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MSF in North Korea, 2004
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In 2003 and 2004, the food situation remained critical for most people in the Democratic People's Republic of Korea, better known as North Korea, for whom access to international assistance remains impossible.
Economic reforms, introduced in July 2002, officially dismantled the public food distribution system and installed a new price and salary scheme to reflect production costs, but since then, salaries have remained largely unpaid. The reforms have resulted in runaway inflation and have undermined people's ability to find basic food items on the black market, a system increasingly controlled by the North Korean regime.
Amid these stark conditions, North Koreans continue to flee deprivation and violence orchestrated by the country's leaders in Pyongyang. They keep crossing the border into China in search of food for their families or a temporary job that will enable them to buy medicines or other essential goods needed to survive. Considered unwanted economic immigrants by the Chinese authorities, they live in hiding and face the risk of being arrested at any time, forcibly repatriated and subjected to imprisonment and brutal treatment back in North Korea.
For the past year, the systematic hunt for North Korean refugees has continued to intensify on the Chinese side of the border. Every month, hundreds of North Koreans in search of assistance and asylum have been forcibly repatriated to the North. The humanitarian aid workers who attempt to rescue refugees also face the brutal determination of the Chinese authorities, who deem such assistance a criminal offense. Bounties are commonly given to those who identify humanitarian aid workers or North Koreans. Predictably, in this context, support for refugees in distress is diminishing and assisting them has become a challenge that increasingly few aid organizations, crushed by this sanctions policy, are able to undertake.
The systematic and organized dragnet taking place in China leaves most North Korean refugees no alternative but to undertake a desperate flight to a third country. They cross thousands of kilometers in order to reach more welcoming southeast or northeast Asian countries. Most gain assistance after jumping over embassy walls or dashing through the doors of diplomatic offices. A few hundred North Koreans manage to find their way to South Korea each year, bringing the number of defectors there to more than 5,000 in June 2004.
MSF in North Korea and the region
MSF operated inside North Korea from 1995 to 1998. During this time, the organization attempted to supply drugs and medical training for approximately 1,100 health centers and to run 60 therapeutic feeding centers for malnourished children in three provinces. In 1998, convinced that its assistance was not reaching the most vulnerable people, and was, on the contrary, helping to feed the regime oppressing them, MSF withdrew from the country. Certain however that North Koreans were still in dire need of assistance, MSF tried to develop, with local networks, alternative ways of directly assisting North Koreans in the region.
Since 1998, MSF has provided shelter, clothing, food and medical care to hundreds of refugees hiding in China and third countries. In 2003, MSF opened a medical and psychosocial program based in Seoul, South Korea for vulnerable refugees facing immense difficulties resettling in the South. Many are traumatized by years of organized violence in North Korea including man-made famine, a lack of medical care and the resulting deaths of loved ones. Some have faced denunciation, imprisonment and torture. North Koreans may also have experienced brutal situations during their flight such as forced prostitution, arrest, the death or disappearance of friends or relatives and the pain of exile. Plus, once they arrive in South Korea, the refugees encounter stigmatization and rejection. Not surprisingly, North Koreans often find themselves completely unable to restart their lives in South Korea. Of the 60 patients followed by MSF psychologists and medical doctors during the first nine months after their arrival in South Korea, almost 70 percent experienced mild to extremely severe psychological problems. In addition to providing direct assistance, MSF systematically documents the hardships faced by North Korean refugees by collecting personal testimonies from refugees and speaking out at international forums about their plight.
MSF has been providing support for North Korean refugees since 1995.