A Danish aid group is getting a rare look at the food situation in North Korea, and it says the conditions there are desperate.

The managing director of the group Mission East, Kim Hartzner, told VOA Friday that during the past week he oversaw the distribution of food aid in the city of Haeju , and that never before had he seen malnutrition so severe.

“I’m a medical doctor and in my 21 years of being engaged in relief activities I have never ever seen something as what I saw in Haeju.”

He said some of the 218 children he saw in one facility will die if they do not receive food assistance.

“I saw children sitting in groups, some 50 children that were marred by long-term malnourishment, malnutrition, some children that were with extended bellies, as in very severe protein deficiency, with extremely thin limbs, with skin sort of hanging in layers due to the lack of muscles, with total listless expressions, apathetic expressions. Some of them were rocking due to psychological under-stimulation, some were crying out, most of them were sitting absolutely numb, listless without any facial expression whatsoever. I saw a 4-year-old girl who looked like a one and-a-half year-old-girl, who could barely walk.”

Hartzner said he saw no irrigation systems where he was in North Korea. He said longs lines of people with water buckets were transporting water from the river to nearby maize fields.

The aid group director said rice supplies are still available in most of the areas he visited, but that in some places the rice has already run out.

“And that is very critical because then there’s no rice until the end of November.”

Mission East is providing 12 tons of food aid to 20,000 children and 1,500 pregnant women in Haeju for three months. The aid group is distributing the food mostly to nurseries, kindergartens and orphanages.

The group says an estimated 1 million North Koreans died from hunger in the 1990s, and says it is worried that a similar situation may take place again.

In a report last month, the United Nations said 16 million North Koreans are suffering from chronic food insecurity, high malnutrition rates, and deep-rooted economic problems. It said undernourished children are particularly at risk, with nearly one-third of children under five showing signs of stunting, and hundreds more dying from preventable conditions such as diarrhea.