How sanctions, weather and a bad harvest have left North Koreans without enough to eat

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• Judy Woodruff:

  But first, Xi Jinping's visit to Pyongyang today was the first by a Chinese leader in 14 years.

  Over a two-day summit, the leaders will discuss denuclearization and other issues, including providing North Korea much-needed humanitarian assistance.

  Just yesterday, South Korea announced that it would send 50,000 tons of rice to the North. Hunger is a way of life for many North Koreans.

  But, as Nick Schifrin back to report, conditions inside North Korea are worsening, and hunger is increasing.

• Nick Schifrin:

  In the most isolated country on the planet, the U.N. says 10 million North Koreans don't have enough food. Dry spells and low rainfall produced the worst harvest in a decade. And U.S. and U.N. sanctions mean farmers work with rudimentary tools. Instead of tractors, they use oxen.

  North Korea is one of the world's poorest countries and has long faced food shortages, but now the World Food Program says they're worse. Last month, they studied the shortage and called for an urgent humanitarian intervention into North Korea, also known as the DPRK.

• Nicolas Bidault:

  What is clear is that the succession of a bad drought, heat wave and floods this year is badly impacted the crop production.

• Nick Schifrin:

  As seen in video, Ms. Ree is a cooperative farmer. But because of the bad harvest and lack of tools, she's not making enough money. And so the chicks she raises to eat will have to be sold, so she can get by. Instead, she will eat rice and cabbage.

  Already, one in five North Korean children are too short for their age because of poor nutrition. And the communist government is providing them less. In 2018, the daily food ration was 380 grams, the equivalent of eight small potatoes. But, in January, the ration dropped by a quarter.

• Mario Zappacosta:

  Around 40 percent of the population are considered to be food-insecure and in need of urgent food assistance.

• Nick Schifrin:

  But U.S. officials say the problem isn't as bad as the U.N. depicts, because many North Koreans get their food from private markets, seen here in rare footage filmed by an anti-North Korean activist group.

  But humanitarian workers say the problem runs deeper and is urgent.

• Dr. Kee Park:

  We're talking about up to 20,000 kids, kids that could potentially not survive.

• Nick Schifrin:

  Dr. Kee Park is a Korean neurosurgeon who's been visiting the country for the past 12 years, training doctors. When he first traveled, the hospital had X-ray machines. Today, because of a lack of supplies, he operates as if in the 19th century.

• Dr. Kee Park:

  We don't have the X-ray machine to tell us exactly where we are. And we had to rely on other markers, other anatomical points to guess where we are.

• Nick Schifrin:

  He blames U.N. and U.S. sanctions. They began in 2006, and included obviously military items like tanks, combat aircraft and technical training. By 2017, the U.N. imposed its strictest sanctions yet, on all industrial machinery, transportation vehicles, iron, steel and other metals. That has had side effects.

• Dr. Kee Park:

  Basic medical equipment, almost every one of them have broken down and we're now unable to repair because of parts availability. Medical equipment shouldn't be part of sanctions.

• Nick Schifrin:

  And was that the case 12 years ago, when you started?

• Dr. Kee Park:

  No.

• Nick Schifrin:

  The sanctions are designed to stop North Korea from redirecting machinery, metals, and aid to its missile and nuclear programs. The restrictions are necessary, argues former State Department official Balbina Hwang.

• Balbina Hwang:

  When the international community rallies and then pours aid into the country, then the government, unfortunately, receives the aid, and instead of distributing it to the people in need, it basically extracts it, and, we think, diverts it, and proceeds to use it for activities that, unfortunately, are very, very threatening to the international community.

• Nick Schifrin:

  U.S. officials also accuse Kim Jong-un of diverting resources to himself, the elites who go shopping in high-end malls, and the military officials he's surrounded by.

  The U.S. says, if he wanted to, he could alleviate his people's hunger and poverty that sanctions have exacerbated.

• Balbina Hwang:

  There is certainly no doubt that the North Korean population is suffering greatly under international sanctions. And this is primarily due — well, completely due to the actions of a very, very terrible regime.

• Nick Schifrin:

  But humanitarian officials say, despite the regime's evils, the U.S. should still help the North Korean people.

• Chris Rice:

  Humanitarian engagement shouldn't be connected to politics. The vulnerable shouldn't be hurt by these political shifts.

• Nick Schifrin:

  Chris Rice is the Northeast Asia representative for the Mennonite Central Committee, a faith-based organization that sends food aid, hygiene kits, and clean water to North Korean hospitals. He began leading humanitarian trips four years ago, and was on the ground just last month.

• Chris Rice:

  We visited three pediatric hospitals. Kids were malnourished, and had also diarrhea, chronic diarrhea. And that indicates lack of clean water.

• Nick Schifrin:

  Joy Yoon, on the right, has worked in North Korea for more than a decade and created this rehabilitation center for children with cerebral palsy and autism, children like Oo-Ein , a quadriplegic with cerebral palsy.

  After 11 months of therapy and treatment, she walked for the first time. Yoon says their work is more difficult because U.N. and U.S. sanctions and President Trump's maximum pressure campaign.

• Joy Yoon:

  This affects all nonprofit organizations doing medical work in North Korea. Any kind of needle, any kind of rehabilitation equipment, any kind of medical equipment that has even a hint of metal in it is now sanctioned from entering North Korea.

  All these things complicate what we're doing in North Korea and it really slows the progress.

• Nick Schifrin:

  Their progress was temporarily halted after American student Otto Warmbier was arrested and tried by the North Korean regime.

  He came home in 2017 in a vegetative state, and died shortly later. Afterward, the U.S. required all U.S. citizens to apply for a special validation passport to enter North Korea. By last year, the administration stopped allowing humanitarian workers into the country entirely.

  This year, the State Department eased those travel restrictions, but maintained sanctions.

• Balbina Hwang:

  We are waiting to see if we can achieve the goals of denuclearization. Unfortunately, it seems that North Korea is probably not going to denuclearize. And so, for the time being, I think we have to continue where we are with the restrictions.

• Nick Schifrin:

  Humanitarian workers say that policy punishes the innocent.

• Dr. Kee Park:

  The U.S. possesses overwhelming economic, political, and diplomatic power. And right now, they're exercising these powers to block and prevent humanitarian assistance.

  U.S. policies are actually contributing to deaths of innocent pregnant mothers and children. Are we willing to accept these deaths in the name of U.S. national security?

• Nick Schifrin:

  U.S. officials say they are trying to balance national security with allowing some humanitarian aid.

  But whoever's at fault, it is ordinary North Koreans who need help the most.

  For the "PBS NewsHour," I'm Nick Schifrin.