During the devastating famine that struck North Korea in the 1990s, families struggled to survive on severely limited food supplies, reliant on minimal rations provided through the state's Public Distribution system. One mother recounted breastfeeding her sick toddler due to the absence of alternative nourishment, questioning whether the leadership was still fulfilling its promise to care for its people.

Kathi Zellweger, who served as the North Korea country director for the Swiss Agency for Development and Cooperation and the Swiss Ministry of Foreign Affairs, made more than 75 humanitarian trips to the country during this period. Based in Pyongyang, Zellweger gained rare access to affected areas beyond the capital, which were largely off-limits to foreign journalists. Her unique position enabled her to witness firsthand the dire conditions hidden from much of the outside world, including scenes of emaciated children and severely impacted rural communities.

While state-organized events in Pyongyang projected an image of strength and stability, international aid workers like Zellweger saw the harsher reality. The North Korean government tightly controlled information and sought to conceal the full impact of the famine, which was further aggravated by widespread flooding in the summer of 1995. Zellweger described entire villages being obliterated by natural disasters, with just remnants such as a giant kimchi pot visible amid the destruction.

The severity of the crisis eventually compelled North Korea’s leadership to accept international humanitarian assistance to prevent further loss of life. Despite the profound hardships of that era, Zellweger noted signs of recovery and change in subsequent years. By the early 2000s, she observed the emergence of new economic and social dynamics within the country, including increased access to markets, mobile phones, motor vehicles, and a growing middle class—elements she encapsulated as the "5 Ms."

Moreover, during her final visits from 2006 to 2011, Zellweger identified a significant shift in the attitudes of younger North Koreans born during or after the famine. She added a sixth "M"—mindsets—to her list, reflecting how this generation, having experienced reduced governmental support, developed a mindset of self-reliance in navigating daily life.

Zellweger’s experiences underscore the complexity of North Korea’s transformation over recent decades, highlighting both the persistent challenges faced during times of crisis and the gradual social and economic changes that have followed.