Aim and methodology of medical observation and research on survivors of Nazi German concentration camps

How to cite: Kłodziński, S. Aim and methodology of medical observation and research on survivors of Nazi German concentration camps. Bałuk-Ulewiczowa, T., trans. Medical Review – Auschwitz. December 21, 2018. https://www.mp.pl/auschwitz/. Originally published as “Cel i metodyka badań lekarskich byłych więźniów hitlerowskich obozów koncentracyjnych.” Przegląd Lekarski – Oświęcim. 1965: 34–36.

Author

Stanisław Kłodzinski, MD, 1918–1990, lung specialist, Department of Pneumology, Academy of Medicine in Kraków. Co-editor of Przegląd Lekarski – Oświęcim. Former prisoner of the Auschwitz‑Birkenau concentration camp, prisoner No. 20019. Wikipedia article in English

Research on concentration camp survivors has been systematically conducted outside Poland, especially in France and Denmark since the very first months after the cessation of hostilities. In France a special department was established for veterans’ affairs. The first phase of the research was connected with the medical care dispensed to survivors, and subsequently with their application for disability pensions and compensation. That is probably why the initial research took a decidedly somatic course, and the organic aetiology, which was readily observable, served as the basis for the assessment of victims’ state of health.

It was not until a later stage that more emphasis started to be put on the emotional factors, especially once survivors began to develop conditions such as premature ageing, psychosomatic diseases, and certain mental disorders, which did not happen until several years after their release from a concentration camp. This led to the identification and description of a set of syndromes typical for survivors, especially post-concentration camp asthenia or the concentration camp syndrome, premature involution, and disorders qualifying the victim for a disability pension.

Participants attending international conferences which have been held since 1954 in Paris, Copenhagen, Moscow, Oslo, Liege, The Hague, Baden-Baden, and Bucharest, have been making a concerted effort to produce a cohesive account of the medical phenomena they have observed in survivors, and an integrated set of diagnostic and therapeutic recommendations.

An extensive and diversified scientific bibliography has built up on the effects of detention in a concentration camp.

Notwithstanding differences of opinion on the aetiology of post-concentration camp disorders – which some authors regard as chiefly due to organic factors such as starvation, head injuries, and infectious diseases; while others emphasise the importance of factors impacting on victims’ psychiatric condition, such as humiliation, loss of human dignity, loss of freedom, destruction of inmates’ established hierarchy of values; and still others envisage as due to a combination of mental and somatic factors – we have nevertheless arrived at a set of generally accepted conclusions based on all the work that has been done.

In the light of the research accomplished hitherto, these conclusions do not require further discussion. They may be summarised as follows: concentration camp experiences, far in excess of the normal human experience, could not but leave a permanent mark on survivors. Their effect need not always be observable in a cursory medical examination, and may only emerge in survivors’ later life. It is reflected in both their level of physical immunity and mental resilience. The permanent somatic impairment incurred in the concentration camp due to bacterial infections, damage to the alimentary system, and mechanical injuries may be progressive in character and reduce survivors’ psychophysical fitness.

In Poland for obvious reasonsa it was not possible to provide special medical care for survivors in the first years after the War, nor to conduct research on their experiences. They were treated on a par with the rest of Polish society as regards access to the state medical services. The bibliography produced in this period was meagre. Scientific studies on specific groups of survivors did not start on a significant scale until fifteen years after liberation. However, the first research was conducted already in the first years after the War by Professor Michejda of the Gdańsk Surgery Clinic, who examined the Ravensbrück Guinea-Pigs. The quality of the Polish research is superior to the projects conducted in other countries because on the whole it is not associated with compensation claims, which of course tend to impair the objectivity of the study. In addition, Polish research projects have considered survivors’ experiences during their time in concentration camps, whereas in the world literature this aspect is addressed only by survivors themselves. It should be said that the Polish research is being conducted by survivors who are members of the medical professions as well as by physicians with no personal experience of imprisonment in a concentration camp, which gives a broader spectrum of viewpoints and arguably greater objectivity.

The Polish research has been hindered by the lack of full statistical data, in particular of survivors still alive, their morbidity and mortality rates, their general social and living conditions, average state of health etc. A requirement which I believe should be met for further progress in the research is the compilation of a comprehensive register of all the survivors in Poland addressing all the points I have enumerated. In my opinion, this is a matter which should be handled by the Board of ZBoWiD,b and for Auschwitz survivors by the Auschwitz Museum. Of course, the public health authorities should make a substantial contribution.

The research could proceed in two basic directions: the in-depth examination of the somatic and mental health of all the survivors (this is the path chosen by the Warsaw research group), or the study of specific issues (targeted research). The latter path is being followed by the Kraków and Poznań research groups. The following issues call for special study: cardiological aspects, since we may speculate that starvation, typhus and typhoid fever could well have left a permanent effect on the heart muscle; gynaecological research, as the effects of concentration camp stress on the body’s hormone system is a subject still waiting to be examined; and gastrological and rheumatological research, in connection with the nutritional and general living conditions in the camps. A separate chapter of studies should be devoted to the examination of the children of survivors, to determine the genetic and environmental influence effected by survivor parents. We should also continue the research launched by the Kraków group on survivors who were children in the camps. This work may throw a lot of light on the impact of extremely strong stress on the development of children and adolescents.

An interesting issue from the sociological, psychological, and medical point of view is the question of marriages contracted by couples both of whom were inmates. Studies on premature ageing and higher mortality rates among survivors could provide an insight into some geriatric problems. Analysis of the criminal Nazi German experiments offers an extensive range of research issues both from the theoretical point of view as well as for the practical provision of care for victims. Another open issue is the question of the best way to dispense rehabilitation services for disabled survivors; treat tuberculosis, neuroses and psychoses contracted in concentration camps; and the best approach to treating post-concentration camp alcoholism.

Alongside physicians, psychologists, sociologists, and even lawyers and forensic experts should be encouraged to join in the research. Their contribution would be particularly helpful in the reconstruction and analysis of the history of the concentration camps. Survivors’ experience still offers a broad range of biological, psychological, sociological, and moral issues for further study.

In the research we conduct we should always consider the interest of our subjects, to offer them the help they need if they are found to be suffering from diseases or disorders which require hospital treatment, or if they require social welfare services. It is generally known that ZBoWiD has a thousand places in sanatoria at its disposal, many of which are being used by survivors. Perhaps the time they spend convalescing in these institutions should be utilised to conduct in-depth medical examinations for the purposes of the research I have listed.

It would be a good thing if more scientists joined in the research now being conducted by the Polish Red Cross on the victims of Nazi German pseudo-medical experiments. There is a large group of physicians – former inmates with excellent qualifications for such work, as they know the conditions in the camps and because they are in touch with other survivors. It would be expedient for these physicians – former prisoners – to offer an advisory service for survivors – a task in which the Ministry of Health and the public health authorities could provide invaluable assistance. Centres of this kind are already operating in Warsaw, Kraków, Łódź, Wrocław, and Poznań. University chairs of the history of medicine should offer courses and conduct research on medicine during the Second World War. The Social and Health Committee attached to the Board of ZBoWiD should coordinate regional research projects and draw practical conclusions from them for recommendation to ZBoWid’s Board and Central Council for practical implementation.

Translated from the original article: Kłodziński S.: Cel i metodyka badań lekarskich byłych więźniów hitlerowskich obozów koncentracyjnych Przegląd Lekarski - Oświęcim, 1965.

Notes:

a. After the War Poland was in a state of absolute ruin, having lost one-fifth of its population and sustained material losses estimated in the hundreds of billions of US dollars, as well as territorial loss to the Soviet Union. It received no compensation from Germany, and the aid offered by the United States was embezzled by the Soviet Union. These were facts which could not appear in print in 1965, but Polish readers knew what “for obvious reasons” meant.
b. ZBoWiD, the Society of Fighters for Freedom and Democracy, the official veterans’ association operating in the People’s Republic of Poland.

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