Giving Until It Hurts

"I can't raise money wearing a mask," he says.

LINTON'S FOUNDATION IS NAMED AFTER ONE OF HIS GREAT-GRANDFATHERS. A farmer's son and Presbyterian missionary from Kentucky, Eugene Bell went to Korea with his family in the 1890s as part of a post-bellum onslaught to Christianize the East. The connection has endured through generations: Eugene's son William founded what is now Hannam University in Taejon, South Korea; his son Hugh, Stephen's father, brought his wife and children over in 1954, after serving in South Korea during the war. Stephen attended schools there and obtained graduate and postgraduate degrees in Seoul and the United States, including a PhD in Korean history at Columbia University. In the early '90s, while Linton was working at Columbia, the late evangelist Billy Graham tapped him as an interpreter on two visits to North Korea.

In 1997, with North Korea nearly extinguished by famine, Linton left Columbia to help the country's ministry of public health organize international aid efforts. It was a formative experience. While in the city of Sinuiju on the North Korea-China border, Linton leased a freight car and loaded it with packages of instant meals meant for famine-relief centers. But bureaucratic snarls meant he had to wait two weeks to distribute the cargo. "I still have nightmares from watching children picking out kernels of corn from railroad ties," he says.

Linton has been battling North Korea's health crisis and its commissars ever since.

"THIS IS A NASTY BUSINESS," LINTON SAYS, grimly spooning mocha mix into his morning coffee on the first day of the fall mission. His eyes are bleary. He spent much of the night before negotiating with health ministry officials over rounds of soju, the potent Korean liquor. "They say they want to save wear and tear on the vehicles, so they need to cut our sites by a third. Fine. I'll cut theirs as well. Mary, I'll need a red marker."

Linton and his six-person delegation have settled in at the Kobangsan Guest House in Pyongyang, where they were installed by government minders after flying in from Beijing the day before. The Kobangsan, a four-story villa perched regally on the banks of a man-made lake, once accommodated visiting heads of state. The ministry of foreign affairs now runs it as a lodge for NGOs and deep-pocketed VIPs. The building affords sweeping views of Pyongyang's stark rural outskirts and boasts a bowling alley, a banquet hall, a billiards room, a karaoke lounge and a lavishly appointed VIP suite with an eight-track stereo player in the bed's headboard.

Linton's delegation breakfasts in a well-lit dining area, served by female attendants in red dresses. (When not seeing to guests -- which is often, as the Kobangsan appears to be otherwise vacant -- staff members occupy themselves by watching old films on a television in the lobby.) Linton is fatigued and agitated. The previous evening, the ministry of public health, the agency responsible for Eugene Bell's work in North Korea, had suddenly announced that a banquet honoring Linton and his delegates would begin an hour early.

"They knew what was coming," Linton says. "We were up until 1:30 a.m., negotiating. They thought if they got me liquored up I'd let things pass. But I told them I wasn't drinking because I was so concerned about the scheduling."

Most of the cancellations involve small sanatoriums in rural areas -- the very sites his donors are so keen to support. Linton suspects his hosts want to avoid those facilities because, relative to the urban care centers, their poor sanitation makes them legitimately hazardous. And the wear-and-tear issue isn't just a red herring. Spending days crisscrossing the countryside on unpaved roads takes a huge toll on the delegation's fleet of SUVs -- vehicles that, between Linton's visits, the ministry is allowed to use for its own purposes. In resource-starved North Korea, even government officials must barter to replace broken fan belts and transmissions. The last thing the bureaucrats want is to risk losing a precious automobile.

Whatever the reason for the recalcitrance, Linton decides to meet his hosts head-on by matching each canceled visit with a cancellation of his own -- mostly at the expense of hospitals the ministry appears to favor. This choice comes with real consequences for both sides: Some patients will die without the fresh supply of drugs. And some of Linton's donors will be angry that the care unit or hospital wings they gave money to support ended up being passed over.

Linton has requested an afternoon meeting with health ministry officials in a bid to get back at least some of the canceled visits.

"This is a nasty business," he repeats. "But we'll get through it."