CFK continues providing support to TB facilities, sending food, TB medicine, medical equipment and supplies, greenhouses, a Mobile Survey X-ray Vehicle, and other support.

CFK installs 30 kilowatt generators at our three provincial-level TB hospitals to provide a baseline of electric power for x-ray and other equipment at these facilities. This is the first of many technical projects to be completed by teams of skilled CFK volunteers working side by side with local colleagues.

We begin providing assistance to the Kaesong Provincial Pediatric Hospital (KPPH) (formerly known as the Ivey Hospital) which was established and built in Kaesong by Methodist missionaries in 1907. An x-ray machine is successfully installed at South Hwanghae #3 TB Hospital by a volunteer technical team. Efforts to provide clean water to the North Hwanghae #3 TB Hospital commence, and CFK supplies the first doctor’s kits to TB doctors.

CFK teams continue efforts to bring clean water to North Hwanghae #3 TB Hospital and also make assessment and delivery visits to Ryanggang Province—related to a special request to provide Painted Mountain Corn Seed to this region. On the home front, CFK moves from a one-room office to a larger office with enough warehouse space to facilitate growing work. CFK hosts a delegation from the DPRK’s Mission to the United Nations in New York at our home office in North Carolina. In September 2004, CFK's office in NC is severely flooded by rains from hurricane Frances and Ivan, disrupting work for several months thereafter.

CFK continues to send more greenhouses and walking tractors to help care centers produce more food locally and to transport goods more easily between care centers. Medical and dental equipment sent to KPPH is installed, along with a 30-kilowatt generator needed to provide power to this facility. Basic ambulances are also provided to our supported hospitals to enable them to transport patients between facilities.

Technical projects completed by skilled volunteers increase in 2007. Operating room suites are reconstructed at the Sariwon and Haeju Provincial #3 TB Hospitals; Kaesong and KPPH follow in 2008 and 2009. Among other major renovations, the first solar-powered, gravity-fed water system is installed at KPPH establishing a new model for sustainable, year-round distribution of clean water at care centers.

The Ministry of Public Health (MoPH) also provides CFK with a new warehouse facility to house incoming shipments and CFK delivers the first lab training workshop for TB physicians in Kaesong. CFK also sends building materials that enable Hwangju #3 TB Rest Home to completely rebuild their care center while providing a model for the rest of the country. Late in 2008, CFK is asked to visit the National TB Reference Lab (NRL) and assess it for a full renovation.

Large-scale flooding in 2007 causes extensive damage and more food shortages throughout the DPRK. In response, the US government negotiates a new food aid program, including 100,000 metric tons of food that is to be distributed through US non-governmental organizations (USNGOs).

CFK, along with World Vision, Mercy Corps, Samaritan's Purse, and Global Resource Services partner together over a 9-month period to deliver this food aid on behalf of the American people. The program is funded by USAID and Food for Peace, staffed by 16 resident USNGO representatives, and 71,000 metric tons of food is delivered to more than 900,000 people in North Pyongan and Chagang Provinces.

In the late fall of 2009, CFK was asked to support hepatitis care centers. At the request of MoPH, and in partnership with Stanford University, the Bay Area TB Consortium, Global Care Partners, and other experts, we began a major renovation of the National TB Reference Lab (NRL) in Pyongyang. The lab was fully equipped and supplied. A grand opening celebration, attended by the Vice Minister of Health and other dignitaries and donors, was celebrated in October 2010. Since 2010, CFK has continued to facilitate ongoing high-level training of the staff in order to build proficient diagnostics for TB patients.

In 2010, a 5-year effort to drill for clean water at the North Hwanghae #3 TB Hospital was successfully concluded. CFK learned many important lessons along the way. Out of this effort, Wellspring for Life, a NC-based NGO dedicated solely to the establishment of an indigenous water well drilling industry in the DPRK, was formed. CFK continues to partner with Wellspring for Life to drill wells at CFK-supported care centers. Significant redesign of greenhouses commenced including the construction of new quarter-round style greenhouses. Solar-powered gravity-fed water systems were installed by volunteer teams at Hwangju and Unpa #3 TB Rest Homes transforming these communities. Finally, in late 2010, CFK purchased its first permanent home in North Carolina—a property that includes an existing house converted into an office with additional space for a warehouse to be built on the premises.

CFK teams renovate the operating room and construct a passive solar greenhouse at the Central #3 TB Hospital, and ongoing training takes place at the NRL. Along with Stanford, CFK brings a team from the NRL and MoPH to Shanghai for a study tour. Water systems are installed at the Central Hospital and KPPH, and renovation materials are delivered to three TB care centers to improve shelter for patients. A new vehicle is sent and dedicated to support regular team visits, and CFK also delivers emergency flood aid to affected areas as part of a USNGO consortium effort funded by the US Office of Foreign Aid Disaster Assistance.

CFK initiates fundraising for two large projects: construction of a warehouse building in North Carolina to help facilitate shipping and assembly of materials needed for technical projects, and a new Training Center to be constructed at the Central TB Prevention Hospital. Training at the NRL continues, and water filters and greenhouses are delivered to many TB and hepatitis care centers. CFK also installs solar-powered water systems and connects them into new wells drilled at Kaesong #3 TB Rest Home and Kaesong #2 Hepatitis Hospital. CFK signs MOU's with MoPH to expand water well drilling at CFK-supported care centers and to guide the construction and use of the new Training Center building.

Construction materials arrive, and construction volunteers work alongside local staff to construct the new Training Center at the Central #3 TB Hospital. By the end of 2013, the building shell and roof are completed. Meanwhile, training efforts continue at the NRL. A shipment of water well hand pumps arrive in Pyongyang, facilitating expansion of well drilling efforts. New wells are drilled at South Hwanghae #3 TB Hospital, Paechon County People’s Hospital, Paechon #3 TB Rest Home, and Haeju TB Sanitarium. A new patient ward is completed at Changyon #3 TB Rest Home supported by renovation materials supplied through CFK.

Construction of the new training center is completed in spring of 2014 with a grand opening ceremony. A two-day training workshop is held in May. This in-depth workshop brought together primary care physicians and laboratory specialists from Global Care Partners and Stanford University, and local doctors who are on the front lines of diagnosing and treating regular and multi-drug resistant TB patients at many different care centers.

Co-founder of Hepatitis B Free (Australia), Dr. Alice Lee, joins a CFK delegation for the first time, opening new pathways for expanded hepatitis treatment. The warehouse in NC is also completed, expanding our capability to assemble and send materials for technical projects, and receive donations. Twenty-seven motorcycles and cargo tricycles are sent to CFK-supported care centers to enhance basic transportation. Solar-powered water distribution systems were installed at Changyon #3 TB Rest Home and Sariwon #3 TB Rest Home. Solar lighting systems were also delivered and installed at multiple care centers.

After a delay in travel caused by a 7-month long Ebola quarantine, CFK teams return to confirm the completion of nearly a dozen renovation projects, to continue lab training at the NRL, and to develop a new hepatitis B treatment program in partnership with MoPH, Hepatitis B Free, and Global Care Partners through discussion and negotiation. The 10-year pilot program established guidelines for improvement of diagnostic capability, screening, follow up care for qualified program participants, and support for life-saving antiviral therapy for chronic hepatitis B patients. Solar-powered water distribution systems were installed at South Hwanghae #3 TB Hospital and Paechon #3 TB Rest Home, and deep-water wells were drilled at ten more care centers.

In October, CFK celebrates its 20th Anniversary with an open house at its headquarters in Black Mountain, North Carolina. Following in November, the first patients are screened in North Korea for the HOPE hepatitis B treatment program.

While CFK faced progressively increasing restrictions due to external tensions and sanctions, work focused on strengthening diagnostic foundations for TB and hepatitis. Improvements were made at the National TB Reference Lab and an automated blood chemistry analyzer was installed at the hepatitis lab. Solar/gravity water systems were installed at the Haeju TB Rest Home and the South Hwanghae #2 Hepatitis Hospital, and repairs were made at two other facilities. 700 water filter buckets were delivered to the country for distribution to patients. In the HOPE program, 1, 517 patients were screened at two clinic sites, and 395 started antiviral treatment.

While still navigating through an environment of tension and increased sanctions, CFK was able to expand the HOPE program to South Hwanghae and South Pyongan (Pyonsong) Provinces (Haeju). By the end of 2018, 1,377 patients had been screened at four clinic sites, and 424 had started on antiviral treatment (through the HOPE program). Our teams also made repairs to eight water systems and continued regular shipments and verifications of food, blankets, and other goods not impacted by sanctions.

We continued the HOPE program at existing locations (Pyongyang, Kaesong, Haeju and Pyongsong) and initiated clinics in one additional provincial city (Sariwon). By the end of of 2019, 1,616 patients had been screened at five clinic sites, and 700 had started on antiviral treatment. Hepatitis C treatment was also initiated for 37 patients. Renovations of a third hepatitis lab (in South Hwanghae Province) began. Fifteen sea container shipments were sent, including 3,500 water filter buckets.

DPRK closed its borders to all travel and shipping in late January 2020 due to the global Covid outbreak. Borders currently remain closed. We seek to resume active engagement as soon as borders reopen.