Sovereignty, endurance, and the elusive search for humanitarian space in north Korea.

Pity the poor nongovernmental organizations trying to work in North Korea…It is, by all accounts, a lose-lose situation. 1 Brad Glosserman The Japan Times In this issue of Prehospital and Disaster Medicine, Yim, Choi, and Van Rooyen provide us with a unique glimpse into the sensitivities and complexities surrounding the delivery of humanitarian aid in North Korea and the compelling struggle that the humanitarian community must face to find the elusive humanitarian space. The lessons learned from this study are powerful testimony to the will of humanitarianism and the willingness of non-governmental organizations (NGOs) to patiently challenge what doubters saw only as Orwellian theater that had no good ending. The concept of " espace humanitaire " or " humanitarian space " ensures that the humanitarian community's actions for civilians exposed to extreme distress and caught up in war and conflict remain unencumbered and " free to evaluate needs, free to monitor the distribution and use of relief goods, and have a dialogue with the people who receive it. " It is a synonym term for a physical, geographical space that is protected from fighting and maintained as a " conducive humanitarian operating environment. " 2 Part and parcel of the work of the International Committee of the Red Cross, United Nations Children's Fund, and NGOs, is that their access and actions to protect civilians are uniquely protected under international law and covenants. Admittedly, the stated right of the humanitarian community to bypass governments , go directly to the beneficiaries in need, and operate free from unwarranted governmental interference or intrusion becomes an ideal that is more often than not challenged by nation-state authorities. Many see humanitarian space as a valid issue only in context of war and conflict, the examples of which are many. 2,3 Normally, NGOs work in failed states where the central authority has collapsed. Even in Afghanistan where aggressive violence takes place, donors and aid agencies that span the continuum between relief and every aspect of development, have insisted on their own assessments, monitoring, ongoing evaluation, and direct implementation of projects. Delivery of aid, in general, is a hazardous business and risks to relief workers during this decade have grown exponentially. Unconventional or asymmetrical warfare in Iraq and Afghanistan are just two examples where perpetrators, motivated by control of a population, leave everyone as a vulnerable target, resulting in a shrinking or absent humanitarian space. In Darfur …