Book Review: What Miss Kathi Reveals About Engagement with North Korea
Miss Kathi: Saving Lives in North Korea[1]
By Kathi Zellweger and Mike Chinoy. Post Hill Press, 2026. 384 pp.
During a 2013 visit to a hospital in Hamhung, Kathi Zellweger photographed two patients sharing a bed. Many observers would have regarded the scene as straightforward evidence of deprivation. Zellweger, however, found it encouraging. On previous visits, hospital beds had stood empty because there were no medicines, no food, and sometimes insufficient staff to treat patients. Two people occupying one bed therefore signals an improvement, she argues. The episode captures what makes Miss Kathi such an excellent book: the ability to place an observation within a longer history and recognize changes that a visitor without knowledge of context might miss.
Written with veteran journalist Mike Chinoy, the book recounts Zellweger’s decades of humanitarian and development work in North Korea. Between 1995 and 2019, she made 75 trips to the country and spent five years living in Pyongyang. Her work took her from Caritas to the Swiss Agency for Development and Cooperation (SDC), and eventually to KorAid, the organization she established in Hong Kong in 2015. The result is an unusually rich account of how international engagement worked in practice, what it achieved, and why it so often struggled.
For readers already familiar with North Korea, much of the broad chronology will be recognizable. The book’s distinctive contribution lies in connecting those familiar events to the people, negotiations, and everyday decisions through which they unfolded. It is both a compelling personal account and a valuable resource for understanding a period of international cooperation whose practical history deserves to be preserved.
Making Humanitarian History Tangible
An aid shipment can appear in an institutional report as a quantity of grain delivered to a port. Here, it becomes a story involving traders, donors, shipping arrangements, local officials, warehouse inspections, and families waiting for food. People who rarely appear in accounts centered on diplomacy emerge as essential participants. Humanitarian assistance becomes understandable as work undertaken by identifiable individuals, with all the ingenuity, frustration, and uncertainty that entails.
Some details are unforgettable. In 1996, two South Korean priests arrived at Zellweger’s Hong Kong office carrying a brown McDonald’s bag containing roughly $300,000 for relief work. Elsewhere, a consignment of rotten peas required an urgent visit, an apology, and negotiations over compensation. Such episodes explain how assistance depended on personal initiative and how credibility could be damaged, or repaired, through seemingly mundane operational matters.
The famine chapters are especially powerful. Zellweger began visiting in April 1995 and witnessed the deterioration over successive trips. Adults grew thinner, followed by children whose parents could no longer shield them from shortages. Her descriptions of hospitals, nurseries, and households give concrete meaning to the catastrophe. They also explain her characterization of a “hidden famine”: in urban areas, people could waste away inside their homes, without the highly visible concentrations of suffering associated with other emergencies.
The account gains depth from following the same places over time. As the worst hunger gradually receded, malnutrition and the breakdown of health services remained. The changing needs of these institutions help explain the movement from emergency relief toward agricultural recovery, training, and development assistance. This transition emerges from the circumstances Zellweger encountered rather than from an abstract debate about aid categories.
Crucially, the narrative rests on an extensive contemporary written record. Zellweger explains that she produced detailed reports after every visit, supplemented by regular reports during her residence, letters, journals, photographs, and videos. Chinoy drew on these materials and extensive conversations with her to write the manuscript. The result combines the immediacy of personal recollection with a documentary foundation that gives the accumulation of detail particular value.
One painful episode underscores the importance of preserving such records. When the Food Aid Liaison Unit closed in 2005, staff burned boxes of documents because they were uncertain they could remove them and feared leaving them behind. Researchers will wince at the loss. Against that background, this book is also an act of historical preservation.
Learning to Work Together
Among the book’s strongest contributions is its account of mutual learning. North Korean officials initially had little understanding of how international humanitarian organizations operated. Foreign aid workers, in turn, could arrive with limited knowledge of the country and expectations shaped by emergencies elsewhere. An international appeal that failed to raise its target could look to North Korean officials like a broken promise. A request for an intrusive household interview could seem self-evidently reasonable to a monitor and deeply unsettling to the family concerned and to skeptical officials who suspected intelligence gathering.
Zellweger’s comparison with her mother’s likely reaction to unfamiliar foreigners questioning her in a Swiss village is particularly effective. It invites readers to consider the encounter from the recipient’s perspective. That sensitivity helps explain her working method: repeated visits, careful preparation, discreet conversations, and delivering what had been promised.
Her experience also reveals how much negotiation occurred within the North Korean system. Officials responsible for cooperation had to secure permissions from other institutions, sometimes against considerable resistance. The Flood Damage Rehabilitation Committee could facilitate access while also resisting attempts by its foreign partners to develop separate relationships with the Korean Federation for the Protection of the Disabled. Such episodes show bureaucratic interests and institutional rivalries operating beneath the appearance of a monolithic state.
This matters for interpreting foreign behavior as well. In Zellweger’s account, delayed assistance and demands that local counterparts could not satisfy immediately risked weakening those arguing internally for cooperation. The implication is significant: the reliability and conduct of outside partners could affect the room available to North Korean officials willing to work with them.
The 1998 nutritional survey provides a revealing example. Obtaining permission required prolonged negotiation and assurances that North Korean authorities would have an opportunity to review the findings before publication. According to Zellweger, pressure from donors led to their release before that process was complete, provoking anger and jeopardizing further cooperation. Readers need not endorse Pyongyang’s insistence on controlling information to recognize the cost of an assurance not being honored.
Nor does Zellweger suggest that sensitivity should replace accountability. She describes tracking deliveries, seeking greater access, and using the nine humanitarian principles agreed in 1998 as a basis for negotiation. Her determination to stay engaged coexisted with judgments about when a particular partnership was no longer worthwhile. Later, she decided against continued support for a hospital that resisted training and transparent reporting. These distinctions make her account useful to practitioners confronting similar choices.
Change Seen at Close Range
The book contains a wealth of information about initiatives that rarely receive sustained attention. Among them were arrangements enabling 35 North Koreans to study at Central European University in Budapest, and the Pyongyang Business School’s instruction in management, marketing, and accounting. These programs illuminate a period when some North Korean institutions were actively seeking knowledge from abroad, even while restricting its content and controlling participants’ exposure.
Especially interesting are the effects that went beyond a course’s formal syllabus. Business school participants worked with people from other organizations, discovered shared problems, and encountered teaching methods that required initiative. The potential significance of these experiences lies partly in changes to professional relationships and habits of thought. Zellweger’s descriptions provide concrete material for examining how learning could occur within an exceptionally restrictive institutional environment.
Her agricultural examples are equally instructive. A farm manager’s hesitation about crop rotation becomes understandable when viewed against immediate food needs and state production targets. Successful demonstration of the benefits of crop rotation could create room for experimentation. Other projects ran into institutional arrangements that undermined their intended benefits. In a pilot agricultural credit scheme, for example, loans intended to empower small sub-work teams were largely controlled by the cooperative farms, while the state continued to determine production, distribution, and prices. The willingness to describe these failures strengthens the book’s account of what cooperation could realistically accomplish.
Meanwhile, the expanding presence of markets, consumer goods, restaurants, cars, and mobile phones complicates any picture of an unchanging society. Zellweger follows the emergence of prosperity alongside continuing deprivation. These observations raise a question central to assessing humanitarian need: whose circumstances are improving? Visible consumption in Pyongyang tells us little by itself about the position of a child in an underheated residential school elsewhere.
The book offers material for answering that question through comparisons across places and repeated visits. Its strongest contribution to scholarship is this sustained record of encounters and institutional change. Specialists like myself will find highly valuable connections between developments they may previously have known only in isolation; practitioners will find examples of negotiation and implementation; general readers will encounter a society far more varied than its official presentation suggests.
The Value of Staying Engaged
Zellweger’s moral position is explicit: “My own view was that allowing North Koreans to starve because of distaste for the country’s political system was morally wrong” (28). The narrative repeatedly returns to the difficult practical choices that arising from this conviction. Helping people required dealing with institutions implicated in their suffering, accepting restrictions, and deciding which compromises still allowed useful work.
Her disagreement with Médecins Sans Frontières over its 1998 withdrawal makes those dilemmas especially clear. Different organizations could reach different conclusions about operating under severe constraints. Zellweger’s contribution is to show, in considerable detail, what staying engaged made possible. She is also candid about obstruction, officiousness, failed projects, and the frustrations of dealing with her own organizations. Her confidence in engagement is persuasive because readers can examine the experiences behind it.
The later chapters on disability assistance and cataract surgery are particularly moving. In the case of cataract surgery, patients describe being able to read, cook, move independently, and contribute again to family life after their sight was restored. KorAid supplied 35,000 lenses for such operations. Such outcomes give substance to arguments about humanitarian cooperation: the benefits can be assessed in terms of changes to people’s everyday lives.
The description of obstacles along the way is equally concrete. An Indian supplier’s reluctance to send lenses and eye medicine illustrates how fear of involvement with North Korea could obstruct assistance even when the items were understood to be exempt from sanctions. North Korean restrictions and bureaucratic delays added further difficulties. The book makes these overlapping barriers visible at the point where they affected actual projects.
Obviously, there are limits to what any such account can establish. Access remained negotiated, conversations often passed through interpreters and official counterparts, and some names and locations have been changed for protection. Successful projects cannot by themselves demonstrate that engagement would transform national policy. Yet Zellweger is clear about the book’s character as personal history, and its value does not depend on proving such a sweeping proposition. It documents meaningful achievements within a constrained space.
A chronology of major programs would have made this material easier to navigate; evocative chapter titles such as “Holy Peas” and “Barking Rabbits” are more helpful to the storyteller than to the researcher. That is a modest reservation about a book whose readability is otherwise a considerable strength.
Miss Kathi deserves a wide readership. It preserves an extraordinary body of experience, gives due attention to people who made assistance possible, and demonstrates the analytical value of sustained presence. Above all, it makes the impact of engagement tangible. For anyone considering what future cooperation with North Korea might achieve, Zellweger and Chinoy have provided an exceptionally useful and deeply humane place to begin.
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This review was originally written in German. The English translation was produced with the help of ChatGPT-6 Astra, October 2026, and subsequently checked and corrected by the author. All ideas, interpretations, and judgments are the author’s own, and the author takes full responsibility for the final text.