some extent,
the North Korean situation was no different to similarcomplex emergencies. As Haggard and Noland (2007)
point out, ‘as is true in any aid game, the North
Korean government sought to maximise flows of aid
while limiting the conditions attached to it’. Evenso, humanitarian organisations faced a worrying
contradiction. They had been invited by the North
Korean government to deliver humanitarian support,
yet that same authority was the main obstacle tocarrying out aid work. Aid organisations could notoperate in a manner they found acceptable, creating
intense frustration and suspicion. For instance,
information routinely made public by other countries
was considered a state secret in North Korea, andwhen information was made available it was notunreasonable to suppose that this had been done forstrategic reasons.

Humanitarian organisations faced a series ofimpediments, including poor-quality data, restrictions
on the movement of personnel and monitoring
activities, intrusive oversight of staff by North Korean
guides, drivers and translators, the requirement for aid
staff to be housed in elaborate and costly hotels, theassignment of local staff with English-language but norelevant technical skills, the banning of aid staff who
spoke Korean and lack of access to restricted regionsof the country (Smith, 2005; Schloms, 2003; Natsios,
2001; MSF, 2008).
The intransigence of the North Korean authorities
created greater difficulties for some organisations
than others. The internal report from MSF’s 1995
exploratory mission noted the authorities’ objections
to the presence of expatriates in the field (MSF, 2008).
This proved to be a particular problem for NGOs
such as MSF and Médecins du Monde (MDM), whichplace a high priority on patients having direct accessto expatriate medical staff. In turn, the response to thisintransigence also varied, depending on the nature andlocation of projects and agencies’ operational values
and protocols. For some organisations, conditions inNorth Korea were considered no worse than in otherhumanitarian theatres (Smith, 2005). Others felt thata continued presence in the country could encourage aculture of negotiation and compromise with their North
Korean interlocutors.
Among the organisations most tolerant of the initial
North Korean official response, the view was thatshort-term compromise would lead to long-term gains
in access and monitoring (Haggard and Noland, 2007;
Smith, 2005; Snyder, 2003). This policy achieved somesuccess. Demands for access from the World Food
Programme (WFP) opened up the north-east provinces
to exploratory visits in 1997, revealing the full extent
of the crisis and making it possible ‘to ramp up supplies
to these highly distressed areas’ (Haggard and Noland,2007). There were also small-scale successes withinprojects as a result of sustained engagement. One
MSF doctor recalls how ‘week after week, relations
were increasingly straightforward and direct’; anothertells of how her North Korean interpreter assisted inchecking stocks of drugs, reporting irregularities to her

5and finding out from local staff how drugs had been
distributed (MSF, 2008).
Other obdurate behaviour on the part of the authorities
could not be ignored by even the most pragmatic
humanitarian organisations. Of particular concern
was the denial of access to visibly sick children. MSF
field staff witnessed ‘children in bad general condition
driven away [from a hospital] in a cart to an unknown
destination. No reasonable explanation could begiven by the staff’. Other examples included seriously
malnourished children being present one day forclinical examination, then never being seen again. In
one instance, on finding wards empty and being toldthat there were no patients, an expatriate searched
the hospital and found ‘about thirty children in a very
bad general condition, physical, medical as well a[s]nutritional’ (MSF, 2008).
For a number of organisations, therefore, the challenges
created by the intransigence of the North Koreanauthorities, particularly in areas such as access andmonitoring, meant that their minimum requirements for
operating could not be met. In the 1998 MSF-France
President’s Annual Report, reviewing the organisation’s
mission in North Korea, President Dr Philippe
Bieberson wrote that ‘for the first time, in 1995, theNorth Korean government called upon internationalaid, but fixed conditions whilst doing so: no evaluationof needs, no serious control over the destination ofaid, selection and drastic discipline demanded ofaid organisations’ (MSF, 2008). MSF’s press releaseannouncing its decision to close its operations in1998 stated that ‘the lack of access, the inability toevaluate the quality of our programme all led to ourdecision to withdraw’ (MSF, 2008). Similarly, in its
announcement of its decision to pull out of North
Korea in 2000, ACF revealed that ‘the North Koreanauthorities did not accept Action Against Hunger’s
normal standards of supervision and monitoring …
therefore, the organisation opted to leave North Korea
rather than implement a programme where these very
basic principles of humanitarian intervention could not
be observed’ (ACF, 2000).
ACF worked in North Hamgyong province˘(Hamgyongbukdo),
in the north-east of the country,
and had its base in the industrial city of Chongjin
˘(Ch’ongjin-si),
where it ran nutrition programmes
supporting nurseries and kindergartens. This area ofthe country suffered disproportionately during thefamine, and the horror of the situation was directly

witnessed by ACF workers when, during a trip to newly
opened areas in North Hamgyong, ACF staff witnessedpeople so malnourished they looked like ‘walking
skeletons’ (ACF interview, 2015). People in Chongjin
lived in dense urban conditions, without access to landfor subsistence farming, and so were wholly reliant
on the public distribution service (PDS) for rations tomeet their basic needs. When the authorities stopped
providing through the PDS (a decision believed bysome aid organisations to be in retaliation for thequestionable loyalty of people in the north-east), many
quickly succumbed to hunger and disease (Demmick,2010; ACF interview, 2015). Observing the severe
deprivation of people in the city, especially homelesschildren seen ‘in alarming conditions in the streets’,
ACF proposed a programme of soup distribution. The
agency had planned to work with official North Korean
institutions in the preparation and distribution of hotsoup to zones across the city with acute needs during
the winter of 1999–2000, and the idea was originallywelcomed by ACF’s North Korean interlocutor in
Chongjin. However, the proposal was finally rejectedby higher authorities. Prevented from carrying out
work to meet the needs of people in desperate need,
ACF concluded that withdrawal was the only available
option (ACF, 2000; ACF interview, 2015).
Perceptions of official intransigence at times reflected
insufficient knowledge on the part of humanitarianorganisations, in part because the government refused
to allow international organisations to employ
Korean-speaking staff (Natsios, 1997). With little orno experience of operating in North-east Asia, thehumanitarian community’s understanding of the social,historical and political context in North Korea wasoften limited. This was exacerbated by a chronic lack of
local knowledge and the technical inability of local staff
to carry out basic procedures such as data collection
and reporting. This led to a perception that the North
Korean authorities were unwilling to assist, when infact individual North Koreans may have simply lacked
the skills or cultural understanding of the humanitarian
actors they were working with.
A political culture that emphasised self-reliance,
national pride and resistance to foreign influencecertainly motivated some of the intransigent attitudes of
the North Korean authorities. An endemic nationalism
prevented some in North Korea from admitting theextent of the problems they faced, and feelings ofshame surrounded the acceptance of external aid.
During negotiations on the UN Agricultural Reform

6 Famine in North Korea: humanitarian policy in the late 1990s

and Environmental Programme (AREP), one North
Korean delegate admitted that, as a representative of
his country, he found it difficult to be a recipient ofaid because the North had itself been a donor in thepast (Smith, 2005). There was also deep mistrust of theaims of the international community and humanitarianorganisations. For their part, the aid community blamed
the North Korean authorities for the extent of thehumanitarian disaster. It was generally held by those
involved in North Korea that the fundamental cause of
the problem was the country’s political and economic
system, and thus the ‘fault’ of the regime. Unlike thesituation that had applied in earlier humanitarian
donations to the North by its Cold War allies, thisaid was not being given to express solidarity with thegovernment in its plight. It is also likely that North
Korea’s own experience of donating foreign aid during
the Cold War meant that it perceived assistance as
being politically motivated. The North’s nascentnuclear programme and ongoing negotiations on it
created additional complications and tensions. Given
the political and security environment and the culturalcontext, intransigence on the part of the authorities
was perhaps inevitable. The surprise displayed byhumanitarian actors in the face of these challenges,
therefore, suggested a profound naivety amongst manyorganisations operating in the country.

3.2 Access to information
Reaction to the North Korean crisis from within theinternational aid community was shaped by a second
theme that characterised this period: the challenge of
information. Scant and unverifiable information about
matters that aid organisations needed to address fed
the frustration and mistrust felt by many humanitarian
actors towards the North Korean government. The lackof available data meant that, at the height of the famine,
there was still debate among humanitarian actors as
to whether acute malnutrition and starvation actuallyexisted. This shortage of data was due primarily torestrictions on free access to the population, especiallyin areas of the north-east most heavily affected by foodshortages (Haggard and Noland, 2007). This confused
picture was made worse by the challenges involved incollecting information in the field: the nervousness ofnational staff and interlocutors; the use of interpreters;
the genuine lack of knowledge amongst local workers
and officials; fear of losing face; and expectations –claiming shortages in order to get additional supplies(MSF, 2008; Smith, 2005; Schloms, 2003; Snyder, 2003).

The North Korean government was also concernedthat the sharing of information on the nutritional andhealth status of its population with the international
community was a threat to its security. It is likely that
the North feared that US and South Korean knowledgeof the dire nutritional state of its people might
encourage hawkish elements in these administrations.
Thus, when the results of a 1998 UNICEF/WFP/
EU nutritional survey were made public, there wasgreat indignation on the part of the North Koreanauthorities, which believed that such a disclosure
justified their tight management of information(Schloms, 2003).
Assessing the precise extent and gravity of the famine
was so opaque and confusing that aid organisations
contradicted themselves in public as different parts ofan organisation reported different interpretations of thesame events. MSF’s internal review of its organisation’s
experience in North Korea admitted that ‘in theinternational press … MSF stated that it did not haveany solid proof for denying or confirming the existenceof a famine. At the same time, the international press
circulated witness accounts of North Korean refugees,
received from the MSF team in China, reporting afamine situation’ (MSF, 2008).
Hazel Smith argues that the lack of information
and access meant that ‘Western policymakers too
often import[ed] worst-case analysis of DPRK
intentions and capabilities into the political arena as
established fact’ (Smith, 2005: 23). In other words,
the lack of information combined with high levels of
suspicion meant that an adverse scenario was always
assumed. Thus, what appeared on the surface tobe malfeasance on the part of the regime may notalways have been wrongdoing. One example was
the disappearance of medicines. One MSF doctor
described how drugs would go missing, only to
discover that clinic staff were hoarding them fearfulof MSF’s departure, and was certain that in the caseof the operations she was involved in, they were notbeing diverted:

If we insisted, saying that we wouldn’t leave
without looking over the medicines, we always
ended up seeing them. We never saw medicines
being given to the army … The message
denouncing the diversion of aid was sometimes
issued outside the country … but we neverreally talked about the diversion of medicines,
because this was never proven (MSF, 2008).

7

Such minor examples of acknowledged misunderstandings were insufficient to convince some NGOs
that the authorities were sincere. Information provided
to MSF on the destination of its aid often did not tallywith the site visits organised by the North Koreanauthorities. It also became clear that the demographic
data provided to MSF by the government was‘implausible’, and the agency became convinced thatits food and medical aid was being diverted through‘discriminatory food distribution systems’ and directed‘according to social position and to party loyalty’ (MSF,
2008). Evidence of diversion was sometimes discoveredby accident, increasing distrust and suspicion. In achance meeting with Russian diplomats, ACF staff wereinvited to the Russian consulate in Chongjin, where
they were shown a collection of ACF items including
baby soap and shampoo intended for orphanages andkindergartens. The diplomats told ACF that they had
purchased these items in the Rajin-Sonbong Free Trade˘˘˘Zone (Rajin-Sonbong
KyongcheT’ukku),located on theborder with China. After this discovery, the ACF team
was prevented from further interaction with the Russian
consulate (ACF interview, 2015).
When MSF pulled out of North Korea, it was explicit
in its accusation that food was being diverted frompeople in need and being given to the military and otherpolitically important groups. Interviewed in the French
newspaper Libération, the President of MSF France
said that ‘the objective is to provide humanitarianassistance to the most vulnerable but there is every
reason to believe that the aid channelled throughthe system does not reach them’ (Franklin, 1998
[translated from French]). ACF aired similar concerns
when it wrote that ‘it seems likely that the number ofbeneficiaries listed in 1998 was a gross overestimate.
Does that imply that AAH made distributions to
50,000 people who did not exist? Where, or who, did
this assistance go to?’ (ACF, 2000). Following MSF’s
claims about the diversion of food aid, humanitarianorganisations still in North Korea were challenged tojustify their continued presence there. The UN, which
also had strict requirements for the monitoring of aid,
had to publicly refute the allegations and argued that
WFP should continue its work. In an interview with
Libération, Catherine Bertini, the Director-General of
WFP, argued that ‘food handled by the WFP was indeed
reaching those for whom it was intended’. She admitted
that monitoring was unsatisfactory, but argued that toreach malnourished children WFP had to find a way towork within the system (Haski, 2001[translated from
French]).

These discussions went to the core of the debate overhumanitarian aid to North Korea: what should be done
when there are suspicions that aid is being diverted
away from the most needy by the authorities or otherthird parties, and being used by Pyongyang to serve
political and military ends? However, given the intensityof the food crisis and famine, leaving the North Korean
people to the mercy of the regime seemed equallyunpalatable for many organisations. Later analysis of
the North Korean food crisis provides some comfort
to those agencies that decided to remain. It suggests
that, while as much as 30% of food aid might havebeen diverted (Haggard and Noland, 2007), this was
not a centralised conspiracy but more often the resultof activities by local authorities (ibid.). Certainly,
rent-seeking behaviour encouraged diversion of aid
to the market, enabling dishonest officials to makeconsiderable profits. However, this diversion also
lowered the price of food available in the market, thus
making it affordable to more people, including manyin desperate need (ibid.). It is also likely to have had aneffect on the broader process of marketisation in North
Korea (ibid.). Of course, the vulnerable target groups
for whom this aid was really destined were deprivedof it, and diversion to private markets benefited elites
who could easily afford to purchase food on the open
market. But the image of a planned and centrally
controlled rerouting of aid to the elite and the military
was more than likely incorrect.
This analysis is supported by the work of Schwekendiek(2011), who argues that ‘people living in areas
presumed to have military privileges were not found tobe significantly better off during the famine’. Instead,he concludes that a ‘decisive factor leading to theimprovement of the nutritional status of North Koreans
was probably international food aid’. That is not todeny that diversion of aid to the military took place –it may well have fed low-ranking conscripts, many ofwhom also fell victim to the food shortages that ravaged
the country. Notwithstanding the image presented in
the media of highly trained fighting machines, the bulkof North Korea’s military consists of scrawny teenage
conscripts in ill-fitting uniforms, assigned to civilian
tasks such as cultivation and construction. Many ofthese young men and women were also in desperateneed of humanitarian assistance.
The benefits of hindsight and the new data that madethese retrospective reviews possible were not available
to the agencies operating in North Korea during thefood crisis. Agencies on the ground had to make

8 Famine in North Korea: humanitarian policy in the late 1990s

decisions based on their organisational values and theinformation available to them at the time, which often
corroborated their belief that the regime was misusingaid. That does not, however, preclude questioning ofthese agencies’ actions. While the decision to withdraw
was the prerogative of those organisations that choseto do so, one might argue that their criticism of thoseorganisations that elected to stay was misplaced. On
the other hand, given the size and influence of the UN
operation in North Korea during the famine, perhaps
UN agencies should have been less willing to compromisewith North Korean officials on issues around accessto information for the purposes of assessment andmonitoring. Being more demanding may have enabled
the UN to shape an aid environment in which moreagencies could operate according to their values.
The challenge of access to information persists. A
number of areas of the country remain completely
closed to humanitarian agencies. Staff movements arestill restricted and the presence of expatriates is limited.
The increased amount of data now available reflects therelationships of trust and compromise that have beendeveloped over time, and attests to the benefits of asustained presence in North Korea. However, for many
NGOs whose organisational values cannot be respectedby the kind of engagement and compromise required
to work in the country, the historic and contemporary
challenges mean that operating in North Korea willremain highly problematic.

3.3 Linking humanitarian aid andsecurity goals
The third predominant feature of this history of aid
to North Korea is the perception that humanitarianassistance was linked to the foreign policy goals ofboth the North Korean government and international
aid donors, in particular around the North’s nuclear
programme. Coinciding with the emergence of thefood crisis, the international community was becoming
increasingly concerned by the North’s nascent nuclear
capability. As discussions around security took placeat the same time as the international community
was trying to deal with the food crisis, there was a
growing perception that aid was being used as a toolby governments, the United States in particular, tocurtail North Korea’s nuclear ambitions. The first
Agreed Framework to control the North’s nuclear
programme was signed in October 1994 following thedeclaration by Hans Blix, the head of the International
Atomic Energy Agency (IAEA), that the North was
in violation of the Nuclear Non-Proliferation Treaty(NPT). This coincided with a public announcement by
the US Central Intelligence Agency (CIA) that North
Korea had accumulated enough plutonium to constructa nuclear weapon. The North’s participation in theAgreed Framework was rewarded by a package ofmeasures, including energy assistance and financial aid(Cha, 2012: 253).
For its part, North Korea has been accused of using
the nuclear programme as a bargaining chip to extract
humanitarian assistance (Lankov, 2010). An MSF reportin September 1995 noted that the North Koreans ‘were
jubilant when they mentioned their atomic negotiations
with the Americans during which they obtained
undreamed of concessions’ (MSF, 2008). Although theUnited States to this day denies that aid was linked
to security considerations, it appears that the North
Korean authorities were well aware of the utility ofsuch considerations in achieving positive outcomes innegotiations for aid – a reflection, perhaps, of theirearlier Cold War experiences of the ‘aid game’.
For some NGOs it was not the instrumentalisationof aid in nuclear negotiations that caused the greatest
concern. Both MSF and ACF believed that aid was
being used by the international community to prop
up the regime. Bieberson wrote in his annual report
that, through the provision of aid to North Korea, aid
agencies were being manipulated to achieve a larger
American and European plan to preserve stability on
the Korean peninsula by preventing the fall of theregime (MSF, 2008). This view was widely held within
MSF. Fiona Terry, an MSF researcher, wrote thathumanitarian aid in the mid-1990s served to perpetuate
the regime and thus extend the hardships faced by theNorth Korean population. Terry also suggested thatsome governments were giving aid in pursuance of
their own long-term economic and regional interests,
for example to prevent a mass outflow of refugees,
to pursue future economic interests and to promote asmooth unification with the South (Terry, 2001).
Perceived threats to security also determined North
Korean attitudes to aid, and to the aid agencies
operating in North Korea during the famine. In
particular, the presence of foreign humanitarian actors
in the country constituted a challenge to the regime’s
survival. Admitting foreign aid workers underminedthe credibility of the regime in the eyes of its citizens.

9Foreigners are seen as agents of cultural infiltration, andto let them move around freely in North Korea posed agrave threat to the regime by demonstrating its relianceon outsiders – people the regime had consistently denigrated in its propaganda – to feed its citizens. Andrei
Lankov has consistently written about the potential
of information to bring about reform, arguing that‘combining engagement, information dissemination …
is the only way to promote change in North Korea’ –exactly what aid workers ‘threatened’ by their presence(Lankov, 2009).5 Aid workers inside North Korea werealso able to report on the illicit and abusive behaviourof the regime. For example, one NGO worker reported

5 See also Eberstadt (2004; 2011), generally known for his
hawkish stance on North Korean issues, who argues thatthe persistence of the regime has resulted from a policy of
economic and cultural isolation and the rejection of the system
of international trade. Eberstadt highlights the official North
Korea policy and doctrine that rebuffs interaction with outsiders
through ‘economic exchange and personal interchange’
because of the dangers of ‘ideological and cultural infiltration’.

that poppy cultivation was so vast in North Hamgyong
Province that it was visible from the main provincial
roads. The regime also tried to use NGOs as channels
for counterfeit currency.
Unpicking the relationship between aid decisions andforeign policy or security goals is extremely difficult given
the opaque nature of these issues and the negotiations
and decisions that surround them. Nonetheless, 20
years on from the beginning of the ‘Arduous March’,allegations of the instrumentalisation of aid for political
purposes continue to surround humanitarian projects
in North Korea. For the foreseeable future, the needfor aid to the North Korean population will coincidewith international concerns over the North’s nuclear
programme and its continued political survival. As aresult, the link between humanitarian assistance andforeign policy objectives must continue to be interrogatedto ensure that the basic needs of the North Korean
people are not forgotten amidst the international effort tosecure this volatile region.

10 Famine in North Korea: humanitarian policy in the late 1990s

4 Conclusion: an ‘Arduous March’for humanitarian actors?
Whatever changes we may see on the Korean peninsula,
North Korea will remain on the humanitarian agenda
for years to come. Its 25m people continue to faceconsiderable hardship as a result of a failed politicalsystem, compounded by intermittent natural disasters
and the rise of infectious diseases such as TB and its
drug-resistant form. In April 2015 the UN launched an
appeal for $111m, calling North Korea ‘both a silent
and underfunded humanitarian situation’. According
to the UN, 70% of North Koreans (18m people) areconsidered food insecure, with high levels of chronic
and acute malnutrition among children (UN, 2015).6
Yet many of the behaviours and attitudes witnessed
during the famine, on the part of both the regime
and humanitarian agencies, have continued to shapehumanitarian actions in the decade or more that has
passed since the ‘Arduous March’. In recent years asenior UN official was denied access to North Korea
despite the UN’s ongoing and significant operations
there (Haggard and Noland, 2007), and two foreign
NGO officials, including the head of Welt Hunger
Hilfe, were recently expelled from the country (Ryall,2015). Access to parts of the country remains restricted,
and other controls remain in place. Many agencies are
cautious about operating in North Korea, and crises
such as Ebola in West Africa and civil wars in Syria andSouth Sudan (to name only a few) mean that North
Korea is considered too low a priority and too difficult
a context in which to work.
The political and security concerns linked to the
granting of aid to North Korea have also continued,
in particular because of the North’s determination
to develop its nuclear capability. Since the 1990s, US
aid has been implicitly – and sometimes explicitly –linked to negotiations regarding the North’s nuclear
programme, leading to an almost complete cessation of
US support for humanitarian activities in North Korea(Manyin, 2005; Lee, 2013). Similarly, South Korea and6 See http://www.un.org/apps/news/story.asp?NewsID=50523#.
VS1mSPmUeUV.

Japan have routinely linked the granting of aid, andtheir willingness to allow their countries’ NGOs to
operate in North Korea, to political goals. China, theNorth’s main source of economic aid, gives assistance inorder to sustain North Korea as a buffer between itself
and South Korea, and the US forces based there, and toprevent the destabilising impact of the North’s collapse.
Meanwhile, the vast majority of the North’s population
continues to suffer.
There are signs of change, some of which has arguably
been encouraged by aid actors that have continued tooperate inside the country. The persistence of WFP and
the UN has increased transparency in the aid-giving
process (Haggard and Noland, 2007; Smith, 2005).
Many NGOs continue to work in North Korea, andeven MSF has returned to the country to open smallscale projects. It is promising that China has shifted its
position regarding multilateral action, recently donating
food through WFP, rather than sending it via bilateralchannels.7 Humanitarian aid has also been given in forms
that will enable the North Korean population to sustain
an improved standard of living. There are some excellent
examples of longer-term projects providing technicaltraining in areas such as agriculture and medicine.8
Retrospective analysis suggests that, overall, theNorth Korean people benefited from the interventionof the international aid community, and that thestory of aid diversion is more complex than wasoften presented at the time. Further, the inflow of
information, increased marketisation and independentactions by regional and local authorities have proved
corrosive to a rigid authoritarian regime (Smith, 2005;
Haggard and Noland, 2007; Noland, 2012; Lankov,
2013). Unfortunately, the pervasiveness of the threethemes that characterised humanitarian aid in the
7 See https://www.wfp.org/node/3498/4572/326028.
8 The Swiss government is providing training to North Korea inland management and agroforestry practices and the European
Union (EU) sponsors a range of projects to improve agricultural
practices, enhance public health and provide technical training(Morris-Suzuki, 2011).

11

1990s – intransigence, lack of information and the
instrumentalisation of aid – suggests that many of
the same challenges continue to face those trying tobring relief to the North Korean people. Perhaps themost important lesson from the food crisis in North
Korea, therefore, is that the policy of providing aid to

the North Korean people should continue. It is vitalthat humanitarian agencies working in North Korea
are culturally and practically willing to be patient andpragmatic. In other words, those who wish to engage
with North Korea in an effort to reach its desperate
people must be prepared for an ‘Arduous March’.

12 Famine in North Korea: humanitarian policy in the late 1990s

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