On December 12 at the Atlantic Council, U.S. Secretary of State Rex Tillerson revealed the United States had assured China that in future North Korean “eventualities,” U.S. military forces moving into North Korea would later pull back south of the 38th parallel—which currently divides North and South Korea—thereby signaling a willingness to work with Beijing to reach an understanding regarding the future of the Korean Peninsula. Similarly, the political scientist Oriana Skylar Mastro, writing in this magazine, argued that “China is no longer wedded to North Korea’s survival” and may in fact wish to cooperate with the United States in the event of a crisis.

If the regime of North Korean Supreme Leader Kim Jong Un was to collapse, whether from internal problems or external force, one of the most pressing problems facing the United States, China, and South Korea—as well as one of the most promising avenues for cooperation—would be how to respond to the resulting humanitarian crisis. A collapse of the regime would likely exacerbate the chronic food shortages North Koreans have endured for 25 years and worsen the country’s problems with infectious disease and public health. This would in turn provoke mass population movements from North Korea into China. To prevent these large-scale refugee flows, the United States, China, and South Korea would need to work together to provide food, clean water, and basic medical treatment for the North Korean population.


Outside of its strategic concerns, including the prospect of a U.S.-allied, unified Korea on its border, China’s main worry in the event of a crisis is to prevent a massive influx of North Korean refugees, which would create a crisis of public order that could include rising crime rates, potential radicalization within the refugee camps, and destabilization of the large ethnic Korean community in China’s northeastern provinces. And since the principal reasons people move in times of crisis (other than to escape violence) are the threats of starvation and epidemic, providing the North Korean people with food security and public health would become a top priority for outside powers.

North Korea has been suffering from a serious food problem since the great famine of the 1990s.

North Korea has been suffering from a serious food problem since the great famine of the 1990s, which may have killed as many as 2.5 million people, according to estimates by Hwang Jang Yop, a former member of the North Korean Politburo who defected to South Korea. Food insecurity remains a major concern, even though modest agricultural reforms have increased production since their nadir at the height of the famine. For instance, despite North Korean claims that it produced a good harvest in 2017, evidence suggests otherwise. A severe drought from April to June damaged crops and was relieved by rains only in August. These rains were too late to save most of the harvest, and their severity destroyed many of those crops that survived the drought. A recent analysis by the US-Korea Institute at Johns Hopkins University said that based on satellite imagery from 2016 and 2017, “the early and mid-season drought will take a heavy toll on food crop production.”

During the peak of the famine of the 1990s, between one million and two million North Koreans moved in search of food, despite the existence of the regime’s travel permit system, which severely restricts people’s ability to leave their village or neighborhood. In the event of a regime collapse or other crisis, the resulting power vacuum could result in population movements on a far larger scale. North Korea’s deplorable public health conditions, which have led to high levels of infectious disease, only increase the pressure on ordinary people to move. In turn, large population movements have a number of ancillary consequences, including an increased risk of communicable disease outbreaks; higher mortality rates among children, pregnant women, and elderly people; violence against women; higher crime rates; and disrupted agricultural and industrial production as workers leave their places of employment.

Government officers work at a farm in Pyongyang as part of a labor festival, January 2018.
KCNA / Reuters

To prevent a humanitarian disaster, the United States and South Korea would have to improve food security on the ground, thus incentivizing North Koreans to stay in their neighborhoods and villages rather than move en masse toward the Chinese border. Doing so would require the swift delivery of food and health aid, as well as immediate efforts to treat contaminated village water supplies—one of the principal reasons for high mortality rates from infectious disease. Using coercive measures to prevent people at risk from moving during a crisis is a serious violation of international human rights law, but addressing the root causes of the mass population movements is a legitimate way to prevent a crisis from getting worse.

According to some estimates, the scale and logistics of such aid delivery would require from 115,000 to 400,000 troops in North Korean territory to stabilize the country, provide security to humanitarian organizations, and directly deliver food and medical supplies. Eliminating weapons of mass destruction and combating organized resistance by elements of North Korean state or society would require additional troops. Although South Korea will have primary responsibility for transitional operations on the Korean Peninsula, the scale of such a response makes it likely that substantial U.S. participation will be needed. Since around two-thirds of North Korea’s population lives within 50 miles of the coast, substantial food aid should be delivered through as many port cities as possible. Roads in the North Korean countryside are often unpaved or in disrepair and are inadequate for the heavy vehicle traffic needed to move large amounts of food across the country. If more food can be delivered through every smaller port along both coastlines, less will have to be delivered by road.

Such operations would bring South Korean and U.S. troops and ships into North Korean territory and closer to the Chinese border. They would thus require clear lines of communication with Beijing. But since timely aid to North Korea will reduce the flow of North Koreans into China—indeed, the Chinese themselves likely have contingency plans for intervention into North Korea in order to stem mass refugee flows—Beijing may be open to talks on humanitarian efforts. Coordination between the Chinese, South Koreans, and Americans would not only mitigate the chances for unwanted military escalation but also save North Korean lives.

The three countries, for instance, could plan to create a joint humanitarian operations center, a coordinating mechanism that has been successfully used in other crises, such as the Kosovo crisis in the 1990s. In these centers, South Korean, Chinese, and U.S. military representatives would continuously coordinate their humanitarian operations to prevent redundancy and conflicts with international nongovernmental organizations (NGOs) and UN agencies and share information on security problems. The U.S. Agency for International Development’s disaster management offices have extensive experience in managing these centers and could lead the American planning effort with the State Department and the U.S. military. UN humanitarian agencies and NGOs would join the operations center after the crisis started.

Coordination between the Chinese, South Koreans, and Americans would not only mitigate the chances for unwanted military escalation but also save North Korean lives.


Tillerson’s assurances to Beijing represent the start of an understanding on how to ameliorate the costs of a potential crisis on the Korean Peninsula. The U.S. commitment to return troops south of the 38th parallel reflects a calculation that the Chinese can live with U.S. forces south of the parallel in a post-Kim peninsula and that they will temporarily accept U.S. operations north of it on issues of shared interest, such as humanitarian aid and the seizure of weapons of mass destruction, including nuclear, biological, and chemical weapons. Assurances by themselves are unlikely to resolve Chinese suspicions regarding the movement of U.S. troops in North Korea. Repeated, public, and consistent announcements of the goal and temporary nature of such operations would nevertheless make it harder for skeptics to dismiss them.

We do not know how, or if, the Chinese might respond to a U.S. overture. Yet there is a level of inherent unpredictability to the timing of authoritarian breakdown, and signs point to Beijing taking the prospect seriously when it comes to North Korea. The Financial Times and The New York Times both reported in early December that the Chinese government is constructing refugee camps along the border with North Korea, anticipating a crisis that would lead to mass population movements. In his speech at the Atlantic Council on December 12, Tillerson also confirmed that the Chinese were preparing for a regime collapse, indicating that “the Chinese concern is about a mass flow of refugees across the border in the event of a regime collapse” and revealing that “China is taking steps to prepare for such an eventuality.”

China is no longer the staunch ally of North Korea that it once was. Beijing’s ongoing fears about the consequences of regime collapse have, however, made it either unwilling or unable to force North Korea to end its nuclear and missile programs. A concrete operational strategy to show Beijing that Washington and Seoul share its concern about the humanitarian and security consequences of such a collapse might address China’s fears and lead to greater cooperation among these three governments. From a purely humanitarian perspective, preventing a refugee crisis before it has a chance to take place is a prudent way forward: it would save North Korean lives. It could also contribute to resolving the nuclear crisis and prevent a deadly conflict on the peninsula. 

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  • JOONBUM BAE is Visiting Assitant Professor of Political Science at Hobart & William Smith Colleges. ANDREW NATSIOS is an Executive Professor at Texas A&M University’s Bush School of Government and Public Service and Director of its Scowcroft Institute of International Affairs.
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