Inter-Korean relations interspersed with tension and confrontation have moved to another
precarious level in the wake of North Korea’s recent nuclear weapons and missile tests.
Despite these circumstances, a civic group has consistently delivered humanitarian aid to the North.
It is the Eugene Bell Foundation, established in 1995 by Stephen Linton, a great-grandson of
American missionary Eugene Bell, to mark the centennial of his arrival in Korea.
Stephen Linton, founder and chairman of the Eugene Bell Foundation, talks with patients about tuberculosis treatment during a visit to North Korea.
Stephen Linton and his team visit North Korea twice each year no matter how tense the inter-Korean relations or Pyongyang-Washington ties are. This year is no exception. They visited the North in May and November, along with foreign donors and medical staff, carrying medicines and medical equipment. This is because treating the severe forms of tuberculosis (TB) that many North Koreans are suffering from is more urgent than any political or diplomatic issue. Regardless of whether relations between the two Koreas are good or bad, the foundation never wavers in its belief that humanitarian aid should be “apolitical and non-ideological.”
Linton, a Korean at heart who likes using his Korean name “In Se-ban,” has taken the lead in the efforts to beat TB in the North for 20 years. After launching the Eugene Bell Foundation in 1995, Linton first delivered food aid to the North, but then turned his attention to fighting TB there after receiving an official request by the Pyongyang authorities. In 1997, North Korea’s then vice minister of public health, Choe Chang-sik, sent a letter to Linton, asking for “assistance for TB treatment instead of food aid,” although the country was experiencing severe food shortages at the time.
Linton has visited the North more than 80 times, and over 50 times for TB treatment alone. His foundation has so far delivered some US$51 million (roughly 57.8 billion won) worth of medicines and medical equipment to the North. The medical equipment included mobile X-ray vans, diagnostic X-ray machines, microscopes and surgical instruments. More than 250,000 patients were treated from 1997 to 2007, thanks to the foundation’s active medical support.
Treating MDR-TB Patients
The situation is still not good despite the consistent efforts by Linton and the Eugene Bell Foundation, because Korean winters are cold, particularly in the North, and it is easy for its residents to contract TB as North Korean families often live together in small spaces. Young women who have just given birth and elderly people are especially prone to the disease.
“Women’s immune system weakens after childbirth and so they get susceptible to TB, and it becomes more difficult for them to take care of their babies,” Linton says.
Moreover, the situation is increasingly worsening due to the growing number of patients with multidrug-resistant tuberculosis (MDR-TB) that cannot be cured with ordinary medication because its germs are resistant to various types of drugs. Some 4,000 to 5,000 fresh cases of MDR-TB occur in the North each year. The treatment success rate for ordinary forms of TB reaches 90 percent, if patients take medicines regularly for six to eight months. Medicines for MDR-TB are up to 100 times more expensive than drugs for ordinary TB, and the patients have to take such expensive medicines for a year and a half to two years. Besides, the treatment success rate is lower.
“It needs some 5,000 dollars, including medicine expenses, to treat an MDR-TB patient, while a mere 20 dollars is needed to treat an ordinary TB patient,” Linton says.
What is more embarrassing is that any lapse in the timing of taking the medication can be critical for MDR-TB patients. It will grow even more difficult to treat the patients and their fatality rate will rise if MDR-TB develops into the so-called “super extensively drug-resistant TB.” MDR-TB patients can develop this more dangerous type of TB in a short period of time if their treatment stops. Therefore, aid materials for the treatment of MDR-TB patients should be delivered at least once every six months.
For this reason, the Eugene Bell Foundation has focused on treating MDR-TB patients in the North since 2007. In this process, it has run one of the world’s largest MDR-TB treatment programs and given hundreds of North Korean doctors and TB patients a chance to learn how to treat the illness.
“In 2008, we began collecting phlegm samples of 19 patients with a potential risk of MDR-TB in North Korea. Six months later, we went back to the North to treat those who had tested positive, carrying the necessary medicines,” Linton says. “This program has developed to the extent that it’s possible to treat more than 1,500 patients at any time. We now can immediately conduct tests and begin treatment on the spot.”
A team of about 10 people, including Linton, stays in the North for about three weeks on every visit. But Linton says three weeks is not long enough to carry out substantial activities. “We visit all of the 12 sanatoriums during those 21 days. We test and accept new patients to the facilities. And we check to see if patients show improvement and give them medicines.”
Thanks to careful management, Linton says, the treatment success rate for MDR-TB patients has increased to 76 percent. It is a remarkable achievement, compared with the world’s average treatment success rate of the disease still hovering at 45 percent. These days, there is a saying among North Koreans that “there is hope even for MDR-TB patients if they just go to a Eugene Bell sanatorium.”
Aside from the delivery of medicines and medical equipment, the greatest achievement Linton and his foundation have accomplished in the North is the education of TB patients and medical personnel. Through the foundation’s TB treatment program, thousands of North Korean residents have learned what to do and what not to do when they are infected with TB bacteria. Linton himself seems to have become a TB expert in the course of helping treat North Korean patients.
North Korean medical staff unload boxes of medicines brought by the Eugene Bell Foundation from a truck. All boxes of medicines and medical supplies are emblazoned with the names of South Korean and American donors.
‘We’re Mere Errand Runners’
Linton fell ill with TB twice himself when he was a child, so he knows well how much pain the patients experience. Come to think of it, the Linton family had something to do with TB treatment all along. Stephen Linton’s mother, Lois Linton, founded the Soonchun Christian Tuberculosis Rehabilitation Center in 1960 when the Suncheon area in South Jeolla Province was hit by a flood and TB was running rampant. She fought the disease there for about 30 years.
Linton meticulously checks to see how the medicines and medical equipment delivered to the North are used and spares no effort to enhance transparency in the distribution of aid supplies. The Eugene Bell Foundation is run with donations from South Korean and American donors as well as assistance from the South Korean and U.S. governments. Currently, 85 percent of donors are South Koreans, and North Korean beneficiaries are reportedly well aware that most donations come from them.
The foundation makes it a rule to identify donors on all items it delivers on every visit to all target hospitals and facilities. There is no indication of the “Eugene Bell Foundation” but instead, the donors’ names are emblazoned on every medicine box the foundation delivers. Linton warns against the foundation and himself being made heroes. He keeps saying that the Eugene Bell Foundation is an “errand agency” and he is “nothing but an errand runner.”
“We’re just playing the role of a delivery man or a donkey,” he says. “We’re only delivering and managing medicines and equipment. It is the Korean people who donate money for medical activities, give medical services, and benefit from these activities. My foundation and I have come forward, just because of the situation where it’s not easy for South Koreans to deliver their love to their compatriots across the border.”
Then he adds, “The most difficult part of this job is to get all the necessary cooperation from Pyongyang, Seoul and Washington at the same time. Tense relations between the two Koreas always affect our efforts. But we aren’t worried because there are many donors who care about what we are doing. And it’s hard to remember when there wasn’t any tension.”
In 2016, his travel schedule was interrupted once after a nuclear test by the North, causing a setback in the treatment of MDR-TB patients, due to the suspension of the South Korean government’s approval. But Linton says that in 2017 everything has proceeded smoothly according to schedule.
He delivers just six months’ worth of medication each time.
Therefore, an interruption in his travel schedule means that MDR-TB patients in the North fail to receive timely treatment. This is why Linton hopes that the South Korean government will introduce a license system for aid groups and simplify the approval process for all aid groups regularly visiting the North.
“The most difficult part of this job is to get all the necessary cooperation from Pyongyang, Seoul and Washington at the same time. Tense relations between the two Koreas always affect our efforts.”
Love of Korea over Generations
Linton first visited North Korea in 1979 when the World Table Tennis Championships were held in Pyongyang. From 1992 to 1994, he met then North Korean president Kim Il-sung three times as an interpreter and advisor for American pastor Billy Graham. In 1995, while a professor at Columbia University, Linton established the Eugene Bell Foundation to commemorate the centennial of the start of Eugene Bell’s missionary activities in Korea and immediately began delivering food aid for North Korean residents.
Eugene Bell, his great-grandfather on his mother’s side, arrived in Korea in 1895 toward the end of the Joseon Dynasty. He began missionary activities and volunteer work in the Jeolla area. William Linton, his grandfather, also did missionary work in Jeolla after marrying Charlotte Bell, a daughter of Eugene Bell. In 1919, during the Japanese colonial period, William Linton, who was principal of the Jeonju Shinheung High School, supported the Korean independence movement in Gunsan, North Jeolla Province, and informed Americans of it. He eventually saw his school closed and was deported from Korea for having refused to pay respects at a Shinto shrine. After Korea was liberated, he returned and founded a college that has since grown into Hannam University in Daejeon.
Born in Philadelphia, Pennsylvania, in the U.S. in 1950, Stephen Linton came to Korea with his missionary father, Hugh Linton, and grew up in Suncheon. He obtained a bachelor’s degree in philosophy from Yonsei University and a Ph.D. for a comparative study of North and South Korea from Columbia University. Later, he served as a professor and deputy director of the East Asian Institute’s Center for Korean Research at Columbia University.
Asked why he turned from a scholar into a civic activist, Linton says, “As a Christian, I don’t believe that individual persons can change the world. I believe that the key is to put the love of neighbors into practice.”
He keenly felt the need for the “love of neighbors” in 1995 when the North Korean authorities made a formal request for assistance to the international community as its food shortage came to a head. At the initial stage, his younger brother, John Linton, who is currently director of the International Health Care Center at Yonsei University’s Severance Hospital, helped give medical assistance to the North.
Regarding his family’s love of Korea over four generations, Linton simply notes, “We’ve done what we should have done as believers of God.”
But he seems firmly resolved when he says, “I would have retired by now if I had been a university professor. But I will continue to help treat TB patients in North Korea as long as I see the necessity.” Then he goes on to express his gratitude to all donors, as well as the medical staff in the North, saying, “Without their admirable spirit of sacrifice, this job would have been impossible.”