Quiet Christianity

There was one snag: the facility's name. Cho's first choice-Pyongyang Gospel Heart Hospital-sounded a bit too liturgical for the regime's tastes, so the preacher backed down. The Rev. Cho Yonggi Heart Hospital is scheduled to open in 2010.

Anything is an improvement on North Korea's present health-care system. Even in privileged Pyongyang hospitals lack electricity and running water as well as basic equipment and supplies. And the facilities outside the capital are far worse. At the People's Hospital in Kusong, some 30 miles north of Pyongyang, patients are X-rayed by a 40-year-old Hungarian-built fluoroscopy machine that emits dangerous levels of radiation. Orderlies fashion bandages from cotton grown on the hospital grounds, and intravenous drugs are administered with upended soda bottles. Conditions at Kusong would be even more desperate without donor groups like the Maryland-based Eugene Bell Foundation, which insists on delivering aid directly its final destination. If North Korean officials refuse, the foundation warehouses its aid until permission is given.

Regular site visits by donor representatives are basic to responsible NGO work, not only in North Korea but everywhere else, says Eugene Bell director Stephen Linton. "People who think otherwise are kidding themselves."

Lack of oversight, however, hasn't stopped some South Korean religious groups from planting their flags-both spiritual and humanitarian-throughout the north. In 2005 a South Korean Christian denomination authorized construction of a church with $1 million in donations. But the building doesn't even have a cross, say defectors interviewed in Seoul, and there's nothing the group can do about it.

The South's Jogye Buddhist denomination recently spent $8 million to rebuild a temple on Mount Kumkang that was bombed during the Korean War. After the new temple was dedicated in October, however, the southern monks' northern partners seized control of it, prompting a public expression of regret from the Jogye leader who oversaw the three-and-a-half-year project.

Two years ago representatives of Seoul's Youngnak Presbyterian Church were in advanced negotiations to build a children's health center in the North Korean city of Sinuiju, which is on the Chinese border. Blueprints were drawn up and approved, and delegations from the church met with senior officials in Sinuiju's North Pyongan province. But negotiations came to a halt when the North Koreans demanded that the facility be built in the capital instead. Youngnak says it's holding firm.