Population movements are taking place out of the large cities of the Northeast to rural areas where they have a better opportunity to find wild famine foods, and to China where they can seek help from relatives, according to interviews with refugees. Population movements generally take place on a large scale as a famine increases in severity and people are unable to cope with their hunger by any other means. These population movements are accompanied by very high death rates of people already debilitated by hunger moving in very cold weather on foot. The latest survey shows epidemic levels of communicable disease are taking as many lives as starvation. This is also a common consequence of famine, where people's ability to resist disease outbreaks diminishes because the body's immune system collapses as a result of severe malnutrition.
People die of disease before they starve to death.
Many of these diseases are directly attributable to inadequate water supply or contaminated water. The survey provides detailed information on the coping mechanisms people are using to survive, mechanisms which are commonly found in most famines. These include scavenging wild foods, sale of household furniture and house, stealing, begging and getting help from relatives. The survey indicates that sufficient food has not made it into the cities of the northeastern provinces whether through domestic sources of production or the humanitarian relief effort. International aid organizations such as the World Food Program have been alarmed by how early in the agricultural year that food stocks appear to be running out in the public warehouses across the country.