PYONGYANG / GENEVA, 20 February 2003 -- Malnutrition rates among children in the Democratic People's Republic of Korea (DPRK) have improved considerably over the past four years, according to a new survey, but the UN agencies that announced the findings today said the gains could be lost if international support for humanitarian assistance to the country continues to slacken. The assessment -- the largest of its kind ever to be undertaken in the DPRK -- covered both child and maternal nutrition and was carried out last October by the government's Central Bureau of Statistics and Institute of Child Nutrition, in collaboration with UNICEF and the World Food Programme.
The two UN agencies said although the new assessment is not strictly comparable with an earlier survey carried out in 1998, clear positive trends are discernible:
- The proportion of children underweight
(weight-for-age) has fallen from 61 percent in 1998 to 21 percent in 2002
- Wasting, or acute malnutrition (weight-for-height),
has fallen from 16 percent to 9 percent
- Stunting, or chronic malnutrition (height-for-age), has dropped from 62 percent to 42 percent.
"The results are very encouraging and our assistance is clearly reaching the people intended with positive effect," said Kenzo Oshima, Under Secretary-General of the United Nations for Humanitarian Affairs.
The assessment also provided the first objective analysis of differing vulnerability across the country. Stunting among children in Nampo City was 25 percent, for example, compared to 48 percent in South Hamgyong Province. The wasting rate in Pyongyang, the capital, was just under 4 percent, against 12 percent in South Hamgyong. The survey found similar patterns in food availability and the incidence of childhood diarrhoea.
UNICEF and WFP said such patterns confirmed their observations from field monitoring that the northeastern provinces are more vulnerable than other parts of the country.
A further important finding was that about one-third of mothers are malnourished and anaemic. "This is certainly a crucial factor contributing to child malnutrition," said Carol Bellamy, Executive Director of UNICEF. "Among other things, the survey proves yet again how important a mother's health and nutritional status is to that of her children."
Though child malnutrition has fallen considerably, according to the survey, the two agencies said there is still "great cause for concern."
According to World Health Organization criteria, the wasting rates are still "high", and the stunting rates are "very high." Moreover, the recent slump in external donations for food, medical and other assistance could compromise the gains.
"The crisis is not over. If the UN can't provide more medicine and food -- and quickly -- we will see malnutrition rates rise again, undoing much of the progress that has been made," warned James T. Morris, WFP Executive Director.
UNICEF and WFP staff working in the DPRK participated in the data collection teams for the assessment. In addition, experts from the UK's Centre for International Child Health and the Bangkok-based Thailand Health Foundation provided support for survey design, training and verification of statistical accuracy. The two independent bodies pronounced it a credible and accurate assessment.
The survey covered children under seven years of age and their mothers, from 6,000 randomly selected households in 10 of the country's 12 provinces and municipalities. The youngest child from each household was weighed and measured, and the mother's nutritional condition was assessed. In addition, questions were asked about factors that could influence nutrition, such as food availability, child feeding and care, and health status.
For further information, please contact:
Richard Bridle, UNICEF Representative, DPRK: (+8502) 381-7234 Charles Rycroft, UNICEF Media, Beijing: (+8610) 6532-3131 Emily Booker, UNICEF Media, Bangkok: (+622) 356-9406 Wivina Belmonte, UNICEF Media, Geneva: (+4122) 909-5509
Trevor Rowe, WFP Spokesman, Rome: (+3906) 6513-2602
Gerald Bourke, WFP Public Affairs Office, Beijing: (+8610) 6532-3731 ext. 209 Mobile: (+8613) 8010-54051
Copies of the Nutrition Survey are available on www.reliefweb.int
UNFPA - EMERGENCY REQUIREMENTS UNMET IN 2003 -
In 2003 UNFPA faces critical funding shortfalls that are required to respond to identified needs in the health sector.
UNFPA emergency requirements are included in the UN Consolidated Inter-Agency Appeal for 2003. UNFPA is anxiously seeking donor support for two specific projects:
Improved capacity to provide basic obstetric services at the community level. There is a significant need to upgrade community level facilities with reproductive health (RH) kits including basic drugs, appropriate instruments and medical equipment.
Reduced maternal mortality ratio and improved women's health status in four selected areas. The need is to upgrade delivery and consultation rooms, operation theatres with medical equipment, instruments, supplies as well as capacity building. The impact of under-funding for the above projects means increased maternal mortality - Reduced access to quality RH services and increased risks on HIV/AIDS. The old treatment practices, together with poor nutrition/health status of pregnant women have further contributed to an increase in maternal mortality.
Therefore UNFPA together with the International Planned Parenthood Federation (IPPF) assisted the Ministry of Public Health of the DPRK in review and revision of Reproductive Health Guidelines with a view to improving them to meet international standards.
The new guidelines have been adopted as State-Standard guidelines. However, there is a danger that due to the shortfall of funding resources:
The medical staff will miss the training of updating their skills and be familiar with the latest international professional modern techniques, treatment methods and technically appropriate procedures in area of RH, and full benefits of these guidelines can not be obtained nationwide.
Given the lack of public transportation, combined with the shortfall of resources for obstetric and gynaecological services means that women living in remote areas are unable to access quality reproductive health services.
Instead of achieving the MDG (Millennium Development Goal) of 'Reducing maternal mortality by three-quarters' the maternal mortality could be further doubled (from 105 to over 200), as it has been the case in the past few years when the country has been facing the shortage of food and basic RH health services (MMR has jumped from 54 to 105/100,000 live births).
The awareness and prevention on HIV/AIDS remains weak and thereby a future explosion of HIV transmission similar to that experienced by other countries in the region could be anticipated in these already highly vulnerable circumstances.
For further information please contact Mr.Kauko Hakkinen, UNFPA Programme Office DPRK: (+8502) 381-7346
UNFPA -- ANNUAL REVIEW
UNFPA Country Director for DPRK, Ms. Siri Tellier, based in Beijing, visited 26-30 November to participate in the UNFPA Annual Review Meeting of programme activities. The review recommended printing and distributing more IEC (Information, Education and Communication) material and reproductive health (RH) guidelines and protocols. Also the necessity for a regular supply of RH commodities was pointed out.
Concern was raised during the annual review of the elevated maternal mortality, which still remains high due to the poor nutritional status of pregnant women coupled with high risk of iron deficiency, anaemia and inadequate RH services in the whole country. During the visit to the Central Medical Stores it was noted a need to upgrade storage facilities including logistic support. Monitoring activities should be further strengthened to the programme sites. In the meetings with the Government, UN and other international agencies the preliminary strategy reviews/outlines were exchanged for the next country programme due to start January 2004 and to be harmonized with the respective country programmes with UNICEF and UNDP.
Ms. Tellier was accompanied by Dr. Ba Thike from UNFPA Country Support Team, Bangkok, Mr. Yu Yu, Programme Officer from Beijing and Ms. Ng, Programme Officer from IPPF, Kuala Lumpur.
UNFPA -- REPRODUCTIVE HEALTH SURVEY
Mr. Rajendra Lal Dangol, Computer Data Specialist from Nepal, visited DPRK to work with The Population Centre, in order to facilitate the process of the RH Survey taking place in UNFPA current programme area in three provinces. The results of the survey will be an important tool for the formulation of the next country programme. UNFPA plans to release the survey in late April.
UNFPA -- CORE FUNDING
On 24 January 2003 UNFPA initially approved from its regular resources the amount of US$ 800,000 for the ongoing programme "Improving RH status of men and women in three selected provinces in DPRK". Main components of the programme are capacity building, advocacy, IEC material production as well as provision of essential drugs, medical equipment, contraceptives and other supplies.
WHO -- URGENT FUNDING NEEDS
WHO Urgently Needs Funds for Malaria Control and Strengthening of Health Services at the Community and County Level.
WHO has supported malaria control for the past three years. In 2002, a reduction in the number of malaria cases was noted for the first time in recent years. This is attributed to the control efforts made in the last two years. The main strategies for containment of malaria are prompt diagnosis and treatment and vector control through use of impregnated bed nets and residual spraying, supported by making anti-malarial tablets available to the people who fall sick with malaria.
However, in spite of the improvement observed, the number of reported cases almost reached 250,000, and malaria remains a public health problem in the country. So far the malaria control activities for 2003 has not yet been funded, and it would have negative impact on the efforts of containment if funding for the planned activities is not forthcoming. Funds are therefore urgently required to procure the necessary supplies, medicines before the onset of the Malaria season in 2003 as well as provide technical support to Ministry of Public Health on malaria control.
There is also urgent need to strengthen the health services at the community and county level. During the winter time the existing crises in the health services are more visible than ever. There is a critical
shortage of basic equipment, consumables and many other important items in clinics and hospitals. WHO has, based on technical assessments, identified suitable material and equipment that adapted to the conditions in DPR Korea. The WHO support for basic equipment for community and country hospitals require urgently additional funding.
CARITAS CONTINUES TO SUPPORT THE HEALTH SYSTEM
CARITAS Hong Kong, on 21 December signed an agreement with FDRC for the provision of equipment and medical supply kits for 100 ri-hospitals in the provinces of South Hamgyong(14) and North Hamgyong (86) (SOA 15/02.6A).
The value of this donation is approximately US$124,738and the estimated delivery from the supplier in Netherlands is March April 2003. Implementing partners are MoPH, WHO and FALU/WFP (for monitoring and reporting).
IFRC HEALTH CARE
The arrival of household doctor kits from the Netherlands RC at the end of December and the German Red Cross in early January started a new round of distribution and monitoring for DPRK RC/IFRC Health and Care departments. A significant number of delivery kits and basic essential drug kits arrived in the middle of January. The distribution and monitoring of these supplies to the RC operational area is well underway, providing the recipient institutions with New Year stocks.
1,515 Safe delivery kits - donated by
the Australian and Germany Red Cross.
1,905 Household Doctor kits - 655 kits donated by Netherlands Red Cross.
1,250 kits were donated by German Government through Germany Red Cross.
5,824 Basic kits (donated by ECHO through the Danish Red Cross)
MILLIONS AT RISK -- ASSISTANCE DRIES UP
Immediate pledges of 105,000 mt are required to ensure continued implementation of the complete range of WFP's planned activities throughout the remainder of the first half of 2003. Commodities most in need include cereals (84,500 mt); CSM (10,000 mt); and Dry Skimmed Milk (3,000 mt). The latter is critical to avoid extended closure of most LFP factories.
The food pipeline for WFP's operation in the DPR Korea is at a very critical point. Starting in September 2002, WFP was forced to phase out cereal distributions to up to 3 million beneficiaries due to lack of resources. Without immediate, additional contributions WFP will not be able to reach approximately 2 million of the most vulnerable targeted populations during much of the first quarter of 2003. These most at-risk beneficiaries include children in nurseries, kindergartens and primary schools, pregnant/nursing women, elderly persons, and caregivers in child institutions and hospitals. In addition, Food for Work activities will have to be drastically curtailed, while Local Food Production factories, already beginning to slow down production, will be forced to stop functioning altogether towards the end of January.
WFP is very concerned that if it does not get the resources it needs, very serious consequences will result for these targeted groups, including increased child stunting and malnutrition. A cash contribution of Euro 9.5 million from ECHO (European Commission) was confirmed in early January. This contribution will be used to purchase much needed cereals (expected delivery in March or April) for continued implementation of WFP activities in the west of the country. Immediate pledges of 110,000 mt are required to ensure continued implementation of the complete range of WFP's planned activities throughout the first half of 2003.
IFRC - DISASTER PREPAREDNESS AND RESPONSE
Disaster Preparedness (DP) Master Training Workshop
A training workshop for DP master trainers was held on 22-23 January 2003 in Phyongsong, South Phyongan Province. 24 master trainers from North and South Phyongan Provinces, Chagang Province and Kaesong Municipal City attended the workshop. The workshop was facilitated by the Disaster Preparedness and Relief Department of the DPRK Red Cross Society and the Federation Delegation.
Topics discussed included: the Change Strategy of the Secretariat, the Federation's DP Policy, Strategy 2010, keys to effective training, integration of CBFA and water/sanitation into CBFA, summing-up of training in 2002, 2003 disaster management plan, and lessons learned from 2002 flood operation.
DP Restocking In Regional Warehouses
The DPRK Red Cross Society transported and restocked 3,588 cooking sets, 7,750 plastic sheets and 2,028,670 water purification tablets from the central warehouse in Pyongyang to regional DP warehouses in Huichon, Kaesong, Wonsan and Sinuiju in order to make timely and effective response at times of disasters.
Distribution Of Water Containers, Plastic Sheeting, Blankets
The following items arrived in January:1,744,000 water purification tablets; 12,000 water containers; 3,000 cooking sets and 390 first aid kits. As part of the flood operation in 2002, the following items were distributed to beneficiaries in January: 3,897 blankets Anju city, 12,688 water containers in North & South Phyongan Provinces, South Hwanghae Provinces, Kangwon Province and Kaesong Municipal City.
Study tour to the Philippines
A 3-man delegation headed by a Deputy Secretary General of the DPRK RCS visited the Philippines from 14-22 December 2002 to get acquainted with the experience of the Philippine Red Cross gained in the field of integrated community disaster planning programme (ICDPP).
WATER AND SANITATION - REHABILITATION ACTIVITIES
IFRC water and sanitation activities during the period were as follows:
- Monitoring distribution of cement and
reinforcement for waste water collecting system in 10 villages. Cement
and reinforcement had purchased and distributed in the end of November
2002. Monitoring was carried out for 2 weeks, from 3rd of December to 12th
of December and it was confirmed that all materials were distributed correctly.
- Monitoring distribution of accessories
for pump house in 20 villages. It was done at same time when monitoring
distribution of cement and reinforcement was carried out.
- Drawing up the design of Ecosan toilet
and calculating amount of materials for Ecosan toilet project.
- Distribution of 4 Delaqua Kits to North
and South Phyongan Provinces, Chagang Province and Kaesong Municipality.
- Assessment of 40 villages for the 2003
project was finished.
- Selection of 10 villages for the Swedish
Red Cross/SIDA funded project in 2003.
- Procurement of Ecosan toilet materials,
90 MT of cement and 0.7 MT of reinforcement.
- Watsan Training Workshop in South Phyongan Province with 34 participants from 7 Counties was conducted. Emphasis was put on sanitation components.
ACT/Diakonie continues to provide support to increased food production in Maengsan County, South Pyongan. The aim of the project is to increase the yield in kitchen gardens of 7,554 rural households for their own consumption as well as increasing the amount of food supply to be sold in urban market places. Between 17 and 24 January, 300 MTs of NPK Fertilizer arrived in Sinuju. Each household will receive 39.7 kg of NPK from this shipment. The value of this consignment is approximately US$52,000.
Concern Worldwide has commenced two new Food Security projects in 2003. One of which is funded by Concern, and deals with improving food security on cooperative farms in Pukchang and Anju through the introduction of appropriate technology and sustainable inputs. The second project concerns the introduction of integrated pest management and will be carried out in collaboration with Swiss Development Cooperation and is jointly funded by OCHA, SDC and Concern.
International Federation of Red Cross and Red Crescent Societies - Funding Update
As at the end of January, it is assessed that the IFRC programme in the DPRK will receive funding at about the same level as 2002. The Health and Care programme is already funded through September.
Support for the Disaster Preparedness programme is pledged by the British Red Cross at the same level as 2002 through 2003. A final decision on the next two years of funding is scheduled to be made by DFID in April.
Water and Sanitation activities will be expanded to 40 communities this year. A proposal to assist 10 villages was sent to SIDA by Swedish Red Cross. A funding decision has not yet been made. A proposal for 30 villages, which are currently supported by ECHO, will be presented to ECHO for consideration in April. Current ECHO contract will be finalized by mid June.
All other National Red Cross Societies who supported DPRK in 2002 have pledged same level a similar level of support for 2003.
EUROPEAN COMMISSION GRANTS 9.5 MILLION EURO IN EMERGENCY HUMANITARIAN FOOD AID FOR CHILDREN
(EC Press Release IP/03/20 Brussels, 8 January 2003)
The European Commission has adopted a humanitarian aid decision worth €9.5 million to help meet the winter needs of pregnant and nursing women and children in North Korea. The aid is being channelled through ECHO, the Humanitarian Aid Office of the European Commission, which comes under the responsibility of Commissioner Paul Nielson. Commenting on the decision, Mr. Nielson said: "A significant proportion of North Korea's population of 23 million faces food shortages and the situation is likely to worsen during the winter. Children are particularly at risk with many already seriously malnourished. The aim of this funding is quite simply to save the lives of people in desperate straits, in keeping with basic humanitarian principles." This decision will finance the procurement and distribution of 39,000 tons of cereals for the most vulnerable, and especially children and mothers of new-born babies*. The funding will be channeled through the World Food Programme (WFP), which has distribution outlets at community level in the country. This aid will help fill the gap resulting from decisions by other donors (Japan and US) to reduce their bulk food aid programmes. This reduction has resulted in difficulties for WFP to maintain its aid programmes. Humanitarian aid from the European Commission is needs-based and is allocated impartially and without conditions to victims of both natural and manmade crises in countries outside the European Union (1). The delivery of aid is constantly monitored in order to ensure that it goes to its intended recipients.
Since the early 1990s, economic and social conditions in the Democratic People's Republic of Korea (DPRK) have steadily declined. Supplies of water, vital foodstuffs and medicines have diminished drastically. Droughts and floods since the mid-1990s have contributed to an already difficult situation.
Over the past six years, ECHO has provided more than €50 million in humanitarian support to ease the suffering of vulnerable groups in North Korea, including more than €19.5 million in 2002. Previous decisions in 2002 focused on health and nutritional projects and on improving water and sanitation systems.
* The indicative target group of 2,173,000 people is broken down as follows:
|Children in nurseries||
|Children in kindergartens||
|Children in primary schools||
|Pregnant nursing women||
(1)This decision is not linked to and does not weaken the EU's determination to see North Korea comply with its international obligations under the Non-Proliferation Treaty and the Agreed Framework
Maurice Strong, Personal Envoy of the United Nations Secretary-General for North Korea, visited DPR Korea 14 to 18 January 2003.
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