Given the secrecy of the North Korean regime, it is unsurprising that contem- poraneous estimates of the death toll from the famine vary enormously. State- ments by North Korean officials in May 1999 and again in July 2001 offered an estimate of 220,000 famine-related deaths between 1995 and 1998, or roughly 1 percent of the population. Yet interviews with party defectors, including the highest-ranking official to leave the country, Hwang Jang Yo˘p, suggest internal estimates ranging from 1 to 2.5 million deaths. Outside observers, by contrast, have offered estimates as high as 3.5 million famine-related deaths, a staggering 16 percent of the population.
What can we say about these efforts to quantify the famine’s toll? The usual
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metric is “excess deaths”: the elevation in the mortality rate as a result of pre- mature death, inclusive of “births forgone,” or the drop in fertility that accom- panies a famine. Births forgone during famine are often at least partly offset by unusually high fertility once the famine has ended and normal conditions are reestablished; early or premature death is an obviously irreversible condition.
The first systematic attempt to quantify the demographic impact of the fam- ine came from the Good Friends researchers; their work formed the basis of many subsequent statements about the famine’s consequences. Extrapolating to the whole country, Good Friends and other commentators working from their survey produced estimates of famine-related deaths on the order 2.8 to 3.5 million (13 to 16 percent of the population).
Similar, though more methodologically rigorous work was subsequently conducted by a team from Johns Hopkins (Robinson et al. 1999). On the basis of 771 refugee interviews conducted in 1998 and 1999, this group recon- structed mortality rates for a single heavily affected province and concluded that between 1995 and 1997 nearly 12 percent of that province’s population had died. Projected across the whole country, this would yield excess deaths of 2.64 million. That figure is consistent with a number of often-cited estimates.
In 2003, for example, USAID administrator Andrew S. Natsios testified that
“2.5 million people, or 10 percent of the population” had died in the famine (Natsios 2003), a number roughly consonant with South Korean estimates as of 1999 (KINU 2004). On the basis of defector accounts, Médicins sans Frontières offered a still higher estimate, of 3.5 million deaths (Terry 2001).24
The high end of these estimates is almost certainly exaggerated. The precrisis population of North Korea was approximately 22 million, but some share of that population in fact faced little or no risk of starvation, even if individuals may have experienced food shortages and even hunger. We do not know the size of this elite, and we have refugee evidence of malnutrition in the army as we have noted. But if we assume a privileged or protected share of the popula- tion of 4 million—roughly equal to but not coterminus with the populations of the armed forces (about 1 million) and Pyongyang (around 3 million)—this would leave a total nonprivileged or “exposed” population of around 18 mil- lion people.
The work of Robinson and his collaborators implies an excess mortality rate of roughly 12 percent for refugees coming from the most severely affect northeastern provinces, an estimate that the team then used to calculate excess for mortality for North Hamgyo˘ng Province as a whole. Even applying this mortality rate to an entire province is questionable if we assume that refu- gees reflect a particularly affected part of the population. If we nonetheless
The Distribution of Misery 75 apply the 12 percent figure to the total “exposed” population of 18 million, it yields a figure of just over two million excess deaths. In our view, this number has to be considered the absolute upper estimate. The reason is as follows: If one accepts the Robinson et al. estimate of 245,000 excess deaths for North Hamgyo˘ng Province out of a precrisis population of approximately 2 million, the Natsios statement implies that there must have been roughly 2.25 mil- lion deaths among the remaining 16 million “exposed” population, implying an excess mortality rate of 14 percent. Such a mortality rate would be higher for the country as a whole—fully 15 percent higher—than what Robinson et al. calculated for what was, by consensus, the worst affected province. This extrapolation is not plausible.
Two accounts that have attempted to take a somewhat more systematic approach to calculating excess deaths also come to somewhat lower estimates of total excess deaths. Taking 1994 as the base, Daniel Goodkind and Lorraine West (2001) use an age-specific death-rate model and official DPRK statis- tics on crude death rates to arrive at an estimate of excess deaths of 236,900 between 1995 and 2000. Using the same model with the much higher mortal- ity rates implied by the Robinson et al. interviews generated an estimate of 2.6 million excess deaths over the same period—a figure more than ten times the estimate derived from the official statistics. Of all the alternative estimates reviewed by Goodkind and West, they prefer those based on data from the 1998 WFP nutritional survey and calibrated with crude death rates for the period of China’s Great Leap Forward. This approach yields excess deaths for the period 1994–2000 of about 1 million based on the Chinese death rates, and 605,000 adjusted for nutritional status from the 1998 WFP survey.
A problem with the Goodkind and West study is that they date the start of the famine to 1995, using 1994 as a baseline for their calculations. Suk Lee’s careful analysis of official statistics finds (2003), however, that mortality was already elevated in 1994. Also using a gender- and age-specific model of death rates, Lee estimates that between January 1, 1994, and August 31, 1999, North Korea experienced 668,000 excess deaths. Lee ignores population loss stem- ming from refugee flows into China, and, as a consequence, his analysis may wrongly include these as famine-related deaths. But from what we know of the collapse of the economy, declining agricultural production, and anecdotal evidence from refugee interviews, Lee is almost certainly right that the fam- ine started in 1994. If so, then the estimates by Goodkind and West probably underestimate its impact.
Both Goodkind and West, as well as Lee, assume that fertility rates remained unchanged and hence do not consider births forgone as part of the famine’s
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demographic toll. This assumption is probably more defensible than it might appear at first glance. The Good Friends interviews document a decline in fer- tility, but the analysis of other famines has suggested that this drop in fertility is typically offset by a subsequent rise in fertility when the crisis passes.
There is still much we don’t know about the demographic effects of the North Korean famine. Moreover, the excess deaths are just one summary mea- sure of the famine’s costs. Such statistics do not capture the long-run devel- opmental effects of early childhood stunting, not to mention the wide-rang- ing social consequences of the food shortage, from the breakup of families to human trafficking, prostitution, and crime born of desperation. Nonetheless, in our view, the most sophisticated attempts to measure excess deaths put them in a range of roughly 600,000 to 1 million, or approximately 3 to 5 percent of the precrisis population.
Conclusion
In chapter 2, we took a broad approach to the famine by looking at overall food availability. In this chapter, we complemented that approach by consider- ing in more detail the question of distribution and entitlements, including the question of who perished and how. We paid particular attention to the regional dimensions of the famine and its impact on the urban working classes in the industrial cities of the east coast. Yet perhaps the most important point to emerge from this overview is not the differences across groups—as important and fateful as those proved to be—but the systemic nature of the crisis. In the mid-1990s, the most fundamental component of the socialist social compact—
the ability of the government to guarantee adequate food—broke down. This compact had been strained by food shortages and possibly by localized famine before. But the famine of the mid-1990s and the subsequent persistence of shortages were something altogether new: a chronic and generalized breakdown of the food distribution system. In chapter 7, we return to the long-run impact of this change. But before doing so we turn to a more detailed consideration of the aid effort, which after 1996 became a central pillar—arguably even the mainstay—of the ability of the government to provide food at all.