Why feed the cadres first?

When Medecins Sans Frontiers announced this week (last week) that they were pulling their "doctors without borders" operations out of North Korea, what it meant was that they were being kicked out. According to MSF, the North Korean government told the relief agency that its services were no longer needed on the front lines of the nation's war against hunger and disease.

Foreign observers in North Korea have reported that much of the food donated from overseas ends up being diverted to the military, and North Korean refugees say that only party cadres and others with political connections receive full food rations from the central distribution system.

Outside famine fundraising efforts, Pyongyang seems uninterested in the health of adults as well. MSF has been told that its doctors are unwelcome in the provinces, for instance. This despite the fact that MSF says abortions and other surgical procedures are being performed with no anesthetic, antiseptic, or even gloves. In one case, household scissors were used to perform an appendectomy, with an old beer bottle serving as an I.V. drip.

If North Korean leaders are not already ashamed by their own actions, then there is nothing anyone else can say or do that will make them so. The only leverage the international community has is the promise of more aid. If it is to be effective, this leverage must be used well. The first step is recognizing that there is no point in sending any kind of material relief to North Korea that is not accompanied by strict conditions -- in particular, for independent monitoring of how this aid is distributed.

-- The Asian Wall Street, Singapore