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Aid workers who have been secretly helping starving North Korean refugees have broken their silence to protest against a crackdown by China which threatens the lives of tens of thousands sheltering along the border between the two countries. In the past six years many North Koreans have fled a famine estimated to have killed more than 1m people.

China, which maintains friendly relations with the Pyongyang regime, treats them as illegal immigrants. This has forced church groups, Sino-Korean families and international aid agencies to work under cover to provide food, clothing, medicine and shelter.

These covert relief operations have come under intense pressure since June when China launched a "Strike Hard" campaign which has involved a sharp increase in the number of aid workers arrested and fined and refugees repatriated, many to face death or imprisonment. With the situation deteriorating every day the aid agency Médecins sans Frontières has broken cover to voice its "grave concern" at the attitude of the Chinese authorities.

"What we've seen and heard is that there is a new policy that is putting large numbers of people in jeopardy and making it almost impossible to carry out even the silent kind of support local networks have been giving," an MSF volunteer who has just visited the border said.

In the city of Tumen "Strike Hard" posters exhort residents to report criminal activities and to expect house-to-house searches. It adds: "Then criminals of all kinds will be sinking into the sea of the people's battle, becoming like rats running away along the streets while everyone is shouting to beat them." Although the campaign is a national one and not restricted to illegal immigrants, aid workers say it is being applied with particular force in border areas.

The maximum fine for individuals caught sheltering illegal immigrants has been increase from 3,000rmb to 10,000rmb (Ã?£860), and more people are being arrested. Four members of the Good Friends organisation, which has been at the forefront of the effort to help the starving North Koreans, were recently jailed for 50 days and questioned under torture about their alleged spying activities. In the biggest raid yet, local aid workers say, 4,000 illegal immigrants were arrested in Yanji on the night of June 27.

Residents in Tumen - one of the four main border crossing points - say that repatriations have jumped from 20 a week to more than 150. Those sent back can be charged with treason. The maximum penalty for third-time offenders, women who have become pregnant while out of the country, and people who associated with South Korean or Christian groups is death.

Amnesty International says repatriated refugees often become the victim of "serious human rights violations, including imprisonment in harsh conditions, torture and the death penalty". This prospect has created an atmosphere of terror among the refugees. "People are scared. They are afraid to talk, afraid to meet," the MSF volunteer said. "The crackdown means they have to go into even deeper hiding - they cannot go out to work, they cannot even go out to beg.

On top of that, the people who are supporting them are coming under pressure, so they are running out of options." Why China has chosen this moment to act is uncertain. One possible explanation is that it fears a surge of refugees across the 550-mile border as conditions deteriorate.

Estimates of the number of North Korean refugees in China range from 10,000 to 500,000. MSF says it is probably about 200,000. Guardian Newspapers Limited 2001