He had traveled 7.5 miles that day from his home, back to the TB rest home, just to share his story with us. Mr. Ri's hands were rough from long days in the fields, and he was dressed in a padded coat and pants to ward off the late winter's cold. He came in politely to the chilly room, bowed slightly and joined us at a small table. We asked him to tell us about the impact on his life and his family since receiving a water filter bucket. He began earnestly, "My home is about 12km down the coast, so it takes a bit to travel here. I used to have a lot of problems with digestion. It was such a pain, and made life difficult. I came here for treatment after I got sick (with tuberculosis). When I went back home, the doctor gave me this filter bucket to take with me. When we first started using it, I was not sure it would be much use. It is just a bucket (and a small filter). But then, after using it for about six weeks, I realized I had started to feel better. I went from having diarrhea 5-6 times a day, to only 1-2 times a day, to finally, none.
Wow - is it true? This is great! Even my wife started to share the news, and our neighbors also wanted to share the filtered water. The well does not have a lot of water, but people all wanted to have some. There are about eight houses all together in our area - a community of about 40 people. We made a special table just for the filter, so it can filter and drain water continuously. We can let it run while we work or do other things. We have it inside our house and keep it warm so it does not freeze. In my house, there are five people in the family. I have gained about three kilos (nearly seven pounds) since I have been using this bucket over the last five months. My wife's stomach does not hurt anymore so now she is happier. I have also been healed of TB. No more coughing, no more fever, now a negative sputum test, and no more stomach pain! It's a little strange to have more fat on my face now - I think I'm looking healthier than before!" He smiled, thanked us with an open heart and a hearty handshake and went on his way.
Later, that evening, after returning to Pyongyang, an official who had traveled with us for the first time and who heard Mr. Ri share his story said, "This was the first time I had the opportunity to see your work. This is really good work! Thank you for all the help you are bringing to our people and our nation."
Contributed by: Heidi Linton
February
My favorite places to visit in DPRK are the kitchens. There are many beautiful places in DPRK—lovely landscapes, flowers, and impressive buildings, but the kitchens really take the cake for me. The smells of a nourishing stew cooking and the smiles of the dedicated staff preparing meals impresses me more than the mountains of Gangwon or the stunning gold of ripe rice fields.
Through Christian Friends of Korea, the Mennonite Central Committee (where I serve as program coordinator for North Korea) and other organizations send canned meat from the US to care centers supported by CFK. Canned meat is often cooked into stews with cabbage and fermented soybean paste, a traditional staple. The meat juice in the cans is used to flavor the stew and the high-quality meat is fully cooked and easy to digest, especially for TB patients who may already have a suppressed appetite. The meat is processed well and sealed, and as a result does not spoil or require refrigeration.
The meals prepared by the staff with this canned meat are special for more than their caloric value. These meals represent a visceral tie between two countries; dedicated churches and volunteers sharing a meal in the name of Christ with patients who live far away.
The kitchen represents the heart of the home, of care for each other, and life being sustained through the sharing of meals. Through these meals we hope to share the message of Christ’s love and compassion for all with vulnerable people. The kitchens inspire me because of the potential for small acts of love and kindness to transform us, to open up space for a new future in which those who were once enemies are becoming neighbors and friends. I pray these small acts of love will open doors for reconciliation and relationship.
Contributed by: Jennifer Deibert
March
My grandmother was an artist as well as a missionary to Korea, so the Taedongmun (gate) has always been a visual part of my life. Because I watched her paint, I can easily imagine a small, dark clad lady in 1940, with her easel and water colors carefully capturing the details as a curious crowd watched. I can see her, on a different sunny day, across the river painting the Taedongmun as boats toiled past. These paintings have now followed into my home. I can also visualize the drama of less bucolic times for the Taedongmun as it stood in the background of the dramatic 1590s siege of Pyongyang played out across a monumental eight-panel screen which graced my parents’ Chonju home.
I knew that the Taedongmun was a much beloved destination for my parents as they explored the city of Pyongyang as teenagers. I had heard fondly remembered stories and watched as my parents and their contemporaries relived their youthful escapades as students at Pyongyang Foreign School. Now, with CFK, more than three quarters of a century later, I found myself walking the same ground, looking at the Taedongmun’s graceful lines and battered stones and feeling a flood of memories from the past.
Though the past is always foundational, something important has been happening. I was able to witness the results of the Kingdom expanding as a team of people from many nations worked together to assemble solar electrical systems, build water towers, install clean water systems, and assemble laboratory facilities. This was not a one-sided exercise but a truly cooperative effort. It takes multiple hands to plan, arrange supplies and logistics so that the willing hands can accomplish shared goals in the short periods allocated for our visits. I was privileged to be on the end where one experiences the sense of completion. In every case our North Korean counterparts were fully engaged –working shoulder to shoulder to accomplish the task.
I watched the growing trust as shared goals were accomplished and new ideas were implemented. I saw the curious and expectant faces of patients as they lined up for their blood work and examinations. I got to see lab technicians working in a lab where just a few hours before a completed lab did not exist. I heard the passion of a hospital director as he advocated for his patients. I could feel the calm commitment of a TB rest home director as he explained the operation of his facility and spoke to the care of his patients and the successes he is experiencing in curing a horrible disease. I was amazed by the pride of plans being presented for a new facility with the expectation that someday this would be built.
I know my parents and grandparents would approve. Thank you CFK.
Contributed by: John Crane
April
They were just old army trunks that were used when my family moved to Korea in 1954, after the war. For us, they served as a place to store summer or winter clothes, and they sat, like furniture, at the foot of our beds or as a coffee table. When my parents returned from Korea in 1981, these trunks came back with them, filled with their personal belongings. During the next several years, they stored stuff in my parent’s basement in Montreat, North Carolina.
In 2004, I became involved with Christian Friends of Korea. A few years later in 2007, my mother passed away and the house was rented out, so three of the old trunks found their way to a shed where they stayed waiting for a new purpose. One made its way to North Korea with Wellspring, filled with well drilling equipment, and eventually the other two were sent with Christian Friends of Korea.
I have had the privilege of serving with Christian Friends of Korea as their technical team leader since 2006. During this time, the team, with local help, has remodeled operating rooms, remodeled their National TB Reference Laboratory, built a medical training center, installed 18 solar-powered, clean water systems, and remodeled two hepatitis laboratories (including one that is now the National Hepatitis Reference Laboratory), both of which are solar-powered.
From a practical perspective, these trunks carry our tools that Christian Friends of Korea’s technical teams use to repair water and electrical systems. On their tops, they still have my father's name and address, which prompts conversations with the Koreans, sometimes about the history of the trunks and the old missionaries that worked in Korea, and sometimes about the message that they brought to the Korean people. We continue to bring that same message of hope and reconciliation.Each trip to the DPRK is an opportunity to share the light and love of Jesus among the North Koreans through acts of service and love. I pray that their presence will continue to serve as a testimony of God’s grace and mercy in Korea for years to come.I know my parents would rejoice.
Contributed by: Rob Robinson
May
I can’t tell the story of the little girl in this photograph.
While I meet many of the patients and hear their stories- how far they traveled, their family history, the challenges of life with a disease- I did not meet with this mother and her child.
A virus like Hepatitis can be a heavy burden on a family. But we see how precious treatment and care is, as many of the patients travel a long way to come to clinic, and then repeat that same trip once a month to receive their medicine.
We could never feed all the hungers, or heal every disease, or solve every problem, but ultimately that is not any single person’s responsibility. We are called to trust in a Father who is faithful over the infinite and minuscule, and from that trust, we are enabled to do what we can do.
Elijah did not go to every widow’s house, and Jesus did not heal all of the lepers in Israel. God’s economy will always be different from ours, and on the scales our actions and understanding will always be found wanting.
But children are a picture of grace in our broken world. That day in clinic, to see a mother with her child was special. She was all dressed up, curious about everything. Jesus said “Let the children come to me, for the Kingdom belongs to such as these.”
She was a reminder to me that day of what hope is all about.
Contributed by: Stone Johnston
June
This was my 15th trip to North Korea, and I felt at ease returning. It had been almost a full year since my last visit and I needed to be back. Our failed attempt to return in November left us disappointed and sad, but I don’t think it compared to how the locals must have felt. They were so glad and relieved to see us. I am not sure if they knew why we could not come, or was it that we had given up on them? I wanted to ask but...
The welcome we received was genuinely heart-warming, expressed in so many ways. Setting up rooms for our clinics, finding additional fuel to keep the generator running, heated rooms in one place, moving the kerosene heater from room to room during the day to take the edge off the cold at another place, blankets to cushion our wooden benches where we would sit all day seeing patients, and even rebuilding the toilets. With each visit, the sense of familiarity grew and clinics were set up quickly: unpacking all of our gear, connecting power, setting up multiple stations (reception, Fibroscan, ultrasound, consultation, pharmacy) smoothly transiting so that the busy clinics ran with a quiet hum. Our team, including 4 doctors, huddled in corners of the large room in teams of two or three (a local doctor, a visiting doctor, and a translator - when needed), talking to patients, consulting with each other and agreeing on the best way forward. Notes scribbled, results explained, languages learnt, prescriptions written and counseling done.
Every now and then, there was laughter as we shared a quiet joke. Chocolates shared, coffee topped up, we often sat working for hours at a time glued to the chair, only to get up and stretch our legs, thaw out in the sun for a minute or two and then rush back in. No one complained.
I teach, I learn and I share. I guess that is why I come. Perhaps a more accurate order should be that I learn, I share and I teach. Diligent, persistent, caring, devoted, unassuming in their work, the local doctors remind me of what it really means to be a doctor. Their intimate knowledge of their patients, the trust that I see between them, sharing mobile numbers, calling them in to clinic, explaining, reassuring them. Doing home visits weekly for those who cannot come to them. One special incident among many: Hospital doctors ask us to meet with a doctor who traveled far to come to clinic in place of his patient, who waited in line in the cold, explaining that his patient needs treatment but is too ill to attend, not wanting the patient to miss out. Then, happy that he was able to convince us to trust him with the patient's medicine, returned back to the patient, on a bike over a 43 km dirt road.
Could I do that? For our team, it is a battle balancing the need to see many patients, but needing each exchange to be meaningful - that each patient is heard and acknowledged. Not always successful, but moments during the day when we do this well, captured with a smile, a simple word or phrase, the twinkle of an eye, the nod of the head when connections are made. Words are scarce, even dangerous. Every now and then, a confession is made. “I am less tired,” “my appetite and indigestion is improved”…and then I am caught off guard when I hear, "I feel like I am floating…" ("I am so much better") as this lady walks away from me. I am so glad!
Not everyone is satisfied. Hundreds of patients are seen, some are turned away from treatment disappointed, but we remind them it is because they do not need it. Relief often replacing their disappointment when we tell them they are okay. They need to hear this. But then there are the others, where the disease is not something we can help with right now. This is hard. Telling them that they are sick, often very sick, but we are not sure of why and we have little to help them.
I feel hopeless but they are accepting that this is it, and grateful that we tried.
Our program is without doubt a miracle or many miracles come to life. I am not sure how far we can push this - is there a limit to what we can realistically achieve? We have nearly 1,600 patients on treatment, 4 treatment sites so far, adding hepatitis C treatment and a 5th treatment site this year, two labs rebuilt so far and expanding laboratory systems, promoting prevention programs and care of patients with late stage liver disease. Well beyond any dream or wish, this has taken on a life of its own. I am reminded that greed for the needy is good greed and hence we will remain very very greedy.
Contributed by: Dr. Alice Lee
July
I run a company that builds greenhouses for growing tomatoes, cucumbers and flowers. In 2016, I visited North Korea for the first time with my wife and a missionary friend to look for opportunities to start a greenhouse business cooperation. Two years earlier God had asked me, "who will go?" and this trip was the answer to that question. The rules given by the travel agency that organized this trip were clear and simple: you cannot bring Bibles, Christian books or any symbols related to Christianity. While at the airport in Beijing, as I was standing in the queue to check-in for a flight to Pyongyang, I noticed a piece of luggage with a sticker of Korea and a cross. I would not have paid much attention to it except that the travel agency had so emphasized the ban of Christian symbols that the sticker leaped out at me. I pointed it out to my friend and he replied that there was no way this luggage would fly to North Korea.
Over the next few days, we visited the most important tourist sites of Pyongyang and Kaesong. In our group, there were about 20 people including two brothers from Norway with whom I shared my desire to build a greenhouse in DPRK. This trip was very interesting yet also sad because I saw that any cooperation at that time with DPRK would be impossible. However, it is God who opens doors. A week after my return, I received an email from one of the Norwegian brothers. He wrote that he had learned from his parents that there were already Christians building greenhouses in North Korea. I was surprised and asked myself how it was possible so I went online to the website of this organization in order to learn more. I learned that they actually help Koreans in many areas, and part of their work includes the construction of foil tunnels (like greenhouses) for hospitals and rest homes. After reading each webpage, I returned to the home page where I saw the exact same logo as the sticker on the suitcase at the airport in Beijing - Korea and a cross. Wow! I wrote an email to the office of Christian Friends of Korea (CFK) and a year later I went with them to Korea for a second time, but on a much different trip. I could take a Bible with me and Christian books. Immediately, I received a T-shirt with the CFK logo (Korea and the cross), which I wore with pride on the streets of Pyongyang. What seemed to be impossible a year ago had become possible in a short time. Since then, I have been with the CFK team three times and now I have friends with the same heart – a Korean heart. :)
I know there will be other unusual stories since Heidi ended her first email to me "... and we will see where our Lord will lead us.” What God does exceeds our wildest dreams and expectations. I am grateful to Him for the opportunity to travel with the CFK team to North Korea, for the opportunity to help the Koreans by helping patients in the midst of very challenging living conditions, the ability to stay with Koreans and share my work experience and life with them.
The CFK logo has a special meaning for me and I believe that is also true for the Koreans who see the logo. Some may be indifferent to the logo, not noticing it, but for others, it is a reminder of endless love and hope.
Contributed by: Zbyszek Węgrzyn
August
Responding to a call “Are you in the lab?” Dr. Kim Yon Ok and I are smiling from the Haeju Hepatitis Hospital laboratory archway and most probably each thinking, “Where else would we be?” – the clinical laboratory, our favorite shared place. For laboratory professionals, that is our workplace “home,” where we are happy serving the needs of patient care by sharing our knowledge and expertise. For those not well acquainted with what a clinical laboratory professional does, if one thinks about visits to physicians, laboratory testing usually accompanies the visit. The physician may have made a comment such as, “I’m not totally certain what is going on, so I’ve ordered some tests and will get back to you when I have the results.” In Western-style medicine, where laboratory testing is readily available, the accepted estimate of the impact on physician decision making is that 70% (some authors say as much as 80%) of patient diagnostic decisions made by a physician are based on laboratory results. Now consider the difficulty for DPRK physicians where all too often only very basic and severely limited diagnostic tests are available.
Nine years ago, I first met Dr. Kim at the National Tuberculosis Reference Laboratory (NTRL), Pyongyang, DPRK, where CFK volunteers were in the process of renovating the laboratory. Dr. Kim had recently been appointed head of the of the new, modern clinical diagnostics (hematology, clinical chemistry, and body fluids) section for the NTRL. My responsibility had been to develop the clinical diagnostics section where none had previously existed. Appropriate and sustainable equipment had to be selected, all of which are completely unavailable in country. Dr. Kim and her colleagues had to be taught how to run a modern clinical laboratory beginning with the basics of equipment use and maintenance, making certain test results were accurate, reporting results, and permanent record keeping. What a joy to see their palpable excitement when they recognized they finally had the tools necessary to perform vitally needed patient testing.
However, test results are only helpful if the clinical relevance and implication of the different diagnostic tests are linked to the health and well-being of the patients. Visit by visit, years of mentoring, teaching clinical relevancy, and how to perform quality diagnostic testing, have now gone by, each trip with my ultimate goal of “training trainers.” As time passed, Dr. Kim proved herself to be the one individual who stepped up to the daunting challenge of being the resource and reference person who could support and assist in improving laboratory diagnostics across her nation. How would one know that all of those years of building capacity for support of tuberculosis patients would prove essential for CFK to branch into another aspect of patient outreach – hepatitis B assessment and treatment? Until the Pyongyang Hepatitis and Kaesong Hepatitis Hospital laboratories could be built, literally thousands of samples from the hepatitis patients were taken to the NTRL for testing. Without the experience and willingness of the NTRL staff and the laboratory capacity, the hepatitis B project could not have gone forward.
As each new hepatitis hospital laboratory was built, first in Pyongyang and then in Kaesong, Dr. Kim was essential in helping her colleagues develop the same high level of diagnostic expertise. The needs for laboratory testing are tremendous. Now, on each CFK trip into the countryside, Dr. Kim, my dear colleague, accompanies me, bouncing along over the amazingly bumpy roads in the back of one of the vehicles on our way to work with the laboratory staff in Kaesong or Haeju. We smile often at each other as we watch the views of the beautiful countryside pass before us and know that the workload to come will be enormous, the hours long, and the challenges sometimes almost overwhelming. Yet, we both recognize that the years of working together have forged a shared confidence and that we are up to the challenge. And so, we smile!
Contributed by: Marcia Kilsby
September
We met her on a chilly day at Ryokpo TB Rest Home where she has been a patient for many months. Ryokpo is fairly close to Pyongyang (really just a 45-minute drive away), nestled into a low rise of hills that edge the wide valley. The final road off the highway leading to the rest home winds through a commercial-sized tree nursery, and then up through cornfields. On a rainy day, the road through the cornfield can become quickly impassable, as the dirt turns to thick and slippery mud. Many times, we have come so close to a visit, only to be turned back by an impassable road. On those days, the director will often walk out to meet us.
But this was a beautiful dry day, although chilly and windy. We had asked to visit with a patient who was receiving food provided by Rise Against Hunger. She met us in the courtyard and told us her story.
Ms. Ri (not her real name) is 41 years old and a textile worker. She is married and has a 4-year-old daughter. Some time ago, she developed a fever, and TB related symptoms (night sweats, weight loss, chronic cough) and was started on treatment. About 2 years ago, she was diagnosed as having multi-drug resistant TB (MDR-TB), and began treatment.
MDR-TB means that a patient has resistance to at least two of the primary drugs used to treat tuberculosis. This means that patients now have to take different medicines, for a longer time, in the hopes of killing the TB bacteria that are resistant to the first-line medicines. These MDR-TB drugs are more expensive and have more painful side effects that patients must endure if they want to successfully recover from TB. The mental, physical and emotional toll can be overwhelming.
Because MDR-TB is contagious, and because the treatment is so difficult, patients often have to spend months/years at care centers while they undergo treatment. This means long separations from loved ones while they recover. Visits are possible, but for the safety of the visitors, they need to take place in the open air, to reduce the risk of contracting TB or MDR-TB from an active patient.
Ms. Ri told us how much she appreciates receiving the extra nutrition provided by Rise Against Hunger meals which she prepares into a porridge twice a day, shares with her two roommates, and eats in between her regular meals. She said, “I think the food rations, the fortified food (from Rise Against Hunger), and the medicines are helping me recover from this disease.” She said, “I hope to be fully recovered by May 2019. I am thankful for the help I have received, and I hope to encourage and help other TB patients recover from TB after I am released from treatment.”
Contributed by: Heidi Linton
October
I was partnered with a young female doctor at the Pyongyang Hepatitis Hospital during my first time in DPRK, and now we work together every time I visit. She has become like a younger sister to me. We share chocolates, laughs, and tidbits about our lives. I’ve learned about her family, her country, and things she enjoys. I want to share more of my story with her, but there are barriers, so we do our best. I met her when she was single, and now she is married, about to have her first child. I see her concern for her patients that are struggling to live with their disease. She acknowledges the predicament of trying to provide hope and healing in the midst of limitations due to circumstances and the unknown. Hope seems fragile and unfamiliar. It is not often given, nor received easily. However, with the hepatitis B treatment project, I am seeing glimpses of people who are beginning to hope and envision a better future.
Behind her big smile, I often wonder what she is thinking and feeling. I long to have deeper conversations with her. Nevertheless, I realize the best I can do is to pray for her and for her nation. God knows the details. Every time I visit the DPRK, God shows me that this is His work, which is done in His timing and direction. He reminds me that he has promised to never forget or forsake His people, and He desires for all to know Him. That is the hope I desire to share with the people. My presence there is merely to be a vessel that extends God’s love and leaves His lingering fragrance in that place.
Contributed by: Dr. Christine Jun
November
Memories of my childhood in the rural countryside of South Korea flood me during each of the so far 14 trips to North Korea. But it is with sadness in that many scenes, such as those of oxen and hand-plowed fields, represent suffering and hardship. My heart breaks for the people of North Korea. It is such a privilege to be able to work among them and to hear about their lives and their stories.
Taking care of patients anywhere in the world gives one a glimmer into hearts and homes of people in different walks than my own. But it is because so few get to share their stories and be heard with compassion that working in North Korea is SO important and purposeful. We ask how they came to contract Hepatitis and who in their family has suffered from the disease. “I’m so sorry” seems so insufficient of a response as one hears how someone’s mother, brother, sister, aunt, etc. all died with the disease. One can see the fear in their eyes as they now foresee the same fate since they have just been diagnosed with this dreaded illness. “I have come that they may have life and have it abundantly (John 10:10).” Oh, that we could offer them the real, eternal life we know. But the best we can do is give them antiviral medications to sustain them through this illness in this earthly life and pray and hope that somehow they will find the true Physician and complete Healer.
Each of us is called to a specific task, and though it may seem inconsequential or just a “band-aid” for a bigger problem, let us do what we can and trust God to do the rest! It is all He calls us to - the small things! May we serve Him with all our hearts, souls and minds; loving our neighbors as ourselves!
Contributed by: Dr. Sissel Topple
December
There are many unsung heroes who work on the front lines of caring for TB patients around the world, and Dr. Choe at the remote Tosan TB Rest Home in DPRK is no exception.
An effective director has to be skilled in many things. He must recruit and retain staff members to help a revolving door of very sick people who have a highly contagious, deadly disease. Patients come from different backgrounds and sectors of society, strangers thrown together by a common disease, and he, together with his staff, must manage them, motivate them, and care for them for months on end with compassion and kindness. The medicines often have uncomfortable side-effects, and he must encourage patients to finish treatment, and endure long separation from loved ones. He must also comfort his staff and the other patients when one among them succumbs to the ravages of TB, as they sometimes do.
He must make sure his care center can house and feed them. In order to do this, he must construct or repair buildings, starting with digging sand and gravel from the riverbanks, sifting it and mixing it with concrete, forming it into bricks, and then building those bricks into a building. If he needs other building materials such as wood, windows and doors, tile or other things, he must convince local officials to help supply those things to him, or allow him to reach out to a group like us for help. He must use the land allocated to him to grow crops – usually corn, soybeans, and vegetables in the summer, and greens like spinach, lettuce, onions and crown daisy through greenhouse production in the winter. This particular director, through his effort and stewardship, produces 1-2 tons of fresh produce every year for his patients – supplying 70% of their fresh produce needs.
He must make sure his facility has water – if they don’t have a protected well, then that means sending staff at least two times a day to collect water from the nearest source, which for him was 2,000m (1.25 miles) away. This was a real challenge for this place and took up a lot of time and resources until we were able to arrange for a deepwater well to be drilled there in 2015. After drilling the well, the director said that it saved them 60% of their workload because they no longer had to collect the water, or so much fuel for boiling the water to make it safe to drink. As winter approaches, he must make sure that they have coal or wood for burning in the winter months to support cooking, and also for warmth.
Each facility has unique challenges. In the case of Tosan, they lack for any electrical power at all – the nearest source of electricity is more than 1km away. If they could connect to it, it would supply a few hours of power every day. However, he lacks the transformer and wire for the connection, so for now he must manage care for his patients without any power for lighting, running equipment, or anything else.
It is truly a privilege to come alongside so many sincere, hardworking people like Dr. Choe, who brighten the lives of TB patients, bringing hope, healing and a future to many whose names we will never know.
Contributed by: Heidi Linton