This scene sums up the bizarre and gruesome situation in North Korea today. Hunger and disease are so commonplace that they are hardly subjects for concern. Yet, the ruling Communists are loath to allow outsiders see what is happening as a consequence of their disastrous policies.
Nevertheless the disaster is so all encompassing that the regime which allegedly follows the late dictator Kim Il Sung's "Juche Idea" of self reliance has been forced to seek outside help. As a result, the World Food Programme is now distributing more food in Korea than anywhere else in the world. Around a quarter of the population, including all children under seven, are fed by international agencies.
The economy has ground to a virtual halt. An estimated 80 per cent of industry has fallen into disuse. The rest, according to the United Nations Development Programme (UNDP) is "very simple and basic".
Asked to give details of shortages North Korea suffers, a government official says simply: "Everything".
Even in the capital Pyongyang, which has been sheltered from the worst ravages, the population shuffles around the streets in threadbare clothing. Food stores are empty, aside from bottles of water, some soya sauce and, occasionally, some dubious-looking tins of canned food. Even the showpiece underground railway system has descended into gloom, as there is not enough power to create more than a trickle of light in the rundown carriages.
In the streets, some people carry knapsacks containing their last items of value, which might be bartered for food, shoes or another necessity.
Everyday the citizens of Pyongyang dutifully report to their offices and factories. They attend air raid drills and propaganda sessions where the endless slogans of the Great Leader Kim Il Sung, are screeched out, but there is no work for them to do, no power to turn on the machines, no supplies to turn into goods.
Only the bureaucrats are occupied, pushing grey pieces of paper from desk to desk. One day a week, office and factory workers are sent to the fields in the hope that throwing manpower at the problem of food shortage will somehow overcome it.
The food ration in Pyongyang is about 400 grams of food per day, outside it is as low as 100 grams, about enough for a bowl of rice or maize per person per day.
A slow seven-hour train journey from the capital to the Chinese border offers a panorama of a country receding into the kind of dire poverty normally seen during a civil war. Buildings are crumbling, while the rolling stock littering the side of the tracks is rusted or covered in weeds.
Most people are abnormally thin, though not skeletal. Only the soldiers, with stubby semi-automatic rifles hanging off their shoulders, seem to have clothes in good condition.
The obsessive secrecy which is part of everyday life in North Korea, is reinforced by fear that the world will see just how bad things are in the state where, according to Kim Il Sung, "the sun is more glorious".
"These people are great at building Potemkin villages", said a senior official working for an international aid agency, referring to the phony villages erected in Russia to please the eye of Catherine the Great.
Willi Scholl, the deputy resident representative of the UNDP in Pyongyang, describes the country as being gripped by "a silent famine".
Yet it cannot be hidden. Although the authorities closely supervise foreigners, they are still able to bring out details which, together, paint a horrifying picture.
In July, the Christian charity World Vision sent Dr Milton Amayun to measure children in the centres it is running. He found 30 per cent were severely malnourished, while only 15 per cent showed no signs of malnutrition. A West European ambassador emerged in a distressed state from visiting an orphanage where the children were little more than skin and bones. The North Koreans, however, were appalled when an aid agency, trying to raise money, published pictures of severely malnourished children.
"They don't want to admit to the world that their people are starving," says Watt Santatiwat, World Vision's vice president for the Asia-Pacific region. "It's against the very nature of their culture to admit they need help."
His colleague Dave Toycen, who heads the Canadian section of the organisation, says North Korea "is facing the question of whether you are going to save face or save lives".
After more than two years of unusually bad floods and droughts, the question remains unanswered. At the beginning of the week the biggest ever delegation of US Congressmen visited the country to be told that aid would not be bartered for changes to the system. "They refuse to abandon their centralised political and economic systems," said a US official.
The Koreans are uncomfortable with the modest influx of foreigners asking questions, most of which their officials cannot or will not answer. And some matters cannot be questioned. Power is, found to keep the exhibition of gifts to the Great and Dear Leaders (Kim il Sung and his son Kim Jong Il) properly chilled.
The party elite need not worry about hunger. They flash through the streets of the capital in sparkling German and Japanese cars, secure in the knowledge that they are their families will be well cared for.
At the Kim Song Ju creche in Pyongyang the children of the party elite provide a showcase for visitors. Comfortable in the kind of air-conditioned surroundings which do not extend to ordinary hospitals, the 400 children enjoy use of a lavishly equipped playground, exercise room and plastic paradise of animals and plants, described by Pak Ryon Sil, the deputy head of the creche, as a "nature room".
Clearly used to the attention, the well-fed children put on performances for visitors. Most involve chanting or signing the praises of the Great Leader, or the Dear Leader. Dressed as if they are about to go a Western middle-class children's party in the 1950s they put on their little songs. On closer examination it turns out that the lips of both boys and girls have been smeared with lipstick.
But crude reality has a habit of poking its nose in when least expected. The Workers' Party newspaper, the Rodong Sinmun, told its readers last week that they were facing the "Third Arduous March". The newspaper compared this march to the first, which took place during the struggle against Korea's Japanese colonisers and the second, in the aftermath of the 1950- 53 Korean War, when the ruling party in the now divided Korea was purged of "reactionaries and splitists".
The people are urged to go the countryside to cut down weeds and make compost, under the rallying slogan of "The pile of compost is a pile of rice". Under the guidance of the party, they are assured, "the last charge of the arduous march" will result in victory.
To foreign eyes the bilge churned out by the propaganda machine seems pathetic and unbelievable, yet there is no outward sign that the regime is facing a challenge. Even stories of marauding peasants roaming the country looking for food are wide of the mark, says Mr Scholl, who points out that all movement is under strict control.
He says the regime insists it needs only two years of normal weather and everything will be fine.
Fundamental economic reforms are required, though there are few signs of any taking place. One of the few foreigners in Pyongyang who expresses any optimism is Keith Chiddy, a Briton who runs one of the only two Western financial institutions in the country, the ING Bank.
"This is a more sophisticated country than you realise," he says. "They are still doing business, there is no corruption and there is money here."
The smallest hints of reform are seen in the street markets where farmers sell food from their private lots. State corporations are encouraged to compete with one another.
It is impossible to believe these moves could solve the crisis. The North Koreans seem to possess a peculiar ability to endure the most adverse conditions. This endurance will be put to even more arduous test in coming months.
n This is the first of a three-part series by Stephen Vines, reporting from Communist North Korea.Reuse content