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Matthew McGrath (@mattmcgr) is a Seoul based contributor for NK News.
It’s an article of faith among North Korea’s critics that the regime can’t feed it’s own people, and that its problems with food insecurity are among the worst internationally.
But what if what they know just isn’t so?
Hazel Smith, professor of Resilience and Security at Cranfield University in the United Kingdom, has some startling statistics on public health in North Korea that suggest the regime might not be as exceptional as you’d otherwise think.
For one, the rate of severe malnutrition in the North, at 5 percent, is in fact significantly lower than the 17 percent average in Asia.
CHRONIC AND SEVERE MALNUTRITION
Of course, to understand such data, one must first understand the definition of “severe malnutrition.”
“What it means is that if somebody is severely malnourished then they are at risk of dying without medical intervention,” Smith told NK News. “It’s not just a case of food. It’s a very, very serious situation; acute malnutrition might be a better way of putting it.”
Smith cited data for 2012 that puts North Korea at about 5 percent severe malnutrition, much lower than India (at 20 percent) and Indonesia (at 14 percent), for example. Then there is the separate, less immediately life-threatening but still serious category of “chronic” malnutrition, which she says is “stubbornly persistent” across Asia.
“What that means is that you live but you don’t get enough vitamins and minerals to keep you leading a fully healthy life,” Smith said. “North Korea (at 32 percent) is at about the average for Asia (at 34 percent), but it’s better than India (at 48 percent) and Indonesia (at 37 percent)…two capitalist countries.”
So what does this say about the North, and how its hunger problem is portrayed?
“It tells you you’ve got a society that hasn’t collapsed, for a start,” said Smith, probably to the surprise of those accustomed to hearing of the regime’s desperate food shortages, indicating that its demise is certain.
“Most of all it tells you terms of poverty indicators, when you’ve got child mortality, infant mortality and maternal mortality, they’re a lot better than lots of other Asian countries,” she said.
Furthermore, the North’s conditions are actually improving in certain areas, particularly regarding infectious diseases.
“… if you look at (tuberculosis) and malaria you see that those shot up in the ’90s and there were a lot of NGOs as well as the (World Health Organization) working in (the North),” she said. “But if you look at the data on TB and malaria from the 2000s, you see that with the help of the WHO and the (Bill & Melinda) Gates Foundation, they’ve shot down.
“If you compare the data, you find that North Korea is actually doing pretty well in getting these diseases under control, with help of course but pretty well.”
Vaccination coverage for the preventable diseases – Smith lists polio, measles and whooping cough as examples – have been reasonably good in the North since the 1990s.
“It did descend for a little bit but now it’s all gone back up again and in some cases the vaccination coverage is better than some of the developing countries,” she said. “You’ve also got now, because the WHO also collects the data…(information) on deaths that are caused by vaccination-preventable diseases…All of these are indicators that show that the vaccination campaigns have been successful.”
WHERE THE NORTH BELONGS
Smith suggests that a big part of why the North’s reputation for poor public health persists is due to the region it belongs to, Northeast Asia, where much better-performing nations can be found that include South Korea, Japan and even China.
“In fact, I’ve been arguing for some time that we should be thinking of North Korea in social economic terms, as a country much more akin to the poor countries or poorer parts of Southeast Asia,” she said. “That tells us much more about where the society is.”
Also, the North’s inability to feed so many of its own people is frequently described as a human rights abuse. Would its critics be willing to apply that label to nations in Southeast and South Asia, and wish for their collapse as they have with Pyongyang?
“…one would have to argue the governments of India and Indonesia are also doing the same,” she said. “In many senses one could argue (India and Indonesia) are more culpable because there is more wealth in those countries.”
Smith emphasized, however, that this is just a logical exercise; she does not support regime change in those countries, nor does the exaggeration of its food shortages mean that she supports the North.
“Of course the North Korean government is not a good government, of course it could change its policies, although as we’ve seen from other countries, changing policies towards an open market…doesn’t necessarily mean that things get better automatically for everybody,” she said.
“What we do know is that North Korea is by no means one of the worst-off countries in Asia, definitely (not) in terms of severe malnutrition, and also in terms of chronic malnutrition, and in terms of poverty indicators like child mortality and infant mortality.”
WEALTH OF NEW DATA
One reason this has recently been determined is because of a recent influx of usable data on living conditions in the North, Smith said.
“Since the early ’90s, when the international organizations have gone (into North Korea), we’ve had lots of incredibly good data,” she said. “We can now look at this data across time, from 1998 to 2012, roughly 13 years worth.”
This information, she said, is reliable enough for use by international organizations such as the World Bank and UNICEF. That does not mean there aren’t holes in the data, though.
“We’ve got some very reliable poverty indicators, which we can compare across time in North Korea, but we haven’t got anything for the elderly so it’s patchy, but we’ve got enough to say some things,” she said.
“We’ve got all those indicators about deaths; the common causes of deaths among children and adults…We’ve also got that because of the World Health Organization has details of immunization coverage, has been covering this with UNICEF and we’ve got the census data since the ‘90s.”
Up to the 1990s, she said, international observers lacked data this comprehensive.
“Since then, we’ve been able to accumulate usable data and even if the data is not accurate to the number, we can check the methodologies,” she said. “For example, when they do a nutrition survey, they have nutritionists from the London School of Tropical Hygiene go in, and/or other respected institutions, and we can check their work.
These statistics are published regularly by the WHO and are easily accessible online, and therefore exaggerations of the North’s malnutrition are “lazy scholarship” or worse, she said.
“Or else it’s more sinister than that, but I’ll put it down as lazy scholarship to be kind,” she said.
Source: Unicef’s “State of the World’s Children 2012: Children in an Urban World”
Pictures: NK News