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Otto Warmbier Got an Extra Dose of Brutality From North Korea. The Mystery Is Why.

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SEOUL, South Korea — One American who was held captive in North Korea said he was interrogated up to 15 hours a day by officials who wanted him to confess to plotting to overthrow their government.

Another said she was held in a 5-by-6-foot windowless cell. Yet another former American inmate shivered on the concrete floor of a room “no bigger than a dog’s house.’’

But despite a history of such treatment of prisoners dating to the 1950-53 Korean War, North Korea has generally refrained from physically abusing the Americans it has held in recent decades. That makes the case of Otto Warmbier, a 22-year-old American college student who had been serving a 15-year sentence in North Korea, even more striking.

Mr. Warmbier was released in a coma and returned on Tuesday to the United States, where he was immediately taken to the University of Cincinnati Medical Center for treatment. Details of his condition are not yet known. A senior American official has said the United States obtained intelligence reports that he had been repeatedly beaten. His fate has cast new attention on how North Korea treats foreigners in captivity.

North Korea is known to have detained 16 American citizens since 1996, including three who are still in custody. They have been subjected to varying degrees of mental abuse but less often physical torture.

SEOUL, South Korea — One American who was held captive in North Korea said he was interrogated up to 15 hours a day by officials who wanted him to confess to plotting to overthrow their government. Another said she was held in a 5-by-6-foot windowless cell. Yet another former American inmate shivered on the concrete floor of a room “no bigger than a dog’s house.’’

But despite a history of such treatment of prisoners dating to the 1950-53 Korean War, North Korea has generally refrained from physically abusing the Americans it has held in recent decades. That makes the case of Otto Warmbier, a 22-year-old American college student who had been serving a 15-year sentence in North Korea, even more striking.

Mr. Warmbier was released in a coma and returned on Tuesday to the United States, where he was immediately taken to the University of Cincinnati Medical Center for treatment. Details of his condition are not yet known. A senior American official has said the United States obtained intelligence reports that he had been repeatedly beaten. His fate has cast new attention on how North Korea treats foreigners in captivity.

North Korea is known to have detained 16 American citizens since 1996, including three who are still in custody. They have been subjected to varying degrees of mental abuse but less often physical torture.

Despite its longstanding enmity toward the United States and its allies, North Korea remains deeply sensitive to outside criticism of its human rights record, billing itself as a righteous nation that respects international norms. And while its propagandists have presented American prisoners as proof that the United States has been sending subversive agents into the country, it has also used them as bargaining chips in dealing with Washington, analysts said. The prospect that the Americans might eventually be released as part of negotiations seems to have influenced their treatment.

“There seems to be a general attitude of not using physical violence against Americans, although they don’t appear unwilling to use psychological tactics and that sort thing,” said Robert R. King, a former State Department special envoy for North Korea human rights issues who handled Mr. Warmbier’s case until he retired in January. “This situation with Warmbier is likely something that happened that they did not intend.”

The worst known case of abuse before Mr. Warmbier was that of Robert Park, a Christian missionary who said he was severely beaten by North Korean soldiers after he was caught in 2009 while walking across the border from China waving a Bible. After he was transferred to Pyongyang, North Korea, he said, he was subjected to torture so horrific he begged for death.

“Several North Korean women surrounded me and did the worst thing to me to try to make me commit suicide,” Mr. Park said in an interview with the South Korean news agency Yonhap. He said the women beat his genitals with a club.

Mr. Park has said he was diagnosed with post-traumatic stress disorder and has attempted suicide since his release. One former American detainee, Evan C. Hunziker, took his own life less than a month after he was released from North Korea in 1996, although it was unclear whether this was related to his experiences in the North.

In a 2015 interview, the former detainee Aijalon Gomes recalled “a cement cell, which was beyond freezing.” He was later taken to a house where he was instructed to make bricks all day. Asked whether he was tortured, he said, “There were moments of violence and of humanity.”

Laura Ling, who was held in North Korea in 2009 together with a fellow American journalist, Euna Lee, said she was held in a dark 5-by-6-foot cell.

“Once I heard those words, ‘12 years,’ come from the judge, I could barely stand up straight,” Ms. Ling said on the “Oprah Winfrey Show,” recalling the day she and Ms. Lee were sentenced to 12 years of hard labor for illegal entry into the country. She spiraled into a deep depression.

But she was not sent to a labor camp but was instead moved to a regular room while she was treated for ulcers. She was also allowed to place a few calls and send letters to her sister, husband and parents in the United States. She even taught curious guards a few yoga poses.

The two women were released later in 2009 after former President Bill Clinton visited Pyongyang.

It was a similar pattern for Kenneth Bae, a Korean-American missionary who was sentenced to 15 years of hard labor on charges of trying to establish a secret proselytizing network in the North.

In his book “Not Forgotten,” Mr. Bae said his North Korean captors interrogated him up to 15 hours a day for the first four weeks. His treatment improved only after he wrote a confession in which he described himself as a terrorist who plotted to overthrow the government.

Mr. Bae toiled on a soybean farm and lost more than 30 pounds. But he was allowed to read emails from his family and friends in the United States. He was hospitalized three times for problems including diabetes, an enlarged heart and back pain. And he was permitted to read his Bible.

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While his treatment was harsh, Mr. Bae said he also sensed an undercurrent of respect toward foreigners by the North Korean authorities, who were concerned about their image abroad. He was never beaten, said Mr. Bae, who was freed in 2014 after the American government sent the director of national intelligence at the time, James R. Clapper Jr., to Pyongyang.

Some of the American detainees even said they were treated rather decently.

Matthew Todd Miller said he was surprised that he was allowed to keep his iPhone and iPad for “at least a month” after his arrival in North Korea, enabling him to listen to music and access other stored information, although he could not use them to send or receive messages.

“I was prepared for the torture. But instead of that, I was killed with kindness,” he said in an interview with NK News.

Another former detainee, Jeffrey E. Fowle, also said he was never harmed physically during nearly six months in detention.

Arturo Pierre Martinez said he was treated “well,” and was even allowed out to take photos like a tourist.

Mr. King said North Korea appeared to be very concerned about the health of the Americans it held.

“They don’t want anyone to die on their watch,” he said. “This is why the Otto Warmbier case is unusual.”

In his book “The Last P.O.W.,” the journalist Mike Chinoy said that a North Korean doctor and nurse appeared to check the blood pressure, pulse and heartbeat of Merrill E. Newman, then an 85-year-old American detainee, four times a day. Mr. Newman was released after 42 days in 2013.

“The North Koreans have traditionally not wanted to keep Americans if there’s a possibility of having a health issue,” Mr. King said.

Mr. King said that Mr. Warmbier was treated much like other Americans until his trial in March last year, when he was sentenced to 15 years of hard labor for trying to steal a political banner from his hotel in Pyongyang.

What happened afterward is unclear. His family in Cincinnati reportedly was told that after his trial he contracted botulism and took a sleeping pill, and then fell into a coma. Mr. King suspected that North Korea may have been less willing to provide information about Mr. Warmbier’s health during rising tension over recent American sanctions against the country.

The news about Mr. Warmbier deepened the anxiety among families of South Koreans and Japanese citizens held in the North. North Korea is accused of kidnapping more than 450 South Koreans, mostly fishermen, and 12 Japanese citizens in the decades after the Korean War.

“This sounded like a warning to us, signaling what might happen to our family members if we spoke out against human rights abuses in the North,” said Hwang In-cheol, whose father was on a South Korean airliner hijacked to the North in 1969.

The families of the Japanese citizens who the government says were abducted by North Korea in the 1970s and early ’80s know the pain of waiting for loved ones to return. North Korea has told the Japanese government that eight of the 12 are now dead but many families refuse to give up.

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