One cool morning last April in Pyongyang, North Korea, I watched a woman squat over a patch of grass along the Daedong River. A large handkerchief covering her head was knotted below her chin, encircling her sunburned and wrinkled face. As a van passed by blaring patriotic hymns from the oversize speakers on its roof, she weeded the riverbank. In North Korea, keeping the neighborhood clean is a civic duty. But she was far from any neighborhood. She was gathering the weeds for food.
On Nov. 13, a North Korean soldier in his 20s was shot multiple times as he ran across the demilitarized zone into South Korea. His surgeons reported finding dozens of parasitic intestinal worms inside his abdominal cavity, some as long as 11 inches, suggesting severe malnutrition.
As these stories show — and as I have seen during my 16 visits to North Korea in the past decade — hunger remains a way of life there. Forty-one percent of North Koreans, about 10.5 million people, are undernourished, and 28 percent of children under 5 years old have stunted growth. When my 4-year-old daughter visited Pyongyang in 2013, she, all of three feet, towered over children twice her age.
The hunger is devastating. And it’s our fault.
Led by the United States, the international community is crippling North Korea’s economy. In August and September, the United Nations Security Council passed resolutions banning exports of coal, iron, lead, seafood and textiles and limiting the import of crude oil and refined petroleum products. The United States, Japan and South Korea have each imposed bilateral sanctions on Pyongyang to further isolate the country.
We are trying to inflict pain on the North Korean regime to stop the development of nuclear weapons and missiles. That’s understandable. But in the process, we are also punishing the most vulnerable citizens and shackling the ability of humanitarian agencies to deliver aid to them.
That North Korea cannot feed its people on its own is not new. It was the catastrophic famine in the 1990s that caused the reclusive government to open itself to international aid. Despite recent improvements in the nation’s food-production capacity, frequent natural disasters such as floods and droughts still cause severe food shortages.
This year is no different. In July, drought reportedly reduced the harvest by 30 percent compared with last year. As of August, each person receives a daily ration of 300 grams per day, about half the government target of 573 grams per day. That is like having only two medium potatoes for the day, every day.
It should be no surprise that around 60 percent of North Koreans buy food at informal markets to supplement their diets. To do that, they need money.
Last year, former President Park Geun-hye of South Korea shut down a joint project in the border town of Kaesong that employed 53,000 North Korean factory workers. This year, with the United Nations Security Council ban on textile exports, countless factory workers — far more than the tens of thousands from last year — will no longer have jobs. The ban on seafood exports means that fishermen will no longer be able to sell their catches to the Chinese. The reduction in how much oil North Korea can import will also cause food prices to rise. The impending loss of income from the sanctions will mean that people will go without food.
The sanctions have also crippled humanitarian help. In one troubling example, Tomas Ojea Quintana, the United Nations special rapporteur on human rights in North Korea, has written that cancer patients may not get access to chemotherapy because of the sanctions. Just last month, Britain announced it was cutting off all humanitarian aid to North Korea.
There is disagreement on whether the sanctions are even effective. The United Nations Security Council has unanimously passed eight sanctions resolutions against Pyongyang since 2006, the year North Korea first tested a nuclear device. But as many as 49 countries may be in violation of the sanctions because the United Nations does not have the power to enforce them.
Their effectiveness is also limited because North Koreans are used to shortages and hardship, and the country can survive without exports. (Sanctions on Iran, often cited as an example to justify sanctions on North Korea, were more effective because the country is much more dependent on exports.) Even President Trump acknowledged recently that he doesn’t know if sanctions will work in North Korea.
The North Korean regime could halt its costly nuclear and missile program and use the money to feed its people. But the leaders have made it clear that they will never give up their quest for nuclear weapons as long as the United States continues its “hostile policies.”
This is a chicken and egg game. While we are playing, people starve.
Kee B. Park, a neurosurgeon and Harvard Medical School global surgery scholar, is the director of the North Korean program at the Korean American Medical Association.