While international relief efforts have alleviated widespread hunger in the Democratic People's Republic of Korea since the worst food shortages in 1997, the country's children still suffer from malnutrition and disease related to a lack of adequate nutrients and clean water. In North Korea, as in many developing countries, an ailment such as diarrhea can prove to be life threatening due to weakened bodies, a shortage of medicine, and a lack of safe drinking water and sanitation. More than 20 percent of deaths under age five are from diarrheal dehydration.

Following a record low harvest, the coldest winter in 50 years, and the worst spring drought in 80 years, North Korea is overwhelmed by deteriorating nutrition, health, water and sanitation, and education systems. As the country faces its seventh straight year of food shortages due to drought, floods, crumbling infrastructure, and a depressed national economy, the World Food Program (WFP) has named North Korea a "Hunger Hot Spot" for 2001. All of North Korea's 22 million people are affected to some degree by severe shortages of food and health care.

The humanitarian emergency in North Korea has further deteriorated due to a series of natural disasters. Last year, drought in June, followed by typhoons in August and mid-September, made a poor food supply even worse. This year's spring drought resulted in a severe shortfall in wheat, barley, and potato crops. The unprecedented dry spell is also likely to reduce the main harvest of rice and maize in October.

As a result, North Korea is expected to fall 1.8 million tons short of its projected grain production levels this year, increasing the need for international food aid.

During a visit to North Korea, the director of the United Nations World Food Program (WFP) said on August 21 that there has been "no significant improvement in the country's ability to feed itself" in the past few years, the New York Times reported. The official, Catherine Bertini, added that nutrition levels have been maintained only because of huge amounts of donated food, which will be needed for many years to come.

WFP and UNICEF have agreed with the authorities to conduct a nutritional survey next year to assess future needs. The two agencies now feed about 7.6 million North Koreans. According to WFP figures, food aid has saved 3.3 million North Korean children from severe malnutrition.

But it will take more than food donations to revive the country's ailing population.

"It's not enough to give food, if hospitals have no medicines and the water supply is contaminated," David Morton, the United Nations coordinator in Pyongyang, the capital, told the New York Times. "Malnutrition in [North] Korea is a combination of shortage of food, breakdown of the health system, and poor water supply. People who are weakened by years of hunger get sick very easily and are very vulnerable."

At a recent UNICEF conference in Beijing, a senior North Korean official revealed that infant and child mortality rates have risen markedly since 1993, while average life expectancy and income have fallen — all due to economic collapse, famine, and a lack of basic health and sanitation services. According to a report in the New York Times, Deputy Foreign Minister Choe Su Hon disclosed on May 15 that the mortality rate of children under five rose from 27 deaths per 1,000 in 1993 to 48 deaths per 1,000 in 1999, and the infant mortality rate rose from 14 to 22.5 per 1,000 during the same period. Life expectancy fell from 73.2 years in 1993 to 66.8 years in 1999, while access to safe drinking water fell from 86 percent of the population in 1994 to 53 percent in 1996.

A nutritional survey conducted by the UN in 1998 determined that 63 percent of North Korean children were too small (or stunted) for their age as a result of undernourishment, a factor that can affect the intellectual development of children.

UNICEF continues to aid 12 million people in North Korea ?including 2.1 million children under five and 850,000 pregnant or lactating women. UNICEF's mission in North Korea is to improve the country's capacity to provide its women and children with adequate health care, better nutrition, clean water and sanitation, and education.

With the fall of the former Soviet Union in the early 1990s, North Korea lost its main trading partner, as well as a major provider of foreign aid. Since then, as its manufacturing and trade sectors have collapsed, North Korea has faced a near collapse of its economy and an increasing dependency on foreign aid. The per capita gross national product has fallen by about half ?from $991 to $457, according to the New York Times.

Also according to the Times, foreign estimates of deaths from famine since 1995 range from 270,000 to 2 million, while the North Korean government maintains that no more than 220,000 people died from famine between 1995 and 1998. The authorities have struggled to provide even the most basic services to its people: heat, adequate health care, and clean water are in extremely short supply.

Despite the authorities' efforts, however, economic recovery remains slow, contributing to acute power shortages that disrupt essential systems ?such as "cold chain" equipment needed to keep vaccines fresh and pumps needed to provide clean water.

At a recent UNICEF conference in Beijing, a senior North Korean official revealed that infant and child mortality rates have risen markedly since 1993, while average life expectancy and income have fallen — all due to economic collapse, famine, and a lack of basic health and sanitation services. According to a report in the New York Times, Deputy Foreign Minister Choe Su Hon disclosed on May 15 that the mortality rate of children under five rose from 27 deaths per 1,000 in 1993 to 48 deaths per 1,000 in 1999, and the infant mortality rate rose from 14 to 22.5 per 1,000 during the same period. Life expectancy fell from 73.2 years in 1993 to 66.8 years in 1999, while access to safe drinking water fell from 86 percent of the population in 1994 to 53 percent in 1996.

North Korea began to emerge from years of diplomatic isolation last year when a historic summit meeting was held between the leaders of North Korea and the Republic of Korea (South Korea), Kim Jong Il and Kim Dae Jung, in June 2000. The summit led to a thaw in relations between the two countries. During the last week of February, North and South Korea staged the third round of reunions between families separated during and after the 1950-53 Korean War. The reunions took place in the capitals of Pyongyang and Seoul and mark a continuation in humanitarian and political cooperation between the two Koreas.