David Austin is one of the few outsiders who has seen firsthand how people live in the North Korean countryside, and he describes a population "lethargic" from malnutrition.
Just two weeks ago, he visited an orphanage as part of his work as the North Korea programme director for the relief organisation Mercy Corps.
He said the last protein children had eaten was in January -- eggs.
"That tells us not only are they not getting a balanced diet but in terms of the rations, they're getting only about 60% of what a child needs," he said.
Austin describes widespread severe malnourishment and "an entire generation" that is "stunted physically, developmentally because of chronic malnutrition."
According to Austin, in seven visits since 2007, he has been to dozens of orphanages and hospitals and more than 19 private homes...
..."We know there is a need and we know we can met the need. As a humanitarian organisation we are saying there is an opportunity to do that," Austin said. "I don't want to assign blame. But I'm saying there is an opportunity to engage positively and constructively with a group of people the White House describes as innocent and starving, and we can do that."