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The family of an American tour operator and Christian missionary who has been detained in North Korea for the past nine months is renewing calls for his release as concerns about his health mount.

Kenneth Bae was arrested in November, accused of “hostile acts” against the government and sentenced to 15 years of hard labor: farming beans, potatoes and other vegetables.

His recent letters home have portrayed troubling health conditions, including blurred vision that could be associated with his diabetes, his sister, Terri Chung, said Wednesday during an interview at her mother’s home in Lynnwood.

“He doesn’t know how much longer his body can stand the physical labor,” Chung said. “Eight hours a day, six days a week in the fields; it’s not the kind of thing the average American is used to.”

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Bae, 45, the father of three, was born in South Korea and immigrated to the U.S. with his parents and sister in 1985. For the past seven years he has been living in China, and a couple of years ago began leading small tour groups, mostly of American and Canadian citizens, into a “special economic zone” designed to encourage commerce in North Korea’s northeastern region of Rason, Chung said.

Chung said the family has few details about why her brother was imprisoned. She said she is familiar with a video of him taken several years ago, in which he advocates bringing Americans to North Korea for a mass prayer session to bring about the reunification of North and South Korea.

“His personal convictions and his beliefs as a Christian may have been deemed as, I don’t know, perhaps hostile acts, but all I know is that he only had the best of intentions to help the people,” Chung said. “Maybe he was a little bit overzealous, I’m not sure.”

The family has largely remained quiet as State Department officials and others have called for Bae’s release because relatives were concerned about fouling back-channel efforts to free him, she said.

But with the North Koreans allowing the release of an interview with Bae in his cell last month and with Bae himself urging them in his letters to take a more prominent role, “it seemed like this was the time to speak up,” she added.

Chung and her mother, Myunghee Bae, have scheduled a prayer vigil for 7 p.m. Saturday at Quest Church in Seattle and have granted a series of news interviews. They said that in addition to his diabetes, Bae has an enlarged heart and a bad back; in the video released last month, he appeared to have lost 30 to 40 pounds since his imprisonment.

Bae is at least the sixth American detained in North Korea since 2009. The others eventually were allowed to leave without serving out their terms, some after clemency missions by prominent Americans, including former Presidents Clinton and Carter.

North Korea’s young leader, Kim Jong Un, has the power to grant special pardons. There is no sign that a high-profile U.S. envoy is set to travel to North Korea, Chung said.

Analysts have suggested North Korea is using Bae as a diplomatic bargaining chip. The country remains locked in a standoff with the U.S. and its allies for continuing to develop nuclear weapons despite United Nations sanctions.

The family has received five batches of letters from Bae, the most recent Wednesday, Chung said. He wrote that he has been treated well and has access to a doctor, and that he has been wearing a hat and placing a towel on his neck to protect himself from the sun while he works.

He had hoped to be released in time for the 70th birthday of his father last month and had been planning a family reunion in Hawaii to celebrate it. Now, Chung said, the family hopes to reschedule it when Bae is released.

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