Where famine stalks the land

World concern is focused on the health of North Korea's children

For more than five years, the people of North Korea have suffered a chronic food shortage, which is thought to have killed up to two million people.

Another five million, many already severely malnourished and susceptible to disease, are threatened with starvation, according to the United Nations.

North Korea is desperate for food

Many in the countryside are relying increasingly on an artificial food made from ground-up twigs, tree bark and leaves.

The mixture, which is compressed into dried noodles, is low in nutrition and can cause internal bleeding, dysentery and diarrhoea.

United States congressman Tony Hall, who was allowed rare access to rural areas in a recent visit to North Korea, says the humanitarian crisis could turn out to be one of the worst of the last 50 years.

Five million are at risk

Relief agencies estimate around two million people may have already died, but precise information is hard to obtain because of the closed and secretive nature of the regime.

Refugees who have escaped over the border to China say the world is only seeing a fraction of the suffering.

Others have reported in the past that food aid has been siphoned off by the military and government officials.

Roots of famine

In the past 50 years, North Korea has made much of its policy of Juche or self reliance, but despite the use of improved seeds, fertilisers and irrigation, it is still unable to feed itself.

Aid is arriving but is it reaching those who matter?

The current crisis is blamed on the centrally controlled economy, now on the verge of collapse, and a series of natural disasters.

Two successive years of floods in 1995 and 1996, followed by a typhoon and a drought in 1997 destroyed much of the country's crops and left hundreds of thousands of people homeless.

Earlier this year torrential rains and a typhoon swept across the west of the country causing an estimated $6bn worth of damage, according to the government.

But disasters such as these have also been blamed on Pyongyang's push for self-sufficiency.

For example, trees have been cut down to increase the amount of land available for agriculture, making vast areas of the country even more prone to flooding.

Food aid

The UN is appealing for nearly $400m in aid next year - four times the amount requested this year.

It has warned that five million people face starvation in North Korea unless foreign aid is dramatically increased.

But the worsening situation and calls for more aid create a dilemma for foreign governments.

Critics say providing too much aid will merely prolong the totalitarian regime.

Others fear a desperate North Korean Government might lash out with the considerable weaponry at its disposal.