A harsh winter created further hardship for the population and made implementation of the water and sanitation project difficult. Already, 36 hospitals have benefited from this project, which will be extended shortly to another 30.
Health institutions have exhausted the most recent distribution of medicines; the next distribution will take place shortly. Health training for government and Red Cross workers continues. Setbacks have been encountered in the collection of disease surveillance data.
From its initial emphasis in 1995 on food aid and shelter for the flood-stricken population, the Federation and the DPRK Red Cross emergency programme has gradually changed focus and now gives priority to health sector support. A food aid component was retained and longer term disaster preparedness support added. The Federation/DPRK Red Cross operational area covers four provinces -- North Pyongan, South Pyongan, Chagang and Kaesong -- targeting 47 counties with an estimated population of 5.8 million.
Despite massive humanitarian assistance since 1995 the situation in the DPRK remains precarious; any reduction in aid would have serious consequences. The Government's mid-term strategy will concentrate on the rehabilitation of the agricultural sector in order to maximise food security, with the recognition that international support to the health sector will be needed this year. The present health services are unable to handle the increased health problems and the high prevalence of acute malnutrition, communicable diseases, and the inadequate immunisation of children, resulting in high mortality.
The International Federation and the DPRK Red Cross plan to continue their joint multi-component health programmes in 2000. They include the distribution of drugs and equipment to 1,681 institutions, health promotion, training of health personnel, Community Based First Aid (CBFA), and water and sanitation and winterisation programmes.
Disaster Preparedness, Response and Capacity Building will be undertaken through a countrywide operation consisting of Disaster Preparedness and Response training, the continued decentralisation of disaster preparedness stocks to regional warehouses, and disaster preparedness measures by Red Cross branches jointly with other agencies.
The DPRK has had a particularly severe winter this year. January was especially difficult, with many roads covered in sheets of ice. The low rainfall last summer has reduced hydro-electric power. Pyongyang is subject to numerous power cuts. Factories, offices, residential buildings and institutions -- including hospitals -- are not heated. Only families with kerosene solid fuel stoves can heat their apartments. Schools and kindergartens are closed. As public transport is all electrically powered, people have to walk in sub-zero temperatures.
Because of a general lack of food and coal for heating in the medical institutions there are very few patients. Most of the hospitals have used up the drugs distributed at the end of November/beginning of December which should have lasted until February.
Red Cross/Red Crescent action
A comprehensive training programme for health institutions in 2000 has been finalised and training will begin shortly. The programme has two main objectives:
- to increase knowledge on preventive and curative measures among government health staff at ri-level in the targeted areas, in order to enhance the proper use of the drugs distributed;
- to develop knowledge of health promotion among government staff and Red Cross branch staff.
Ri-clinic kits donated by the Norwegian Red Cross arrived in Pyongyang by rail on 18 February and are now being distributed.
The winterisation programme for 1999/2000 has consisted of the distribution of 39,400 blankets procured in China with funds donated by the German Red Cross. They were received in country in January in two consignments. Distribution is taking place and will be completed this month.
In January, 600 bicycles to be used by staff involved in drug monitoring arrived from China. The bicycles, funded by the Norwegian Red Cross, were distributed in South Pyongyan and Kaesong in February.
The Ministry of Public Health requested the Federation to provide support in the form of drugs and health education training on malaria. A proposal on malaria was drafted and a request for medicines needed for the treatment of malaria cases in the Red Cross operational area has been presented to the Federation.
Disease surveillance information was collected from 15 health institutions during the period March -May 1999. After long negotiations with the Ministry of Health, the Federation was allowed to continue collecting this information, as from December 1999 for a three month period. Despite the best efforts of the Federation Delegation data was not available in January: The explanation given was that data collection has been postponed by the Ministry until February - March 2000.
Water and Sanitation
The weather conditions in recent months have made work outside health institutions difficult, but the Water and Sanitation project finally got under way with the completion of the delivery of materials and equipment for all 15 hospitals selected for the project in 1999.
All of the 4,285 water filters financed by the German Red Cross arrived in country in February and have been stored in the medical rub hall. Distribution is scheduled to begin this month. The assessment has been completed in 21 hospitals and distribution of material and equipment will take place shortly, bringing the total number of institutions having benefited from the programme to 36. An additional 30 Ri-hospitals have been selected for the programme but have not yet been assessed.
A slight delay in implementation has been caused by a lack of hand tools, which are not available in the quality required in the DPRK and hence have to be procured from China. The training of hospital technicians in welding is scheduled to take place in the coming months.
Community Based First Aid ( CBFA)
The DPRK delegation and the National Society will draw up a revised proposal for 2000.
Disaster Preparedness and Response (DPR)
A total of 1,500 helmets, jackets and badges funded by the British Red Cross were distributed. This is part of a project to give the DPRK Red Cross better visibility when conducting relief work.
Outstanding needs, constraints
- The anticipated delay of the first distribution, due to lack of funds will cause problems at the health care facilities as well as affect the monitoring activities of the Federation Delegates
- Negotiations with the Ministry of Health on the drug distribution impact analysis and the disease surveillance reports will continue.
The Federation Delegation has requested Cholera Kits for the Disaster Preparedness stocks. All expired items from old kits need to be replaced before the summer.
External relations - Government/UN/NGOs/Media
The past three months have seen the departure of Oxfam and Action Contre La Faim (ACF) from the country. The decision of Oxfam and ACF to leave due to unacceptable working conditions has had a discouraging impact on the aid community. During a visit to the DPRK in early January, the Head of Regional Delegation held discussions with the Acting Director of the Flood Damage Rehabilitation Committee (FDRC) during which he expressed the Federation's concern over these departures and also pointed out the negative effect they have on donors.
WFP reports that if additional pledges are not received soon, WFP's cereal contributions will run out in April and the break in the food supply will have serious consequences for the North Korean people during the lean season between April and June. Supplies of edible oil will run out at the end of July and pulses will be exhausted by mid-September. WFP further reports that the government has announced it will conduct a nutritional survey in April 2000. There will be no international participation, unlike the UNICEF\WFP\EU survey in 1998.
A World Disasters Report writer visited the country in order to collect information for an article on the public health situation in North Korea. The Regional Information delegate from Kuala Lumpur also visited the DPRK in order to prepare an issue of "Insight" and other information material on the DPRK operation.
A two-person delegation from the Danish Red Cross visited the DPRK in late February on a one week monitoring trip that included a three day field trip to the provinces of North and South Pyongan.
See Annex 1 for details.
Asia and Pacific Department
Operations Funding and Reporting Department