“Miss Kathi: Saving Lives in North Korea” by Kathi Zellweger and Mike Chinoy chronicles the remarkable story of Kathi Zellweger, a native of Switzerland whose history of engagement with a secretive, isolated North Korea over nearly three decades is unprecedented in its scope, access, and humanitarian impact. It is one of the first book-length accounts in English by an aid worker operating on the ground in North Korea – the story of a woman who has lived out her commitment to the poor and most vulnerable undaunted by the tensions and threat of conflict perpetually looming over the Korean peninsula.
For many North Koreans, Kathi was the first foreigner they had ever met or even seen. Playing a central role in the early years of international relief efforts in North Korea was a lonely job, as Kathi addressed the humanitarian needs of a suffering people largely ignored by the world because of their citizenship. She befriended local doctors, nurses, and caregivers; negotiated with suspicious government officials; overcame international doubts about the diversion of relief supplies to the military; and, over a period of years, spearheaded an effort that provided food, medicine, and development aid. Ultimately, her efforts saved the lives of thousands of people – most of them children.
This excerpt from the book describes visits to people struggling to survive the famine in the northern city of Sinuiju.
It was September 1998. I sat on the floor, Korean style, in Mrs. Kim’s apartment in Sinuiju, one of North Korea’s five largest cities. Located on the banks of the Yalu River just across from the Chinese town of Dandong, Sinuiju had been an important industrial center and a key transit point for trade with China before North Korea’s economy collapsed. Yet even though there was more contact with China in Sinuiju now than in other North Korean cities, it remained shabby and dilapidated, especially in contrast to the bright lights and bustling streets visible on the Chinese side of the Yalu in Dandong.
And Sinuiju had not been immune to the devastating impact of the famine. Indeed, earlier in the year, the North Koreans and the World Food Program had asked Caritas, the international charity where I worked, to ship 1,500 metric tons of barley there. As was often the case, providing the aid opened the door for me to visit an area that had previously been off limits to visitors. Along with Mary Healy, a nurse and midwife from the Irish NGO Trócaire (Caritas Ireland), which had become one of our most important international partners, I was making my first trip there. Local officials told us that, for many people, our supplies had been crucial in keeping hunger at bay. But the situation remained bleak.
At the Amnokgang Hotel, a large, square building with damp, smelly rooms and balconies whose doors could not be opened, we were virtually the only guests in the cavernous dining hall. The hotel shop offered an eclectic collection of basic necessities, but most striking to me was the jewelry that was also on sale. It was evident that some desperate citizens had pawned their personal valuables to get money to buy food. I bought a pair of earrings inlaid with small red stones. I still have them today. I keep them in a box. They bring back sad memories.
In a dismal gray Stalinist-style building typical of most North Korean cities, 69-year-old Mrs. Kim shared a tiny flat with her son, daughter-in-law, and six-month-old grandson. The son and his wife both worked in a nearby textile factory. Mrs. Kim and her daughter-in-law kept the apartment spotless. On one wall hung a guitar, which Mrs. Kim’s son apparently liked to play.
As I entered the room, I was startled to hear the gravel-tinged vocals of American country music legend Kenny Rogers coming from a cassette recorder. It made for an incongruous juxtaposition with the obligatory pictures of Kim Il Sung and Kim Jong Il mounted on another wall. I was tempted to ask about the music, but it occurred to me that the tape and the cassette player likely had come from China, that Mrs. Kim might well not be aware that Rogers was an American, and that the “guardian angels” accompanying us were probably equally ignorant. Inquiring as to why the family had popular music from the United States could have caused trouble for everyone, so I stayed silent. Mary and I just looked at each other with slightly puzzled expressions.
Under other circumstances, owning items such as a guitar and a cassette recorder, or the sewing machines and refrigerators I saw in other urban homes, would, in North Korean terms, have been signs of a decent standard of living. But on this visit, they could not mask the family’s grim plight.
“Is this the end of the Great Leader taking care of us?” the daughter-in-law asked plaintively. Her baby was ill. She said she was still breastfeeding and planned to continue to do so as long as possible. She had nothing else to feed her son. Six months had passed since they had received their last rations through the Public Distribution System. Apart from 14 kilos of rice and some bean curd delivered to mark North Korea’s National Day, they had been subsisting on alternative food plus whatever they could obtain by bartering textiles and other items with relatives who lived in the countryside and were able to grow some food for themselves.
Later that day, Mary and I were taken to meet the family of Mr. Lee, a 71-year-old carpenter. We found him sitting on his living room floor designing some furniture. He was surprised to see two unexpected foreign visitors but was gracious and friendly. Mr. Lee lived with his wife and youngest son. Three older sons were married and lived elsewhere. Like Mrs. Kim, Mr. Lee told us he had last received rations from the Public Distribution System in February. He was surviving by making furniture for people in the countryside, which he exchanged for food.
The examples of the Kim and Lee families highlighted two important characteristics of the famine in North Korea. Its epicenter was in urban rather than rural areas. More than two-thirds of the population lived in or near cities and towns. Unlike farmers in the countryside, who had the ability to grow some food on small private plots, which the authorities understood were necessary to survive and thus (perhaps grudgingly) tolerated, urban residents, often stuck in large apartment blocks, had no such option.
The result was unprecedented hunger in what had been a relatively well developed modern industrial society. With the collapse of the Public Distribution System, which had been the sole source of food, many urban residents, unable to grow anything for themselves, simply wasted away in their homes, starving quietly and out of sight. This was one reason I began to describe the situation as a “hidden famine.” In contrast to predominantly rural Somalia or Ethiopia, the worst suffering was not immediately visible. That didn’t make it any less real.
For the families we visited in Sinuiju, and many others, bartering was a crucial survival mechanism. What had begun with urban residents trading items of value, either from their homes or what could be stripped from their places of work, for food grown by farmers in private family garden plots became the foundation for the broader development of markets. As I traveled around the country, I would see people by the side of the road selling everything from buns to cigarettes to vegetables to live fish. As time passed, I also started to see little businesses appearing – people mending shoes, sewing, fixing bicycle tires, transporting wood in simple carts. Almost all of those involved appeared to be women, presumably because men were more likely to have fixed jobs or be serving in the military.
The emergence of these markets was a sensitive political issue. As a de facto privatization of an important part of North Korea’s economy, they posed not only practical challenges to state control but also an ideological one. Initially, when roadside vendors noticed a foreigner like me approaching, they would quickly cover the plastic buckets containing their products and run away. The government officials accompanying me were visibly uncomfortable as well and would often look in the other direction.
But the trend only accelerated with the creation of larger markets, especially in or near urban areas, which took over the role of the largely nonfunctional Public Distribution System. Before long, they became not only a source of food but of many other goods, although as they expanded, prices rose as well, and many people remained too poor or too far away to benefit. Indeed, some people told us they were spending up to 80 percent of their salary just to purchase vegetables.
The availability of cereals was a particularly sensitive issue. The government jealously guarded its monopoly on distributing items such as rice and maize. Occasionally, these products did make their way to the markets but were usually hidden from the public and sold surreptitiously.
In 2002, in an effort to reform the economy, in conjunction with a broader outreach to Tokyo, Washington, and Europe, Kim Jong Il formally sanctioned the existence of some markets in cities and towns. Before then, however, they operated in a kind of gray area. At that time, foreigners were forbidden from visiting them, which made it hard to determine the precise nature, scale, and impact of the phenomenon, but sometimes on my colleagues’ and my travels, we would end up driving right through one, with crowds of people stepping aside to let our vehicle pass. It was yet another of the many paradoxes of North Korea.
Excerpted from “Miss Kathi: Saving Lives in North Korea”
By Kathi Zellweger and Mike Chinoy © 2026 by Kathi Zellweger and Mike Chinoy
Published by Post Hill Press. This excerpt is used with permission.
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