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A Small Problem Growing

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Times Staff Writer

At 16, Myung Bok is old enough to join the North Korean army. But you wouldn’t believe it from his appearance. The teenager stands 4 feet 7, about the size of an American sixth-grader.

Myung Bok escaped the communist North last summer to join his mother and younger sisters, who had fled to China earlier. When he arrived, 14-year-old sister Eun Hang didn’t recognize the scrawny little kid walking up the dirt path to their cottage in a village near the North Korean border. She hadn’t seen him in four years.

“He’s short. I can’t believe he used to be my big brother,” Eun Hang said sadly as she recalled their early childhood, when Myung Bok was always a full head taller. Now she can peek over the crown of his head without standing on her tiptoes.

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The teenagers go through an almost daily ritual: They stand against a wooden wardrobe in which they’ve carved notches with a penknife, hoping that by eating a regular diet Myung Bok will grow tall enough to reclaim his status as big brother.

They’re not the only ones obsessed with height. The short stature of North Koreans reflects an international humanitarian crisis -- one fraught with diplomatic and political overtones. It is at the heart of a debate in the international community over whether North Korea should continue to get food aid despite its quest for nuclear weapons.

The World Food Program and UNICEF reported last year that chronic malnutrition had left 42% of North Korean children stunted -- meaning their growth was seriously impaired, most likely permanently. An earlier report by the United Nations agencies warned that there was strong evidence that physical stunting could be accompanied by intellectual impairment.

South Korean anthropologists who measured North Korean refugees here in Yanji, a city 15 miles from the North Korean border, found that most of the teenage boys stood less than 5 feet tall and weighed less than 100 pounds. In contrast, the average 17-year-old South Korean boy is 5-foot-8, slightly shorter than an American boy of the same age.

The height disparities are stunning because Koreans were more or less the same size -- if anything, people in the North were slightly taller -- until the abrupt partitioning of the country after World War II. South Koreans, feasting on an increasingly Western-influenced diet, have been growing taller as their estranged countrymen have been shrinking through successive famines.

It is brutal proof of the old aphorism: You are what you eat.

“Human beings are really plastic. Features and size are not entirely racial, but are greatly affected by diet,” said Chung Byong Ho, a South Korean anthropologist who worked on the Yanji study, which was published in December in the academic publication Korea Journal. “We Koreans are genetically homogenous, but we are not really the same anymore.”

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Foreigners who get the chance to visit North Korea -- perhaps the most isolated country in the world -- are often confused about the age of children. Nine-year-olds are mistaken for kindergartners and soldiers for Boy Scouts.

“They all looked like dwarfs,” said Kim Dong Kyu, a South Korean academic who has made two trips to North Korea. “When I saw those soldiers, they looked like middle school students. I thought if they had to sling an M-1 rifle over their shoulders, it would drag to the ground.”

To the extent that they ever get to meet South Koreans, the North Koreans are likewise shocked. When two diminutive North Korean soldiers, ages 19 and 23, accidentally drifted into South Korea on a boat, one reportedly was overheard saying they would never be able to marry South Korean women because they were “too big for us,” according to an account in the book “The Two Koreas,” by Don Oberdorfer. The soldiers were repatriated to the North at their own request.

The North Koreans appear to be sensitive about their stature. In dealings with the outside world, the country likes to present a tall image by sending statuesque (by North Korean standards) athletes to joint sporting events in South Korea and elsewhere and assigning the tallest soldiers to patrol at the demilitarized zone that divides the countries.

Starting in the mid-1990s, North Korean leader Kim Jong Il (who reportedly wears elevator shoes to boost his 5-foot-3 height) ordered people to do special exercises designed to make them taller. As a result, it is not uncommon to see students hanging from rings or parallel bars for as long as 30 minutes. Basketball is also promoted as a national sport to instill the yearning for height.

“Grow taller!” instruct banners hung in some schoolyards, defectors and aid workers say.

Seok Young Hwan, a North Korean army doctor who defected to South Korea in 1998, said the Health Ministry also ordered government research institutes to investigate herbal remedies and vitamins believed to promote growth. One popular Chinese medicine distributed to soldiers and students is made of pine tree powder, another of calcium.

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“People are really fixated on what they need to do to make children grow,” Seok said.

It appears that none of these curatives has been effective -- although North Korea can boast of the world’s tallest basketball player, 7-foot-9 Li Myung Hoon, who is believed to have a pituitary imbalance. The North Korean military had so much difficulty finding tall enough recruits that it had to revoke its minimum height requirement of 5-foot-3. Many soldiers today are less than 5 feet tall, defectors say.

Height, however, is only the outward manifestation of the problem. The more troublesome aspect of stunting is the effect on health, stamina and intelligence.

“There is a difference between being naturally small because your parents are small. That’s not a problem,” Seok said. “But if you’re small because you weren’t able to eat as a child, you are bound to be less intelligent.”

The issue of IQ is sufficiently sensitive that the South Korean anthropologists studying refugee children in China have almost entirely avoided mentioning it in their published work in Korea Journal. But they say it is a major unspoken worry for South Koreans, who fear that they could inherit the burden of a seriously impaired generation if the Koreas are reunified.

“This is our nightmare,” anthropologist Chung said. “We don’t want to get into racial stereotyping or stigmatize North Koreans in any way. But we also worry about what happens if we are living together and we have this generation that was not well fed and well educated.”

About 500 North Korean children have come to South Korea, either alone or with their parents, and they are known to have difficulty keeping up in the school system, say people who work with defectors.

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Although South Korea gives defectors priority in going to the best universities in a form of affirmative action, about 80% have dropped out, Chung said.

“People assume that children are more adaptive than adults, but it is not always so. Famine is not just malnutrition, but often a long period in which education is disrupted,” Chung said. “South Korea is education hell. It is very competitive, and there is no way for them to catch up.”

Pak Sun Young, an anthropologist at Seoul National University who measured the children in China, said the height disparity alone would subject North Koreans to discrimination. “In almost every society, taller-than-average people are preferred. Short people have a harder time getting a job,” Pak said. “People already talk about how short North Koreans are. We are a very looks-conscious society.”

From an anthropological standpoint, the North Korea situation has attracted interest because it is, Pak said, the first documented case in which a homogeneous group of people has become so distinct because of nutrition and lifestyle.

Because North Korea is so secretive about statistics, it is difficult to quantify the height disparity between North and South. The anthropologists who worked in China caution that the 55 refugee children they measured are probably smaller than the children of elite party cadres in Pyongyang, the capital, who are better fed.

There is virtually no height difference among adults older than 40, who came of age at a time when the North’s economy was on a par with that of the South. The trouble is most acute with those younger than 20, who were in peak growth years during the mid-1990s, when North Korea experienced a famine that is believed to have killed 2 million people -- 10% of the population.

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Like almost everything else to do with North Korea, discussions of height are deeply wrapped up in politics. Conservatives -- in South Korea and the United States, among others -- who may prefer a change in leadership in North Korea point to residents’ shrinking stature as evidence of Kim’s failure.

“I just can’t respect anybody that would really let his people starve and shrink in size as a result of malnutrition,” President Bush told White House reporters in October.

Humanitarian agencies argue that more food aid is needed for North Korea to prevent the stunting of more children. North Korea’s pursuit of nuclear weapons has made the country unpopular with donors, who are faced with competing crises in Iraq and Afghanistan.

The World Food Program said this week that it had secured less than one-third of the 485,000 tons of food needed for North Korea this year and that it had been forced to cut off almost all its 6.5 million food aid recipients until April. Although more food is available at private markets because of economic reforms, the U.N. agency said, the prices are out of reach for most North Koreans.

Emergency intervention after the famine of the mid-1990s brought about a dramatic improvement, but the situation could rapidly reverse itself, experts warn.

“We’ve gone from seeing six out of 10 children to four out of 10 children stunted, but that is still, medically speaking, a crisis, and the gains are not irreversible,” said Masood Hyder, the U.N.’s humanitarian coordinator in Pyongyang.

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Another aspect of the problem is that children stunted through malnutrition can be permanently impaired even if the food supply improves.

Myung Bok, for example, comes from Chongjin on North Korea’s east coast, which was hit particularly hard by the famine.

Even afterward, the food supply was meager. Until he left in August, the teenager ate mostly corn porridge mixed with rice and an occasional cabbage leaf. He and his grandmother hunted for wild herbs and plants to supplement their diet.

“We had meat maybe once or twice a year for special occasions, like Kim Jong Il’s birthday,” said Myung Bok, a quiet boy who, for lack of other clothes, wears his sister’s pink stretch pants and a spangled sweater. “We never had milk that I can remember.”

Even by the standards of rural China, the family is poor. But they manage to eat rice and vegetables every day, meat three or four times a week. Fourteen-year-old Eun Hang has virtually caught up with other children her age since leaving North Korea when she was 10.

The prognosis for Myung Bok -- and millions like him still in North Korea -- is less certain.

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“There is catch-up growth in children who are malnourished. Boys can grow up to age 22, but they have to have access to good diet and healthcare,” said Judit Katona-Apte, a nutritionist with the World Food Program who is working on stunting issues in North Korea.

Anthropologist Pak was less encouraging.

“For North Korea as a whole, the situation could change in a generation. The people are genetically identical to us,” she said. “But for the individuals who are already short, there isn’t much to do. Usually by the time you are in your late teens, more calories won’t make you taller, only fatter.”

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