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PYONGYANG, North Korea — Millions of North Korean children are not getting the food, medicine or health care they need to develop physically or mentally, leaving many stunted and malnourished, the United Nations said Tuesday.

Nearly a third of children under age 5 show signs of stunting, particularly in rural areas where food is scarce. Chronic diarrhea because of a lack of clean water, sanitation and electricity has become the leading cause of death among children, the agency said. Hospitals are spotless but bare; few have running water or power, and drugs and medicine are in short supply, the agency said in a detailed update on the humanitarian situation in North Korea.

The report paints a horrific picture of deprivation in the countryside, not often seen by outsiders. The report provides not only further evidence of North Korea’s inability to feed its people but also bolsters critics who say the government should be spending on food security instead of building up its military, testing rockets and pursuing a nuclear program denounced by the U.N., the United States and South Korea.

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