UCSF Doctor Explores North Korea

By Jeff Miller Ricky Choi likes to challenge assumptions with experience. A self-described intellectual with a passion for health and human rights, Choi has traveled and studied widely. But there was no place on earth about which this third-year pediatric resident in UCSF's PLUS (Pediatric Leadership for the UnderServed) program was more passionately curious than North Korea. "I applied to the UCSF's pediatrics program in part because it was one of the few programs that would allow residents to take a few months off to pursue projects. North Korea was so much on my mind that I even mentioned my dream to do related work there in my residency application," says Choi. In August 2006, part of that dream came true. The 30-year-old Choi and eight other Korean Americans traveled to the North Korean capital of Pyongyang under the auspices of a Korean community organization based in New York. The purpose of the 11-day trip was to promote peace and "tong-il," reunification of the Korean peninsula, and to cement ties with children of the "Korean diaspora." Choi later spent an additional four days on his own at a nongovernmental organization (NGO)-run health clinic in an "experimental free trade zone" along the Chinese-North Korean border. On the two-hour flight from Beijing, Choi, accompanied by his wife, had time to reflect on his young life and all that had brought him to this moment. Born in Moore, Oklahoma, of immigrant parents, Choi went to college at the University of Chicago, medical school at the Medical University of South Carolina and public health school at Harvard. Raised as a Christian, Choi credits his faith and his parents - one a social worker and the other a nurse - with instilling in him a deep sense of service to others.

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Choi had seen true poverty and suffering in Ghana, and had briefly visited Guatemala and Nicaragua, but there was something about the famine and resulting starvation in 1990s North Korea that troubled both his heart and his mind. "I looked at pictures of these starving people [an estimated 1 million died] and they all looked like me, my relatives and close Korean American friends. I felt a personal obligation to respond." Choi was also troubled by Western media reports about North Korea, believing them to be oversimplified and a one-sided view of a country stripped of its energy supplies when the Soviet Union dissolved, and then crippled by flooding and other natural disasters. This is to say nothing of the consequences of more than 50 years of American trade sanctions, he adds.

Downtown Pyongyang as seen from the Juche Tower. (See larger)

Part of his reason for going to North Korea - and paying his own way - was to see for himself what only a few thousand Americans see each year. "There was an unreal quality to it all, since after the North Koreans fired their test missiles in July and experienced damaging floods in May, I was very skeptical that the trip would ever happen," he explains. It all became real on the ride from the airport to the hotel, a trip that took the group through the capital city of the "Hermit Kingdom," known for its wide boulevards devoid of cars, giant Soviet-style "heroic" memorials and acres of concrete. "North Korea was carpet-bombed during the war, so the whole country was built from scratch. I saw a lot of people on the streets walking to work. They even had an aboveground train system running on electricity and, of course, no advertisements," says Choi. Health Struggles Continue Choi and the rest of the group had input into their itinerary, although it was not entirely self-selected. One must-see on Choi's list was the 2,300-bed Pyongyang Maternity Hospital. Choi was struck by its "frozen-in-time" quality. "The hospital lacked all the latest technology we're used to. Much of what they had seemed to be from the 1970s."

Pyongyang Maternity Hospital.

Still, for all its technological shortcomings, the staff were very hard at work serving their patients. "About 30 babies are born every day. The hospital also has a neonatal intensive care unit." What was also clear is that the threat of malnutrition and shortages of medicine and supplies still linger, despite the assistance of international aid agencies, which continue to ship food and equipment. "Many of the children I saw appeared thin and had obvious nutritional deficiencies. I never saw a plump, pudgy baby while I was there. A 2004 UNICEF report estimated that 37 percent of the total population also is chronically malnourished," says Choi. Such evidence, together with the country's recent military bellicosity, is often used in the West to characterize the North Korean government as brutal, uncaring and paranoid - a country of concentration camps, regimentation and repression. Choi does not point fingers or aim barbs. He did not go to North Korea to criticize, but to understand. Besides, he says, there is plenty of blame to go around. "You can go to North Korea and be suspicious about everything. But if you go with a critical, but open mind, I think you would be impressed, as I was, with the people's genuine warmth, generosity and passion for the success of their country." These characteristics were very much on display during various stops along the journey, he reports. At the Demilitarized Zone (DMZ) near the border between North and South Korea, Choi recalls the soldier who was embarrassed by the ongoing division of the Korean people, whose history extends back 5,000 years. Meeting young adults from a farming community and a group in Kaesong, Choi found people friendly and curious, eager to discuss their different norms in dating, clothing and education. "These people are not strange, weird and backward as depicted," says Choi. Indeed, they are very hard-working, forced by a shortage of farm equipment to toil long hours. Office workers must also spend one day in the field each week. At Baekdu Mountain, spiritual home of the Korean people, Choi was inspired by the beautiful mountain and its crater lake. "Going to a site deeply revered by all Koreans, but a place so few Koreans in the southern half of the country can visit, impressed upon me the transcendence of ethnicity over political ideology.

Ricky and Tammie Choi at Baek-du Mountain, a crater lake located at the border of China and North Korea and long regarded as the birthplace of the Korean people. (See larger)

"Korea has been repeatedly attacked and colonized in its long history. The North Koreans say that they have no intention of destabilizing the region - or the world - by developing weapons. Whether I agree with their strategy or not, it is important to recognize that they are not crazy. Rather, they have a very logical internal rationale for their actions, given their historical context and the way they think they have been treated by other nations." Whatever the outcome of a possible new round of negotiations among national governments, Choi believes that a diplomatic effort using cooperation with North Korea in health and humanitarian activities can help reduce mutual suspicion and hostility. Should that help line form, don't be surprised to see Choi at the front. "There is a lot to be done to assist in meeting the health needs of the people, as well as building trust with foreigners. I would like nothing more than to play a part." Related Links: Open Forum: The Nuclear Club Is Expanding. Is There Another Way? Ricky Y. Choi, Thomas E. Novotny San Francisco Chronicle, October 13, 2006