Food is never plentiful in North Korea, but the current situation has grown so bad that the country risks a return to famine, aid workers say.
Food rations have been cut, economic reforms have sent prices soaring, and as a nuclear crisis grinds on, the country's main donors have cut back.
"It is very much a crisis already... Of much bigger proportions than we have had in recent years," said Gerald Bourke, spokesman for the UN's World Food Program (WFP).
North Korea struggles to feed itself due to a mixture of geography and economic policy. Photographs which depict a lush, rural environment are misleading. The country needs an average of 1million tons in food aid a year.
"North Korea is not an agrarian country," said Kathi Zellweger, a frequent visitor to the country with aid organization Caritas. It is mostly rugged mountain terrain, and only about 18% is arable.
It is dependent on fertilizer and machinery to make that land productive, both of which are expensive.
Politics compounds topography. Agriculture in North Korea was collectivized in the 1950s, in line with its Stalinist philosophy of self-reliance.
"If their farm produces five times as much, they don't get five times as much food," Paul French, a writer on North Korea says. “Instead, they concentrate on their own private plots, which they use to feed themselves and to produce food for the markets.
Market reforms, instituted in 2002, have sent prices soaring at a higher rate than wages. "Who can afford this stuff in the markets?" asked Mr French.
The answer: only the elite. Government officials, senior managers of state enterprises, security forces, and the leadership of the army are all unlikely to go hungry.
But a typical urban family can now only afford to buy 4kg of maize — the cheapest commodity — a month.
The WFP estimates that an average urban North Korean's guaranteed diet is around 280 grams of cereals a day. The internationally recommended minimum is 550-590 grams a day, provided this is nutritionally balanced. But dietary balance is difficult to achieve in North Korea, where foodstuffs such as oil are prohibitively expensive.
"The rural folk have already learned how to cope," said Tim Peters, director of aid agency Helping Hands Korea. "But the urban people are so dependent on the government for distribution."
And there is always the risk of natural disaster.
Floods exacerbated the extreme food shortages 10 years ago, and North Korea's ability to cope with them "is now probably worse," said Mr French.
[Excerpts from article by Sarah Buckley, Seoul Times]