I have two lasting memories of my two trips to North Korea. The first was visiting the obstetrics unit of a hospital near Wonsan on the eastern coast; it looked like a medieval torture chamber. The second was visiting numerous orphanages where 14-year-old children looked as if they were only eight because they were so malnourished.
The latest escalation of tension between North and South Korea can only mean that these impressions will become reality more frequently.
The North Korea aid program of the Catholic agency Caritas Internationalis, now managed on behalf of the Confederation by Caritas Corea of the South, began in the mid-1990s after the harvest was devastated by floods and many tens of thousands died of starvation.
For more than a decade, Caritas Australia contributed significantly to the response, funding more than $1.15 million worth of grass-roots nutrition and humanitarian projects.
The program was gradually built up to include not just food aid but agricultural inputs, equipment for health centres, and work with the elderly and disabled. The food aid was targeted for the poorest groups such as orphans. Now there is a hepatitis B campaign as part of the package.
North Korea is the most bizarre place I have ever visited. It has been run since 1948 by the Kim dynasty of Communist dictators.
The Kim family is deified. In primary school classes, little chairs surround a plastic model of where the founding father, Kim Il Sung and his son, Kim Jong-Il, were supposed to have been born. It looks like a crib scene from Bethlehem. No criticism of the family is tolerated and the people live in the most controlled state on Earth.
If roads need fixing, factory workers are drummed out of the factory on to the roads. Counties are regularly closed because of military manoeuvres or food shortages. Even the capital, Pyongyang, North Korea's 'showpiece', is largely devoid of traffic except pushbikes, and very few private shops are allowed.
The control extends to religion. There is a Catholic Church in Pyongyang and it holds a liturgical service each week and, when a priest is visiting, a Mass. Most parishioners are members of the government controlled Catholic Association and free