Day 5: Fighting tuberculosis in North Korea

Wednesday

Tucked away atop an obscure office building in Seoul, the Eugene Bell Foundation is making a difference in a crisis that much of the world does not know about: the dramatic rise of tuberculosis in North Korea. Dr. Stephen Linton, the foundation chairman and a member of a third-generation American missionary family based in Korea, is quite familiar with the issue.

He has twice been infected by the disease.

Tuberculosis is the Number 1,2 and 3 health concern there, he said. Using North Korea's own statistics, 5 percent of the 22 million people are infected. But it would not surprise Linton if the real figure were a hundred times that many. TB arises in societies where the natural immune systems of the inhabitants are at risk. And North Korea's health system, set up to deliver care to every citizen, has suffered a virtual collapse.

So groups like those run by Linton have made it their mission to find ways to do something few are doing: provide help and, at the same time, respect the integrity of a dedicated and brave medical community in North Korea that's trying to stave off a major health calamity. At the moment, tuberculosis is taking many people in their 20s and 30s out of the workforce. And it's killing the children very quickly, Linton said. It's a tricky disease, because it tends to come and go, striking each time with more force. In the U.S., we faced the disease over 100 years ago before essentially taming it. At one point in those times, it was considered a disease of writers and intellectuals. Edgar Allen Poe had it. And other people in those days, whose vanity outstripped common sense, sought to become infected because it was a sure way to lose weight and provide facial color. In North Korea, the disease is now so dreaded that it has massive social implications. So it's not unusual, Dr. Linton said, to find women waiting until the end stages of the disease before seeking treatment. A diagnosis kills all hope of marriage and often means years, even a lifetime, in quarantine.

Conditions in hospitals are hideous. Doctors there are often working without salaries and no electricity or heat. Operating rooms are nearly 50 years old. Syringes are used over and over again. Anesthesia is not readily available, and IVs are made from old bottles.

And because there are no x-ray machines, doctors stand unprotected near fluoroscope machines almost 40 times a day. Not surprisingly, they have been dying of radiation poisoning. I saw a picture of one chief doctor whose face was yellowed because her liver had been destroyed by the fluoroscope. Medical professionals are so desperate that they are shooting drugs directly into the lungs of patients. Dr. Linton said that he saw a doctor do this with a rusty needle and a pair of pliers to help guide the thrust through the chest wall.

The patient, he said, did not cry out in pain. The threshold for suffering is high. Little help is coming from abroad, and nothing is being sent from China or Russia. Most of the $2 million in annual funding for Dr. Linton's work comes from South Korea and generous Korean Americans. Despite his Presbyterian affiliation, he said that few churches have been willing to take on this cause.

But a difference is being made. The foundation is sending a multitude of special packages: mobile x-ray tucks where patients can be diagnosed safely; wrapped boxes of tuberculosis medicine divided for each patient; operating room equipment; and stocks of medical manuals and guidebooks. And once the foundation starts helping, assistance continues each year. So far, Eugene Bell covers an area where one-third of the population lives and there are over 40 hospitals and tuberculosis centers.

To give some perspective, the UN estimates that there are 600 hospitals in North Korea. Why focus on TB when there are so many other medical needs? Dr. Linton said that making progress against the nation's top killer will give patients the confidence to see the doctor for other maladies. Essentially, it opens up the mind to the possibility that medicine can do wondrous things.

“Eugene Bell has always been a vehicle, no more and no less, connecting people who care with people who need help,” said Linton.

In his entire presentation, I never heard him talk about his Presbyterian faith. There is no proselytizing when medicine and supplies are delivered in North Korea. But his simple presence in a land of a forgotten people is surely a guiding light.

Editor's Note: For the next two weeks, Star editor Randy Smith will be traveling with a dozen U.S. journalists in both North and South Korea. The trip, set up through the Gatekeeper Editor's program with the International Reporting Project, provides journalists with a glimpse of countries often in the news but not well covered. Look for regular updates at KansasCity.com. Send questions or comments to him at rsmith@kcstar.com.