Observers have revealed that even while North Korea prepares a lavish funeral for late leader Kim Jong-Il, outside the capital people are struggling to survive and so hungry they even eat grass.
Since Kim's body was laid out in a glass coffin, official television has shown a procession of smartly-dressed, well-fed members of the country's privileged elite paying their respects.
But away from the television cameras, whose lenses are largely focused on Pyongyang, many North Koreans are trapped in poverty, malnourished or even starving to death, according to aid workers and defectors.
"Food distribution in Pyongyang cannot be compared to other places because it is the face of North Korea," said Yeom Kwang-Jin, a defector with the South Korea-based organisation Durihana which helps refugees from the North.
"In other places food distribution had completely stopped, while in Pyongyang people get a small amount. People turn to the black market to survive."
Kim Jong-Il presided over a 1990s famine that saw hundreds of thousands of people die, but still found the funds for a nuclear weapons programme.
There are still chronic food shortages in the impoverished communist state.
"The food distribution system has long collapsed and everyone has to fend for themselves," said Lee Hae-Young, director of the Seoul-based Association of North Korean Defectors.
"Eating three meals a day is now unheard of. People try their best just to eat one meal a day. Half of my friends back there are either dead because of starvation or nearly invalids, with all their teeth gone. I'm only 49."
UN agencies have said six million people -- a quarter of the population -- urgently need food.
When the World Food Programme's Jonathan Dumont visited earlier this year he met a four-year-old who was so malnourished he could not stand up, and seven-year-old schoolchildren who were too weak to play outside.
"Rations have been cut to a few small potatoes a day for each person -- almost one third of what they were," he said afterwards.
According to the Seoul-based aid group Good Friends, many farmers survive on grass porridge.
But children cannot easily digest wild grass and straw -- which they mix with corn to supplement their meagre diet -- and sometimes die, according to aid workers.
Even in hospitals, there is not enough food for patients.
Chronic power shortages are a part of daily life and clothing is in short supply, making the harsh winters -- when temperatures drop well below zero -- a test of endurance.
"Electricity is only provided for two hours a day in Pyongyang, and in other parts of the country not at all," said a defector who did not want to be named at Open Radio for North Korea, which broadcasts across the border.
People chop up furniture to use as firewood to heat their homes, or sell it to buy food.
There is no independent media and state newspapers, radio and television churn out government propaganda.
Drug use is said to be increasingly prevalent and locally produced amphetamines, known as "ice", are widely available.
The country was richer than the South in the 1960s but suffered economic decline in the 1990s after the loss of key aid and trade with the collapse of the Soviet bloc.
Per capita income in the North is about five percent of that in the South, which has enjoyed steadily rising living standards since the division of the Korean peninsula at the end of World War II.
Life became even tougher in the North in 2009 when the government suddenly revalued the won currency, almost wiping out people's life savings.
The regime cracks down severely on dissent and has expanded its political prison camps in the past decade to hold about 200,000 people in "horrific" conditions, according to Amnesty International.
Some prisoners eat rats or pick corn kernels out of animal excreta to survive, it said in a report published in May.
Images which leak out of the isolated nation provide a stark illustration of the hardships faced by the poor.
In one video, shot in 2010 by a North Korean citizen journalist working for the Japan-based underground magazine Rimjingang, an emaciated 23-year-old girl whose parents are dead is interviewed collecting grass.
Asked "What do you eat?" she replies: "Nothing."
The group said her body was found a few months later.