Washington (CNN) -- 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 program director for the relief organization 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."
No sign of North Korean rocket launch
According to Austin, in seven visits since 2007, he has been to dozens of orphanages and hospitals and more than 19 private homes.
Factfile: North Korea
North Korean citizens bow before the portraits of the founding father Kim Il-Sung, left, and his son Kim Jong-Il, in Pyongyang, North Korea on Monday, April 9, 2012. April 15 marked the 100-year anniversary of the founder's birth and journalists were allowed inside the country.
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He says he is troubled that the United States plans to call off a massive shipment of food aid as a result of the anticipated rocket launch by North Korea between now and Monday.
Pyongyang insists that the rocket is necessary to put a weather satellite in orbit, but Washington and Seoul consider it a ballistic missile test in disguise. Such launches by North Korea breach U.N. Security Council resolutions.
Under a recent food deal with the United States, North Korea agreed to refrain from long range missile launches and nuclear tests. In exchange, the United States would provide what Austin described as a year's worth of corn-soy porridge mixed with vegetable oil for children younger than 10 and pregnant women.
The food "wouldn't taste delicious but it saves lives," Austin said, noting that it would have helped 2.4 million people.
At the White House, President Barack Obama's aides suggest their hands are tied after Pyongyang announced the launch just weeks after the food deal was agreed.
The North Koreans' "blatant disregard for their commitments makes it impossible for the United States to provide the nutritional assistance that it had hoped to provide for the North Korean people," said Jay Carney, the White House press secretary.
Some observers have doubts about the White House's approach.
"I have real questions about whether we should have linked humanitarian food assistance to the nuclear missile program in the first place," said Mike Green, who was senior director for Asian affairs at the National Security Council during the Bush administration. "It is not the fault of the average North Korean who needs the food, who is at starvation level, that the regime is developing nuclear missiles."
He said the threatened missile launch was a "provocation that should have been predictable."
But Green acknowledged that if the North Koreans flaunt the deal, sending the food "would be a political liability for the administration at home, and it would look weak internationally."
Austin of Mercy Corps was careful not to criticize the Obama administration. But he did say the administration had previously made it clear it would send food to North Korea if there was a verified need for that aid.
"We know there is a need and we know we can met the need. As a humanitarian organization 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."
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North Korean technicians check the Unha-3 rocket at Tangachai-ri space center on Sunday, April 8.
A controller is seen from the window of a train along the railway on the west coast Sunday. A controversial missile launch is expected to take place in the coming days. Pyongyang insists it has no bad intentions and invited foreign journalists to view its launch site.
Citizens dance on Monday during a rehearsal for the commemoration of Kim Il-Sung's 100th birthday anniversary. Japan, the United States and South Korea see the launch -- which would violate U.N. Security Council resolutions -- as a cover for a long-range ballistic missile test. And a South Korean intelligence report says it's likely to precede a nuclear test, as it did in 2006 and 2009.
North Korean soldiers are seen from the window of a train along the railway heading from Pyongyang to the North Pyongan Province on the west coast.
A woman plays the piano and entertains in a downtown Pyongyang restaurant. U.S. President Obama said the real consequence for North Korea, should it go through with the launch, is that the country's leaders will miss an opportunity. "I hope that at some point the North Koreans make the decision that it is in their interests to figure out how to feed their people and improve their economy rather than have big parades where they show off weapons," he said in March.
Two women on the the train prepare food for the journalists traveling across the country.
The dress rehearsal for the celebration continues in the capital.
A pin with the face of Kim Il-Sung is affixed to the uniform of a North Korean soldier standing guard at the space center in Pyongyang on Wednesday, April 11.
A woman ties the branches of apple trees on a farm near Pyongyang on Tuesday, April 10.
Workers and farms are seen through the window of a train as it passes through the country.
Bicycles line the road as citizens work the land between Pyongyang and the North Phyongan province.
A North Korean soldier is seen from the window of a train as he walks near a small town along the railway heading from Pyongyang to the North Pyongan Province on the west coast.
Employees work in a textile factory in Pyongyang.
People line the street as they wait for a bus.
A dance troupe performs during the opening ceremony of the Spring Arts Festival in Pyongyang.
A band performs during the opening of the Spring Arts Festival.
A building adorned with a huge portrait of the late president Kim Il-Sung is cleaned by workers in Pyongyang.
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