To this day, the vast majority of (North Korean) refugees who MSF has interviewed say they have never received food aid. Anyone who has sat and talked with these refugees would find it difficult to believe that aid is saving millions of lives. Yet North Korea has been one of the largest recipients of food aid in the world for a number of years.

Mr. Chairman, thank you very much for giving me the opportunity to testify before you in the name of Médecins Sans Frontières (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.

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. 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.

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. 

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 rewards 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. 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. MSF urges UNHCR and the Chinese government to open a dialogue leading to ensuring protection of North Korean refugees in China.

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.

Médecins Sans Frontières 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