Visitors pass before a propaganda poster showing Korean People's Army soldiers at a museum Saturday in Sinchon, south of Pyongyang. (Ed Jones/AFP/Getty Images)

American humanitarian agencies that work in North Korea and Americans with relatives there are expressing grave concerns about the new restrictions on U.S. citizens traveling to the country.

The restrictions, set to be published in the Federal Register on Wednesday, will require all American citizens who hope to travel to North Korea to apply to the State Department for a passport with a special validation.

This, some say, will mean that previously private and nonpolitical work — sometimes already viewed with suspicion by the regime in Pyongyang — will now have a literal U.S. government seal of approval.

“When the North Koreans look at our delegation, they cannot assume that we got permission from anybody,” said Stephen Linton, an American who heads the EugeneBell Foundation, a nongovernmental organization that treats thousands of people with multi-drug-resistant tuberculosis inside North Korea.

His is one of about 25 American humanitarian groups that are active in North Korea, trying to relieve ordinary people’s suffering. The EugeneBell Foundation administers medicines to TB patients who have proved resistant to previous rounds of treatment, and the treatment must follow a strict schedule to be effective.

“As soon as you have a licensing system, the immediate question is: Why did you get permission?” said Linton, who has been working inside North Korea since 1979. “What was in it for the U.S. government to issue you the permission to come here? And there’s nobody in North Korea that I’ve ever met who would believe that the U.S. government would issue that permission purely for humanitarian reasons.”

The new “geographic travel restriction” will come into effect in 30 days’ time.

It is a direct response to the treatment of Otto Warmbier, the 22-year-old Ohio man who went to North Korea as a tourist and was arrested there, spending 17 months in a coma before being returned to the United States in June. He died less than a week later.

Three other U.S. citizens — one a businessman and two affiliated with a private American university — remain in North Korean custody.

Every year, about 1,000 Americans had been going to North Korea on organized tours, but tourism will be banned for U.S. citizens starting next month.

This new rule is much stricter than the policy the Trump administration has implemented toward Cuba, which Americans are still allowed to visit if they travel with a licensed tour company under U.S. jurisdiction. Independent travel is still allowed for Americans to visit their family members in Cuba and for religious activities and humanitarian projects.

Just four categories of Americans will be allowed the special endorsed passports: journalists, Red Cross representatives on official missions, humanitarian workers and anyone else whose trip is “in the national interest.”

Those who are approved will be issued “a limited validity U.S. passport permitting one-time travel to North Korea,” according to the State Department.

Humanitarian groups have been appealing to the State Department not to make the new rule bureaucratically burdensome. Some are asking for a system where blanket approval can be given to their organization, rather than every person having to get approval for every trip.

“U.S. humanitarian workers have been providing relief to the poorest and most deprived of North Korea’s population for over 20 years,” said Keith Luse, executive director of the National Committee on North Korea, a Washington-based NGO that promotes cooperation between the United States and North Korea.

“A majority of them have built meaningful relationships with North Koreans at the local level and not been confronted by the authorities,” Luse said. “As travel-ban details are finalized, we hope the State Department will consider their experience.”

Amid years of failed nuclear talks and an enduring reluctance to engage with North Korea, private-sector activities such as humanitarian work have been “the only positive aspect” in the relationship between the United States and North Korea, said Linton, of the EugeneBell Foundation.

“Make no mistake — if the American private sector is now banned from travel, it will be another major step toward the diminishing of U.S. influence in East Asia,” Linton said. “Asians are well aware of this downward trend and are already thinking about how to resolve challenges related to North Korea should the U.S. government and its private sector be unwilling or unable to play a major role in the region.”

The new rules will particularly affect Korean Americans. Between 200 and 500 Korean Americans travel to North Korea each year, a significant proportion of them for reunions with family members from whom they were separated during the Korean War. Many of them travel to North Korea as tourists, and they would not appear to qualify for travel permission under the new restrictions.

There are also as many as 100 Korean Americans living or working in North Korea at any given time. Most are associated with Kim Il Sung University or the private American-run Pyongyang University of Science and Technology.

Two of the Americans detained in North Korea earlier this year, Tony Kim and Kim Hak-song, were affiliated with the Pyongyang University of Science and Technology, which was started by Korean American Christians.

The third detainee, Kim Dong-chul, was working in the Rajin-Sonbong Special Economic Zone in the northeast of the country near the Chinese border and has now been held for almost two years. Efforts to free the men are continuing.

But there are also some Americans who live in North Korea permanently in the Rajin-Sonbong zone.

“To the extent that the permanent residents need to travel back and forth to the U.S. from time to time, the travel ban would adversely impact them,” said Sam Yoon, executive director of the Council of Korean Americans.

There are about 1.8 million Korean Americans in the United States, according to population estimates from the Census Bureau.

“One could argue that the travel ban — especially for families — would in fact hurt them the most,” Yoon said.

The National Coalition for the Divided Families voiced similar concerns.

Rather than just an exemption so that Americans “won’t be punished for searching for their long-lost loved ones in North Korea,” the coalition called for the U.S. and North Korean governments to organize “state-approved reunions for our divided families before it’s too late.” 

The Korean War ended in 1953, leaving members of many families stuck on opposite sides of the armistice line. Those separated siblings and parents are now elderly.

“Since the mid-1980s, North and South Korea have had 20 rounds of reunions. The U.S. and North Korea [have had] zero,” said Jeane Noh of the divided-families coalition. “Today, President Trump can make it happen.”