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At the Heart of North Korea's Troubles, an Intractable Hunger Crisis

Frozen human waste is being chipped out of public toilets in cities and towns across the country. Every factory, public enterprise and neighborhood unit has been ordered to produce two tons of toibee, according to Good Friends, a Buddhist charity with informants in North Korea. In the spring, it will be dried in the open air before being transported to state farms.

Barring a miracle, it won't work.

North Korea needs to produce about 5.5 million tons of rice and cereal grain to feed its 23.5 million people. Nearly every year, it falls short, usually by about a million tons. The country lacks arable land, denies incentives to farmers and cannot afford fuel or modern machinery. It has also lost access to the modern chemical fertilizers on which it had become unusually dependent and which organic fertilizers cannot realistically replace.

To fill the shortfall, the Communist government has had no choice but to unlock its gates and let in the foreign technocrats who manage food donations.

In the 14 years since the famine first attracted international aid, a growing contingent of nutritionists, economists and agriculture experts has been intermittently allowed -- with minders in tow -- to inspect the North Korean countryside. Despite government efforts to limit their numbers and restrict their access, they have conducted thousands of interviews and built up a detailed portrait about how people live, especially those who are most in need of food.

For North Koreans with cash, private markets offer food in abundance, along with Chinese-made TVs, DVD players and refrigerators. But aid workers found last year that nutrition in state-run institutions for children and the elderly has not improved in the past decade.

"The children looked very sad, very emaciated, very pathetic," said one aid expert who had visited many schools and orphanages.

Four nutrition surveys conducted between 1998 and 2004 by the government, UNICEF and the World Food Program found that wasting, a symptom of severe malnutrition, was three to four times more prevalent in remote provinces than in Pyongyang. Judging from a U.N. food assessment last fall, that pattern persists. Since the 1950s, the government has classified citizens based on its assessment of their political reliability and sent those it deemed untrustworthy to remote corners of the country.

Although North Korea is often called the last bastion of Stalinism, it is better understood as a quasi-feudal police state where bloodlines dictate access to the best schools, jobs and food.

Service in the military was for decades a way for children from the least-favored bloodlines to escape hunger. But in recent years, food shortages have also affected low-ranking soldiers, said Kwon Tae-jin, a frequent visitor to the North and director of North Korea agriculture studies at the Seoul-based Korea Rural Economic Institute, which is funded by South Korea.

During a severe pre-harvest food shortage last summer, many soldiers received only two meals a day, were visibly malnourished and scavenged for food by stealing crops from state farms, he said. Troops in the city of Kangdong, about 18 miles east of Pyongyang, were ordered to stop training to conserve energy, according to a photographer who smuggled out photos of emaciated soldiers.

"The military was popular for kids so they wouldn't starve," Kwon said. "Now they feel it is better to make money in the market."

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