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It is estimated that between 220,000 and 269 500 individuals with schizophrenia were sterilized or killed.

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Abstract

Although the Nazi genocide of Jews during World War II is well known, the concurrent Nazi genocide of psychiatric patients is much less widely known. An attempt was made to estimate the number of individuals with schizophrenia who were sterilized and murdered by the Nazis and to assess the effect on the subsequent prevalence and incidence of this disease. It is estimated that between 220 000 and 269 500 individuals with schizophrenia were sterilized or killed. This total represents between 73% and 100% of all individuals with schizophrenia living in Germany between 1939 and 1945. Postwar studies of the prevalence of schizophrenia in Germany reported low rates, as expected. However, postwar rates of the incidence of schizophrenia in Germany were unexpectedly high. The Nazi genocide of psychiatric patients was the greatest criminal act in the history of psychiatry. It was also based on what are now known to be erroneous genetic theories and had no apparent long-term effect on the subsequent incidence of schizophrenia.

Keywords: schizophrenia, psychosis, genocide

Introduction

The anti-Semitic horror of the German Third Reich has been extensively chronicled. In The War Against the Jews: 1933-1945, eg, Dawidowicz detailed the appalling annihilation of 6 million Jews, two-thirds of the entire European Jewry. Much less well known is the German genocide of other groups, including gypsies, homosexuals, and individuals with physical deformities, mental retardation, and serious psychiatric disorders, especially schizophrenia. This article will use published data to summarize what is known about the sterilization and killing of individuals with schizophrenia. It will then ascertain what effect, if any, these actions had on the subsequent prevalence and incidence of schizophrenia in Germany.

Background

The systematic sterilization and killing of individuals with schizophrenia in Nazi Germany from 1934 to 1945 was influenced by several factors. Perhaps, of greatest importance was a belief that schizophrenia was a simple Mendelian inherited disease, passed down from generation to generation. In Germany, this theory was promoted by Drs Ernst Rüdin and Franz Kallmann, among others. Rüdin, whose research was supported by the Rockefeller Foundation, was the director of the Genealogical-Demographic Department of the German Institute for Psychiatric Research in Munich. He had a special interest in schizophrenia, which he believed was caused by a Mendelian recessive gene, and advocated that "people who are themselves mentally ill ...should not have children." Kallmann, a Berlin psychiatrist who had been a student of Rüdin, studied schizophrenia in twins and also believed that the disease was transmitted by a recessive gene. In a 1935 speech, Kallmann advocated the examination of all relatives of individuals with schizophrenia to identify nonaffected carriers, which he believed could be done by noting "minor anomalies," and then the compulsory sterilization of such individuals. A year later, Kallmann emigrated to New York, where he continued his twin research and later became one of the founders of the American Society of Human Genetics.

The theories of Ernst Rüdin and Franz Kallmann coincided with a growing interest in Germany in eugenics and "race hygiene" ( Rassenhygiene) in the early 1930s. At the time, the eugenics movement was strongest in the United States and Britain. Indiana had passed the first state compulsory sterilization law in 1907, and by 1928, 20 more states had followed, most including "lunatics" among the target population; California was the most active state in this regard. In 1916, New York patrician Madison Grant had published The Passing of the Great Race, a jeremiad about the dangers of interracial marriage that Science magazine called "a work of solid merit"; it was subsequently translated into German and cited by Hitler in Mein Kampf. The International Congress of Eugenics was also based in the United States, and in 1932, its presidency passed from Dr C. B. Davenport of Cold Spring Harbor Laboratory to Dr Rüdin.

In 1933, Rüdin was one of the guiding forces behind the passage of Germany's first compulsory sterilization law, called "the law for the prevention of progeny with hereditary defects." Its initial target was individuals with mental retardation, schizophrenia, manic-depressive disorder, epilepsy, Huntington chorea, hereditary blindness and deafness, hereditary alcoholism, and "grave bodily malformation." Hitler had become chancellor 6 months earlier. The majority of the targeted individuals were in psychiatric hospitals, which had become massively overcrowded, thereby forcing the discharge of some patients to make room for more admissions. Patients with schizophrenia who were scheduled for discharge were deemed to be of high priority for sterilization in order to prevent them from producing offspring.

This massive increase in patients in psychiatric hospitals came at a bad time for Germany economically. Following World War I, Germany had been stripped of valuable industrial and coal-producing areas and saddled with onerous reparations. The decade following was marked by strikes, clashes between Communists and nationalists, inflation, bankruptcies, and a severe economic depression. Funding for psychiatric care was sharply reduced even as the number of patients requiring care was rising. In 1931, the German Psychiatric Association organized a prize for the best essay on the topic "How can provision for mental health care be more cheaply reorganized?"

The idea of killing the patients in psychiatric hospitals first surfaced prominently in 1920 in a publication by Karl Binding, a lawyer, and Alfred Hoche, a psychiatrist. Entitled Permission for the Destruction of Life Unworthy of Life, the tract posed the question: "Is there human life which has so far forfeited the character of something entitled to enjoy the protection of the law, that its prolongation represents a perpetual loss of value, both for its bearer and for society as a whole?" The authors' answer was clearly affirmative and described such individuals as being "mentally dead" and "on an intellectual level which we only encounter way down in the animal kingdom." The authors emphasized the economic burden of such individuals to Germany. The economic argument was repeated in subsequent discussions of this issue, such as in a 1932 article entitled "The Eradication of the Less Valuable from Society," in which the author, psychiatrist Berthold Kihn, estimated that mentally ill individuals were costing Germany 150 million Reichsmarks per year.

Hitler was interested in these ideas and is said to have discussed a program to kill chronic mental patients in 1933, shortly after assuming the chancellorship. He said that "it is right that the worthless lives of such creatures should be ended, and that this would result in certain savings in terms of hospitals, doctors and nursing staff." Prophetically, he suggested that such a program would be easier to implement during wartime, when public opposition would be less.

The idea of killing psychiatric patients continued to be discussed privately by Nazi officials throughout the 1930s. Finally, in July 1939, as he was planning to invade Poland, Hitler asked his private physician and other officials to draft a law that permitted the killing of mental patients. From the beginning, the euphemism "euthanasia" was used to refer to the killings; as Fredric Wertham noted in A Sign for Cain, "these were not mercy deaths but merciless murders."

The result was a memorandum on "the destruction of life unworthy of life" and a draft law that included the following provision:

The life of a person, who because of incurable mental illness requires permanent institutionalization and is not able to sustain an independent existence, may be prematurely terminated by medical measures in a painless and covert manner.

Selected professors of psychiatry and asylum directors who were known to be sympathetic to the plan were asked to comment on the draft. All agreed that such a program was necessary, but some suggested granting exceptions to patients who were doing "economically important work in the institution." Friedrich Mauz, professor of psychiatry at Königsberg University, argued against granting any exceptions for those individuals diagnosed with schizophrenia "as a matter of principle.",

Hitler's letter authorizing the program to kill mental patients was dated September 1, 1939, the day German forces invaded Poland. Although the program never officially became law, Hitler guaranteed legal immunity for everyone who took part in it. In October 1939, the directors of all German psychiatric hospitals were asked to fill out forms indicating the diagnosis and capacity for useful work of each patient, although they were not told what the forms were for. These forms were then assessed by a committee of selected psychiatrists who targeted approximately 70 000 patients for death, 1 for every 1000 people in Germany, which was the initial goal of the program. The program was known as Aktion (action) T-4, after the address of its headquarters in Berlin on Tiergartenstrasse 4.

Killing of Psychiatric Patients

The planning and logistics for such mass murder elicited much discussion. The method finally chosen was the release of carbon monoxide gas into a closed room outfitted to look like a shower room and the subsequent burning of the bodies in crematoria. Gold fillings were removed from the deceased and used to partially pay for the program. In early January 1940, the first 20 patients were led into a "shower room" at the Brandenburg asylum and killed. This method was judged to be highly successful and was later adapted for the killing of Jews. Five additional asylums, at Bernburg, Grafeneck, Hadamar, Hartheim, and Sonnenstein, were designated as killing centers, and patients marked for death at other hospitals were transported to these regional centers. By August 1941, 70 273 patients had been killed. Careful records were kept, and the 6 centers competed with each other in efficiency. Hadamar, eg, "celebrated the cremation of its ten-thousandth patient in a special ceremony, where everyone in attendance-secretaries, nurses and psychiatrists-received a bottle of beer for the occasion."

Once the initial goal of killing 70 000 patients was achieved, the Aktion T-4 program was halted. Although some resistance to the program had developed, especially among the churches and in communities near the killing centers, the T-4 program personnel were needed for a bigger job. Beginning in April 1941, selected personnel were transferred from the psychiatric hospitals to concentration camps and asked to set up similar killing facilities. According to Cleansing the Fatherland: Nazi Medicine and Racial Hygiene of Aly et al, "the original commandants of Belzec, Sobibor and Treblinka came from T-4 and were on its payroll." The German solution for its problem of chronic mental patients thus morphed into the "final solution" for its problem of Jews, gypsies, and others deemed undesirable.

Although the formal Aktion T-4 program was halted in mid-1941, the killing of mental patients continued throughout the war. In March 1945, Red Army troops even found a crematorium still under construction at one liberated mental asylum. Some psychiatrists were fully cooperative with the ongoing program, while others opposed it and tried to save patients by falsifying their records. In some cases, the killing was done using carbon monoxide, but in most cases it was done by injection (eg, morphine, phenobarbital, or scopolamine) or starvation. Psychiatric asylums implemented 2 diets: minimum calories for those who could work and a starvation diet of vegetables only for those who could not. These killing programs were highly effective. At the Hadamar asylum, eg, of the 4817 patients transferred there between August 1942 and March 1945, 4422, or 92%, died. At the Obrawalde asylum in German Sileasia, of the 3948 admissions in 1944, 3814, or 97%, died. Postwar investigators estimated that 18 232 people had died at Obrawalde alone in the previous 3 years.

According to Fredric Wertham, the mass sterilization and killing of psychiatric patients in Germany "was organized as well as any modern community psychiatry project, and better than most." At the Grafeneck asylum alone, 594 patients were killed in 133-day period, and "eventually the crematorium of Grafeneck smoked incessantly."

Estimates of Numbers Sterilized and Killed

What percentage of these had a diagnosis of schizophrenia? It is clear that individuals with this diagnosis were sterilized and killed disproportionately compared with individuals with other diagnoses. This was because of the strong belief among German psychiatrists that schizophrenia was genetically inherited and also because individuals with schizophrenia were less likely to have been able to work. According to Friedlander, the "overriding criterion" for selection for death in the T-4 program "was the ability to do productive work." The few patients who were still alive in German psychiatric asylums at the end of the war were those who could work or had useful skills, such as a patient, formerly a dentist, in the Obrawalde asylum "who was temporarily acting as asylum director" after the staff left before the advancing Russian army. Having schizophrenia put one in the category of those for whom there were no exceptions to sterilization or killing. Benno Müller-Hill, the author of Murderous Science, noted that "a German who was diagnosed 'schizophrenic' had to be sterilized without exception. Equally, a person who was diagnosed 'schizophrenic' and who was hospitalized for at least five years had a strong chance to be murdered in the euthanasia murders." Given the facts that 56% of hospitalized psychiatric patients in 1929 and two-thirds of admissions during the war had schizophrenia, it seems reasonable to estimate that at least half of the 200 000-275 000 patients killed or 100 000-137 500 individuals were so diagnosed.

Thus, in the 12-year period of 1934-1945, an estimated 600 000-675 000 individuals in Germany were sterilized or killed under medical rationalizations, including an estimated 132 000 with schizophrenia who were sterilized and 100 000-137 500 with schizophrenia who were killed. There would have been some overlap among these groups, but except for Jewish patients, it is not likely that it would have been extensive. The Germans kept careful records; because the goal of this program was to prevent reproduction and thus promote racial purity, killing an individual who had been previously sterilized would have been pointless. The exception to this was Jewish patients with schizophrenia, who appear to have been selectively killed whether or not they had been previously sterilized., It has been estimated that the total number of Jewish patients with schizophrenia who were killed was between 5000 and 7000.

Combining the estimated 132 000 individuals with schizophrenia who were sterilized and the estimated 100 000-137 500 individuals with schizophrenia who were killed, and allowing for a modest overlap, yields a total of 220 000-269 500 individuals with schizophrenia who were sterilized or killed. What percentage of all Germans with schizophrenia does this represent? As noted above, in late 1939, there were 283 000 patients in German psychiatric hospitals. A survey 10 years previous reported that 56% of the hospitalized patients were diagnosed with schizophrenia, a percentage consistent with data from other countries; if that was true in 1939, there would have been 158 480 patients with schizophrenia so hospitalized.

Immediately preceding the implementation of the sterilization program in 1934, there were also 3 studies of the prevalence of schizophrenia carried out in Germany. ⁻ They were done between 1929 and 1931 in predominantly rural areas of Thüringen and Bavaria in southeastern Germany by Carl Brugger, associated with the German Psychiatric Research Institute in Munich. Brugger used key informants, hospital records, and interviews of community residents to identify all individuals with psychiatric problems, including those in hospitals. He said that it was especially important to identify individuals with schizophrenia, which he believed was carried by a recessive gene. Citing Rüdin's work, Brugger said that "only sterilization ensures that the genes do not spread all over the nation." In the 3 studies, Brugger identified 93 individuals with schizophrenia, including an unspecified number who were hospitalized, among the total population of 46 189 people of all ages, for a point prevalence rate of 2.0 per 1000 population. This rate was consistent with other prevalence studies done in the 1930s, including a rate of 1.8 per 1000 in a study of rural Tennessee, 3.3 per 1000 in Denmark, 4.2 per 1000 in Finland, and 1-year prevalence rates of 2.3 and 2.9 per 1000 in 2 studies in Baltimore.

In 1939, the total population of Germany, including the eastern regions that subsequently became part of Poland, was approximately 70 million. If 2 cases of schizophrenia per 1000 population were representative of the entire country at that time, the total number of Germans with schizophrenia in 1939 would have been 140 000 individuals. However, Brugger's studies were carried out almost exclusively in rural areas, and it is known that urban schizophrenia prevalence rates are significantly higher than those in rural areas. In addition, new cases of schizophrenia continued to be diagnosed between 1940 and 1945. Most incidence studies reported in the postwar years around the world ranged between 10 and 30 new cases of schizophrenia per 100 000 population per year; however, as will be noted below, German incidence rates were higher.

Given the estimate of 158 400 individuals with schizophrenia in psychiatric hospitals; the 140 000 individuals with schizophrenia, including some of whom were hospitalized, identified in rural surveys; and new cases of schizophrenia diagnosed during the war years, it seems reasonable to estimate that between 1939 and 1945 there were at least 250 000, and perhaps as many as 300 000, individuals with schizophrenia in Germany. Because we have estimated that between 220 000 and 269 500 of them were sterilized or killed, this means that between 73% and 100% of individuals with schizophrenia in Nazi Germany shared this fate. This estimate is also consistent with the fact that the psychiatric hospital census in Germany in 1945 was only 14% of what it had been in 1939.

Postwar Studies

What effect, if any, did the sterilization and killing of individuals with schizophrenia have on the subsequent prevalence and incidence of this disorder in Germany? First, is this a legitimate question to ask? There is widespread agreement that the results of Nazi experiments carried out on individual prisoners, such as those on hypothermia, should not be published. The sterilization and murder of psychiatric patients was not such an experiment but rather was a policy applied to an entire population. As such, it is similar to other Nazi policies, such as the decision to blockade Holland in late 1944, leading to widespread starvation during the Dutch Hunger Winter of 1944-1945. Studies of the children who were in utero during this period have shown that they had an increased rate of developing schizophrenia. Looking at the effects of psychiatric genocide is similar, and in addition, all the prevalence and incidence studies associated with this question have already been published.

The first schizophrenia prevalence study carried out in Germany following World War II was done in 1971, 26 years after the last individuals with schizophrenia had been sterilized or killed. It covered 424 000 people in 3 counties in Bavaria, including Rosenheim, the site of one of Brugger's studies 40 years earlier. The authors reported a 6-month prevalence of 1.5 per 1000 total population, lower than the point prevalence rate of 2.0 per 1000 that had been reported by Brugger. Between 1975 and 1979, this same research group randomly sampled 1536 adults in Traunstein, one of the 3 counties they had studied previously. They reported a 6-month schizophrenia prevalence of 3.9 per 1000 for individuals aged 16 years and above. They reinterviewed the same individuals between 1980 and 1984 and reported a similar rate of 3.6 per 1000, point prevalence, for individuals aged 15 years and above. The authors noted that the schizophrenia prevalence rates in the German studies were lower than rates being reported in other postwar studies in Sweden, Norway, Iceland, and France, where the rates ranged between 6.0 and 10.0 per 1000, but they did not speculate on why that might be the case.

In addition to the Bavarian studies, beginning in 1974, Heinz Häfner and his colleagues carried out additional German schizophrenia prevalence studies in Mannheim, utilizing their case register. Between 1974 and 1980, they reported a 1-year schizophrenia prevalence rate of 2.3 per 1000. They also noted without comment that this rate was lower than the rates being reported in comparable schizophrenia prevalence studies in England (3.4 per 1000), the United States (4.7 and 5.1 per 1000), and Ireland (8.3 per 1000). The low German schizophrenia prevalence rates were also observed in a 2005 review by Saha et al of 188 schizophrenia prevalence studies published between 1965 and 2002. All these studies suggest that the prevalence of schizophrenia was relatively low in Germany following World War II, as would be expected due to the genocide.

Regarding the incidence of new cases of schizophrenia, no published studies were apparently carried out in Germany prior to World War II. The first postwar study was done in Mannheim in 1965, 20 years after the last patients had been sterilized or killed. Heinz Häfner and Helga Reimann at the University of Heidelberg identified all new cases of schizophrenia reported during the year among the city's 330 000 inhabitants. They reported an incidence rate of 53.6 per 100 000, which the authors noted was "more than twice as high as the mean of 21.8 per 100 000 calculated in 1965 by Dunham from different studies and two to three times as high as the rates of 23.8 or 15.8 respectively, ... for the U.S.A. and England and Wales in 1969." The German rate, they added, was comparable to the "rate of 52 per 100 000 given by Walsh for Dublin in 1969."

Häfner and his colleagues subsequently opened a psychiatric case register and recorded the incidence of schizophrenia for each year from 1974 to 1980; it ranged from 48 to 67 per 100 000, averaging 59. In one report, the authors compared the incidence of schizophrenia in Mannheim with 11 studies in the Netherlands, Italy, Denmark, Norway, Iceland, the United Kingdom, the United States, and Australia; the 11 studies averaged 24 per 100 000, less than half the incidence rate for Mannheim, and only one, a 1970 study in Rochester, NY, reported a higher rate than Mannheim. In another publication, Häfner compared the Mannheim incidence rate with that of 8 centers in the World Health Organization Determinants of Outcome Study; only 1 of the 8 centers had an incidence of narrowly defined schizophrenia exceeding that of Mannheim.

The other area in Germany where schizophrenia incidence studies were carried out was in Bavaria. A 1971 study found 102 cases in a predominantly rural population of 424 000 for a 6-month incidence rate of 24 per 100 000. Another study done in the same area in 1974-1975 reported an annual incidence rate of 48 per 100 000, thus being more similar to the rates reported for Mannheim. These high German incidence rates were also confirmed by international comparisons. For example, a review of 55 schizophrenia incidence studies by McGrath et al found the median schizophrenia incidence to be 15.2 (7.7-43.0) per 100 000; few of the studies achieved the high incidence rates reported in Germany.

Discussion

The sterilization and murder of hundreds of thousands of patients with schizophrenia and other psychiatric disorders in Nazi Germany between 1934 and 1945 was the greatest criminal act in the history of psychiatry. It was perpetrated in an attempt to decrease the incidence of schizophrenia and purify the race, based upon a mistaken belief that schizophrenia was a simple Mendelian inherited disease in which a single gene, or small number of genes, is sufficient to cause the disease. Furthermore, it should have been known even in 1940 that removing cases of schizophrenia from society would have no impact on the incidence of the disease because the vast majority of individuals with schizophrenia do not have a family history of the disease and do not reproduce. Current research suggests that the cause of schizophrenia involves dozens, and perhaps hundreds, of genes and includes common variants such as single nucleotide polymorphisms or less common variants such as copy number variations. Such variants may be carried by large numbers of people, most of whom never develop schizophrenia. It is possible that such genetic variations may cause disease only if they are activated by life experiences such as perinatal hypoxia, nutritional deficiency, infections, or other environmental factors.

Is there any apparent explanation for the relatively high incidence rates of schizophrenia in postwar Germany? One possible explanation is that the areas in which postwar incidence studies were carried out were less affected by the psychiatric genocide. This seems unlikely because many Bavarian psychiatrists enthusiastically supported the eugenics program, and individuals with schizophrenia in the Mannheim region were killed initially in Grafeneck and later in Hadamar asylum.

Another possible explanation is that postwar incidence studies of schizophrenia in Germany included large numbers of non-German immigrants. In fact, 13% of Mannheim's population in the 1970s were foreign workers. Studies of the incidence of schizophrenia among these workers, however, reported that "when corrected for age, the rates of treated schizophrenia episodes ... were significantly lower than those of the German population."

A third possibility is that much broader diagnostic criteria were being used to diagnose schizophrenia in Germany after the war compared with before the war. If this had been the case, one would expect to find high rates in prevalence as well as in incidence studies, but this is not the case. It is difficult to determine what diagnostic criteria were being used in prewar studies. Brugger did not define the diagnostic criteria he used in his 1929-1931 studies, but they were probably the classical criteria of Emil Kraepelin, who dominated diagnostic thinking in Munich psychiatry until his death in 1926. Most studies after the war used the diagnostic guidelines of the International Classification of Diseases, Eighth Revision ( ICD-8), and International Classification of Diseases, Ninth Revision ( ICD-9), introduced in 1965 and 1975, which use somewhat broader criteria for diagnosing schizophrenia. However, most of the other European studies that were being done at the time and that reported much lower incidence rates also used ICD-8 or ICD-9 criteria.

A fourth possibility is that social conditions during or after the war produced environmental factors that led to an increase in the incidence of schizophrenia. An example was the increase in schizophrenia in Holland that followed the Dutch Hunger Winter in 1944-1945. The cause of the high schizophrenia incidence rates in postwar Germany is thus not apparent and is an appropriate subject for additional research.

The major limitation of this article is the quality and quantity of the available data. In some cases, the projected numbers are merely informed guesses whose credibility rests upon their reasonableness and their consistency with other related data. It is hoped that this article will elicit additional, previously unpublished, data that can be used to document and memorialize this reprehensible but important chapter in psychiatric history. In addition, perhaps, the most appropriate response the profession of psychiatry can have to the Nazi eugenics and psychiatric genocide program is to focus additional resources on examining more complex forms of genetic and gene-environmental interactions in order to understand the true genetic contribution to schizophrenia. This knowledge should then be used to develop methods for disease prevention and treatment that can be used ethically in all populations.

Funding

Stanley Medical Research Institute.

Acknowledgments

We are grateful to Dr Sandra Dittmann and Ms Gabriele Chidichimo for assistance with translations of German articles, Dr Vishwajit Nimgaonkar for reviewing the article, and Ms Judy Miller for technical assistance. The authors declare that they have no conflicts of interest.

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# data[].attributes.attachment_link.title
Psychiatric Genocide: Nazi Attempts to Eradicate Schizophrenia

# data[].attributes.attachment_link.description
Although the Nazi genocide of Jews during World War II is well known, the concurrent Nazi genocide of psychiatric patients is much less widely known. An attempt was made to estimate the number of individuals with schizophrenia who were sterilized and ...

# data[].attributes.body
They would kill patients by lying to them. The patients were brought into the "shower room" and then they were murdered by toxic air. The patients were trapped in a tight closed room and the guards released carbon monoxide. These murders started taking place in the Brandenburg asylum.

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There were different symbols that different prisoners would have on their uniforms. political prisoners wore red triangles, Roma wore brown triangles, although they were also sometimes classed as ‘asocials’, which was represented with black triangles, homosexuals wore pink triangles, and Jehovah’s Witnesses wore purple triangles.

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There weren't any big choices when it came to their clothes. The dress and skirt would have a blue and white stripped design and would have a yellow star to show if the prisoner was jewish or not.

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With the number of mental patients in the end bing high brought confusion to everyone but also joy. In the 12-year period of 1934–1945, an estimated 600,000–675,000 individuals in Germany were sterilized or killed under medical rationalizations.

# data[].attributes.body
The way these mental patients were killed was terrible. The Germans later used this tactic of killing on all the Jews that were killed. (Mass Genocide)

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Some women were given a dress while other women were given a jacket and skirt. They were also given kerchief and wooden or leather shoes. It was a privilege to have pockets and only higher ranked prisoners were allowed to have them. People still found ways to sew them into the inside of their uniforms to sneak things around. The prisoners number and marking would be on the left hand side of the uniform.

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with the sterilizing of 73-100% of Schizophrenic, it was expected to have almost no one with this mental disorder in Germany post- Nazis. But Surprisingly the number was very high.

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Shame

Women having periods are normal. Obviously, they were viewed differently back then, especially to men. Women were shamed and made fun of for having their period. A young girl was shamed by a German guard for trying to stop the blood flow. Sometimes, periods would save women from rape.

Summary

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Menstruation

Menstruation was seen as a medical problem. Women the Holocausts cycles impacted their lives. Menstruation was linked to shame of bleeding in public and having to deal with it. Though periods were a struggle (and still are) they have also saved women from being sexually assaulted.

Paraphrase paragraph

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Dr. Perl was such a help to the women in the Holocaust. Abortion was not her strong suit, as the second article states, yet she performed them on these women. The abortions were done in very unclean places with unwashed hands. It was very un-sanitary but these women did what it took to survive.

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This article makes it clear to me that pregnancies were something to avoid in the Holocaust. Women would either have to abort their child while hiding it at the same time, or get shot by the guards. It's not the women's fault most of the time because the guards would rape the women prisoners without being careful and the women would end up making the decision of getting killed or killing the baby. In the end, like this article states, women would abort and if they were even seen while pregnant or with a newly born child they would both be killed.

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George M. Weisz and Konrad Kwiet: “Managing Pregnancy in Nazi Concentration Camps: The Role of Two Jewish Doctors”; NCBI https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2800142/; Rambam Maimonides Med J. 2018 Jul. Published online 2018 Jul 30; Dec. 13, 2020.

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number of newborns killed is unknown but most likely high because of the amount of women in the camps

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Your access to the NCBI website at www.ncbi.nlm.nih.gov has been temporarily blocked due to a possible misuse/abuse situation involving your site. This is not an indication of a security issue such as a virus or attack. It could be something as simple as a run away script or learning how to better use E-utilities, http://www.ncbi.nlm.nih.gov/books/NBK25497/, for more efficient work such that your work does not impact the ability of other researchers to also use our site. To restore access and understand how to better interact with our site to avoid this in the future, please have your system administrator contact info@ncbi.nlm.nih.gov.

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Dr. Gisella Perl-- Protector of Mothers-- was deported to Auschwitz in 1944 with her family but her daughter was left behind. In the camp, she was given the responsibility to report any pregnant woman to Dr. Mengele so that they could be killed. She didn't want the women dying so she had to preform abortions so that the women would escape death.

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(paragraph 3, source card 1, source 1)
Pregnancy was forbidden by the Nazis but some, not all, women wanted to experience bringing life into the world. If a woman became pregnant, they would need to find a way to abort it or they would be killed.

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There were different symbols that different prisoners would have on their uniforms. political prisoners wore red triangles, Roma wore brown triangles, although they were also sometimes classed as ‘asocials’, which was represented with black triangles, homosexuals wore pink triangles, and Jehovah’s Witnesses wore purple triangles.

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Dr. Perl was such a help to the women in the Holocaust. Abortion was not her strong suit, as the second article states, yet she performed them on these women. The abortions were done in very unclean places with unwashed hands. It was very un-sanitary but these women did what it took to survive.

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With the number of mental patients in the end bing high brought confusion to everyone but also joy. In this long 12-year period of 1934–1945, an estimated 600,000–675,000 people in Germany were sterilized or killed under medical rationalizations.

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Some women were given a dress while other women were given a jacket and skirt. They were also given kerchief and wooden or leather shoes. It was a privilege to have pockets and only higher ranked prisoners were allowed to have them. People still found ways to sew them into the inside of their uniforms to sneak things around. The prisoners number and marking would be on the left hand side of the uniform.

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They would kill patients by lying to them. The patients were brought into the "shower room" and then they were murdered by toxic air. The patients were trapped in a tight closed room and the guards released carbon monoxide. These murders started taking place in the Brandenburg asylum.

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with the sterilizing of 73-100% of Schizophrenic, it was expected to have almost no one with this mental disorder in Germany post- Nazis. But Surprisingly the number was very high.

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There weren't any big choices when it came to their clothes. The dress and skirt would have a blue and white stripped design and would have a yellow star to show if the prisoner was jewish or not.

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Menstruation

Menstruation was seen as a medical problem. Women the Holocausts cycles impacted their lives. Menstruation was linked to shame of bleeding in public and having to deal with it. Though periods were a struggle (and still are) they have also saved women from being sexually assaulted.

Paraphrase paragraph

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One day, Cycowicz saw that hundreds of adult women in the camp were sent to a storage building — her mother, Hanna, among them. After a few hours they were all led out of the building and marched out of the camp, but Cycowicz's mother wasn’t with them. Once the coast was clear, she and her sister entered the building and found their mother hiding behind a cabinet. Hanna told them she grabbed another woman to try and hide her as well, but that woman resisted and said she didn’t want to be beaten before being killed. Cycowicz later learned that the women were sent to a labor camp where her mother surely would not have survived.

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Giselle Cycowicz was supposed to spend this year's Holocaust Remembrance Day in Poland. The 93-year-old Jerusalem resident usually accompanies Israeli high schoolers there to learn about life before the Nazi invasion and under occupation.

"Normally, I would be, this time of the year, I would be in Poland, because I also go to Poland to accompany high school kids and we go to all the sites, many sites of the Shoah," Cycowicz told The World. "And I talk about the Shoah. I am the, what they call, witness."

Close to 400,000 survivors of the Shoah, or Holocaust, are believed to still be alive worldwide. About 1.5 million people died at the Auschwitz concentration camp, 90% of them Jews, before the Soviet army liberated the camp on January 27, 1945.

Cycowicz is a survivor of Auschwitz. She was born in the town of Khust, in the Carpathian Mountains. Today, it is part of Ukraine, but at the time it was part of Czechoslovakia. In 1939, Hungary took over the region, and not before long all the Jewish children in the town were expelled from school. Cycowicz was 12 years old at the time.

She didn't go back to school for another three decades, when, at age 42, she went to college in the United States.

Before the war, Khust had about 20,000 residents, about 8,000 of whom were Jews, mainly working in commerce, said Cycowicz's daughter, Yael Bier, who shared some of her mother's recollections with The World. But after the war broke out, there was no livelihood for Jews.

Cycowicz's father did what he could selling mineral water, and to support themselves, the family offered to host overflows of guests at local inns. The children - Cycowicz was the youngest of three daughters - would find empty corners of the house to sleep in as they hosted tourists.

But life for Cycowicz's family was unraveling. From a comfortable home and good jobs, things became very difficult.

In March of 1944, the Nazis marched into Hungary. Within three months, all Jews were sent to the ghettos. Five weeks later, Cycowicz's entire family was sent to Auschwitz by train. She remembers her father, Wolf Friedman, telling them, "Be sure to make yourself useful. That's how you will survive."

"Always on my mind is my parents. My father worked for five months in coal mines on 200 grams of bread a day. That was the entire food other than soup, which was water with some weeds. And when they were brought back to Auschwitz, to Birkenau, his face was all black, because they didn't have a chance to wash, and he was a skeleton without any flesh on his bones."

Giselle Cycowicz, Holocaust survivor

"Always on my mind is my parents," Cycowicz said. "My father worked for five months in coal mines on 200 grams of bread a day. That was the entire food other than soup, which was water with some weeds. And when they were brought back to Auschwitz, to Birkenau, his face was all black, because they didn't have a chance to wash, and he was a skeleton without any flesh on his bones."

She said a person from their town said, "Today, 200 Jewish men were brought back to Auschwitz from the coal mines where they worked ... Tomorrow, we won't be here anymore."

After that, Friedman was sent to the gas chambers.

"He was 49 years old. And he knew all along. This is my biggest pain, that they know that they're going to be killed by gas," Cycowicz said. "Can you imagine this? We know that something like this exists and that it may happen at any moment in Auschwitz, that they should take us and put this into the gas chamber. But it wasn't imminent. We didn't know for sure. But they know, we are now going to go into the gas chambers and be killed."

Cycowicz was in Auschwitz for six months with one of her sisters and mother, Hanna Friedman, who was 50 years old, and frail. Keeping their mother alive became their purpose, Bier said.

One day, Cycowicz saw that hundreds of adult women in the camp were sent to a storage building - her mother, Hanna, among them. After a few hours they were all led out of the building and marched out of the camp, but Cycowicz's mother wasn't with them. Once the coast was clear, she and her sister entered the building and found their mother hiding behind a cabinet. Hanna told them she grabbed another woman to try and hide her as well, but that woman resisted and said she didn't want to be beaten before being killed. Cycowicz later learned that the women were sent to a labor camp where her mother surely would not have survived.

Later, Cycowicz, her sister and mother were sent to a different camp, where they remained until their liberation. One day, the camp's Nazi armed officers, the SS, lined them up and told them: "We're waiting for the Russians. You can go wherever you want, but please don't do anything to us."

After liberation Cycowicz's family moved to the US, where she became a psychologist. She married and had three children in the US. In 1992, after her husband died, she followed her children who had already immigrated to Israel.

Cycowicz joined an organization called Amcha, which provides social and psychological support for Holocaust survivors. She says she has found new meaning in that.

"I've been living alone. And it's fine for me. I am very active. I've been working. I'm still on a payroll. I still have patients and I have now in this week, from the beginning of the holidays, I've had maybe 200 telephone calls," she said. This year's Passover holidays end Thursday.

"Every minute of the day somebody calls to say, to wish a good holiday, and to remember the Shoah, and to wish me good health. So I'm not alone. And I talk to the children a few times today. And I have, thank God, 21 grandchildren and a large number of great-grandchildren. So I don't feel alone."

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From Auschwitz to Jerusalem, Holocaust survivor Giselle Cycowicz shares her story

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Giselle Cycowicz was supposed to spend this year's Holocaust Remembrance Day in Poland. The 93-year-old Jerusalem resident usually accompanies Israeli high schoolers there to learn about life before the Nazi invasion and under occupation.

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Roxzann Baker under the supervision of Dr. Barbara Warnock: “Uniform and Clothing”; THE HOLOCAUST EXPLAINED https://www.theholocaustexplained.org/the-camps/ss-concentration-camp-system/uniform-and-clothing/; developed by the London Jewish Cultural Centre 2020; Dec 13, 2020.

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In addition to forced labour, the Nazis used prisoners incarcerated in camps as live test subjects for medical experiments. These experiments were usually extremely painful, debilitating , and in many cases, lethal.

The experiments had various purposes: experiments attempting to prove the supposed superiority of the ' Aryan ' race, experiments to try and find solutions to military or common war related injuries, and or experiments to further individual doctors' research interests.
Experiments attempting to prove the superiority of the 'Aryan' race
Just six months after Hitler was appointed Chancellor, on 14 July 1933 the Nazis passed their first sterilisation law, which forced people with certain hereditary conditions to be sterilised by law.

Following the mass imprisonments after the start of the Second World War, the Nazis escalated this sterilisation policy and also targeted other racial enemies such as Jews. The Nazis conducted a number of experiments on concentration camp prisoners in an effort to discover a method for mass sterilisation. These experiments primarily took place on women prisoners at Auschwitz and Ravensbrück.
Experiments to find solutions to military or common war related injuries
The start of the Second World War also led to a number of medical experiments on concentration camp prisoners in attempts to discover new, cheaper and quicker treatments for common military injuries. Some examples of these experiments include hypothermia experiments at Dachau, which attempted to discover ways to quickly reverse the effects of hypothermia . This set of experiments forced inmates to be submerged in cold water. Out of the 300 inmates involved, between 80-90 died - typically of heart failure. Other experiments at Dachau involved attempts to make seawater drinkable, in case troops were marooned with no running water, attempts to find a similar drug to penicillin , which involved infecting prisoners with sepsis , and attempts to find a cure for malaria . Almost all of these experiments resulted in a significant number of deaths or physical and mental deformities among the prisoners tested on. Prisoners were typically given little to no pain relief during experiments, and the Nazis saw their deaths as inconsequential due to their inferior status.

Dachau was not the only site of war-related medical experiments on prisoners. Experiments to find a cure for typhus also took place at Natzweiler and Buchenwald (where 154 inmates out of the 729 used died, in addition to 120 carrier patients who died whilst being used to keep the infection alive so it could be further tested). Hepatitis experiments took place at Sachsenhausen and Natzweiler, and bone, muscle and nerve regeneration experiments took place at Ravensbrück.
Experiments to further individual doctors' research interests
Concentration camp inmates were also used as live test subjects in individual doctors research experiments. Perhaps the most infamous example of this was the experiments performed by Dr. Joseph Mengele on inmates of Auschwitz. Mengele was particularly interested in twins, people with different colored eyes, and people with physical impairments. Mengele did not spare any thought for the wellbeing or health of the inmates subject to his experiments, and many of them died or were purposefully killed so that their corpses could be examined.

Another example of medical experiments on inmates driven by personal interest was the Tuberculosis experiments carried out by Dr. Kurt Heissmeyer in June 1944 in Nuengamme. Heissmeyer hoped that his experiments would find a cure for tuberculosis . All of Heissmeyer's experiments failed. Despite the lack of positive results, Heissmeyer continued his experiments, and started new rounds on children in 1945. All of the inmates involved in the experiments either died as a result of them, or were murdered on Heissmeyer's orders directly afterwards.

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In addition to forced labour, the Nazis used prisoners incarcerated in camps as live test subjects for medical experiments. These experiments were usually extremely painful, debilitating , and in many cases, lethal.

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The way these mental patients were killed was terrible. The Germans later used this tactic of killing on all the Jews that were killed. (Mass Genocide)

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Dr. Gisella Perl-- Protector of Mothers-- was given the responsibility to report any pregnant woman to Dr. Mengele so that they could be killed. She didn't want the women dying so she had to preform abortions so that the women would escape death.

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When you reached Israel, did you talk about the Holocaust? Did the Israelis want to listen?

I only told my children. It wasn't like it is today, when we talk about the Holocaust at schools. Then we were quiet, many long years. What my children knew about the Holocaust, they knew from me.
Hedi Solzbach

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Dr. Naama Shik, Yael Novogrodsky

Introduction

This exclusive interview was published in our newsletter Teaching the Legacy (May, 2008). The original interview, conducted in Hebrew, first appeared in our Hebrew edition of October, 2007. While focusing on the touching wartime story of Hedi Solzbach, several issues arise which are intrinsically linked to the female experience in the Holocaust. Thus, for instance, we hear about the day-to-day banter in the women's block at Birkenau, the humiliation of nakedness and fear of bodily harm, use of margarine as an anti-wrinkle cream, "support groups" amongst the female prisoners, care for others as a strengthening or consoling experience, and more. In many ways, Mrs. Solzbach's testimony highlights the "dual" experience, or "double jeopardy" - as it is known in the research - which typified Jewish women during the Holocaust, particularly in the camps, both as Jews and as women.

"They would take you if you'd just open your mouth or if they didn't like your face"
Please tell us a little about your childhood.
I was born into a traditional family in Sobotice, a small town near Novi Sad, [Yugoslavia; today, Serbia] on February 9, 1925. Grandpa Czarny kept a kosher kitchen and was also a member of the Jewish community in Novi Sad. There is no longer a community there. I had a brother, Latzi, from my father's first marriage. When he was three years old, my [birth] mother and father separated, and my father married my mother, so from age three, he was with my mother. In between Latzi and myself, we had a [third] child who died, and then I was born. So there are nine years between myself and Latzi. That's my small family.

I would speak Hungarian with my mother, Yugoslavian with my father, and German with my grandfather. My elementary school was a Jewish day school, and then I went to a general school.
You knew you were Jewish? Did you go to synagogue on the Sabbath? Fast on Yom Kippur? [Jewish Day of Atonement - trans.]
Of course. Father went to synagogue in the morning and at night. I began fasting from age 12 - I even fasted in Auschwitz. I had two Jewish friends there. One of them was very religious and knew all the prayers by heart. We spent our Yom Kippur there. Then I was in Gleiwitz - a coal factory, a sub-camp of Auschwitz. We worked with coal, and I fasted there.
What do you remember from the outbreak of the War?
With us, the Hungarians came in 1941, and then the hell started. In fact, [it started] even earlier, when I finished school in 1939 and wanted to go study at a teaching school. I very much liked children. There was a special childcare school in Belgrade, where I had two aunts - sisters on my father's side - and an uncle, and I had a place to live in, but I wasn't accepted because I'm Jewish. In 1940, everything was closed - Jews could hardly study anything anymore [in schools - trans]. You couldn't move right or left. Then, in 1941, the Hungarians came. Father told me, "My child, you have no choice, you must learn a profession which will provide for you in the future."

He very much wanted me to study a profession, and in those days every Jewish girl learned to sew. I thoroughly hated it, but it later served me very well. There were no courses like there are today. For two or three years, you had to study as an apprentice with a teacher, and I went to study. I had to pay, and I didn't have any money - my father had been paying once a month - and he didn't have a job anymore, so I told him, "No! You're not paying! I will do all the work."

This wasn't simple for me. Our family had been a prominent, distinguished family, and we were very wealthy. It wasn't easy for me, it was very difficult. [...] I worked all day - sewing and felling trees for the owner of the sewing workshop, and then later with small children that I would look after.
Were you scared of the Arrow Cross Party, of the Hungarians?
Of course. They would take you if you'd just open your mouth or if they didn't like your face.

At this stage, when you were 16, and working for this woman, were you alone?
No, I was with my parents. I would sleep at their place at night. My brother went to Budapest thinking he'd find a job there, because there was no work for him in Novi Sad. Luckily we still had our jewelry, so we sold them and lived off that. We didn't have any socks or shirts, so we would insert the shirt collar inwards, unravel it and turn it over. My mother would do this for the Jewish community and earn a small pittance. Socks, too - we couldn't buy any, because there weren't any, so she would match socks from different pairs.
You were hungry then?
No. Mother took care of that very well. I still didn't have a salary. That's the thing that hurt me - today I'm 82 years old but I remember it as if it was today. For me it was humiliating. It's hard to talk [about it]. Our family was an honorable family and here I have to sew dresses in the living room and take them to the clientele? Walking in Novi Sad, "Mrs. Hedi," meeting acquaintances... It was very difficult for me. After a few weeks I adjusted, and I would get a tip for each [dress], and that was money. Money is money. So I was happy, and I could bring dresses to the clients and get some money.
Age 16 - that's an age of blossoming for a young woman. Did you feel you were being robbed of your childhood, or were you too busy simply trying to survive?
I was so preoccupied with thoughts of how to live and how to survive in this situation, so I worked all the time. I would sew from seven to three, then I would run home to eat something, and then I had three children I would look after until seven. I would go for a walk with them, or we would play at the house. They had silk stockings and they would sometimes split. I would sew with a special needle. It's difficult for me to tell, because I came from a very rich, respectable family. It was like I had been cut with a knife. But I told myself - "I must work!" Our days with a maid were over - that I understood. Finita la comedia.

"She didn't hand it to him - she was a proud woman"
What happened when the Germans reached Novi Sad?
The Germans arrived in March, 1943. The first thing they did when they arrived was take the men. My father had an acquaintance who had hot springs - springs with mineral water - and father used to go to him for treatment. As soon as the Germans arrived, he escaped from there and stayed for two days. They took my brother. They took him together with other men from Novi Sad to a giant courtyard. There was a coffee shop there - "Sloboda" - and they were led inside. I took food for him, because they hadn't received any food, and we stood in line [outside] to come in. I was scared. The German officer took me aside and I thought that was the end of me, but he didn't do anything.

On that day, the Germans lined up the men in a row and beat them. Latzi, my brother, was an athlete, and very strong, so he ran, and they told him to slow down. He had been beaten, and when I brought food for him, he was bruised all over. Later on he managed to escape from there, and traveled to Budapest. Father came back at 3 AM from his friend, and wouldn't leave the house. Then we were thrown out of our home because we were Jewish, and that was another blow. We searched for another place to live, and we couldn't find anything because we were Jewish. Eventually we got a tiny apartment from the Methodist community, with no drinking water and no toilet except for a small room in the yard. It was very difficult. We would have to walk over half an hour to draw drinking water from a well. In the winter it would freeze over, and I would bring hot water from home and pour it in so the ice would melt and I could draw the water. Father was closed in his room, and would have to do his business there, because he couldn't leave - he would be seen. He was closed in this way for two weeks. Then they said they were taking all the Jews to work.

In April, 1944 they took us. The Hungarians came and demanded all our jewelry, but the day before I told mother, "You're thinking of giving them all our jewelry? Give me what's left." She gave me some items and I took them to a girlfriend of mine. I later found it, after the liberation, and everything was there, just I had left it. Nothing was missing. So when the Hungarians came, mother only had a ring on her finger. A Hungarian demanded she take it off and hand it to him. So mother removed the ring, threw it far, and said to him, "Now go look for it." She didn't hand it to him - she was a proud woman.

Later they took all over us to the synagogue, and from there to Sobotice. They separated the men and the women there, and they took only the women, not everyone. That was the last time I saw my father. I said goodbye. From there, they took us to Bačka Topola, and from there to Auschwitz, in the closed cars. This took around a week. In the car, I was with my mother, the whole time.
In the train car, what did you talk about with your mother?
What could you talk about? It was very crowded and smelly. We took a small bag with a little bit of food, because we hadn't gotten anything else. It was just like what you see in the movies: "Raus! Raus!" ["Out! Out!" - trans.] The whole time, we thought we were being taken to work. We said this must be work and that with God's help, I am strong, I had always been strong and I can work, no matter what job we're given. My mother was then 50 years old.

We arrived at Auschwitz in the morning, before noon. We were lined up in rows of five. Mister Mengele came, and I was put on one side and my mother on the other. Mother was quite strong and she said she wants to be with her daughter. He asked her if she could run. She answered, "Sure, I have legs." She was always proud of her strong legs. Then she went over to my side, and the capos came. I had special warm shoes. They asked me to give them the shoes. "No. Are you crazy?" They asked for the sweater as well. I refused. How could I have known that in half an hour I would be naked? Then they took us into another room and forced us to strip entirely. [The meaning here is the "Sauna," meaning "shower" in German. This was the place where Jews were sent who had cleared the selection process and had been chosen for forced labor. They were forced to strip naked, and all their head and body hair was shaved. They were sterilized, received prisoner uniform and clogs and, in most cases, were tattooed with a prisoner number on their arm.]

In the room there were SS officers and capos. I didn't know where to put my hands and what to hide. It was horrible. I shudder just thinking about it. You can't describe something like that. Then they shaved off all my head and body hair, but they didn't shave everything off. They left a little bit of hair, like monks.

When they finished, we got our clothes. These weren't striped prisoner uniforms but more like rags. I got one man's shoe and one woman's shoe. I also got a long skirt and a coat. I'm [a] large [woman], and without a bra, it was so painful, I thought I would die. We did get underwear. My mother was very brave and stole some more underwear from the [pile of rags]. We were scared to death, but she took some. When we had gotten all our clothes, we stepped outside and there was a brush with red oil paint. We were marked with a stripe on our backs. They tattooed the number on the arm later. We had gotten a handkerchief, and because I was very strong, I cut it and tied it around my chest, so it wouldn't hurt as much.
In the Sauna, you were with your mother and presumably with other women you knew as well. When you left, did you recognize each other?
We didn't recognize each other. I looked at my mother and thought, "This is my mother?" Later we reached the camp. We slept six to a bunk, three in each direction. I was with my mother the whole time. I always went to a place where there was a window. I had this "bug" where I had to breath fresh air. We were told not to drink water because we could get typhus, so I didn't drink. They had what they would call "tea" or "coffee," which we could drink because it had been boiled.
In the first few days, did you eat the food you were given?
No, of course not.
Describe the initial days in the camp.
Near our block [barrack] we had a giant courtyard with a large pile of rocks. I was taken to work in moving the rocks from place to place. My mother wasn't with me working, she was in the block. Before that we had morning "zelapel" and evening "zelapel" for hours. ["Zelapel" - "roll call" in German. This was one of the most difficult trials for male and female prisoners. It would take place twice a day - in the morning and in the evening - regardless of weather conditions. The prisoners were counted, and often the numbers would not match those of previous roll calls, forcing the prisoners to endure laborious re-counts in harsh weather. Many prisoners died during these roll calls - Naama Shik.]

Mother would always be behind me and I would be in front of her. After around a month and a half, Mengele came. We had some 1,000-1,500 women from the blocks, standing outside. He chose 72 women. All of them strong. I was strong as well. My mother stayed behind - she was [later] liberated in Auschwitz; she stayed in Birkenau until the end. They took us, we had the lager altester, a Czech, Fani. Very pleasant woman. She walked by me and said that when I was asked, I should say I was a "junge frau" - a young woman. I didn't know that that meant "virgin". I told her I wasn't married. She said, "You need to say it that way, don't argue with me." I didn't know why. And then they took us to a place to bathe, and a doctor came, besides Mengele, and everyone asked. We knew they wanted to take us to the whorehouse, for the soldiers. At the last minute, he changed his mind and we were sent to Gleiwitz, a sub-camp of Auschwitz.

"When I had someone to care for, I had strength"
Can you tell me what the women in Birkenau talked about?
We would talk about food, all the time about food. What we would cook today. It was non-stop. From the beginning to the end - in every camp I've been to. In Neustadt, and after the last camp, we once found grass, took it, and said - it's like an onion. And we ate it.
You would think about actual recipes?
Exactly. All day. Food, food. Here and there we might mention our homes, but that was rare. I want to add a story about my mother. She was a very, very elegant woman, and throughout the years she would always take care of her looks. In Auschwitz, they would give out margarine, to put on bread. This was a special portion in Auschwitz, especially since we were hungry all the time. But my mother would not put it on bread, but rather put it on her cheeks so she wouldn't get spots or wrinkles. She truly was a strong person.
Did you have friends during the camp-period? Were there other prisoners with whom you shared the struggle for survival?
In Gleiwitz, we were three friends. When I just moved to Gleiwitz, I had my girlfriend from Novi Sad, whom I had been together with from our school days. But one day she left me. She thought that if she'd go and fight for survival alone, she would be better off, so she left me. I sat in a corner and cried, just cried, I didn't know what to do. I was suddenly left alone and I cried.

Then two girls appeared in front of me. They were friends from a school in a village near where I grew up. They came and asked me what happened and why I was crying. Like a little girl - like a baby - I told them through my tears that I was alone and had no one. They told me that I would be with them, that we'd be a trio. From that moment until the end, we were together. I saved their lives. Even today, when I speak with Katice's husband he says I saved her. She had wounds from head to toe. I cleaned each one for her, and this she can't forget. The other as well - I saved her too. And being together certainly saved me. Still today, I am a person who likes doing things for people so I'm not alone. Being alone, for me, is death. Even as a girl, I've always had a need to care for others, in the camps and still today. When I had someone to care for, I had strength. So I knew I had two friends that I give to, that I do for, and this continued from the beginning to the end [of the war].

Later, the three of us were sent to work at a factory in Gleiwitz. In the work we did, we had to maintain our hygiene, and because of this we were very lucky, considering we were in Auschwitz: We each received six bars of soap a month. This was money. This was something you could trade in. From these I managed to do everything - I traded them and managed to "organisieren" [camp slang - to barter, to "arrange" for goods]. We had all sorts of extra things. They [the friends - trans.] would give me their soap bars, we would pool them and I would be in charge. The factory had an iron floor that could be lifted. I had my corner where I hid the soap and no one knew. With that I did organisieren. It was trade - you would give a slice of bread and get potatoes, and some of that I would give to my mother. On one of the days, when I gave her potatoes, she put it on the oven in the middle of the block. She put the potatoes on it, not exactly to cook them, but just so they would be edible. Then the capo of my mother's block came and tossed her potatoes. She had a whip, and - this is what they told us when we came back to the community, people who had been there with my mother - they said [my mother] took [the capo's] whip and broke it on her leg [and said,] "I could be your mother! You're a little girl, and you're beating me?" She wasn't punished for it. [The capo] was stunned. They only told me that after the war, when we had come back.

In Gleiwitz they had sacks of cement. During work [hours] we would steal the bags, peel off layers and put it under our clothes so we would be as clean as possible and I could save on soap. By the time we learned to bathe, we were black from head to toe. But you couldn't be black in the eyes. We learned how to bathe so there would be no black.
When you were with your mother, who would take care of whom?
I was only a small child then, and in Birkenau my mother took care of me. Then maybe it was fate that allowed me to part from her and go to Gleiwitz, and then I became the strong one, the one who organizes everything and decides everything. We were in Gleiwitz nine months. In January they took us on a death march of 40 kilometers, through snow, and in 25 degrees below zero cold. Before that, when they told us we had to leave - this was a small camp of 360 women - everyone broke into the storeroom to get clothes and they were falling over each other. I already had a striped uniform and also already had longer hair. I would brush Katice's hair, and by that point she was apathetic. When we went to the storeroom we took as many clothes as we could. I took [clothes] for Etti and Kati as well. Just then a huge, blond, fat capo came, she beat everyone and told them to get out of the storeroom. But I had managed to get some clothes, and gave them to Kati and Etti.
What would you talk about, the three of you?
We wouldn't always talk about food, but most of the time. Sometimes we would talk all sorts of nonsense - what young men we had met, how it was in our old youth group, where we used to go, who will be and what will be.
Why did you comb Katice's hair? How did you get a comb?
The comb I bought with a piece of bread. We had soap bars, we were "rich". I saved a little here and a little there. I combed her because she had become apathetic. She didn't have strength for anything, and I was fighting for her life. Gleiwitz was very difficult - I had a hole in my hand because I had ripped a tendon. Terrible pain. It was very difficult, it wasn't easy, but when you have smarts and the will, and when you believe that things happen for a reason, you can [live].
We started talking about the death march, let's go back to that.
So they took us on foot, in open cars. When we needed to go to the bathroom, we couldn't stand or walk, so we would have to go where we were, in our pants. It would quickly freeze and become ice, and then it would chafe. They put us in open wagons, one hundred and fifty women in one car, like sardines. One day, all the cars came to a stop and we were told we were on a "bathroom break". [The car floors were] very high. We jumped off, and when I wanted to come back, I couldn't find Etti and Katice. I went up to the cars and called, "Etti! Katice!" There was one SS officer there who asked, "Where are you going?" I thought to myself - "What's the worst that can happen? I'll get a bullet in the head and that's that." I told him, "I'm looking for my friends." He said, "Go, make sure I don't see you."

I found them four cars from me. I asked if they had taken my blanket and small knapsack where I had the brush, a cup, and so on. They said they hadn't. I asked, "Then why did you leave there?" They answered they didn't know. So I went back to the cars to look for the blanket and the knapsack. The same SS man saw me again, and asked, "What are you looking for here?" I told him, and came back. I barely managed to climb up, and I found the blanket and knapsack. Now I had to walk again. He told me that if he saw me again, I'd get a bullet in the head.

Slowly, the cars started moving, and I started running. With the cars that we had, the floor was a meter high. Half the people in the cars were German and half were us. They grabbed me by the hand and pulled me up. We sat there, maybe a week. The Germans had tinned cans, and they would light small fires in the cars. I thought, "What can happen? I may get slapped or something, but we try." They would throw away the cans. I took some snow and asked if he would let me put the snow in the cans on the fire. He said, "OK, put it on." It thawed, so [I gave] one spoon for Etti and one for Katice. They were nearly dead, and didn't want anything anymore, they simply didn't care. So I kept talking, saying, gave them snow - there was no food or water, so we ate snow. That's how we reached Ravensbruck.

There, they checked who had lice. It was the first transport, and there were no lice at all. In Gleiwitz we were very hygienic, and since we worked with coal we always had soap and water. One SS man, who was tall and fat, looked through all the rows of the block - we had beds. He called me out. I looked at Etti and Katice - "What's happened? Am I being taken back to Auschwitz?" He said, "The number on your hand isn't good. It has to be redone." So they made two numbers over again. Those moments when I was waiting to see what would happen, what's going on - it can't be put into words, that feeling.

During this whole period, did you miss your mother? Did you think about your mother?
Yes, a lot. In Gleiwitz I always went up to the top floor of the factory, and there was a small window that faced towards Birkenau, and I would look out there and imagine all sorts of things about my mother: Mother's coming, Mother's hugging, we meet. That was a point where my head and my thoughts we devoted only to the parents, to the home and my brother, my family. Longing, lots of longing. It would hit me there.
Let's go back to the period when you arrived at Ravensbruck.
When we arrived at Ravensbruck, they put us in a block of Gypsies. A million and one lice. This was a block of "Shema Yisrael" [Jewish prayer, often recited when facing mortal danger - trans.], just horrible. The Germans said that whoever wants to work will get a double portion of food, so I was the first one who wanted to go work. One job was sawing wood. Katice and Etti didn't work. The capo of our work detail said that when I went to the kitchen with another girl to take the bucket of soup, I would get a double portion and I gave the second portion to Etti and Katice.

One day, when we were there at Ravensbruck, we heard that a transport had arrived from Auschwitz. I looked for Mother, I thought maybe she was coming. She didn't, but Etti's sister arrived. She was in the other block. I said that I was going to go get her. I knew this was dangerous, but I went and brought her. So she was with us, but not until the end - she died. We were in Ravensbruck almost a month, and then they took us on a train with open cars. I remember that on February 9th I was still at Ravensbruck. I was so naïve, and I told my friends, "You'll see, on my birthday my mother will come." Right...

They put us in cars and took us to a place - I don't know what it was called. They had huge Hungarians. There were women already there. I saw them sitting there, there was hay, I didn't know what they were doing. [...] Everyone was outside. I had a black kerchief, and behind me stood a woman who said, "You have lice on you." I opened the kerchief and shook it. She slapped me and said, "How dare you throw the lice when you should kill them? They'll breed!" I felt itchy. There were large tree trunks there. I walked between them, they were crawling with millions of lice. I undid my dress, and threw them there. I threw away all my clothes. I stayed only with my striped uniform, so I would have as little as possible to clean. It was a natural disaster.

That's where I met my "lager mama". It was Clarie Hershkowitz (Pressburger). She was from Novi Sad. We had a good connection, until she passed away. She was 40 then, and I would help her. We had already been at Neubrandeburg, and she had a tin cup. She couldn't stand. She was very weak and I told her "Clarika [affectionate nickname - trans.], sit on this and rest." Our capo came and asked why she was sitting down. She wanted to beat her. I knew that if she would get slapped, she would die. I grabbed the capo by the arm, and I was beaten for it. Never mind. But if Clarie had been beaten, it would have been horrible. I was with her all the time, with Katice, with Etti and her sister Pieri, who was ill. I took her to the hospital, and Etti didn't want to leave her alone. She was scared that something would happen to her, so she stayed with her in bed.

That was also the first time that someone tried stealing something from me. No one had stolen from me, but this time they tried. It was a block of Russians, and heard you could get cooked potatoes in exchange for a slice of bread. I had a slice in the pocket of my striped uniform. A slice that was taken from me. That was the first and last time I had been stolen from. I took bread that Pierie ate. It was one day before she died. Etti was also very sick then.

We were liberated by the Russians [on] May 2nd. My husband was 9 kilometers away, and he was liberated by the Americans.

"We danced all night, an English waltz"
Please describe the day of liberation.
On the day of liberation, people stormed the food warehouses. "Don't eat everything all at once" - I didn't allow it. Nor did Etti and Penny, my friend from school who was there. So we were eight girls: Fani, two Hoffman sisters, Bori, her sister Clarie, myself, Katice and Etti. Pieri passed away. Etti was also sick. A few days after the liberation, we left the camp, first to the camp where German officers were. They had a bar and everything. I found alcohol there, so I could disinfect Katice's wounds. We would go from house to house, and we found a villa that had belonged to a doctor. We found a scale there, and we wanted to see how much each of us weighed. I weighed 35 [kilograms, 77 pounds - trans.], Clara weighed 30 [66 pounds]. She was skin and bones. All of them were, more or less.

We wandered from place to place. Always during the day, and at night we'd stay at home. We found the villa, and in one room was Clarie, and in another I was with Fani and Katice. In one home I found a baby carriage, I put Etti inside, and took her to the hospital. From then, I didn't see her until she had already arrived in Israel, and the wedding of her daughter, in the [1980s]. When we went to the villa, Fani and I took a room, and her bed was by the window. All of a sudden I felt a foot on my bed. Someone had climbed through the window - they were Russian soldiers. I was frightened and said in Polish, "I'm a girl! Sick! Auschwitz!" We ran like children to the room where Clarie was. [...] We were there until morning. All night they came, but they didn't do anything to us. Then we went on.

We searched. We were looking for a Yugoslav camp, and we arrived at Pritzwalk. They told us there that we could continue, that there is a bigger camp, in which there are only Yugoslavs, POW's as well. We were there, and we had one room for 8 girls. [...] We invited one of them for a meal. Every day there was someone [designated] who would cook. It was just my turn that day. The girls ate almost everything, and only my portion was left. I told myself, "How can it be that this man came, I didn't know him, and there's nothing left?" I put my portion aside. He came, and I gave him my portion. Since then, we've been together 43 years.

We heard from the Russians that they're having dances at night, with a harmonica. So he promised us - all the girls - that he would come to pick us up for the dance. I very much liked to dance. We waited, but he didn't come. I said, "What kind of person [is he]? Not one word?" I told my friends that we'd go and see what had happened to him. He was in bed. I told him, "What kind of person are you? You said you would take us. You're getting up right now and we're going to the dance!" And so it was. He went with us. We danced all night, an English waltz. It was a large hangar. Everyone moved aside and looked at us.

So we traveled with him for three months, from place to place, until we reached Neubrandenburg. There we boarded trains to Yugoslavia, through Czechoslovakia and Hungary. In Budapest, the cars stopped for two days and I told my husband, "Let's look for my uncle who lives here." The city was ruined. I found him, and he gave us food. [...] On the border between Hungary and Yugoslavia, the cars stopped again, and everyone stepped out to wait until the train would move again. Suddenly, I hear someone yelling, "Does anyone know the Czarny family?" I said, "Me! My mother is a Czarny!" He was happy. It was my mother's cousin. He invited me to his home. We wanted to come back home to see who was still alive. He gave me a suitcase full of food, and this was great for us. So we reached Sobotice. There were two women there from the Novi Sad community. That's where my husband got the bitter news that his mother and two sisters went to the crematorium, and his father had passed as well. Only his two sisters survived. One lives today at Novi Sad, and the other here, in Kiryat Bialik. So we arrived home, at Novi Sad. Mother was already there.
Did you think she would survive?
I did, but when the transports arrived at Ravensbruck and we set out on the death march, I wasn't sure if she went or not. Later she told me she decided not to go, and that if she'd die, it would be at [Birkenau] camp. Why should she suffer and die on the way? She made the smart choice. When I met her, her head was shaved and she had a turban on her head. I argued with her to take the turban off, because her head wasn't getting air and the hair wouldn't grow. She didn't want to - she was embarrassed by it and it was horrible. Later she nevertheless took it off.

When you reached Israel, did you talk about the Holocaust? Did the Israelis want to listen?
I only told my children. It wasn't like it is today, when we talk about the Holocaust at schools. Then we were quiet, many long years. What my children knew about the Holocaust, they knew from me.

A year or two ago, I was in Hulda [a kibbutz in Israel - trans.], where they have service taxis [leaving the kibbutz] [...] I waited for the taxi to fill up with people, and the driver looked at the number on my arm and asked, "Is that your phone number?" I answered that it was. Not all the people know. He had no idea I had been to Auschwitz.

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Interview with Hedi Solzbach (Schlanger), Holocaust survivor

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Dr. Naama Shik, Yael Novogrodsky This exclusive interview was published in our newsletter Teaching the Legacy (May, 2008). The original interview, conducted in Hebrew, first appeared in our Hebrew edition of October, 2007. While focusing on the touching wartime story of Hedi Solzbach, several issues arise which are intrinsically linked to the female experience in the Holocaust.

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E. Fuller Torrey and Robert H. Yolken: “Psychiatric Genocide: Nazi Attempts to Eradicate Schizophrenia”; NCBI https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2800142/; Schizophr Bull. 2010 Jan Published online 2009 Sep 16; Dec 13, 2020

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Abstract

Although the Nazi genocide of Jews during World War II is well known, the concurrent Nazi genocide of psychiatric patients is much less widely known. An attempt was made to estimate the number of individuals with schizophrenia who were sterilized and murdered by the Nazis and to assess the effect on the subsequent prevalence and incidence of this disease. It is estimated that between 220 000 and 269 500 individuals with schizophrenia were sterilized or killed. This total represents between 73% and 100% of all individuals with schizophrenia living in Germany between 1939 and 1945. Postwar studies of the prevalence of schizophrenia in Germany reported low rates, as expected. However, postwar rates of the incidence of schizophrenia in Germany were unexpectedly high. The Nazi genocide of psychiatric patients was the greatest criminal act in the history of psychiatry. It was also based on what are now known to be erroneous genetic theories and had no apparent long-term effect on the subsequent incidence of schizophrenia.

Keywords: schizophrenia, psychosis, genocide

Introduction

The anti-Semitic horror of the German Third Reich has been extensively chronicled. In The War Against the Jews: 1933-1945, eg, Dawidowicz detailed the appalling annihilation of 6 million Jews, two-thirds of the entire European Jewry. Much less well known is the German genocide of other groups, including gypsies, homosexuals, and individuals with physical deformities, mental retardation, and serious psychiatric disorders, especially schizophrenia. This article will use published data to summarize what is known about the sterilization and killing of individuals with schizophrenia. It will then ascertain what effect, if any, these actions had on the subsequent prevalence and incidence of schizophrenia in Germany.

Background

The systematic sterilization and killing of individuals with schizophrenia in Nazi Germany from 1934 to 1945 was influenced by several factors. Perhaps, of greatest importance was a belief that schizophrenia was a simple Mendelian inherited disease, passed down from generation to generation. In Germany, this theory was promoted by Drs Ernst Rüdin and Franz Kallmann, among others. Rüdin, whose research was supported by the Rockefeller Foundation, was the director of the Genealogical-Demographic Department of the German Institute for Psychiatric Research in Munich. He had a special interest in schizophrenia, which he believed was caused by a Mendelian recessive gene, and advocated that "people who are themselves mentally ill ...should not have children." Kallmann, a Berlin psychiatrist who had been a student of Rüdin, studied schizophrenia in twins and also believed that the disease was transmitted by a recessive gene. In a 1935 speech, Kallmann advocated the examination of all relatives of individuals with schizophrenia to identify nonaffected carriers, which he believed could be done by noting "minor anomalies," and then the compulsory sterilization of such individuals. A year later, Kallmann emigrated to New York, where he continued his twin research and later became one of the founders of the American Society of Human Genetics.

The theories of Ernst Rüdin and Franz Kallmann coincided with a growing interest in Germany in eugenics and "race hygiene" ( Rassenhygiene) in the early 1930s. At the time, the eugenics movement was strongest in the United States and Britain. Indiana had passed the first state compulsory sterilization law in 1907, and by 1928, 20 more states had followed, most including "lunatics" among the target population; California was the most active state in this regard. In 1916, New York patrician Madison Grant had published The Passing of the Great Race, a jeremiad about the dangers of interracial marriage that Science magazine called "a work of solid merit"; it was subsequently translated into German and cited by Hitler in Mein Kampf. The International Congress of Eugenics was also based in the United States, and in 1932, its presidency passed from Dr C. B. Davenport of Cold Spring Harbor Laboratory to Dr Rüdin.

In 1933, Rüdin was one of the guiding forces behind the passage of Germany's first compulsory sterilization law, called "the law for the prevention of progeny with hereditary defects." Its initial target was individuals with mental retardation, schizophrenia, manic-depressive disorder, epilepsy, Huntington chorea, hereditary blindness and deafness, hereditary alcoholism, and "grave bodily malformation." Hitler had become chancellor 6 months earlier. The majority of the targeted individuals were in psychiatric hospitals, which had become massively overcrowded, thereby forcing the discharge of some patients to make room for more admissions. Patients with schizophrenia who were scheduled for discharge were deemed to be of high priority for sterilization in order to prevent them from producing offspring.

This massive increase in patients in psychiatric hospitals came at a bad time for Germany economically. Following World War I, Germany had been stripped of valuable industrial and coal-producing areas and saddled with onerous reparations. The decade following was marked by strikes, clashes between Communists and nationalists, inflation, bankruptcies, and a severe economic depression. Funding for psychiatric care was sharply reduced even as the number of patients requiring care was rising. In 1931, the German Psychiatric Association organized a prize for the best essay on the topic "How can provision for mental health care be more cheaply reorganized?"

The idea of killing the patients in psychiatric hospitals first surfaced prominently in 1920 in a publication by Karl Binding, a lawyer, and Alfred Hoche, a psychiatrist. Entitled Permission for the Destruction of Life Unworthy of Life, the tract posed the question: "Is there human life which has so far forfeited the character of something entitled to enjoy the protection of the law, that its prolongation represents a perpetual loss of value, both for its bearer and for society as a whole?" The authors' answer was clearly affirmative and described such individuals as being "mentally dead" and "on an intellectual level which we only encounter way down in the animal kingdom." The authors emphasized the economic burden of such individuals to Germany. The economic argument was repeated in subsequent discussions of this issue, such as in a 1932 article entitled "The Eradication of the Less Valuable from Society," in which the author, psychiatrist Berthold Kihn, estimated that mentally ill individuals were costing Germany 150 million Reichsmarks per year.

Hitler was interested in these ideas and is said to have discussed a program to kill chronic mental patients in 1933, shortly after assuming the chancellorship. He said that "it is right that the worthless lives of such creatures should be ended, and that this would result in certain savings in terms of hospitals, doctors and nursing staff." Prophetically, he suggested that such a program would be easier to implement during wartime, when public opposition would be less.

The idea of killing psychiatric patients continued to be discussed privately by Nazi officials throughout the 1930s. Finally, in July 1939, as he was planning to invade Poland, Hitler asked his private physician and other officials to draft a law that permitted the killing of mental patients. From the beginning, the euphemism "euthanasia" was used to refer to the killings; as Fredric Wertham noted in A Sign for Cain, "these were not mercy deaths but merciless murders."

The result was a memorandum on "the destruction of life unworthy of life" and a draft law that included the following provision:

The life of a person, who because of incurable mental illness requires permanent institutionalization and is not able to sustain an independent existence, may be prematurely terminated by medical measures in a painless and covert manner.

Selected professors of psychiatry and asylum directors who were known to be sympathetic to the plan were asked to comment on the draft. All agreed that such a program was necessary, but some suggested granting exceptions to patients who were doing "economically important work in the institution." Friedrich Mauz, professor of psychiatry at Königsberg University, argued against granting any exceptions for those individuals diagnosed with schizophrenia "as a matter of principle.",

Hitler's letter authorizing the program to kill mental patients was dated September 1, 1939, the day German forces invaded Poland. Although the program never officially became law, Hitler guaranteed legal immunity for everyone who took part in it. In October 1939, the directors of all German psychiatric hospitals were asked to fill out forms indicating the diagnosis and capacity for useful work of each patient, although they were not told what the forms were for. These forms were then assessed by a committee of selected psychiatrists who targeted approximately 70 000 patients for death, 1 for every 1000 people in Germany, which was the initial goal of the program. The program was known as Aktion (action) T-4, after the address of its headquarters in Berlin on Tiergartenstrasse 4.

Killing of Psychiatric Patients

The planning and logistics for such mass murder elicited much discussion. The method finally chosen was the release of carbon monoxide gas into a closed room outfitted to look like a shower room and the subsequent burning of the bodies in crematoria. Gold fillings were removed from the deceased and used to partially pay for the program. In early January 1940, the first 20 patients were led into a "shower room" at the Brandenburg asylum and killed. This method was judged to be highly successful and was later adapted for the killing of Jews. Five additional asylums, at Bernburg, Grafeneck, Hadamar, Hartheim, and Sonnenstein, were designated as killing centers, and patients marked for death at other hospitals were transported to these regional centers. By August 1941, 70 273 patients had been killed. Careful records were kept, and the 6 centers competed with each other in efficiency. Hadamar, eg, "celebrated the cremation of its ten-thousandth patient in a special ceremony, where everyone in attendance-secretaries, nurses and psychiatrists-received a bottle of beer for the occasion."

Once the initial goal of killing 70 000 patients was achieved, the Aktion T-4 program was halted. Although some resistance to the program had developed, especially among the churches and in communities near the killing centers, the T-4 program personnel were needed for a bigger job. Beginning in April 1941, selected personnel were transferred from the psychiatric hospitals to concentration camps and asked to set up similar killing facilities. According to Cleansing the Fatherland: Nazi Medicine and Racial Hygiene of Aly et al, "the original commandants of Belzec, Sobibor and Treblinka came from T-4 and were on its payroll." The German solution for its problem of chronic mental patients thus morphed into the "final solution" for its problem of Jews, gypsies, and others deemed undesirable.

Although the formal Aktion T-4 program was halted in mid-1941, the killing of mental patients continued throughout the war. In March 1945, Red Army troops even found a crematorium still under construction at one liberated mental asylum. Some psychiatrists were fully cooperative with the ongoing program, while others opposed it and tried to save patients by falsifying their records. In some cases, the killing was done using carbon monoxide, but in most cases it was done by injection (eg, morphine, phenobarbital, or scopolamine) or starvation. Psychiatric asylums implemented 2 diets: minimum calories for those who could work and a starvation diet of vegetables only for those who could not. These killing programs were highly effective. At the Hadamar asylum, eg, of the 4817 patients transferred there between August 1942 and March 1945, 4422, or 92%, died. At the Obrawalde asylum in German Sileasia, of the 3948 admissions in 1944, 3814, or 97%, died. Postwar investigators estimated that 18 232 people had died at Obrawalde alone in the previous 3 years.

According to Fredric Wertham, the mass sterilization and killing of psychiatric patients in Germany "was organized as well as any modern community psychiatry project, and better than most." At the Grafeneck asylum alone, 594 patients were killed in 133-day period, and "eventually the crematorium of Grafeneck smoked incessantly."

Estimates of Numbers Sterilized and Killed

What percentage of these had a diagnosis of schizophrenia? It is clear that individuals with this diagnosis were sterilized and killed disproportionately compared with individuals with other diagnoses. This was because of the strong belief among German psychiatrists that schizophrenia was genetically inherited and also because individuals with schizophrenia were less likely to have been able to work. According to Friedlander, the "overriding criterion" for selection for death in the T-4 program "was the ability to do productive work." The few patients who were still alive in German psychiatric asylums at the end of the war were those who could work or had useful skills, such as a patient, formerly a dentist, in the Obrawalde asylum "who was temporarily acting as asylum director" after the staff left before the advancing Russian army. Having schizophrenia put one in the category of those for whom there were no exceptions to sterilization or killing. Benno Müller-Hill, the author of Murderous Science, noted that "a German who was diagnosed 'schizophrenic' had to be sterilized without exception. Equally, a person who was diagnosed 'schizophrenic' and who was hospitalized for at least five years had a strong chance to be murdered in the euthanasia murders." Given the facts that 56% of hospitalized psychiatric patients in 1929 and two-thirds of admissions during the war had schizophrenia, it seems reasonable to estimate that at least half of the 200 000-275 000 patients killed or 100 000-137 500 individuals were so diagnosed.

Thus, in the 12-year period of 1934-1945, an estimated 600 000-675 000 individuals in Germany were sterilized or killed under medical rationalizations, including an estimated 132 000 with schizophrenia who were sterilized and 100 000-137 500 with schizophrenia who were killed. There would have been some overlap among these groups, but except for Jewish patients, it is not likely that it would have been extensive. The Germans kept careful records; because the goal of this program was to prevent reproduction and thus promote racial purity, killing an individual who had been previously sterilized would have been pointless. The exception to this was Jewish patients with schizophrenia, who appear to have been selectively killed whether or not they had been previously sterilized., It has been estimated that the total number of Jewish patients with schizophrenia who were killed was between 5000 and 7000.

Combining the estimated 132 000 individuals with schizophrenia who were sterilized and the estimated 100 000-137 500 individuals with schizophrenia who were killed, and allowing for a modest overlap, yields a total of 220 000-269 500 individuals with schizophrenia who were sterilized or killed. What percentage of all Germans with schizophrenia does this represent? As noted above, in late 1939, there were 283 000 patients in German psychiatric hospitals. A survey 10 years previous reported that 56% of the hospitalized patients were diagnosed with schizophrenia, a percentage consistent with data from other countries; if that was true in 1939, there would have been 158 480 patients with schizophrenia so hospitalized.

Immediately preceding the implementation of the sterilization program in 1934, there were also 3 studies of the prevalence of schizophrenia carried out in Germany. ⁻ They were done between 1929 and 1931 in predominantly rural areas of Thüringen and Bavaria in southeastern Germany by Carl Brugger, associated with the German Psychiatric Research Institute in Munich. Brugger used key informants, hospital records, and interviews of community residents to identify all individuals with psychiatric problems, including those in hospitals. He said that it was especially important to identify individuals with schizophrenia, which he believed was carried by a recessive gene. Citing Rüdin's work, Brugger said that "only sterilization ensures that the genes do not spread all over the nation." In the 3 studies, Brugger identified 93 individuals with schizophrenia, including an unspecified number who were hospitalized, among the total population of 46 189 people of all ages, for a point prevalence rate of 2.0 per 1000 population. This rate was consistent with other prevalence studies done in the 1930s, including a rate of 1.8 per 1000 in a study of rural Tennessee, 3.3 per 1000 in Denmark, 4.2 per 1000 in Finland, and 1-year prevalence rates of 2.3 and 2.9 per 1000 in 2 studies in Baltimore.

In 1939, the total population of Germany, including the eastern regions that subsequently became part of Poland, was approximately 70 million. If 2 cases of schizophrenia per 1000 population were representative of the entire country at that time, the total number of Germans with schizophrenia in 1939 would have been 140 000 individuals. However, Brugger's studies were carried out almost exclusively in rural areas, and it is known that urban schizophrenia prevalence rates are significantly higher than those in rural areas. In addition, new cases of schizophrenia continued to be diagnosed between 1940 and 1945. Most incidence studies reported in the postwar years around the world ranged between 10 and 30 new cases of schizophrenia per 100 000 population per year; however, as will be noted below, German incidence rates were higher.

Given the estimate of 158 400 individuals with schizophrenia in psychiatric hospitals; the 140 000 individuals with schizophrenia, including some of whom were hospitalized, identified in rural surveys; and new cases of schizophrenia diagnosed during the war years, it seems reasonable to estimate that between 1939 and 1945 there were at least 250 000, and perhaps as many as 300 000, individuals with schizophrenia in Germany. Because we have estimated that between 220 000 and 269 500 of them were sterilized or killed, this means that between 73% and 100% of individuals with schizophrenia in Nazi Germany shared this fate. This estimate is also consistent with the fact that the psychiatric hospital census in Germany in 1945 was only 14% of what it had been in 1939.

Postwar Studies

What effect, if any, did the sterilization and killing of individuals with schizophrenia have on the subsequent prevalence and incidence of this disorder in Germany? First, is this a legitimate question to ask? There is widespread agreement that the results of Nazi experiments carried out on individual prisoners, such as those on hypothermia, should not be published. The sterilization and murder of psychiatric patients was not such an experiment but rather was a policy applied to an entire population. As such, it is similar to other Nazi policies, such as the decision to blockade Holland in late 1944, leading to widespread starvation during the Dutch Hunger Winter of 1944-1945. Studies of the children who were in utero during this period have shown that they had an increased rate of developing schizophrenia. Looking at the effects of psychiatric genocide is similar, and in addition, all the prevalence and incidence studies associated with this question have already been published.

The first schizophrenia prevalence study carried out in Germany following World War II was done in 1971, 26 years after the last individuals with schizophrenia had been sterilized or killed. It covered 424 000 people in 3 counties in Bavaria, including Rosenheim, the site of one of Brugger's studies 40 years earlier. The authors reported a 6-month prevalence of 1.5 per 1000 total population, lower than the point prevalence rate of 2.0 per 1000 that had been reported by Brugger. Between 1975 and 1979, this same research group randomly sampled 1536 adults in Traunstein, one of the 3 counties they had studied previously. They reported a 6-month schizophrenia prevalence of 3.9 per 1000 for individuals aged 16 years and above. They reinterviewed the same individuals between 1980 and 1984 and reported a similar rate of 3.6 per 1000, point prevalence, for individuals aged 15 years and above. The authors noted that the schizophrenia prevalence rates in the German studies were lower than rates being reported in other postwar studies in Sweden, Norway, Iceland, and France, where the rates ranged between 6.0 and 10.0 per 1000, but they did not speculate on why that might be the case.

In addition to the Bavarian studies, beginning in 1974, Heinz Häfner and his colleagues carried out additional German schizophrenia prevalence studies in Mannheim, utilizing their case register. Between 1974 and 1980, they reported a 1-year schizophrenia prevalence rate of 2.3 per 1000. They also noted without comment that this rate was lower than the rates being reported in comparable schizophrenia prevalence studies in England (3.4 per 1000), the United States (4.7 and 5.1 per 1000), and Ireland (8.3 per 1000). The low German schizophrenia prevalence rates were also observed in a 2005 review by Saha et al of 188 schizophrenia prevalence studies published between 1965 and 2002. All these studies suggest that the prevalence of schizophrenia was relatively low in Germany following World War II, as would be expected due to the genocide.

Regarding the incidence of new cases of schizophrenia, no published studies were apparently carried out in Germany prior to World War II. The first postwar study was done in Mannheim in 1965, 20 years after the last patients had been sterilized or killed. Heinz Häfner and Helga Reimann at the University of Heidelberg identified all new cases of schizophrenia reported during the year among the city's 330 000 inhabitants. They reported an incidence rate of 53.6 per 100 000, which the authors noted was "more than twice as high as the mean of 21.8 per 100 000 calculated in 1965 by Dunham from different studies and two to three times as high as the rates of 23.8 or 15.8 respectively, ... for the U.S.A. and England and Wales in 1969." The German rate, they added, was comparable to the "rate of 52 per 100 000 given by Walsh for Dublin in 1969."

Häfner and his colleagues subsequently opened a psychiatric case register and recorded the incidence of schizophrenia for each year from 1974 to 1980; it ranged from 48 to 67 per 100 000, averaging 59. In one report, the authors compared the incidence of schizophrenia in Mannheim with 11 studies in the Netherlands, Italy, Denmark, Norway, Iceland, the United Kingdom, the United States, and Australia; the 11 studies averaged 24 per 100 000, less than half the incidence rate for Mannheim, and only one, a 1970 study in Rochester, NY, reported a higher rate than Mannheim. In another publication, Häfner compared the Mannheim incidence rate with that of 8 centers in the World Health Organization Determinants of Outcome Study; only 1 of the 8 centers had an incidence of narrowly defined schizophrenia exceeding that of Mannheim.

The other area in Germany where schizophrenia incidence studies were carried out was in Bavaria. A 1971 study found 102 cases in a predominantly rural population of 424 000 for a 6-month incidence rate of 24 per 100 000. Another study done in the same area in 1974-1975 reported an annual incidence rate of 48 per 100 000, thus being more similar to the rates reported for Mannheim. These high German incidence rates were also confirmed by international comparisons. For example, a review of 55 schizophrenia incidence studies by McGrath et al found the median schizophrenia incidence to be 15.2 (7.7-43.0) per 100 000; few of the studies achieved the high incidence rates reported in Germany.

Discussion

The sterilization and murder of hundreds of thousands of patients with schizophrenia and other psychiatric disorders in Nazi Germany between 1934 and 1945 was the greatest criminal act in the history of psychiatry. It was perpetrated in an attempt to decrease the incidence of schizophrenia and purify the race, based upon a mistaken belief that schizophrenia was a simple Mendelian inherited disease in which a single gene, or small number of genes, is sufficient to cause the disease. Furthermore, it should have been known even in 1940 that removing cases of schizophrenia from society would have no impact on the incidence of the disease because the vast majority of individuals with schizophrenia do not have a family history of the disease and do not reproduce. Current research suggests that the cause of schizophrenia involves dozens, and perhaps hundreds, of genes and includes common variants such as single nucleotide polymorphisms or less common variants such as copy number variations. Such variants may be carried by large numbers of people, most of whom never develop schizophrenia. It is possible that such genetic variations may cause disease only if they are activated by life experiences such as perinatal hypoxia, nutritional deficiency, infections, or other environmental factors.

Is there any apparent explanation for the relatively high incidence rates of schizophrenia in postwar Germany? One possible explanation is that the areas in which postwar incidence studies were carried out were less affected by the psychiatric genocide. This seems unlikely because many Bavarian psychiatrists enthusiastically supported the eugenics program, and individuals with schizophrenia in the Mannheim region were killed initially in Grafeneck and later in Hadamar asylum.

Another possible explanation is that postwar incidence studies of schizophrenia in Germany included large numbers of non-German immigrants. In fact, 13% of Mannheim's population in the 1970s were foreign workers. Studies of the incidence of schizophrenia among these workers, however, reported that "when corrected for age, the rates of treated schizophrenia episodes ... were significantly lower than those of the German population."

A third possibility is that much broader diagnostic criteria were being used to diagnose schizophrenia in Germany after the war compared with before the war. If this had been the case, one would expect to find high rates in prevalence as well as in incidence studies, but this is not the case. It is difficult to determine what diagnostic criteria were being used in prewar studies. Brugger did not define the diagnostic criteria he used in his 1929-1931 studies, but they were probably the classical criteria of Emil Kraepelin, who dominated diagnostic thinking in Munich psychiatry until his death in 1926. Most studies after the war used the diagnostic guidelines of the International Classification of Diseases, Eighth Revision ( ICD-8), and International Classification of Diseases, Ninth Revision ( ICD-9), introduced in 1965 and 1975, which use somewhat broader criteria for diagnosing schizophrenia. However, most of the other European studies that were being done at the time and that reported much lower incidence rates also used ICD-8 or ICD-9 criteria.

A fourth possibility is that social conditions during or after the war produced environmental factors that led to an increase in the incidence of schizophrenia. An example was the increase in schizophrenia in Holland that followed the Dutch Hunger Winter in 1944-1945. The cause of the high schizophrenia incidence rates in postwar Germany is thus not apparent and is an appropriate subject for additional research.

The major limitation of this article is the quality and quantity of the available data. In some cases, the projected numbers are merely informed guesses whose credibility rests upon their reasonableness and their consistency with other related data. It is hoped that this article will elicit additional, previously unpublished, data that can be used to document and memorialize this reprehensible but important chapter in psychiatric history. In addition, perhaps, the most appropriate response the profession of psychiatry can have to the Nazi eugenics and psychiatric genocide program is to focus additional resources on examining more complex forms of genetic and gene-environmental interactions in order to understand the true genetic contribution to schizophrenia. This knowledge should then be used to develop methods for disease prevention and treatment that can be used ethically in all populations.

Funding

Stanley Medical Research Institute.

Acknowledgments

We are grateful to Dr Sandra Dittmann and Ms Gabriele Chidichimo for assistance with translations of German articles, Dr Vishwajit Nimgaonkar for reviewing the article, and Ms Judy Miller for technical assistance. The authors declare that they have no conflicts of interest.

References

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3. Müller-Hill B. Murderous Science: Elimination by Scientific Selection of Jews, Gypsies, and Others in Germany, 1933-1945. Woodbury, NY: Cold Spring Harbor Laboratory Press; 1988. 11, 31, 42-43, 70.

4. Woods FA. Review of the passing of the great race. Science. 1918;48:419-420.

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7. Torrey EF, Miller J. The Invisible Plague: The Rise of Mental Illness From 1750 to the Present. New Brunswick, NJ: Rutgers University Press; 2002.

8. Wertham F. A Sign for Cain: An Exploration of Human Violence. New York, NY: Paperback Library; 1969. 151, 152, 155.

9. Proctor RN. Racial Hygiene: Medicine Under the Nazis. Cambridge, MA: Harvard University Press; 1988. pp. 189-191.

10. Friedlander H. The Origins of Nazi Genocide. Chapel Hill, NC: University of North Carolina Press; 1995. 29, 61, 83, 91.

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26. Jablensky A. Epidemiologic surveys of mental health of geographically defined populations in Europe. In: Weissman MM, Myers JK, Ross CE, editors. Community Surveys of Psychiatric Disorders. New Brunswick, NJ: Rutgers University Press; 1986. pp. 257-313.

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Psychiatric Genocide: Nazi Attempts to Eradicate Schizophrenia

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Although the Nazi genocide of Jews during World War II is well known, the concurrent Nazi genocide of psychiatric patients is much less widely known. An attempt was made to estimate the number of individuals with schizophrenia who were sterilized and ...

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Shame

Women having periods are normal. Obviously, they were viewed differently back then, especially to men. Women were shamed and made fun of for having their period. A young girl was shamed by a German guard for trying to stop the blood flow. Sometimes, periods would save women from rape.

Summary

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Can you tell me what the women in Birkenau talked about?

We would talk about food, all the time about food. What we would cook today. It was non-stop. From the beginning to the end – in every camp I've been to. In Neustadt, and after the last camp, we once found grass, took it, and said – it's like an onion. And we ate it.

Hedi Solzbach

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Dr. Naama Shik, Yael Novogrodsky

Introduction

This exclusive interview was published in our newsletter Teaching the Legacy (May, 2008). The original interview, conducted in Hebrew, first appeared in our Hebrew edition of October, 2007. While focusing on the touching wartime story of Hedi Solzbach, several issues arise which are intrinsically linked to the female experience in the Holocaust. Thus, for instance, we hear about the day-to-day banter in the women's block at Birkenau, the humiliation of nakedness and fear of bodily harm, use of margarine as an anti-wrinkle cream, "support groups" amongst the female prisoners, care for others as a strengthening or consoling experience, and more. In many ways, Mrs. Solzbach's testimony highlights the "dual" experience, or "double jeopardy" - as it is known in the research - which typified Jewish women during the Holocaust, particularly in the camps, both as Jews and as women.

"They would take you if you'd just open your mouth or if they didn't like your face"
Please tell us a little about your childhood.
I was born into a traditional family in Sobotice, a small town near Novi Sad, [Yugoslavia; today, Serbia] on February 9, 1925. Grandpa Czarny kept a kosher kitchen and was also a member of the Jewish community in Novi Sad. There is no longer a community there. I had a brother, Latzi, from my father's first marriage. When he was three years old, my [birth] mother and father separated, and my father married my mother, so from age three, he was with my mother. In between Latzi and myself, we had a [third] child who died, and then I was born. So there are nine years between myself and Latzi. That's my small family.

I would speak Hungarian with my mother, Yugoslavian with my father, and German with my grandfather. My elementary school was a Jewish day school, and then I went to a general school.
You knew you were Jewish? Did you go to synagogue on the Sabbath? Fast on Yom Kippur? [Jewish Day of Atonement - trans.]
Of course. Father went to synagogue in the morning and at night. I began fasting from age 12 - I even fasted in Auschwitz. I had two Jewish friends there. One of them was very religious and knew all the prayers by heart. We spent our Yom Kippur there. Then I was in Gleiwitz - a coal factory, a sub-camp of Auschwitz. We worked with coal, and I fasted there.
What do you remember from the outbreak of the War?
With us, the Hungarians came in 1941, and then the hell started. In fact, [it started] even earlier, when I finished school in 1939 and wanted to go study at a teaching school. I very much liked children. There was a special childcare school in Belgrade, where I had two aunts - sisters on my father's side - and an uncle, and I had a place to live in, but I wasn't accepted because I'm Jewish. In 1940, everything was closed - Jews could hardly study anything anymore [in schools - trans]. You couldn't move right or left. Then, in 1941, the Hungarians came. Father told me, "My child, you have no choice, you must learn a profession which will provide for you in the future."

He very much wanted me to study a profession, and in those days every Jewish girl learned to sew. I thoroughly hated it, but it later served me very well. There were no courses like there are today. For two or three years, you had to study as an apprentice with a teacher, and I went to study. I had to pay, and I didn't have any money - my father had been paying once a month - and he didn't have a job anymore, so I told him, "No! You're not paying! I will do all the work."

This wasn't simple for me. Our family had been a prominent, distinguished family, and we were very wealthy. It wasn't easy for me, it was very difficult. [...] I worked all day - sewing and felling trees for the owner of the sewing workshop, and then later with small children that I would look after.
Were you scared of the Arrow Cross Party, of the Hungarians?
Of course. They would take you if you'd just open your mouth or if they didn't like your face.

At this stage, when you were 16, and working for this woman, were you alone?
No, I was with my parents. I would sleep at their place at night. My brother went to Budapest thinking he'd find a job there, because there was no work for him in Novi Sad. Luckily we still had our jewelry, so we sold them and lived off that. We didn't have any socks or shirts, so we would insert the shirt collar inwards, unravel it and turn it over. My mother would do this for the Jewish community and earn a small pittance. Socks, too - we couldn't buy any, because there weren't any, so she would match socks from different pairs.
You were hungry then?
No. Mother took care of that very well. I still didn't have a salary. That's the thing that hurt me - today I'm 82 years old but I remember it as if it was today. For me it was humiliating. It's hard to talk [about it]. Our family was an honorable family and here I have to sew dresses in the living room and take them to the clientele? Walking in Novi Sad, "Mrs. Hedi," meeting acquaintances... It was very difficult for me. After a few weeks I adjusted, and I would get a tip for each [dress], and that was money. Money is money. So I was happy, and I could bring dresses to the clients and get some money.
Age 16 - that's an age of blossoming for a young woman. Did you feel you were being robbed of your childhood, or were you too busy simply trying to survive?
I was so preoccupied with thoughts of how to live and how to survive in this situation, so I worked all the time. I would sew from seven to three, then I would run home to eat something, and then I had three children I would look after until seven. I would go for a walk with them, or we would play at the house. They had silk stockings and they would sometimes split. I would sew with a special needle. It's difficult for me to tell, because I came from a very rich, respectable family. It was like I had been cut with a knife. But I told myself - "I must work!" Our days with a maid were over - that I understood. Finita la comedia.

"She didn't hand it to him - she was a proud woman"
What happened when the Germans reached Novi Sad?
The Germans arrived in March, 1943. The first thing they did when they arrived was take the men. My father had an acquaintance who had hot springs - springs with mineral water - and father used to go to him for treatment. As soon as the Germans arrived, he escaped from there and stayed for two days. They took my brother. They took him together with other men from Novi Sad to a giant courtyard. There was a coffee shop there - "Sloboda" - and they were led inside. I took food for him, because they hadn't received any food, and we stood in line [outside] to come in. I was scared. The German officer took me aside and I thought that was the end of me, but he didn't do anything.

On that day, the Germans lined up the men in a row and beat them. Latzi, my brother, was an athlete, and very strong, so he ran, and they told him to slow down. He had been beaten, and when I brought food for him, he was bruised all over. Later on he managed to escape from there, and traveled to Budapest. Father came back at 3 AM from his friend, and wouldn't leave the house. Then we were thrown out of our home because we were Jewish, and that was another blow. We searched for another place to live, and we couldn't find anything because we were Jewish. Eventually we got a tiny apartment from the Methodist community, with no drinking water and no toilet except for a small room in the yard. It was very difficult. We would have to walk over half an hour to draw drinking water from a well. In the winter it would freeze over, and I would bring hot water from home and pour it in so the ice would melt and I could draw the water. Father was closed in his room, and would have to do his business there, because he couldn't leave - he would be seen. He was closed in this way for two weeks. Then they said they were taking all the Jews to work.

In April, 1944 they took us. The Hungarians came and demanded all our jewelry, but the day before I told mother, "You're thinking of giving them all our jewelry? Give me what's left." She gave me some items and I took them to a girlfriend of mine. I later found it, after the liberation, and everything was there, just I had left it. Nothing was missing. So when the Hungarians came, mother only had a ring on her finger. A Hungarian demanded she take it off and hand it to him. So mother removed the ring, threw it far, and said to him, "Now go look for it." She didn't hand it to him - she was a proud woman.

Later they took all over us to the synagogue, and from there to Sobotice. They separated the men and the women there, and they took only the women, not everyone. That was the last time I saw my father. I said goodbye. From there, they took us to Bačka Topola, and from there to Auschwitz, in the closed cars. This took around a week. In the car, I was with my mother, the whole time.
In the train car, what did you talk about with your mother?
What could you talk about? It was very crowded and smelly. We took a small bag with a little bit of food, because we hadn't gotten anything else. It was just like what you see in the movies: "Raus! Raus!" ["Out! Out!" - trans.] The whole time, we thought we were being taken to work. We said this must be work and that with God's help, I am strong, I had always been strong and I can work, no matter what job we're given. My mother was then 50 years old.

We arrived at Auschwitz in the morning, before noon. We were lined up in rows of five. Mister Mengele came, and I was put on one side and my mother on the other. Mother was quite strong and she said she wants to be with her daughter. He asked her if she could run. She answered, "Sure, I have legs." She was always proud of her strong legs. Then she went over to my side, and the capos came. I had special warm shoes. They asked me to give them the shoes. "No. Are you crazy?" They asked for the sweater as well. I refused. How could I have known that in half an hour I would be naked? Then they took us into another room and forced us to strip entirely. [The meaning here is the "Sauna," meaning "shower" in German. This was the place where Jews were sent who had cleared the selection process and had been chosen for forced labor. They were forced to strip naked, and all their head and body hair was shaved. They were sterilized, received prisoner uniform and clogs and, in most cases, were tattooed with a prisoner number on their arm.]

In the room there were SS officers and capos. I didn't know where to put my hands and what to hide. It was horrible. I shudder just thinking about it. You can't describe something like that. Then they shaved off all my head and body hair, but they didn't shave everything off. They left a little bit of hair, like monks.

When they finished, we got our clothes. These weren't striped prisoner uniforms but more like rags. I got one man's shoe and one woman's shoe. I also got a long skirt and a coat. I'm [a] large [woman], and without a bra, it was so painful, I thought I would die. We did get underwear. My mother was very brave and stole some more underwear from the [pile of rags]. We were scared to death, but she took some. When we had gotten all our clothes, we stepped outside and there was a brush with red oil paint. We were marked with a stripe on our backs. They tattooed the number on the arm later. We had gotten a handkerchief, and because I was very strong, I cut it and tied it around my chest, so it wouldn't hurt as much.
In the Sauna, you were with your mother and presumably with other women you knew as well. When you left, did you recognize each other?
We didn't recognize each other. I looked at my mother and thought, "This is my mother?" Later we reached the camp. We slept six to a bunk, three in each direction. I was with my mother the whole time. I always went to a place where there was a window. I had this "bug" where I had to breath fresh air. We were told not to drink water because we could get typhus, so I didn't drink. They had what they would call "tea" or "coffee," which we could drink because it had been boiled.
In the first few days, did you eat the food you were given?
No, of course not.
Describe the initial days in the camp.
Near our block [barrack] we had a giant courtyard with a large pile of rocks. I was taken to work in moving the rocks from place to place. My mother wasn't with me working, she was in the block. Before that we had morning "zelapel" and evening "zelapel" for hours. ["Zelapel" - "roll call" in German. This was one of the most difficult trials for male and female prisoners. It would take place twice a day - in the morning and in the evening - regardless of weather conditions. The prisoners were counted, and often the numbers would not match those of previous roll calls, forcing the prisoners to endure laborious re-counts in harsh weather. Many prisoners died during these roll calls - Naama Shik.]

Mother would always be behind me and I would be in front of her. After around a month and a half, Mengele came. We had some 1,000-1,500 women from the blocks, standing outside. He chose 72 women. All of them strong. I was strong as well. My mother stayed behind - she was [later] liberated in Auschwitz; she stayed in Birkenau until the end. They took us, we had the lager altester, a Czech, Fani. Very pleasant woman. She walked by me and said that when I was asked, I should say I was a "junge frau" - a young woman. I didn't know that that meant "virgin". I told her I wasn't married. She said, "You need to say it that way, don't argue with me." I didn't know why. And then they took us to a place to bathe, and a doctor came, besides Mengele, and everyone asked. We knew they wanted to take us to the whorehouse, for the soldiers. At the last minute, he changed his mind and we were sent to Gleiwitz, a sub-camp of Auschwitz.

"When I had someone to care for, I had strength"
Can you tell me what the women in Birkenau talked about?
We would talk about food, all the time about food. What we would cook today. It was non-stop. From the beginning to the end - in every camp I've been to. In Neustadt, and after the last camp, we once found grass, took it, and said - it's like an onion. And we ate it.
You would think about actual recipes?
Exactly. All day. Food, food. Here and there we might mention our homes, but that was rare. I want to add a story about my mother. She was a very, very elegant woman, and throughout the years she would always take care of her looks. In Auschwitz, they would give out margarine, to put on bread. This was a special portion in Auschwitz, especially since we were hungry all the time. But my mother would not put it on bread, but rather put it on her cheeks so she wouldn't get spots or wrinkles. She truly was a strong person.
Did you have friends during the camp-period? Were there other prisoners with whom you shared the struggle for survival?
In Gleiwitz, we were three friends. When I just moved to Gleiwitz, I had my girlfriend from Novi Sad, whom I had been together with from our school days. But one day she left me. She thought that if she'd go and fight for survival alone, she would be better off, so she left me. I sat in a corner and cried, just cried, I didn't know what to do. I was suddenly left alone and I cried.

Then two girls appeared in front of me. They were friends from a school in a village near where I grew up. They came and asked me what happened and why I was crying. Like a little girl - like a baby - I told them through my tears that I was alone and had no one. They told me that I would be with them, that we'd be a trio. From that moment until the end, we were together. I saved their lives. Even today, when I speak with Katice's husband he says I saved her. She had wounds from head to toe. I cleaned each one for her, and this she can't forget. The other as well - I saved her too. And being together certainly saved me. Still today, I am a person who likes doing things for people so I'm not alone. Being alone, for me, is death. Even as a girl, I've always had a need to care for others, in the camps and still today. When I had someone to care for, I had strength. So I knew I had two friends that I give to, that I do for, and this continued from the beginning to the end [of the war].

Later, the three of us were sent to work at a factory in Gleiwitz. In the work we did, we had to maintain our hygiene, and because of this we were very lucky, considering we were in Auschwitz: We each received six bars of soap a month. This was money. This was something you could trade in. From these I managed to do everything - I traded them and managed to "organisieren" [camp slang - to barter, to "arrange" for goods]. We had all sorts of extra things. They [the friends - trans.] would give me their soap bars, we would pool them and I would be in charge. The factory had an iron floor that could be lifted. I had my corner where I hid the soap and no one knew. With that I did organisieren. It was trade - you would give a slice of bread and get potatoes, and some of that I would give to my mother. On one of the days, when I gave her potatoes, she put it on the oven in the middle of the block. She put the potatoes on it, not exactly to cook them, but just so they would be edible. Then the capo of my mother's block came and tossed her potatoes. She had a whip, and - this is what they told us when we came back to the community, people who had been there with my mother - they said [my mother] took [the capo's] whip and broke it on her leg [and said,] "I could be your mother! You're a little girl, and you're beating me?" She wasn't punished for it. [The capo] was stunned. They only told me that after the war, when we had come back.

In Gleiwitz they had sacks of cement. During work [hours] we would steal the bags, peel off layers and put it under our clothes so we would be as clean as possible and I could save on soap. By the time we learned to bathe, we were black from head to toe. But you couldn't be black in the eyes. We learned how to bathe so there would be no black.
When you were with your mother, who would take care of whom?
I was only a small child then, and in Birkenau my mother took care of me. Then maybe it was fate that allowed me to part from her and go to Gleiwitz, and then I became the strong one, the one who organizes everything and decides everything. We were in Gleiwitz nine months. In January they took us on a death march of 40 kilometers, through snow, and in 25 degrees below zero cold. Before that, when they told us we had to leave - this was a small camp of 360 women - everyone broke into the storeroom to get clothes and they were falling over each other. I already had a striped uniform and also already had longer hair. I would brush Katice's hair, and by that point she was apathetic. When we went to the storeroom we took as many clothes as we could. I took [clothes] for Etti and Kati as well. Just then a huge, blond, fat capo came, she beat everyone and told them to get out of the storeroom. But I had managed to get some clothes, and gave them to Kati and Etti.
What would you talk about, the three of you?
We wouldn't always talk about food, but most of the time. Sometimes we would talk all sorts of nonsense - what young men we had met, how it was in our old youth group, where we used to go, who will be and what will be.
Why did you comb Katice's hair? How did you get a comb?
The comb I bought with a piece of bread. We had soap bars, we were "rich". I saved a little here and a little there. I combed her because she had become apathetic. She didn't have strength for anything, and I was fighting for her life. Gleiwitz was very difficult - I had a hole in my hand because I had ripped a tendon. Terrible pain. It was very difficult, it wasn't easy, but when you have smarts and the will, and when you believe that things happen for a reason, you can [live].
We started talking about the death march, let's go back to that.
So they took us on foot, in open cars. When we needed to go to the bathroom, we couldn't stand or walk, so we would have to go where we were, in our pants. It would quickly freeze and become ice, and then it would chafe. They put us in open wagons, one hundred and fifty women in one car, like sardines. One day, all the cars came to a stop and we were told we were on a "bathroom break". [The car floors were] very high. We jumped off, and when I wanted to come back, I couldn't find Etti and Katice. I went up to the cars and called, "Etti! Katice!" There was one SS officer there who asked, "Where are you going?" I thought to myself - "What's the worst that can happen? I'll get a bullet in the head and that's that." I told him, "I'm looking for my friends." He said, "Go, make sure I don't see you."

I found them four cars from me. I asked if they had taken my blanket and small knapsack where I had the brush, a cup, and so on. They said they hadn't. I asked, "Then why did you leave there?" They answered they didn't know. So I went back to the cars to look for the blanket and the knapsack. The same SS man saw me again, and asked, "What are you looking for here?" I told him, and came back. I barely managed to climb up, and I found the blanket and knapsack. Now I had to walk again. He told me that if he saw me again, I'd get a bullet in the head.

Slowly, the cars started moving, and I started running. With the cars that we had, the floor was a meter high. Half the people in the cars were German and half were us. They grabbed me by the hand and pulled me up. We sat there, maybe a week. The Germans had tinned cans, and they would light small fires in the cars. I thought, "What can happen? I may get slapped or something, but we try." They would throw away the cans. I took some snow and asked if he would let me put the snow in the cans on the fire. He said, "OK, put it on." It thawed, so [I gave] one spoon for Etti and one for Katice. They were nearly dead, and didn't want anything anymore, they simply didn't care. So I kept talking, saying, gave them snow - there was no food or water, so we ate snow. That's how we reached Ravensbruck.

There, they checked who had lice. It was the first transport, and there were no lice at all. In Gleiwitz we were very hygienic, and since we worked with coal we always had soap and water. One SS man, who was tall and fat, looked through all the rows of the block - we had beds. He called me out. I looked at Etti and Katice - "What's happened? Am I being taken back to Auschwitz?" He said, "The number on your hand isn't good. It has to be redone." So they made two numbers over again. Those moments when I was waiting to see what would happen, what's going on - it can't be put into words, that feeling.

During this whole period, did you miss your mother? Did you think about your mother?
Yes, a lot. In Gleiwitz I always went up to the top floor of the factory, and there was a small window that faced towards Birkenau, and I would look out there and imagine all sorts of things about my mother: Mother's coming, Mother's hugging, we meet. That was a point where my head and my thoughts we devoted only to the parents, to the home and my brother, my family. Longing, lots of longing. It would hit me there.
Let's go back to the period when you arrived at Ravensbruck.
When we arrived at Ravensbruck, they put us in a block of Gypsies. A million and one lice. This was a block of "Shema Yisrael" [Jewish prayer, often recited when facing mortal danger - trans.], just horrible. The Germans said that whoever wants to work will get a double portion of food, so I was the first one who wanted to go work. One job was sawing wood. Katice and Etti didn't work. The capo of our work detail said that when I went to the kitchen with another girl to take the bucket of soup, I would get a double portion and I gave the second portion to Etti and Katice.

One day, when we were there at Ravensbruck, we heard that a transport had arrived from Auschwitz. I looked for Mother, I thought maybe she was coming. She didn't, but Etti's sister arrived. She was in the other block. I said that I was going to go get her. I knew this was dangerous, but I went and brought her. So she was with us, but not until the end - she died. We were in Ravensbruck almost a month, and then they took us on a train with open cars. I remember that on February 9th I was still at Ravensbruck. I was so naïve, and I told my friends, "You'll see, on my birthday my mother will come." Right...

They put us in cars and took us to a place - I don't know what it was called. They had huge Hungarians. There were women already there. I saw them sitting there, there was hay, I didn't know what they were doing. [...] Everyone was outside. I had a black kerchief, and behind me stood a woman who said, "You have lice on you." I opened the kerchief and shook it. She slapped me and said, "How dare you throw the lice when you should kill them? They'll breed!" I felt itchy. There were large tree trunks there. I walked between them, they were crawling with millions of lice. I undid my dress, and threw them there. I threw away all my clothes. I stayed only with my striped uniform, so I would have as little as possible to clean. It was a natural disaster.

That's where I met my "lager mama". It was Clarie Hershkowitz (Pressburger). She was from Novi Sad. We had a good connection, until she passed away. She was 40 then, and I would help her. We had already been at Neubrandeburg, and she had a tin cup. She couldn't stand. She was very weak and I told her "Clarika [affectionate nickname - trans.], sit on this and rest." Our capo came and asked why she was sitting down. She wanted to beat her. I knew that if she would get slapped, she would die. I grabbed the capo by the arm, and I was beaten for it. Never mind. But if Clarie had been beaten, it would have been horrible. I was with her all the time, with Katice, with Etti and her sister Pieri, who was ill. I took her to the hospital, and Etti didn't want to leave her alone. She was scared that something would happen to her, so she stayed with her in bed.

That was also the first time that someone tried stealing something from me. No one had stolen from me, but this time they tried. It was a block of Russians, and heard you could get cooked potatoes in exchange for a slice of bread. I had a slice in the pocket of my striped uniform. A slice that was taken from me. That was the first and last time I had been stolen from. I took bread that Pierie ate. It was one day before she died. Etti was also very sick then.

We were liberated by the Russians [on] May 2nd. My husband was 9 kilometers away, and he was liberated by the Americans.

"We danced all night, an English waltz"
Please describe the day of liberation.
On the day of liberation, people stormed the food warehouses. "Don't eat everything all at once" - I didn't allow it. Nor did Etti and Penny, my friend from school who was there. So we were eight girls: Fani, two Hoffman sisters, Bori, her sister Clarie, myself, Katice and Etti. Pieri passed away. Etti was also sick. A few days after the liberation, we left the camp, first to the camp where German officers were. They had a bar and everything. I found alcohol there, so I could disinfect Katice's wounds. We would go from house to house, and we found a villa that had belonged to a doctor. We found a scale there, and we wanted to see how much each of us weighed. I weighed 35 [kilograms, 77 pounds - trans.], Clara weighed 30 [66 pounds]. She was skin and bones. All of them were, more or less.

We wandered from place to place. Always during the day, and at night we'd stay at home. We found the villa, and in one room was Clarie, and in another I was with Fani and Katice. In one home I found a baby carriage, I put Etti inside, and took her to the hospital. From then, I didn't see her until she had already arrived in Israel, and the wedding of her daughter, in the [1980s]. When we went to the villa, Fani and I took a room, and her bed was by the window. All of a sudden I felt a foot on my bed. Someone had climbed through the window - they were Russian soldiers. I was frightened and said in Polish, "I'm a girl! Sick! Auschwitz!" We ran like children to the room where Clarie was. [...] We were there until morning. All night they came, but they didn't do anything to us. Then we went on.

We searched. We were looking for a Yugoslav camp, and we arrived at Pritzwalk. They told us there that we could continue, that there is a bigger camp, in which there are only Yugoslavs, POW's as well. We were there, and we had one room for 8 girls. [...] We invited one of them for a meal. Every day there was someone [designated] who would cook. It was just my turn that day. The girls ate almost everything, and only my portion was left. I told myself, "How can it be that this man came, I didn't know him, and there's nothing left?" I put my portion aside. He came, and I gave him my portion. Since then, we've been together 43 years.

We heard from the Russians that they're having dances at night, with a harmonica. So he promised us - all the girls - that he would come to pick us up for the dance. I very much liked to dance. We waited, but he didn't come. I said, "What kind of person [is he]? Not one word?" I told my friends that we'd go and see what had happened to him. He was in bed. I told him, "What kind of person are you? You said you would take us. You're getting up right now and we're going to the dance!" And so it was. He went with us. We danced all night, an English waltz. It was a large hangar. Everyone moved aside and looked at us.

So we traveled with him for three months, from place to place, until we reached Neubrandenburg. There we boarded trains to Yugoslavia, through Czechoslovakia and Hungary. In Budapest, the cars stopped for two days and I told my husband, "Let's look for my uncle who lives here." The city was ruined. I found him, and he gave us food. [...] On the border between Hungary and Yugoslavia, the cars stopped again, and everyone stepped out to wait until the train would move again. Suddenly, I hear someone yelling, "Does anyone know the Czarny family?" I said, "Me! My mother is a Czarny!" He was happy. It was my mother's cousin. He invited me to his home. We wanted to come back home to see who was still alive. He gave me a suitcase full of food, and this was great for us. So we reached Sobotice. There were two women there from the Novi Sad community. That's where my husband got the bitter news that his mother and two sisters went to the crematorium, and his father had passed as well. Only his two sisters survived. One lives today at Novi Sad, and the other here, in Kiryat Bialik. So we arrived home, at Novi Sad. Mother was already there.
Did you think she would survive?
I did, but when the transports arrived at Ravensbruck and we set out on the death march, I wasn't sure if she went or not. Later she told me she decided not to go, and that if she'd die, it would be at [Birkenau] camp. Why should she suffer and die on the way? She made the smart choice. When I met her, her head was shaved and she had a turban on her head. I argued with her to take the turban off, because her head wasn't getting air and the hair wouldn't grow. She didn't want to - she was embarrassed by it and it was horrible. Later she nevertheless took it off.

When you reached Israel, did you talk about the Holocaust? Did the Israelis want to listen?
I only told my children. It wasn't like it is today, when we talk about the Holocaust at schools. Then we were quiet, many long years. What my children knew about the Holocaust, they knew from me.

A year or two ago, I was in Hulda [a kibbutz in Israel - trans.], where they have service taxis [leaving the kibbutz] [...] I waited for the taxi to fill up with people, and the driver looked at the number on my arm and asked, "Is that your phone number?" I answered that it was. Not all the people know. He had no idea I had been to Auschwitz.

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Interview with Hedi Solzbach (Schlanger), Holocaust survivor

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Dr. Naama Shik, Yael Novogrodsky This exclusive interview was published in our newsletter Teaching the Legacy (May, 2008). The original interview, conducted in Hebrew, first appeared in our Hebrew edition of October, 2007. While focusing on the touching wartime story of Hedi Solzbach, several issues arise which are intrinsically linked to the female experience in the Holocaust.

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Jo-Ann Owusu: “Menstruation and the Holocaust”; HISTORY TODAY https://www.historytoday.com/archive/feature/menstruation-and-holocaust; Published in History Today Volume 69 Issue 5 May 2019; Dec. 13, 2020

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Menstruation is rarely a topic that comes to mind when we think about the Holocaust and has been largely avoided as an area of historical research. This is regrettable, as periods are a central part of women's experience. Oral testimonies and memoirs show that women felt ashamed discussing menstruation during their time in the concentration camps, but, at the same time, they kept bringing the subject up, overcoming the stigma that is attached to them.

Typically, menstruation has been seen as a medical problem to be overcome rather than as a natural occurrence and a part of life. Medical historians, for example, have explored the forced experiments in sterilisation that were conducted in Auschwitz. Sabine Hildebrandt examined the research of the pathologist Hermann Stieve, who experimented on female political prisoners awaiting execution in Plötzensee. Stieve looked at the effect stress had on the reproductive system. Similarly, Anna Hájková has written about the Jewish Theresienstadt prisoner and physician František Bass' research on amenorrhoea, the loss of menstruation, which focused on how it was caused by the shock of incarceration. Interestingly, however, almost all this research discussed ovulation (and its lack) rather than menstruation, even though both are part of the same biological function.

Periods impacted on the lives of female Holocaust victims in a variety of ways: for many, menstruation was linked to the shame of bleeding in public and the discomfort of dealing with it. Periods also saved some women from being sexually assaulted. Equally, amenorrhoea could be a source of anxiety: about fertility, the implications for their lives after the camps and about having children in the future.

A much-cited argument in Holocaust scholarship, made by Hannah Arendt, is that the totalitarian regime of the camps broke human solidarity, making them a very isolating place to be. But, contrary to this view, periods could provide moments of bonding and solidarity among prisoners: many older women gave help to teenagers, who experienced their first period alone after their families had been murdered. When we look for it, many survivors talk with great openness about their periods. Having or not having a period could shape daily experience of the camps.

What is a woman?

After deportation to camps and ghettos, due to malnutrition and shock, a significant number of female Holocaust victims of reproductive age stopped menstruating. Many were afraid that they would be left infertile after their bodies were forced to their limits, making the intrinsic link between periods and fertility apparent and increasingly central to their lives. Gerda Weissman, originally from Bielsko in Poland and 15 years old during her incarceration, later reflected that a key reason she wanted to survive was because she wanted to have children. She described it as 'an obsession'. Similarly, the French publicist, resistance fighter and Auschwitz survivor Charlotte Delbo mentions a discussion that took place among a room full of women:

It's upsetting not to go through those unclean period ... You begin to feel like an old woman. Timidly, Big Irene asked: 'And what if they never come back afterwards?' At her words a ripple of horror swept over us ... Catholics crossed over themselves, others recited the Shema; everyone tried to exorcise this curse the German were holding over us: sterility. How could one sleep after that?

These reactions reflected both religious and cultural diversity, showing that regardless of faith, culture or nationality, it was a worry all could relate to. The historian of Holocaust literature S. Lillian Kremer argued that, in addition to the fear of becoming infertile, the prisoners' uncertainty over whether their fertility would return if they survived made the loss of menstruation a 'dual psychological assault' on female identity.

Upon entry into the camp, prisoners were given shapeless clothing and had their heads shaved. They lost weight, including from their hips and breasts, two areas commonly associated with femininity. Oral testimonies and memoirs show that all of these changes compelled them to question their identities. When reflecting on her time in Auschwitz, Erna Rubinstein, a Polish Jew who was 17 when in the camps, asked in her memoir, The Survivor in Us All: Four Young Sisters in the Holocaust (1986): 'What is a woman without her glory on her head, without hair? A woman who doesn't menstruate?'

It is only due to the commercialisation of a natural physical occurrence that we now have resources such as pads and tampons that are specifically geared towards easing the 'inconvenience' of menstruation. Terms such as 'sanitary equipment' show that menstruation is treated as a health and hygiene concern - something to be sanitised. The reality of the camps, however, meant that menstruation was hard to avoid or hide. Its suddenly public nature took many women by surprise and made them feel alienated. An additional obstacle was the lack of rags and the lack of opportunities to wash. Trude Levi, a Jewish-Hungarian nursery teacher, then aged 20, later recalled: 'We had no water to wash ourselves, we had no underwear. We could go nowhere. Everything was sticking to us, and for me, that was perhaps the most dehumanising thing of everything.' Many women have talked about how menstruating with no access to supplies made them feel subhuman. It is the specific 'dirt' of menstruation more than any other dirt, and the fact that their menstrual blood marked them as female, that made these women feel as though they were the lowest level of humanity.

The humiliation was furthered by the struggle of finding rags. Julia Lentini, a 17-year-old Romani from Biedenkopf in Germany, spent her summer months travelling through the country with her parents and 14 siblings. She was placed on kitchen detail during her time in Auschwitz-Birkenau and later Schlieben. She discusses in her testimony how women had to learn tricks for survival when it came to menstruation in the camps. 'You took the undergarment slip they gave you, ripped it and made little rags, and guarded those little rags like they were gold ... you rinsed them out a little bit, put them under the mattress and dried them, then nobody else could steal the little rags.' Rags were precious and, being so, they were not immune to theft. Some people compensated by using other materials. Gerda Weissman recalls: 'It was a hard thing because you had no supplies you know. You had to find little pieces of paper and some things from under the loos.'

Rags could almost be considered to have their own micro-economy. As well as being stolen, they were given away, borrowed and traded. Elizabeth Feldman de Jong's testimony highlights the value of second-hand rags. Not long after she arrived at Auschwitz, her periods disappeared. Her sister, however, continued to menstruate every month. Experiments involving injections in the womb were common, but if a woman was on her period doctors often avoided operating, finding it too messy. One day, Elizabeth was called to have an operation. There were no clean clothes as opportunities to wash were limited, so Elizabeth put her sister's underwear on and showed the doctor, telling him that she had her period. He refused to operate. Elizabeth realised she could use her sister's situation to save herself from experimentation and did so another three times at Auschwitz.

Shame and salvation

Livia Jackson, barely old enough to menstruate, felt repulsion at seeing blood flowing down the legs of another girl during roll call: 'I would rather die than have blood flowing down my legs.' Her reaction conveys a common attitude: although the lack of access to supplies to stem their menstrual flow was not their fault, many women still felt ashamed.

Scholar Breanne Fahs argues that women's bodies are viewed as 'leaky and troublesome' and their bodily functions are seen as inconvenient, distasteful and unhygienic. Men, on the other hand, tend to receive praise for their secretions: urine, flatulence and semen can be seen as humorous, even sexy. Yet the very notion that periods are repulsive could save women during the Holocaust from being raped. Doris Bergen's classic discussion of sexual violence in the Holocaust includes an interesting example of two Polish-Jewish women assaulted by Wehrmacht soldiers:

On 18 February 1940 in Petrikau, two sentries ... abducted the Jewess Machmanowic (age eighteen) and the Jewess Santowska (age seventeen) at gunpoint from their parents' homes. The soldiers took the girls to the Polish cemetery; there they raped one of them. The other was having a period at the time. The men told her to come back in a few days and promised her five zlotys.

Similarly, Lucille Eichengreen, a young German-Jewish prisoner, recalled in her memoir that during her imprisonment in a Neuengamme satellite camp in the winter of 1944-5, she had found a scarf and was thrilled: she planned to use it to cover her shorn head. Worried that she would be punished for owning a prohibited object, Eichengreen hid the scarf between her legs. Later, a German guard took her aside and, while attempting to rape her, groped her between her legs and felt the scarf. The man exclaimed: 'You dirty useless whore! Phooey! You're bleeding!' His error protected Lucille from rape. In discussing these stories, we must discern the irony at hand: it is rape that should be viewed as disgusting and menstruation as natural and acceptable.

Camp families

Some teenagers experienced their first period in the camps alone, separated from their families or orphaned. In such cases, older prisoners provided help and advice. Tania Kauppila, a Ukrainian in Mühldorf concentration camp, was 13 when she started her periods. She did not know what was happening and shed many tears. She was scared that she was going to die and did not know what to do. Older women in the camp taught her and others in the same position about periods. The girls were taught how to handle it and what they needed to do in order to cope with the blood flow. It was a different learning process than they would have had at home: 'You tried to steal a piece of brown paper, you know, from the bags and do the best you can', recalled Kauppila. This story reoccurs across numerous oral testimonies. Many orphaned survivors who had just started mentioned the help of older women, who took on both a sisterly and motherly role in helping these young girls, before they experienced potential amenorrhoea; older women usually lost their period within the first two or three months of imprisonment.

Feminist scholars such as Sibyl Milton have pointed out the female 'camp families' that formed. It is striking, however, that the sisterhood of menstruation has not been written about. As Lentini highlights, if a girl got her period and did not know who to talk to, an older woman would usually 'explain it very simply'. Twenty-year-old Hungarian Vera Federman spent time in Auschwitz and the Allendorf. She and a friend were able to get work in the kitchen, a precious job. Eating extra potatoes caused their periods to come back and then both girls stole rags from the female guards. This theft, of course, put them in great danger (not to mention the threat of losing their job), but Federman stressed the solidarity with her friend as they teamed up to help each other. In the often violent world of the camps, older women were willing to help educate unknown young girls, expecting nothing in return.

Gendered social networks of support and help developed in the camps. Arendt wrote that 'the camps are meant not only to exterminate people and degrade human beings, but also serve the ghastly experiment of eliminating, under scientifically controlled conditions, spontaneity itself as an expression of human behaviour'. The female solidarity brought about by the shared experience of menstruation, however, tells another story.

After the liberation, the majority of those who suffered amenorrhoea during their time in the concentration camps eventually started menstruating again. The return of periods was a joyous occasion for many. London-born Amy Zahl Gottlieb was, at 24, the youngest member of the first Jewish Relief Unit ever posted overseas. While discussing her work with liberated camp members in her interview with the United States Holocaust Memorial Museum, Gottlieb described how women began to lead normal lives and started to menstruate again; they were thrilled to be able to start having children. Menstruation became a symbol of their freedom. One survivor spoke of it as 'my womanhood returning'.

The study of menstruation, a topic that has until now been perceived as irrelevant, or even disgusting, gives us a far more nuanced view of women's experience of the Holocaust. We can see how notions of menstruation, rape, sterility and sisterhood changed in the camps. It seems that periods, a long-stigmatised topic, became, sometimes in the space of only months, a legitimate topic for women in camps.

Following the recent turns to cultural history, the history of the senses and the history of the body, we also need to recognise menstruation as valid and as defining victims' experiences during the Holocaust.

Jo-Ann Owusu is a recent History graduate from the University of Warwick.

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Menstruation is rarely a topic that comes to mind when we think about the Holocaust and has been largely avoided as an area of historical research. This is regrettable, as periods are a central part of women's experience.

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This article makes it clear to me that pregnancies were something to avoid in the Holocaust. Women would either have to abort their child while hiding it at the same time, or get shot by the guards. It's not the women's fault most of the time because the guards would rape the women prisoners without being careful and the women would end up making the decision of getting killed or killing the baby. In the end, like this article states, women would abort and if they were even seen while pregnant or with a newly born child they would both be killed.

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Pregnancy was forbidden by the Nazis but some, not all, women wanted to experience bringing life into the world. If a woman became pregnant, they would need to find a way to abort it or they would be killed.

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"Always on my mind is my parents. My father worked for five months in coal mines on 200 grams of bread a day. That was the entire food other than soup, which was water with some weeds. And when they were brought back to Auschwitz, to Birkenau, his face was all black, because they didn't have a chance to wash, and he was a skeleton without any flesh on his bones."

Giselle Cycowicz, Holocaust survivor

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Giselle Cycowicz was supposed to spend this year's Holocaust Remembrance Day in Poland. The 93-year-old Jerusalem resident usually accompanies Israeli high schoolers there to learn about life before the Nazi invasion and under occupation.

"Normally, I would be, this time of the year, I would be in Poland, because I also go to Poland to accompany high school kids and we go to all the sites, many sites of the Shoah," Cycowicz told The World. "And I talk about the Shoah. I am the, what they call, witness."

Close to 400,000 survivors of the Shoah, or Holocaust, are believed to still be alive worldwide. About 1.5 million people died at the Auschwitz concentration camp, 90% of them Jews, before the Soviet army liberated the camp on January 27, 1945.

Cycowicz is a survivor of Auschwitz. She was born in the town of Khust, in the Carpathian Mountains. Today, it is part of Ukraine, but at the time it was part of Czechoslovakia. In 1939, Hungary took over the region, and not before long all the Jewish children in the town were expelled from school. Cycowicz was 12 years old at the time.

She didn't go back to school for another three decades, when, at age 42, she went to college in the United States.

Before the war, Khust had about 20,000 residents, about 8,000 of whom were Jews, mainly working in commerce, said Cycowicz's daughter, Yael Bier, who shared some of her mother's recollections with The World. But after the war broke out, there was no livelihood for Jews.

Cycowicz's father did what he could selling mineral water, and to support themselves, the family offered to host overflows of guests at local inns. The children - Cycowicz was the youngest of three daughters - would find empty corners of the house to sleep in as they hosted tourists.

But life for Cycowicz's family was unraveling. From a comfortable home and good jobs, things became very difficult.

In March of 1944, the Nazis marched into Hungary. Within three months, all Jews were sent to the ghettos. Five weeks later, Cycowicz's entire family was sent to Auschwitz by train. She remembers her father, Wolf Friedman, telling them, "Be sure to make yourself useful. That's how you will survive."

"Always on my mind is my parents. My father worked for five months in coal mines on 200 grams of bread a day. That was the entire food other than soup, which was water with some weeds. And when they were brought back to Auschwitz, to Birkenau, his face was all black, because they didn't have a chance to wash, and he was a skeleton without any flesh on his bones."

Giselle Cycowicz, Holocaust survivor

"Always on my mind is my parents," Cycowicz said. "My father worked for five months in coal mines on 200 grams of bread a day. That was the entire food other than soup, which was water with some weeds. And when they were brought back to Auschwitz, to Birkenau, his face was all black, because they didn't have a chance to wash, and he was a skeleton without any flesh on his bones."

She said a person from their town said, "Today, 200 Jewish men were brought back to Auschwitz from the coal mines where they worked ... Tomorrow, we won't be here anymore."

After that, Friedman was sent to the gas chambers.

"He was 49 years old. And he knew all along. This is my biggest pain, that they know that they're going to be killed by gas," Cycowicz said. "Can you imagine this? We know that something like this exists and that it may happen at any moment in Auschwitz, that they should take us and put this into the gas chamber. But it wasn't imminent. We didn't know for sure. But they know, we are now going to go into the gas chambers and be killed."

Cycowicz was in Auschwitz for six months with one of her sisters and mother, Hanna Friedman, who was 50 years old, and frail. Keeping their mother alive became their purpose, Bier said.

One day, Cycowicz saw that hundreds of adult women in the camp were sent to a storage building - her mother, Hanna, among them. After a few hours they were all led out of the building and marched out of the camp, but Cycowicz's mother wasn't with them. Once the coast was clear, she and her sister entered the building and found their mother hiding behind a cabinet. Hanna told them she grabbed another woman to try and hide her as well, but that woman resisted and said she didn't want to be beaten before being killed. Cycowicz later learned that the women were sent to a labor camp where her mother surely would not have survived.

Later, Cycowicz, her sister and mother were sent to a different camp, where they remained until their liberation. One day, the camp's Nazi armed officers, the SS, lined them up and told them: "We're waiting for the Russians. You can go wherever you want, but please don't do anything to us."

After liberation Cycowicz's family moved to the US, where she became a psychologist. She married and had three children in the US. In 1992, after her husband died, she followed her children who had already immigrated to Israel.

Cycowicz joined an organization called Amcha, which provides social and psychological support for Holocaust survivors. She says she has found new meaning in that.

"I've been living alone. And it's fine for me. I am very active. I've been working. I'm still on a payroll. I still have patients and I have now in this week, from the beginning of the holidays, I've had maybe 200 telephone calls," she said. This year's Passover holidays end Thursday.

"Every minute of the day somebody calls to say, to wish a good holiday, and to remember the Shoah, and to wish me good health. So I'm not alone. And I talk to the children a few times today. And I have, thank God, 21 grandchildren and a large number of great-grandchildren. So I don't feel alone."

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From Auschwitz to Jerusalem, Holocaust survivor Giselle Cycowicz shares her story

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Giselle Cycowicz was supposed to spend this year's Holocaust Remembrance Day in Poland. The 93-year-old Jerusalem resident usually accompanies Israeli high schoolers there to learn about life before the Nazi invasion and under occupation.

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The World Holocaust Remembrance  Center: “MOTHERHOOD”; Spots of Light: Women in the Holocaust https://www.yadvashem.org/yv/en/exhibitions/women-in-the-holocaust/motherhood/index.asp; Copyright © 2020 Yad Vashem; December 13, 2020

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About a million and a half children perished in the Holocaust. Each of them had parents who stood by helplessly, unable to avert his or her murder. The murderers also identified the mothers as closely bonded with children and treated them accordingly. The fate reserved for mothers was integrated with that decreed for the children-death, of course.

One of the initial dilemmas that the family faced was how to find a hiding place, especially for the children, while it was still possible. Arranging a hiding places for a child was a complicated, expensive, and relatively uncommon process. Parents could not marshal the psychological will to take such a step, knowing that they would never see their child again, unless they sensed that the alternative was death. Since such an insight was difficult to internalize, many parents did not surrender their children to others even when they could have done so.

In the ghettos, mothers were preoccupied with daily survival, mainly in providing food and maintaining hygiene in order to stave off illness. Pregnant mothers wished to abort in most cases, knowing that they could not feed and care for the newborn with the rest of the family barely hanging on. Even so, here and there the very ubiquity of death infused women with the wish to create new life. Later on, the Nazis forbade pregnancy; any woman who became pregnant risked immediate murder or deportation to the death camps. Since contraceptives did not exist, women became pregnant anyway and their fate was sealed unless some means of abortion was available.

When the Nazis employed the method of murder by gunfire at killing pits, the entire population was taken and murdered together, usually after men women and children had been forced to undress. In some cases, however, men were led away separately and women and children were murdered in their absence.

Mothers of children in selection queues may have been the only ones to whom the murderers offered a choice-that of going to death with their children. Even there, however, at moments of difficulty unparalleled in human history, children were sometimes torn from the arms of the few women who were selected for lives of slavery and were handed to grandmothers or to those next to them and went with them to their deaths.

As a rule, there were no children in the camps. Pregnant women sometimes attempted to conceal their condition and in a few cases managed to abort. Births were almost unknown in the camps, and such children as were born were murdered by the Nazis or put to death by their mothers or other women. In Auschwitz-Birkenau, experiments in the sterilization of women and men were performed for the purpose of subsequent mass sterilization of elements that the Nazis wished to render childless.

Amidst all this violent terror, women found the mental fortitude to continue loving their children, caring for them until the moment of death and making decisions about their fate that people until that time had never had to confront. Some mothers, impelled by the survival instinct, made decisions or took actions that clashed with the accepted social norms that govern the mother-child relationship. They were driven to this by the immense distress that had been imposed on them: after spending months if not years struggling for their lives and those of their family members, their strength failed them. Other mothers, however, elected to die with their children even though they could have chosen differently-and this, too, was a choice that is not always comprehensible in ordinary times.

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About a million and a half children perished in the Holocaust. Each of them had parents who stood by helplessly, unable to avert his or her murder. The murderers also identified the mothers as closely bonded with children and treated them accordingly. The fate reserved for mothers was integrated with that decreed for the children-death, of course.