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Barnes in Commonthe magazine of Churches Together in Barnes
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Courage speaks volumes in
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Lying on a makeshift bed in a freezing hospital ward with cracked windows in a central area of North Korea, a frail middle aged woman whispers to an international humanitarian worker: "You can see for yourself. Tell people outside what is happening here."
In another hospital, near North Korea's frontier with China, a coal miner is brought in with a mangled left leg after a mine accident. Within hours, the leg is amputated in a Spartan theatre devoid of modern equipment.
In a recovery room, in the presence of another humanitarian worker, the miner awakens. He pulls himself upright and, in an unstoppable flow of words, gives praise - and thanks for his life - to North Korea's late president, Kim Il Sung, whose legacy is a country of around 22 million people living in Stalinist isolation.
These starkly contrasting stories say much about not only the country's public health problems but also basic beliefs and courage. The woman was risking her life by speaking in such a manner to an outsider.
But the miner was in line with North Korean doctrine that effectively shuns all religions and places Kim Il Sung ("Great Leader") and his son - the country's present leader - Kim Jong Il ("Dear Leader"), as virtual deities and the fount of all that is good and correct.
Corrie Bass, a Dutch-born clinical nurse who accompanied me on a tour of North Korean hospitals for a major international aid organisation, said: "I think the people are suffering so much that some of them will take the risk to tell you how difficult it is for them. The situation is so bad that some of the people will start speaking.
"You must let the people know that you will not forget them", said Baas, with field experience in countries such as Afghanistan and Iraq. "They know you can tell the world. It is not for us to interfere in politics but at least we can make the world aware that people are suffering."
A visit to North Korea, whose nuclear and missile programmes grab world headlines every few months, leaves many of the 4,000 or so foreigners allowed in each year juggling with words such as "xenophobic", "bizarre", "illusion", "surreal" and a "nightmare of conformity".
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Mythology surrounds the Kims. Indeed, children in schools are taught that they came down from heaven, were placed on mountains on the country's remote northern frontier and transformed into humans.
Conventional international history is different. Kim Il Sung, possibly from Mongolia, was installed by Soviet dictator Josef Stalin as leader of the northern part of Korea in 1945 when Japan, which had ruled the Korean peninsula since 1905, surrendered in World War Two. The Democratic Republic of North Korea (DPRK) - or North Korea - was proclaimed a year later in defiance of a UN plan for nationwide democratic elections.
The Korean War between North and South Korea started in 1950 and ended in 1953 with a ceasefire agreement. A peace treaty has never been signed. The conflict pitted northern troops supported by Chinese forces against a 16-nation UN army, led initially by US General Douglas MacArthur, supporting the south.
In North Korea, all traditional religions were effectively proscribed in the early 1950s. They are regarded as expressions of a "feudal mentality" and an obsolete superstitious force opposing political revolution, social liberation, economic development and national independence.
The first Christian missionary, a Roman Catholic, arrived in the northern part of the then united Korean peninsula in 1785. In the second half of the 19th Century areas in the north, which along with the south also embraced Buddhist and Confucian beliefs, were successful centres for American Protestant missionary work.
Similar to some other visitors to North Korea, I saw a showcase Christian church in Pyongyang, the capital, and was also taken to the Buddhist Pohyon temple at Myohyangsan, in truly picturesque mountains near the northern border. But it was clear that the temple's main function was as a tourist attraction.
Although independent confirmation is virtually impossible, it is assumed that there is a sizeable underground Buddhist and Christian following in the country. Much of the information comes from defectors from North Korea, some of whom say even the possession of a Bible can lead to deportation to a prison camp.
The plight of all North Koreans, apart from the elite, is mirrored in the state of the country's public health system. After visiting a variety of hospitals during an eight-day visit, when temperatures often were around 10 degrees centigrade below zero, it was clear that the system, once the envy of many developing countries, was in serious decline.
The decline, as well as in the pharmaceutical, energy and agriculture sectors, is a manifestation of North Korea's economic decline, driven by the break-up of the Soviet Union and a succession of natural disasters such as drought and flooding since 1995.
"Anaesthetics? This is really, really shocking. There is no gas. They don't have the equipment, including masks", one international aid worker said. "They can give local anaesthetics and a very few county hospitals can do spinal anaesthetics - morphine and pethedine are supposedly available. But if you only think how stressful it must be for the patients. This causes, for some people, a lot of problems."
Underlining equipment problems, Paek Sam Kuyu, the director of Kujang's county hospital, was asked what equipment he needed. He said: "Operating equipment, diagnostic equipment, X-ray machine, ECG machine [electro-cardiograph] and a greater selection of drugs for cardiovascular disease and other problems, as well as an ambulance and transport for staff."
In the neighbouring Hiuichon City Hospital, as in most of the other hospitals visited, the director said his staff heated soot - "coalsmoke pieces" - gathered from local chimneys to warm wards.
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Officials say the average amount of such foods taken by a person each day is around 600 grammes, to supplement rations doled out by North Korea's creaking public distribution system. But doctors believe these substitutes form up to 40 percent of total food intake. Ensuing stomach aches and diarrhoea are seen as the side-effects of assuaging hunger.
More than 2.5 million people are believed to have died in North Korea in the past decade following flooding and malnutrition. Both malaria and tuberculosis have been on the increase since 1995.
International impressions of what is happening in North Korea depend
largely on what people are shown, almost always under strict supervision.
What of the future? At a dinner with two officials of the North Korean
Red Cross, one of them a former senior diplomat, a colleague and I asked
if they believed they would see reunification of the Korean peninsula
in their lifetimes.
The ex-diplomat said "yes" without a pause. But his younger colleague thought hard and, after a longish pause, said "no".
It appears likely that it will be a long time before any religion flourishes once again in North Korea. In the meantime, we can only salute those who are willing to speak out on the country's religious intolerance and other deprivations.