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MSF Calls on Donors to Review Their Policy in DPRK
Urgent Needs in North Korea But MSF Forced to Pull Out
Hong Kong/New York, September 30, 1998 — The international medical relief agency Doctors Without Borders/Médecins Sans Frontières (MSF) today announced that it has been forced to pull out of North Korea (DPRK) this week, despite urgent medical and nutritional needs throughout the country. MSF was the largest medical organization working in North Korea and had tried to negotiate to continue to work in North Korea, to have free access, to assess the needs, to bring humanitarian assistance to those most in need and to monitor its aid. The government, on the other hand, refuses to acknowledge that there is still an emergency and only wants structural support to rebuild the national pharmaceutical industry.
"We are sorry to be forced to pull out when there are serious medical, nutritional and sanitation problems which need to be addressed" said Dr Eric Goemaere, Director General of MSF. "The new policy of 'normalization' has nothing to do with the reality of life in North Korea and will cost the lives of thousands. What these people urgently need is more effective accountable humanitarian assistance while structural solutions are found to the underlying crisis" he added.
Since early June, there has been a clear high level policy change to further restrict and limit effective humanitarian aid, which makes it impossible to deliver aid in a principled and accountable manner. MSF is today calling on all donor governments to review their aid policies towards DPRK to ensure it is more accountable, so that humanitarian agencies can freely and impartially assess needs, deliver aid, have direct access to the population and assess the effectiveness of their programs.
Urgent Medical Needs
"There are serious risks of outbreaks of diseases and death from terrible health and nutritional conditions, but there is a problem with the way needs and solutions are prioritized." said MSF field doctor Dr Dominique Lafontaine. "While there is an urgent need to restructure the water and sanitation system, the government responds with mass vaccination campaigns against cholera and while there are urgent day to day medical and nutritional needs, the government refuses to allow humanitarian agencies to assist and only focuses on rebuilding the pharmaceutical industry."
Refugee Reports of Famine
Giving further cause for concern about the real nutritional status of the population, MSF has been systematically prevented from having full and free access to conduct surveys inside the country. MSF has been negotiating since 1996 with the authorities to conduct reliable and representative nutritional surveys inside the country, but no permission has been given.
In ten months, MSF worked in sixty-four feeding centers in four provinces, taking care of around 14,000 children. It was difficult to get information about where the children came from and where they went after treatment. However in one province, South Pyongan, MSF was able to get more information and estimates that about a quarter of the children, in nutritional programs which MSF was able to visit, were orphans or abandoned. Many of them were homeless and were picked up starving from the streets. MSF is convinced that there are certain institutions or places where these children are collected, which are discretely mentioned by local staff, but to which international teams had no access.
Humanitarian Needs vs. Government Priorities
Negotiations broke down this month between MSF and the DPRK over the renewal of the Memorandum of Understanding (working contract), which defines what sort of assistance is needed and how it will be implemented. Over the past year MSF had managed to expand its medical assistance programs to support around 1,400 health centers and hospitals assisting seven million people in four provinces with medicines, equipment and training.
MSF was negotiating to continue this assistance and to target particularly vulnerable groups such as homeless and orphan children. Instead the authorities insist that the most effective type of medical and nutritional assistance for DPRK be for "MSF to pay deep attention to provide pharmaceutical raw materials". *
MSF is convinced there are serious medical and humanitarian needs in DPRK which need to be addressed, but adheres to the international humanitarian principles of impartiality and of freedom to assess needs, to assist the most vulnerable, and to assess the effectiveness of that assistance.
Dr Eric Goemaere said: "It is not easy as doctors to pull-out when so many people have died and when the health and lives of so many people are still in danger. But in the end, humanitarian assistance can only help those who need it when it is impartial and accountable. This is not the case in North Korea." He concluded: "Now it is time for the North Korean government to take responsible for the health of its people and to allow direct humanitarian assistance. It is time for the donor governments to ensure that the humanitarian aid that they fund aid is implemented in a principled and effective manner".
The last of the international MSF teams will leave North Korea tomorrow morning, Thursday, Oct 1, 1998, after working continuously for 16 months running drug distribution programs, training programs and supporting therapeutic feeding centres and health structures.
* MSF team members also caught typhoid from food or water.
* There are no internationally recognized effective vaccines against cholera on the market anywhere in the world. In DPRK, UNICEF and WHO vaccinate people against polio, measles and tetanus. The DPRK government runs mass vaccination campaigns against: diphtheria, whooping cough and cholera. The origin and content of these vaccines is difficult to ascertain.
* Standard obstetrics supplies include Dilatation and Curettage equipment with sterilized instruments, antibiotics to prevent infection and homeostasis to prevent heavy bleeding *Taken from letter sent to MSF Head of Mission by Mr Ri Si Hong, Acting Director, Department of External Affairs of the Flood Damage Rehabilitation Committee DPRK, dated Pyongyang Aug. 24, 1998.