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North Korea has begun accepting international aid to help it combat the spread of COVID-19, but its border with China remains tightly sealed, experts and observers told RFA.

The World Health Organization (WHO) has started sending shipments of medical supplies to North Korea through the Chinese port city of Dalian, it said in its most recent weekly report for South and East Asia, which covered the week of Sept. 20 to 26.

The supplies had been stranded in China since the start of the pandemic in January 2020, when Pyongyang and Beijing closed the Sino-Korean border and suspended all trade, the WHO’s representative to North Korea, Edwin Salvador, told RFA’s Korean Service Thursday.

A few months ago, UN agencies were informed by the Ministry of Public Health that they would allow some of these items stranded in China to be transported to DPR Korea through Dalian seaport,” Salvador said

“Consequently, WHO was able to transport some of the items by ship to Nampo seaport. We are informed that these items along with the other items from the other UN agencies, remain under quarantine,” he said.

The border closure has proven disastrous for the North Korean economy, as China accounts for more than 90 percent of North Korea’s trade and much of the country’s economic activity revolves around the purchase and sale of goods from its northern neighbor.

Without Sino-Korean trade, commerce in entire North Korean towns has dried up, and ships sit idle in port rusting from disuse.

The UN’s Food and Agriculture Organization estimated in a recent report that North Korea would be short about 860,000 tons of food this year, about two months of normal demand.

With the border closed, food from China cannot bridge the gap. Starvation deaths have been reported, and if the border does not reopen soon, North Korea could descend into a food crisis similar to the 1994-1998 famine that killed millions, or as much as 10 percent of the population by some estimates.

Pyongyang’s plans to eventually reopen the border have nothing to do with it allowing shipments of medical supplies from the WHO, Ahn Kyungsoo, head of the South Korea-based, told RFA’s Korean Service.

“Ultimately North Korea must first get a vaccine. In fact, a complete border opening will be possible only when there is a certain amount of herd immunity,” said Ahn.

Gavi, the Vaccine Alliance, said on Thursday that there are “no updates at this stage” in response to RFA’s inquiry about support for COVID-19 vaccine in North Korea. 

Pyongyang surprised observers last month when it turned down Beijing’s offer of about three million doses of China’s Sinovac vaccine.

Britain’s former ambassador to North Korea pointed out to RFA that North Korea has allowed isolated shipments of goods during the pandemic.

“The fact that it is reported in this case to be doing so again does not necessarily indicate or presage any more general opening on its border,” said Alastair Morgan, who was stationed in Pyongyang between 2015 and 2018.

But the shipment could indicate the beginning of a gradual reopening, according to Ramon Pacheco Pardo, Korea Chair at Vrije Universiteit Brussel.

“I believe that Pyongyang will continue to reopen before the winter arrives. Then the Kim regime will have the opportunity to decide whether it wants to close the border during the winter and start to fully re-open from the spring, or whether the regime feels that it is safe to carry on reopening,” he said.

“I think that North Korea will need to be satisfied that the new COVID-19 strains are weaker than previous ones. It will also need to start receiving vaccines so that at least the regime feels that it is safe for its people to meet with others,” said Pacheco Pardo.

A spokesperson for UNICEF told RFA that it was also able to move essential health supplies into North Korea, but not in significant amounts.

Other organizations have reported difficulty in sending aid to North Korea.

The Norwegian Red Cross told RFA last month that it was preparing to provide aid to North Korea, but it was unable to provide in-kind assistance. 

First Steps Health Society, a support group for North Korea located in Vancouver said in a newsletter last month that the import of aid materials to North Korea was still suspended. 

The Canadian group voiced concern that some of its supplies in Dalian were perishable and would go to waste if not shipped soon.

North Korea still claims that it is completely virus-free and has not reported a single confirmed case of the coronavirus. 

Observers doubt the claim, citing costly quarantine measures and reports that hospitals isolate “suspected cases,” while those who die of suspected symptoms are quickly cremated before COVID-19 can be confirmed as the cause of death.

Reported by Jeongeun Ji for RFA’s Korean Service. Translated by Leejin Jun. Written in English by Eugene Whong.

This content originally appeared on Radio Free Asia and was authored by Radio Free Asia.