JANUARY 22, 2001 VOL. 157 NO. 3

Diary of a Mad Place
For 18 months, a German doctor had access to a North Korea few outsiders see. Appalled by the climate of oppression, he has decided to speak out
By DONALD MACINTYRE Seoul

Plus, Excerpts from his diary

Ki Ho Park/Kistone for TIME. Dr. Norbert Vollertsen got a macabre inside look at the chilling reality of life in North Korea.

A day after arriving in North Korea in July 1999, Dr. Norbert Vollertsen made a visit to a hospital in Sinwon, a town near the southeastern port city of Haeju. As a volunteer for German Emergency Doctors, a non-profit medical aid group, his assignment was to assess and assist the North Korean medical system—or what passes for one. At the Sinwon hospital, doctors were preparing to perform an emergency appendectomy on a young North Korean girl. The anesthetic hadn't worked, but the doctors operated anyway. As the surgeons sliced into the girl's belly, her muscles tightened and tears poured down her face, but she didn't scream. Vollertsen took the girl's hand and held it throughout the half-hour operation: "I couldn't believe my eyes. She was so brave—I was nearly crying."

The hospital had no drugs, disinfectant, syringes, IV drips or soap. The doctors worked without surgical gloves. There were no toilets inside the facility, and water had to be hauled in by bucket. The operating room's cement floor was stained with old blood, and the surgery was performed next to a window for light: the hospital didn't have electricity.

That was the start of Vollertsen's mind-boggling, sometimes terrifying 18-month odyssey through a medical system on the verge of collapse. Along the way, the 42-year-old German won a "friendship" medal from the government for his services and became something of a celebrity in the North Korean press. Armed with his medal and an unusual amount of moxie, he crisscrossed the country, slipping behind the cordon North Korea erects to keep out foreigners and recording his experiences in more than a dozen notebook diaries. Vollertsen grew to respect North Koreans' bravery in adversity. But he also glimpsed glaring inequities in a society where the Elite are ferried around in Mercedes Benz cars while children die of hunger in the countryside not far away. When he came across the body of a soldier—lying in the middle of a highway north of Pyongyang—who had died of torture, he broke ranks with the international aid community and spoke out publicly about repression and human rights abuses. On Dec. 30, the North Koreans expelled him, and told him never to return.

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Vollertsen's treatment only made him more determined to tell people what he saw—making him one of the few who have had wide access to secretive North Korea and then talked. (North Korean defectors have provided glimpses of the country they left behind, but their accounts are often unreliable. Refugees often fear reprisals against family members still in the North.) That has put him at odds with former colleagues in North Korea, who feel they have to remain silent if they want to continue to help. "We believe that engagement and dialogue is the way to improve these programs," says David Morton, representative of the United Nations World Food Program in Pyongyang. "The kind of approach Dr. Vollertsen is taking runs completely counter to that. We're still here because there are people who are dying and we can't just run around and leave."

In fact, Vollertsen isn't running away. As early as this week, he hopes to take a load of drugs and medical equipment from Seoul to the demilitarized zone and, as he puts it, "toss it over the fence." Blond, hyperkinetic and an irrepressible talker, Vollertsen is trying to raise money and support for the stunt, which he openly concedes is aimed at generating media attention. He is unfazed by the criticism he has drawn from aid agencies—even his own group has distanced itself from his statements. "It is necessary to create some trouble," he says. Food and medical aid won't make much of an impact, he argues, if the outside world doesn't pressure Pyongyang to cease oppressing its citizens. With North Korea anxious to establish diplomatic relations with Western nations, especially the U.S., the world finally has some leverage that, Vollertsen argues, it isn't using. "The North Koreans are laughing at the international community," he says. "But if you apply pressure, they will respond. Now is the chance."

If Vollertsen wants to make noise, it is because his experiences were so deeply unsettling. North Korea's population has been weakened by years of famine and malnutrition, and diseases like tuberculosis are flourishing. Medical care is below basic. Hospitals lack the money to buy even rudimentary supplies. Many local doctors were trained in the former East Germany, but few know of the recent advances in medicine. During his 18 months in North Korea, Vollertsen says he never saw a major operation, such as heart surgery or even the removal of a gallstone: doctors didn't have the instruments or medicine to perform them. Operations without an anesthetic are the norm. At one hospital, the leg bone of a man who had been hit by a car became badly infected with bacteria. There were no antibiotics. Vollertsen watched as doctors liquored the man up with cheap rice wine and amputated his whole leg: "It was like the Stone Age."

As a troublemaker, Vollertsen has had a long career. In his first medical practice in Germany, he grew disenchanted with what he saw as a system that essentially pushed doctors to make money by ordering expensive treatments. He urged health authorities to give doctors incentives to spend more time with patients and prescribe fewer drugs; he even enlisted a few hundred of his own patients in a protest march. The press, he says, labeled him the "rebel communist doctor."

His big epiphany came during a screening of Patch Adams, an American film based on the true story of a doctor who eschews conventional medicine for a more hands-on, body-and-mind approach. At the end of the movie, a postscript challenges practicing doctors to try that technique. When the lights came up, Vollertsen told colleagues he planned to do just that. German Emergency Doctors, founded in 1979 to help the Vietnamese boat people, offered him a posting in either Sudan or North Korea. He was intrigued by the latter because, he says, "I couldn't find a single book about the place."

Vollertsen made the headlines shortly after his arrival. He was visiting a hospital in Haeju. It was hot and muggy, and the place was filled with exhausted-looking patients trying to escape the heat in non-air-conditioned wards. Vollertsen came across a male patient, wrapped in bloody, puss-encrusted bandages, abandoned in the corner of a ward. More dead than alive, the patient had burns over two-thirds of his body. "He looked more like a corpse from a Western horror film than a human form," Vollertsen wrote in his diary. When he inquired about the man, the hospital staff seemed surprised he was still alive. The North Koreans organized a graft operation. More than 150 doctors and nurses volunteered to donate skin. So did Vollertsen and a foreign colleague. (Without enough scalpels to go around, a doctor removed skin from Vollertsen's thigh with a razor blade.) The patient miraculously survived with a patchwork of Korean and German skin.

In recognition, Pyongyang gave Vollertsen a friendship medal. A glossy magazine ran a feature about him. And a local TV crew was filming when Vollertsen donated a second skin graft. The award came in handy after Vollertsen secured a North Korean driver's license and began touring the country without the requisite entourage of driver, translator and political minder. He carried the decoration with him, and it worked wonders: upon seeing it, truculent soldiers at checkpoints waved him through.

Initially, Vollertsen observed the rule common to aid workers in repressive countries like North Korea: keep quiet about what you see. But he gradually found it harder and harder to obey. When he drove into small towns, he was shocked to see surrounding hills dotted with fresh graves. Clinical depression was rampant, fueled by the mind-numbing rigidities and hopelessness of life in one of the world's last Stalinist states. Alcoholism also was common. Vollertsen found that, as in the former Soviet Union, cheap booze was almost always available to North Koreans, even when everything else had run out. "Anxiety is everywhere," he wrote in his diary. "Where does this inhuman fear in people's eyes come from?"

As a trained pediatrician, Vollertsen was particularly moved by the fate of North Korea's children. Outside Pyongyang, malnutrition is widespread and often severe. On trips to Nampo, a port city a short drive southwest of Pyongyang, he regularly spotted gangs of children working on a 10-lane highway, the kind of grandiose trophy project North Korea loves to build. There were thousands of kids, some as young as eight, breaking rocks with hammers and hauling them in wheel- barrows or makeshift backpacks.

Vollertsen was stunned by what he considered the wasteful obsession with the 55th anniversary of the founding of the ruling Workers' Party, which was held last October. On walks around Pyongyang, he would find parks and parking lots filled with children rehearsing for the celebration. The relentless training continued even during stretches of scorching heat and freezing cold—seemingly at all hours of day and night. "The children looked exhausted and fed up. There was very rigid discipline," he wrote.

A similar extravaganza was later organized for the benefit of U.S. Secretary of State Madeleine Albright, who came to Pyongyang to meet with North Korean leader Kim Jong Il. But while Kim was pulling out the stops for his American guest, Vollertsen was visiting a children's hospital in Pyongsong, a town north of the capital. He walked into a room filled with young children with hollow eyes and skin stretched tight across their faces. To the German doctor, their faces and blue-and-white striped pajamas were horrifyingly familiar: "They looked like the children in Auschwitz and Dachau," says Vollertsen.

The doctor's frustration finally boiled over in November. A driver was taking Vollertsen and a German nurse to a hospital in Pukchang, about 50 km north of Pyongyang. On the way, they saw a body in the middle of the highway. Vollertsen asked the driver to stop, but he refused. When the doctor tried to insist, his translator and minder also objected. Finally, when Vollertsen threatened to jump from the car, the driver relented. The corpse was in uniform: it was a 20-something soldier. Beneath the soldier's shirt, Vollertsen found scars on the neck and back, some fresh. The nurse, who had been a dissident in East Germany, knew immediately that the man had been tortured. To Vollertsen, it amounted to an explanation for the fear in people's eyes, a glimpse into a shadowy world of labor camps and a nation in shackles. "I felt like I had come face-to-face with the violence behind the system," he says. "I thought, 'This is it, I have to act.'"

Back in Pyongyang, he wrote a harshly worded "statement of humanitarian principles," accusing the government of abuses ranging from the use of forced labor and arbitrary arrests to torture, and gave it to German journalists and a visiting U.S. Congressman. North Korean authorities responded by labeling him an "anarchist" and a public enemy. Meanwhile, Vollertsen says, he found that his car was being vandalized bit by bit. The brake fluid was gone one day; the tires were slashed on another. A few weeks later the government ran out of patience and put him on a train to China.

He immediately turned around and headed for Seoul, where he has set up a command post in one of the big downtown hotels that will be his home for the indefinite future. Vollertsen considers himself a rebel with a cause: to help the North Korean people. On Saturday he went to the border and was arrested while trying to give an impromptu speech on human rights in North Korea. He still hopes to return to the North—but it will take more than his friendship medal to get him there.

With reporting by Brian Bennett and Jen Wei Ting

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