OCHA Situation Report
DPR Korea
Report for April - May 2005
27 June 2005


Source: UN Office for the Coordination of Humanitarian Affairs

WORLD FOOD PROGRAMME -- PIPELINE SHORTAGES

WFP operations in the DPRK continued to be hampered by funding 
shortfalls and as a result, 1.2 million pregnant/nursing women and 
kindergarten and nursery children stopped receiving beans in addition to 
oil in May. The situation remains critical and despite intensified 
fund-raising efforts, WFP has received only limited pledges since 
October 2004. Without a radical change of circumstances, WFP will be 
forced to cut cereal rations to 3.6 million elderly people, 
food-for-work participants and their families, primary school children 
and the poorest urban households in mid-June.

Suspensions and reductions in supplies of WFP food have a serious 
adverse impact on the well being of beneficiaries. As rural counties 
have very limited means to make good the difference, child institutions, 
for example, have to reduce the quantity of food served. Children's 
consumption of cereals can fall by as much as 60 per cent, while their 
consumption of pulses and vegetable oil -- key sources of protein and 
fat -- also drops dramatically. Moderately malnourished children can 
quickly become severely malnourished. This, coupled with rising prices, 
and an ever-increasing dependence on the market for food, is leading the 
vulnerable in the country towards a very precarious situation. WFP is 
hoping that donors will continue their longstanding support to the 
Korean people and urgently come forward with new donations.

The Public Distribution System (PDS) ration remained unchanged at 250 
grams per person per day composed of a mix of maize and rice. However, 
officials in many counties informed WFP staff that the ration is likely 
to be cut again in July, to 200 grams. That would be the lowest level 
since 2001.

As part of WFP's new monitoring system, the first periodic Household 
Food Security Assessment took place at the end of May/early June. For 10 
days, WFP monitoring teams conducted 240 family household interviews, 10 
focus group discussions and 70 observational walks within the 
communities where household interviews were held. The focus group 
discussions were particularly successful and informative. Many issues 
otherwise considered as sensitive by the DPRK Government (e.g. the 
informal economy, household expenditure and the deteriorating food 
security situation) were discussed. The intention is to conduct three 
such assessments each year, to reflect the changing food needs in 
specific periods of the agricultural cycle, and thus prioritise food 
interventions more accurately.

HEALTH AND NUTRITION

WHO - Avian Influenza Outbreak - Update

In February-March 2005, poultry in DPR Korea was hit by the H7 subtype 
of the influenza A virus. Three poultry farms in the suburban area of 
the capital city of Pyongyang were affected. The outbreak was contained 
by the rapid destruction of 219,000 birds and strict surveillance of 
human contacts with the infected poultry. The diagnosis of H7 subtype 
was confirmed by FAO. Though no human cases had been reported, the 
national authorities approached WHO for technical support in 
strengthening the state of preparedness. Accordingly, Dr Rajesh Bhatia 
and Dr Ayana Yeneabat from WHO Regional Office for South East Asia 
visited DPR Korea from 16 to 23 April 2005, reviewed the ground 
situation and after consultations with the national authorities, 
suggested strengthening various areas of disease surveillance and 
response so that any occurrence in humans can be detected early and 
appropriate control measures instituted.

During this period, WHO also supported government control measures by 
providing personal protective equipments (PPEs), rapid diagnostic tests, 
laboratory reagents and anti-viral drugs.

WHO also assisted in developing a proposal for the strengthening of 
disease surveillance and response mechanisms in DPR Korea for both 
influenza and avian influenza. This is being done in cooperation with 
FAO. The Government of Australia had pledged AUS$ 250,000 for support 
for activities related to avian influenza control. Additional funding is 
required. This reflects the importance of stepping up preparedness, 
surveillance and capacity to respond to possible new outbreaks of avian 
influenza. Based on experiences from other Asian countries, recurrence 
of the disease occurs frequently. Furthermore, increased efforts are 
needed for the development of a national preparedness plan in DPRK for 
an influenza pandemic.

WHO - Support to County Hospitals

In DPRK, for the majority of the population, county level hospitals 
provide the main health service facility and first referral centre for 
the community at the Ri/Dong level. WHO is currently focusing on 
strengthening the infrastructure of health service facilities at the 
county level with the provision of essential equipment and 
supplies/consumables for surgeries, antenatal care, newborn problems, 
obstetrics and laboratory services, in order to provide access to 
improved health services. WHO is also focusing on improving the 
knowledge and technical capability of health workers with the provision 
of a Korean version of WHO's technical guidelines on internationally 
recognized health service practices. The Korean version of WHO 
guidelines for managing complications in pregnancy and childbirth, 
managing newborn child health complications, and basic techniques for 
health laboratories are already widely available at the county level. 
WHO is planning to print and disseminate translated WHO reference books 
on surgical care for district hospitals, which includes all technical 
and practical aspects of basic surgery, within a few months. The support 
for strengthening county hospitals is funded by ECHO, Japan and 
Australia.

UNICEF -- Health and Nutritional Care Programmes -- Update

UNICEF - National Child Health Day (CHD)

The first National Child Health Day (CHD) for 2005 was held on 20 May. 
About 2 million children aged between 6 to 59 months, 99% of the total, 
received Vitamin A supplements. All children between two to five years 
were targeted for deworming with Mebendazole. The National Child Health 
Day is a joint collaborative effort between the Government of DPRK and 
UNICEF. All operational costs for organizing the CHDs are borne by the 
government, and more than 60,000 health workers and nursery caregivers 
are mobilized for the benefit of the children. UNICEF provides Vitamin A 
capsules, Mebendazole and technical assistance to the Ministry of Public 
Health through contributions from donors such as Canada, Republic of 
Korea and New Zealand.

In DPRK, the CHDs have proven to be a feasible, cost-effective strategy 
for reaching almost all children in the country with a package of 
critical health interventions and are now considered as a possible 
channel for delivery of a broader package of services as well as primary 
health care information to care-givers and parents. DPRK has achieved 
one of the highest coverage of Vitamin A distribution to children among 
countries in the region.

UNICEF - Production of ORS.

1,100,000 sachets were produced during January to May 2005. The 
production was lower than usual because of unexpected problems in 
obtaining spare parts. To increase production capacity, UNICEF has 
procured a new machine, which is expected to arrive in June.

UNICEF - Delivery of Medicines (Japanese funded).

In May, the Central Medical Warehouse distributed medicine kits to 448 
Ri clinics and hospitals and 39 provincial and county hospitals in N. 
Pyongan, S. Hamgyong and N. Hwanghae provinces. The distribution for 
June has started for 1258 Ri clinics and hospitals and 52 provincial and 
county hospitals in S. Pyongan, Kangwon, Ryanggang and S. Hwanghae 
provinces.

UNICEF - Central Medical Warehouse (CMW).

A consultant was in the country from 21 May to 14 June 2005 as a 
follow-up visit on strengthening the logistic capacity of the Central 
Medical Warehouse. Training was conducted for the CMW in Pyongyang and 
the two provincial medical warehouses in Kangwon and S. Hamgyong 
provinces. The consultant also met with WHO, UNFPA and IFRC, and 
extended his advice on the renovation of the UNFPA warehouse. 
Rehabilitation of the CMW (funded by Japan) is on-going.

UNICEF - Safe Motherhood. A first draft of the Reproductive Health 
Strategy paper has been developed and shared with partners in the 
monthly Reproductive Health Taskforce meeting.

UNFPA -- Update on Activities

UNFPA provided US$ 200,000 worth of essential medical equipment and 
drugs for maternal health to 32 hospitals and clinics in 3 provinces, 9 
counties and 23 Ris in May. This assistance is aimed at enhancing the 
capacity of the service delivery points to provide adequate primary and 
emergency obstetric care.

With help from a visiting consultant from UNICEF, the logistics system 
for reproductive health commodities in DPRK was further reviewed. UNFPA 
intends to renovate warehouses to ensure adequate storage requirements 
and to start piloting the Logistics Management Information System (LMIS) 
system in Kangwon province, as a follow up to the LMIS training 
conducted by UNFPA last year, which includes introducing standardised 
national stock cards.

UNFPA supported a ten-day training course in Nanjing, China, on 
Behavioural Change Communication to officials from the MoPH, the Grand 
People's Study House, the Academy of Medical Science, and the Population 
Centre and Health Education Institute. This was particularly useful in 
addressing condom promotion in the DPRK and enhancing the counselling 
skills of service providers for UNPFA assistance.

A study visit in Laos and China on population policy, quality of care, 
informed choice and HIV/AIDs was organized by UNFPA for 3 officials from 
the National Coordination Committee (NCC) in April. For the challenges 
faced in the fight against HIV/AIDs, the mission concluded that the 
government should adopt national policies and regulations on HIV/AIDs 
prevention. National agencies will conduct publicity campaigns through 
the health system and other public organizations such as the Youth 
League and Womens League.

ADRA - Update

After postponing the Nutrition and Hygiene project funded by the German 
Government due to date changes and different seasonal needs, ADRA is 
working on a new proposal. This proposal is focusing on UNICEF's 
Nutritional Assessment 2004 Recommendations and County Hospital hygiene 
standards. ADRA has also submitted a proposal co-funded by ECHO and WHO, 
for the rehabilitation of 5 county hospitals (Sinhung, Jongpyong, 
Toksong, Hamhung, and Hwanjun). Further funding from Norway is under 
discussion for this programme.

Triangle - Update on the Support to the Elderly Programme (Donors: ECHO, 
OCHA, SDC, German Embassy)

The rehabilitation of three Old People's Homes is almost completed, 
providing more hygienic conditions and better care standards for the 
elderly. The renovation of the facilities included the complete overhaul 
of the water and heating systems, the rehabilitation of living rooms 
(insulation, new doors and windows), consultation rooms, kitchens, 
dining-rooms, bathrooms, laundry rooms, and an improvement for security 
and access to the buildings. Food security is expected to improve 
through the building of a greenhouse, the supply of machinery and small 
scale rabbit breeding activities.

On the capacity building side of the project, thanks to contacts 
established in China during the study tour last May, HelpAge members 
received training in survey methodologies. This session was provided by 
the director of the Institute of Gerontology of Beijing, an expert on 
surveys conducted with elderly populations. As the Central Statistics 
Bureau is supposed to be involved in any survey conducted in DPR Korea, 
five persons from this department also participated in this workshop. 
This training allowed the finalization of a questionnaire, the 
preparation of a booklet for the surveyors, the introduction to 
interview methodology and data analysis , and report drafting. This 
survey, planned for the 2nd part of 2005, aims to assess the living 
conditions and health situation of old age people, living both in urban 
and rural areas.

This survey is part of a new programme of support to old age people, 
proposed to ECHO and expected to start in July 2005. This programme will 
include the rehabilitation of three new Old People's Homes (Taesong in 
Pyongyang municipality, Munchon and Kosan in Kangwon province) as well 
as the strengthening of HelpAge DPRK capacities through the realization 
of a second study tour in China, the survey mentioned above and the 
co-management of the project. This new programme will also include a 
follow-up survey of the three current Old People's Homes in order to get 
a better assessment of the impact of the project on the health of the 
elderly.

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