REPUBLIC OF KOREA (DPRK) By Mayling Chan

Democratic People’s Republic of Korea (DPRK) is prone to consecutive droughts and floods which have a significant impact on food security and public health. The most serious flood in the recent history of the DPRK in 1995–96 resulted in a drastic drop of food availability in domestic production.

The total domestic cereal production decreased by more than three times compared to 1993.

According to the officials in the Academy of Agricultural Science, DPRK is not accustomed to droughts but floods. However, this trend is changing. An extended period of abnormally dry spells, the worst in 100 years according to the government, started in early summer 2014 and continued into 2015, resulting in a drought that set back agricultural production and water avail-ability. The combined impact has led to a deterioration in nutrition, health and sanitary conditions, with increasing cases of water- borne and other diseases detected in local clinics according to WHO. In total, it is reported that at least 70% of the country’s population are vulnerable to fluctuations in crop pro-duction (United Nations Office for the Coordination of Humanitarian Affairs [OCHA], 2015, July 1).

Source: World Wide Fund and American National Red Cross (2010).

FIGURE 3.7 Logistics

Photo by CCOUC. All rights reserved.

TABLE 3.3 (Continued)

Adverse psychological and social behaviour

The health and well- being of an individual are affected by not only physical risk factors but also the mental and social factors which surround him/her. Psychosocial health refers to psychological and social factors that infl uence our health. It con-sists of: spiritual health (being), emotional health (feeling), mental health (thinking)

Building up resilience in the DPRK to food insecurity is challenging in the face of consecutive floods and droughts. The country also has natural con-straints, such as the fact that sunlight is only available for six months annually, and arable land only amounts to 0.07 hectare per capita.

At the national level, the government has researched drought- resistant seeds, which could adapt to the changing climate, in order to mitigate the impact of extreme dry weather on crop growth. They have a dual strategy of engaging the Academy of Agricultural Science (a research- based national organisation) in an advisory role and quickly disseminating information and applying new systems through the Ministry of Agriculture. Applications could take place in extended fields and are spread through a hierarchical dissemi-nation system from dissemi-national to provincial to county level. For instance, new seeds have passed the experimental test and been certified for use in the past few years for the purpose of mitigating the negative consequences of droughts. In some areas, farm leaders are advised to grow more maize than rice as the latter is more sensitive to water shortage. Adaptation can be effec-tive in this manner.

Having these measures at the national level for mitigation is a positive step.

However, farmers are organised in a work teams’ and sub- work teams’ man-agement system of collective farming to carry out centralised plans. In these large farms, some of them spanning more than 1,000 hectares of land, there is little scope for adapting necessary strategies at an individual level to cope with the consequences of floods and droughts. It is not easy to switch to other crops in a short period of time when farm inputs are centrally distributed rather than available in free markets as in other countries. Nevertheless, in recent years, the household kitchen garden has become tremendously impor-tant for food diversification in the DPRK. In times of natural disaster, this could be an effective means for farmers to remain resilient, as observed by Oxfam in its project sites in South and North Pyongan provinces. Oxfam has supported more sustainable farm practices as a strategy to overcome difficulties posed by natural disasters. By avoiding “putting all the eggs in one basket”, and diversifying into a number of grain and vegetable crops, farmers can adapt better in periods of difficulty.

Source: Oxfam Hong Kong (n.d.).

and social health (relating). As described by the biopsychosocial model of mental disorder (Kinderman, 2005; See Figure 3.8 ), psychological and social problems may be the result of a combination of biological factors, social factors and circumstantial factors through mediating psychological processes.

After a disaster, survivors may suffer from adverse mental health after witness-ing or gowitness-ing through traumatiswitness-ing events. Apart from direct physical injuries, people may experience drastic changes in their socio- environmental determinants (Carballo, Heal, & Horbaty, 2006), such as the loss of loved ones, housing and property.

Factors which affect mental health outcomes include: physiological and mental statuses before disaster; increased stress as well as feelings of powerlessness due to bereavement; loss of property and loss of livelihood; mental health problems, such as post- traumatic stress disorder, depression and anxiety disorder; the scarcity of basic provisions and disruptions to the economy; destruction of social networks; the breakdown of law enforcement; and the cessation of violence prevention and other social support programmes.

Violence is not associated with all types of disaster. The risk of violence increases with physiological traumas (e.g. brain damage), behaviours (e.g. drug and alcohol addiction), distress responses (e.g. fear and a sense of helplessness) and breakdown of social networks and legal system (WHO, 2002). There are a few types of violence that have been shown to increase after some disasters, including abuse and neglect, inti-mate partner violence, sexual violence, exploitation and traffi cking (in areas where traffi cking is already prominent). These acts of violence may also induce other health and social- related consequences. For example, sexual violence may lead to unwanted pregnancy, transmission of HIV/AIDS and suicide (WHO, 2005). Meanwhile, the prevailing myth of excessive post- disaster violence and cities becoming “a burglar’s paradise” has not been supported by any empirical evidence. In her article “The Myth of Disaster Looting”, Katy Welter (2012), a law and policy analyst for the Chicago Appleseed Fund for Justice, discusses the exaggeration of media reports on looting in disaster- affected communities (see Chapter 6 for further discussion on mental health).

FIGURE 3.8 Biopsychosocial model of mental disorder Source: Adapted from Kinderman (2005).

Long- term consequences

Few published studies have examined the long- term impact and recovery chal-lenges in disaster- affected communities. Most published studies focus on the reporting and documentation of excess deaths and morbidities in the early phase of disasters and only few published studies have examined the long- term impact and recovery challenges in disaster- affected communities. Much like the short- term impact of disasters, the long- term health effects vary according to the type of disaster, its duration and the affected area. Disasters may change the social- demographic make- up of a community. For example, a disproportionally high number of orphans and widows has signifi cant implications on long- term popula-tion planning and welfare spending.

Long- term consequences of disasters not only affect individuals but also can be felt at the community and country level. Excess cases of cancers, infertility, adverse pregnancy outcomes and birth defects were also observed after the atomic bomb-ings of Hiroshima and Nagasaki of Japan and the Chernobyl accident in the former U.S.S.R. Within the internally displaced communities in Bosnia, common medical problems included chronic and psychological illnesses. The long- term conse-quences on the country’s economy will be discussed in the next section.

In summary, the impact of disasters can be understood through the three main dimensions in health – physical, mental and social well- being. As health is a result of a combination of modifi able and non- modifi able determinants that exist across the intrapersonal, interpersonal, community/institutional and macro public- policy realms, multi- dimensional risk factors and their potential consequences should be considered.

Economic consequences of disasters

The public health impact and needs after natural disasters vary according to disaster type, magnitude of the event, as well as the sociodemographic and epidemiological risk factors associated with the affected communities.

Regardless of the type of disaster event, any disaster can leave economic conse-quences that may linger for years. Disaster losses manifest themselves in numerous ways and it is immensely diffi cult to measure them with great accuracy. Direct losses are those resulting from building, lifeline and infrastructure damages, while indirect losses are those lost as a result of the physical damage, such as reduced tourism, disrupted service provision and decreased productivity (Hallegatte &

Przyluski, 2010). In contrast, costs refer to resources required to undertake replacement, repairs and reinforcement of the tangible assets that are destroyed.

Recent trends of economic impact from disasters

Evidence suggests that disasters can affect the economy at the national level by hampering the gross domestic product (GDP) for a short period. A study of 35 disaster events in in Latin America and the Caribbean from 1980 to 1996 identifi ed a decline of GDP in 28 cases in the year of the disaster’s occurrence and a sharp increase two years after the disaster (Charvériat, 2000).

How natural hazards affect the country’s economic condition

The vulnerability of a country’s economy to natural hazards depends on many factors.

Although detailed discussion of this important topic is beyond the scope of this book, fi ve factors which are related to health systems and their resilience to the impact of disasters need to be highlighted: (1) Type of natural hazards . For example, hydro- meteorological hazards can affect agricultural performance, particularly in countries which rely heavily on agriculture. (2) Economic structure . It may affect a system’s productivity, the diversity and competition between sectors, and the nature of produc-tive capital, which in turn can affect the community’s ability to bounce back after a disaster. For instance, the Dominican Republic, which traditionally based its economy on its banana plantation industry, would have suffered enormous setbacks due to the increased frequency and intensity of disasters affecting its agricultural industry. But, in recent years, the country developed a diversifi ed economic setup with industries that are less dependent on the climate, which means it has a stronger capability to recover.

(3) Geographic size of a country and its hazard distributions . For very small countries, the hazards may be countrywide, whereas for larger countries, the hazards may affect only certain parts of the country. (4) A country’s socio- economic development . Although absolute economic loss in developing countries may be small when compared with developed countries, disasters may disrupt the whole economy of the country. (5) The prevailing socio- economic conditions . For example, the economic policy, price fl uctuation and market regulation may have an important role in lessening or exacerbating the impact of a disaster (see Case Box 3.4).

In summary, the economic impact of a disaster may imply additional expenditure or reallocation of fi nancial resources to repair or rebuild public infrastructure. This may lead to the abandonment of ongoing or planned projects and reduce the provi-sion of public services. On the positive side, acknowledging the possible economic impact would help the country to prepare special budgets allocated for disaster mitigation, preparedness and rehabilitation, reducing the potential consequences.

CASE BOX 3.4 ECONOMIC IMPACT OF DISASTERS