DPR Korea OCHA Situation Bulletin Nov 2003

HUMANITARIAN ASSISTANCE URGENTLY NEEDED IN NORTH KOREA
In November, Aid agencies appealed for US$221 million to help meet urgent humanitarian needs in the Democratic People's Republic of Korea, warning that an inadequate response by the international community would aggravate the country's chronic emergency and erode valuable gains made to date.

United Nations Agencies and Non-Governmental Organisations sought backing for a range of food aid, agriculture, education, healthcare and water programmes to be implemented during 2004. The bulk of the funding -- US$192 million -- was requested by the UN World Food Programme, which is planning to feed 6.5 million North Koreans next year.

"The humanitarian emergency in the DPRK is not over", stressed a report released by the Agencies. "Assistance is still needed and continues to play a vital role in safeguarding and promoting the well-being of millions whose nutritional status and general health would otherwise be seriously compromised."

The report cited recent declines in malnutrition rates and in the incidence of malaria, and the increased availability of safe drinking water, as evidence that "well targeted assistance can have an immediate and sustainable impact on the lives of vulnerable people".

But it noted that "continuing economic difficulties and a weakened international response threaten to undermine the substantial gains that humanitarian assistance has achieved".

Only 57 per cent of the US$225 million the agencies sought for 2003 has been pledged to date. Donations of food aid have been much lower than required and healthcare, water and sanitation programmes substantially under-funded.

While acknowledging that "most donors have continued to separate politics from humanitarian aid", the report said the re -emergence of the nuclear issue and the deterioration in the DPRK's relations with South Korea, Japan and the United States affected the level of assistance to the country.

Aid officials said a strong donor response to the appeal would help support the process of change underway in the country. "For those of us who live there, change, though gradual and cautious, is evident all around us", said Rick Corsino, the acting Humanitarian Coordinator. "There is greater openness. We now have access to a local market in Pyongyang. More and more small enterprises are appearing. Mobile phones have arrived."

Relief assistance needs to give way to a development process as soon as possible, the report said. "There will be no significant improvement in the humanitarian situation unless there is a sustainable improvement in the DPRK economy. To this end, it is necessary to create an enabling environment for rehabilitation and development programming."

Source: OCHAPress Release Beijing, 20 November 2003

OCHA HDRC WEBSITE LAUNCHED! www.humanitarianinfo.org/dprk

HEALTH AND NUTRITION

UNICEF

Government -- UNICEF Annual Review of Co-operation

The annual review of co-operation in 2003 was held early December. Over 40 participants attended including from UNICEF's partner Ministries and Institutions; Public Health, Education, State Planning Commission, Institute of Child Nutrition, Health Education Institute and the Grand People's Study House. For the first time ever, representatives of the Women's Union attended. The review looked at key results achieved through co-operation this year as well as under achievements and main priorities for 2004. Greater results were achieved this year than ever before, largely attributed to a continued focus on priorities and improved quality of cooperation and partnerships. Much was learned about the situation of children and women during the year as the October 2002 nutrition assessment results were further analysed, new county surveys were completed and as the quality of dialogue with provincial and county authorities improved during field visits. Highlights of the year were: the successful national child health days held in May and November reaching almost all of the 2 million young children in all villages countrywide; water and sanitation action in selected counties which showed that Government-UNICEF co-operation can carry out large scale water rehabilitation and that gravity water supply systems are one answer; the strong capacity to conduct surveys and statistical methods built at the Central Bureau of Statistics and the Institute of Child Nutrition; the excellent logistics performance of the MoPH Central medical with 88% of vital medicine deliveries to all provinces completed on time; the in-depth analysis and review of the findings of the 2002 nutrition assessment results leading to the adoption of a more integrated approach to ensuring optimum early child development.

The major constraint to achievement of results during the year was under-funding and not the operating conditions for UNICEF co-operation

Some of the main results for children in 2003 were:

• Over 350,000 infants fully immunised protecting them against disease and disability
  
  
• Around 10,000 severely malnourished children treated, many of whom would otherwise have died
  
  
• Almost 2 million children in all villages received vitamin A and de-worming through two child health days, boosting their immunity / helping improve nutritional status
  
  
• Over 10,000 additional families have access to clean water through renewed piped water supply and over 500,000 families through chlorination of city water supplies. Another 15,000 families will receive clean water when ongoing work is completed in March 2004.
  
  
• 650,000 children in primary schools in the northeast provinces and CNSP centres in all provinces as well as 300,000 children in kindergartens countrywide received textbooks and basic school materials
  
  
• Millions of children with simple but life threatening illnesses treated at health clinics as a result of the all year round availability of vital medicines
  
  
• Millions of women and children benefited from iodine intake through iodised salt - half of the country's needs now being produced

The current DPRK Government -- UNICEF Programme of Cooperation ends on December 31st and a new period of cooperation will begin January 1st for the period 2004 -2006.

Combating iodine deficiencies

In November, iodine capsule supplements were provided to 39,300 pregnant women in the two northeast provinces of Ryanggang and North Hamgyong. Iodine deficiencies are widespread in the DPRK and these two provinces are particularly affected. This action, funded by a contribution from the Government of Republic of Korea, is important to prevent still-births and cretinism due to iodine deficiency during pregnancy. Iodine capsule supplementation in these provinces will continue on an annual basis until adequate quantities of iodised salt are produced to meet the total household needs of the country.

In November, a plan for significantly increasing the production of iodised salt was agreed between the State Planning Commission and UNICEF. With UNICEF support, iodised salt production has reached around 18,000 metric tons annually but over 40,000 tons are needed to meet the needs of all families throughout the country. An objective has been set to meet the World Fit for Children Goal of universal salt iodisation by end 2005. This goal is readily achievable.

National Child Health Day

Identified as one the most successful features of the programme, a "National Child Health Day" again took place on 20 November. On that day almost all children under five years of age around the country -- around 2 million children - received a supplementary vitamin A dose (for 6 months to 5 year olds) and de-worming medicine (for 2 years to 5 year olds). As usual, this was an opportunity for inter-agency collaboration on monitoring with over ten teams made up of embassy officials, Red Cross, ECHO, and UN staff visiting clinics and nurseries in all provinces on that day.

Essential medicines

In November, deliveries of essential medicines were completed on time for 274 clinics and hospitals in the four provinces of North Hwanghae, Jaggang, North Pyongan and South Pyongan. In December deliveries will be made to 1,616 health clinics and hospitals as follows: Ryanggang (5 December), N. Hamgyong (19 December) S. Hamgyong (28 December) and Kangwon (6 January 04).

These are the last deliveries of the year to the far north east provinces and will ensure that the most vital medicines for childhood illnesses such as pneumonia and special foods for severely malnourished children will be available for the whole winter period. Vital medicines and therapeutic foods for the three northeast provinces are funded through a contribution from ECHO. One priority this year was to improve the in-country logistics for medicines and supplies. This was highlighted at the end 2002 Mid-term review of the current Government-UNICEF Programme. Good results have been achieved this year. 88% of deliveries were completed on time with an average delay of 10 days for the other 12% of deliveries. Further improvement is planned in 2004.

Baseline nutrition assessments in disadvantaged counties

A new Programme of Co-operation between the DPRK and UNICEF, for the period 2004-2006, will begin in January. Alongside the still very important humanitarian action nationwide, UNICEF will support more focused actions in a selected number of vulnerable counties/cities. In all, ten counties and cities in nine provinces will be earmarked for a focused approach to ensuring that all children survive, grow and develop to their full potential. In these counties UNICEF co-operation will be seeking to demonstrate how child and maternal malnutrition can be reduced significantly and sustainably. In November, baseline surveys were conducted in the first three counties by the government Central Bureau of Statistics and UNICEF. The surveys will give information on the health/nutritional situation as well as information in education, water and sanitation and others. Information gained will be used as the basis for planning actions in these counties. Findings of the surveys will be available in December.

New situation analysis

UNICEF recently completed an updated analysis of the situation of children and women in the DPRK. Copies are available from UNICEF Pyongyang as well as on the new UNICEF DPRK web-site http://www.unicef.org/dprk

WHO -- WORLD HEALTH ORGANISATION

WHO organizes first technical meeting between DPRK and South Korea on malaria control

WHO organized an inter-country workshop on the control of vivax malaria in East Asia 17-20 November 2003 in Shanghai, China. The participants came from DPR Korea, Republic of Korea, China and Vietnam, with five participants from DPR Korea. A total of 31 members participated, including WHO appointed technical experts and secretariat members from WHO HQ, WHO South East Asia Regional Office (SEARO) and Western Pacific Regional office (WPRO).

The objectives of the workshop were to review the current situation of vivax in the four countries, leading to a better understanding of the factors leading to the current resurgence of vivax malaria in East Asia and to form a consensus on vivax control strategies. Furthermore, the workshop identified the capacity building needs for DPRK and worked towards formulating a cooperative training plan for developing national capacity to control vivax malaria. During the four days of the workshop, the current status of vivax malaria globally and country situation in each of the four countries was presented. Technical issues on diagnosis, treatment and vector control were discussed in detail in plenary sessions and group work. Particularly it discussed that the mass chemoprophylaxis trial with primaquine for control of vivax malaria has been successfully conducted in DPRK from 2002 to 2003 with the support of WHO. The number of malaria cases in DPRK has significantly decreased in 2003 compared with previous years.

The presentations revealed that the epidemiology of malaria in DPR Korea and Republic of Korea are very similar. The same species of the malaria mosquito ( An. Sinensis) and vivax malaria with long incubation period are found in the two countries. Malaria on the Korean peninsula can only controlled if the South and the North can work effectively together. The Republic of Korea has, through WHO, been supporting malaria control in DPRK. This workshop also provided the first opportunity for malaria experts and health officials from DPRK and ROK to meet and discuss in their own language technical issues on malaria control. The successful workshop suggests that further technical collaboration between DPRK and ROK on health issues is possible and would be beneficial for both countries.

At end of the workshop, recommendations were made on effective control strategy, integrated vector management, technical support, training network and operational research for vivax malaria control. The needs of continued material and technical support to the DPRK for microscopes, bed-nets and other vector control measures, capacity building & training were highlighted.

National Strategic Plan for Nursing and Midwifery Development completed with assistance of WHO

An in-depth country assessment was carried out in 2002 to study the management of the nursing and midwifery workforce. This study revealed that there are constraints confronting nursing and midwifery that need to be addressed strategically in order to enhance nursing and midwifery contribution to national health development in the country. The ratio of nurses compared with doctors is low compared with other countries, and nursing and midwifery as an independent profession needs to be strengthened.

WHO had engaged two nursing experts from the Faculty of Nursing, Mahidol University in Bangkok who spent one month in DPRK assisting Ministry of Public Health in the development of the strategic plan. The strategic plan was formulated through a consultative process in a national workshop during 12-14 and 17-19 November 2003. The workshop was organized by the Division of Labour, Ministry of Public Health (MoPH), with technical support from the WHO. The WHO regional advisor on nursing also participated in the national workshop.

Forty-six workshop participants were from Pyongyang and outside Pyongyang. Majority of them are principals, vice principals and teachers of nursing and midwifery schools; with a small numbers of senior health officials, public health researchers, and chief nurses, nurses and a midwife. The framework and process used was the similar to that used in many other countries where WHO has supported the development of national strategic plans for nursing and midwifery development. Following the workshop, a small group of participants continue working to further develop detailed action plans for implementing strategic activities during 2004-06

Information Exchange on Hospital Project Activities in DPRK

On 30 October, ADRA, with the support of WHO, organised a meeting to discuss a variety technical issues regarding rehabilitation of health facilities. Topics that were discussed included equipment supply, essential drugs, training of hospital staff, water and sanitation, laboratory set up and rehabilitation of facilities. WHO AFMAL, WHO, IFRC, UNICEF, Premier Urgence, ECHO, OCHA, UNFPA, Concern and OCHA participated in the meeting.

ITALIAN DEVELOPMENT COOPERATION

The most recent activities in DPR Korea for the Italian Development Cooperation, include two Doctors from Pyongyang Maternity Hospital departing Pyongyang to participate in a training course in Italy for one year. The training course, awarded by the Italian Ministry of Foreign Affairs, will be held in the Health Institutions of AFMAL -- FATEBENEFRATELLI in Rome, Naples and Palermo, and it will cover the field of Laparaschopy.

FOOD AID

WFP OPERATIONAL REVIEW

Reports from the provinces indicate heavier rainfall in November this year compared to 2002. Heavy snowfall, about 15 cm, has been reported from Ryanggang province, while other provinces also indicate the start of the winter snows.

Threshing of maize and rice is expected to continue up to mid-December. Delays in this activity are attributed to lack of sufficient power and fuel supplies. Farmers in most areas are involved with managing the winter wheat and barley fields, tilling the harvested fields and preparing organic manure for the next farming cycle. Heavy reliance on oxen-drawn carts for ploughing fields and transportation of manure is common in many counties.

Government food rations provided through the Public Distribution Centers (PDCs) in November remained at 300 grams/person/day, similar to October though down from the 380 gram level reported throughout the July - September lean season. The December ration is expected to also remain at the 300 gram level. Reports from the provinces indicate a growing number of factory workers are being re-deployed in public schemes as local factories cannot function at their full capacities due to lack of raw materials and electricity. Emergency Officers also report that, following the onset of the winter season, the average attendance rate in visited child education institutions has dropped by 5-10% due to the insufficient heating in the rooms. An increase in the incidence of winter colds and flues has also been reported.

FALU

Agreement signed

On The 4 November, Caritas Hong Kong signed an agreement with FDRC for the provision of 2,500 mt of rice for Pregnant and Nursing Women in Kangwon, South and North Hamgyong and Ryanggang provinces. The items are expected to arrive Dec 03 or Jan 2004 with a total value of US$475,000

AGRICULTURE

FAO

Food Crops

Following the harvest of the main summer crops in September-October, focus has been on the sowing of Winter Wheat (and some Winter Barley): the bulk of which is produced in the lowlands and plains of North and South Pyongan, Pyongyang, North and South Hwanghae, Kangwon and South Hamgyong. Cabbage was harvested in October and early-November, much of which has been transformed into kim-chi for immediate consumption and storage throughout the winter months.

Although satisfactory reports on this season's paddy rice harvest were circulated, the post-harvest losses issue still requires further analysis. Unseasonable rains in October and November effectively delayed the drying and collection of the harvested crop. Energy constraints and the intermittent nature of electrical power being provided to cooperative farms have affected threshing. The consequence is that somewhat poorer quality of rice being made available and higher than expected crop losses

Soil Fertility Management (SFM)

Following recommendations made by various a gencies, especially SDC, involved with SFM, specifically legumes, green manure cover crops, FAO has procured a quantity of Hairy and Common Vetch, also Sesbania seed. In conjunction with the Ministry of Agriculture, a Distribution Plan has been compiled for providing seed to a limited number of cooperative farms in the Cereal Bowl area. Included in the list of farms are those where NGOs have ongoing activities. PMU Interlife, DWHH/German Agro Action and CESVI have, in particular, expressed interest in getting involved with SFM. Non-resident organisations (ACIAR, AFSC) are already involved in the aspect of crop production and are interested to share information and collaborate with FAO. FAO has been sounding out interest, initially with nonresident agencies, in arranging a SFM Seminar in Spring 2004.

Integrated Watershed Management (IWM)

Among the various aspects of IWM is environmental protection, which in turn includes soil conservation and water management. FAO, in conjunction with the Ministry of Lands and Environmental Protection (MoLEP) arranged a Workshop in November to discuss all the relevant issues and constraints met. These include the rapid encroachment of agricultural crop cultivation onto hitherto hilly marginal sloping lands, normally under tree and vegetative cover, with selected grazing and browsing. Apart from technical, policy and social elements of the Workshop: the convening of so many local professional experts from various Ministries, Academies, Institutes etc -- many of them meeting for the first time, was of significance. The IWM expertise from FAO met with some of the Agencies having environmental activities in DPR Korea, including UNDP, SDC, Concern Worldwide and Triangle GH

FAO accompanied other UN organisations (WFP, UNICEF, WHO and UNFPA) for the mini-launch of CAP-2004 in Beijing in November. FAO is appealing for US$3.5 million for four project proposals comprising ongoing support to double cropping (inputs, SFM, integrated pest management, training), horticulture and coordination. Following the CAP launch press conference and donors' briefing, much of the following week was spent, briefing individual donors on the food and agriculture situation in DPR Korea, including the economic adjustments policy. The question of ensuring sufficient supplies of mineral fertilisers for cropping season 2004 was among the most important issues, to supplement bilateral donations from the European Union and the Republic of Korea (RoK) and therefore maintain and sustain improved levels of cereal production in the past three seasons

FAO-WFP collaboration

In line with a global agreement for increased inter-agency collaboration, a meeting was held in Pyongyang to explore linkage between ongoing WFP School Feeding (kindergartens, primary schools) and FAO School Gardens initiatives.

FAO is keen to assist with augmenting horticultural production and has already implemented a TCP project in South Pyongan province. A further meeting (FAO-WFP) is planned between the WFP Head of Programmes, School Feeding Focal Point, Head of Targeting and FAO Programme Coordinator to decide on a pilot operation for 2004.

DWHH/German Agro Action is also involved in both School Feeding and Horticultural Production and has shown interest to collaborate with FAO.

Agriculture Sector Group

Sadly, the Agriculture Group's regular fortnightly meetings terminated during 2002. The Group, made up of mainly technical expertise from NGOs, UN agencies and other Pyongyang-based persons, with occasional visitors from non-residential organisations (ACIAR, World Vision, Mercy Corps, AFSC, Caritas etc) and consultants from FAO, UNDP and elsewhere, met frequently from 1998 until 2002. Even though other groups were set up (e.g. Green Table) with the objective of presenting topics and arranging occasional meetings in a most professional manner, the feeling that the regular information exchange and coordination of the former Agriculture Group was missed. Complementarity between various interest groups remains a priority.

FAO arranged a meeting in October with a number of organisations involved with agricultural and related activities to make a decision on reviving the Sector Group. Participating were DWHH/GAA, CESVI, SDC, Campus fur Christus, PMU Interlife, EU-FSU, WFP and UNICEF. It was decide to re-activate the Group, from January 2004, with monthly afternoon meetings on the 2nd Friday, to facilitate those persons involved with field work, Mondays-Thursdays. A provisional list of dates will be circulated for both resident and non-resident organisation, as the latter maintain regular contact with the Group's Focal Point and sometimes plans their trips to Pyongyang so as to include participation at a Sector Meeting. FAO will be in touch with all the previous members, also some intending new members, of the Agriculture Sector Group, with a view to outlining plans for 2004.

Other FAO Technical Cooperation Programme (TCP) activities, 2003

Some projects have terminated and are drawing to a close. These include the Horticulture Pilot Project Goats Milk Collection and Processing, Forest Protection Project. Reports, once cleared, can be made available to interested persons. Please contact the FAO Programme Coordinator. Ongoing projects include Conservation Agriculture, Soil Testing Facility, Integrated Watershed Management, Aquaculture and Goat Breeding. In the pipeline for 2004 start-up, is a Maritime Fisheries Project, to be implemented through the Ministry of Fisheries and fishing cooperatives in South Hamgyong province.

HUMANITARIAN AID WORKS -- SUCCESS IN HEALTH AND NUTRITION ACTIVITIES IN 2003!

In 2003, overall progress in improving health and nutrition has been made in the DPRK, with significant results being achieved with well-targeted assistance. Key achievements in the sector include:

• Rehabilitation of almost 10,000 severely malnourished children in 25 facilities around the country.
  
  
• National supplementation of Vitamin A and de-worming days that reached almost all young children in the DPRK achieving the highest vitamin A coverage in the region.
  
  
• Reported malaria cases are significantly reduced due to prevention and control activities;
  
  
• Expansion of the Tuberculosis (TB) Control Programme based on the Directly Observed Treatment Short-Course (DOTS) strategy supported by WHO and other partners to cover 100% of the population. Still about 55,000 new tuberculosis cases are expected in 2004. The sputum conversion and treatment cure rates are high, i.e. 90 % and 87% respectively, in line with the global targets;
  
  
• Improved availability of basic (very vital) medicines for the treatment of diarrhoea and pneumonia, the main causes of illness and death for children;
  
  
• WFP and UNICEF joint production of blended foods in 2003 will reach 27,000 Metric Tonnes (MTs) by the end of the year;
  
  
• WFP local production of micro-nutrient fortified blended food, noodles and biscuits, with support from UNICEF and NGOs, is projected to exceed 40,000 MTs in 2003 and distributed to more than 2.8 million children and pregnant and nursing mothers;
  
  
• A rapid response by WHO, IFRC, and Premiere Urgence (PU), helped the MoPH with SARS preparedness and prevention. No SARS outbreak occurred in the country;
  
  
• Polio eradication remains on track, and full immunisation coverage was sustained at over 70% and is poised for further increases.

Source: Inter-Agency Consolidated Appeal Process (CAP) -- Democratic People's Republic of Korea, 2004

The OCHA Office in DPRK produces this Bulletin on the basis of information supplied by contributing organizations and public sources.
Swedish SIDA is funding the OCHA Office in 2003