Kathi Zellweger has spent years navigating one of the world's most opaque and restrictive environments: North Korea. Her forthcoming book, Miss Kathi: Saving Lives in North Korea, chronicles the daily realities of running a small NGO in a country where foreign aid workers are rare and every interaction is monitored. For many North Koreans, Zellweger was the first foreigner they had ever met.
Zellweger founded KorAid in Hong Kong in 2015, focusing on three core projects: providing lenses and specialized eye medicine for cataract surgeries, training staff at the Korean Rehabilitation Center for Children with Disabilities (KRCCD) in Pyongyang, and building a greenhouse at the Mirim orphanage on the capital's outskirts to improve nutrition for about 500 children. The cataract program alone has enabled tens of thousands of North Koreans to regain their sight.
Humanitarian Work Under Constant Scrutiny
In December 2019, Zellweger visited the ophthalmology unit at South Pyongyan Provincial Hospital in Pyongsong, a city 32 kilometers northeast of Pyongyang. A retired teacher who had just undergone cataract surgery gripped her hand, tears in his eyes, thanking her repeatedly in Korean and halting English. He wanted to invite her to his home for dinner—a gesture that, as Zellweger and the attending officials knew, would never be permitted. A doctor defused the situation by telling the patient he needed to stay hospitalized to avoid infection. “All of us – including, I suspect, the patient – knew what was actually going on,” Zellweger writes. “But that was the way the system worked.”
Zellweger's relationship with North Korean authorities has been built over decades. She first visited the country in 1995 and later worked with the Korean Federation for the Protection of the Disabled (KFPD), a semi-governmental organization she found slightly more flexible than other state bodies. “My exchanges with officials there often were more open than I had experienced elsewhere,” she notes. This rapport allowed her to formalize the cataract program and expand training for disabled children's caregivers.
The challenges are immense. International sanctions and suspicion about diversion of aid to the military have long hampered relief efforts. Zellweger acknowledges that North Korean doctors know how to perform cataract surgery but lack the necessary lenses and medicines. KorAid sources these abroad and ships them in, a process fraught with logistical hurdles. At the Mirim orphanage, children appeared generally healthy but many were severely stunted—a legacy of the 1990s famine and ongoing food shortages. Electricity cuts lasted only two to three hours most days, but the dining room was small, forcing meal shifts. Zellweger was told that only a handful of orphans would attend university; most would be assigned to factories or farms.
Zellweger's work underscores the broader tensions in international engagement with North Korea. While the denuclearization push has stalled, humanitarian needs persist. Her NGO's existence is a testament to the possibility of aid against the odds, but also to the limits imposed by a state that views foreign contact with deep suspicion. For Zellweger, the gratitude of patients like the retired teacher makes the obstacles worthwhile. “It made worthwhile all the challenges and obstacles in setting up and operating a charity in the DPRK,” she says.
