North Koreans seeking health care often face surgery without anesthesia and hypodermic needles that are not sterilized, Amnesty International said on Thursday.
The destitute state has seen its economic woes deepen since a currency revaluation carried out late last year backfired, leading to public discontent even as it raised security tensions with threats of war against the South.
"North Korea has failed to provide for the most basic health and survival needs of its people," Amnesty International deputy director for Asia, Catherine Baber said in a report.
The group said witnesses it interviewed described hospitals where hypodermic needles were not sterilized and sheets not regularly washed. Amputation and other major surgery is routinely conducted without anesthesia, it said.
Amnesty urged the international community to resume providing humanitarian aid to the North and not allow recent diplomatic tensions involving the North's leadership to get in the way of help.
"The North Korean people are in critical need of medical and food aid," Baber said. "It is crucial that aid to North Korea is not used as a political football by donor countries."
A team of investigators led by Seoul blamed Pyongyang for launching an attack on a South Korean warship in March, killing 46. Analysts said the North may have tried to divert attention from domestic troubles and seek a way back into arms talks that have given it needed economic and energy aid.
The U.N. Security Council last week condemned the sinking of the Cheonan corvette but did not directly blame the North. Pyongyang denies it was involved in any way.
The North is already under sanctions from the South, the United States and Japan that are further squeezing its broken economy by choking off trade, movement of cash and a large part of humanitarian assistance.
South Korea has been allowing only shipments of milk and baby formula to the North's child care centers, suspending food and medicine assistance sent for the past decade.
North Korea said at the weekend that it was willing to return to six-party talks that in 2005 produced a deal to compensate it with massive aid in return for steps to end its nuclear program.
The North has boycotted the talks since late 2008, saying it cannot continue dialogue with the United States because of Washington's "hostile policy."
It conducted a long-range missile test and a second nuclear test in 2009 that led to Security Council sanctions that all but cut off its lucrative arms trade.
The North Korean government claims health care is free, but the Amnesty said witnesses spoke of having to pay for services, with doctors getting paid for checkups and tests.
Many patients bypass medical professionals altogether and go to the markets to buy medicine randomly or on the advice of vendors, it said.