Between Foreign Politics and Humanitarian Neutrality: Medical Emergency Aid by the Two German States before 1970

Between Foreign Politics and Humanitarian Neutrality: Medical Emergency Aid by the Two German... Summary During the armed conflicts of decolonisation in Korea, Vietnam and the Congo in the 1950 s and 1960 s, both German states joined the competition between East and West by sending medical teams to conduct aid work. West German numerical advantages in funds and available staff were countered by East German governmental command of human resources and productive capacities such as the pharmaceutical industry. As a result, the German Democratic Republic (GDR) preferred shorter stays and the supply of large amounts of equipment and materials whereas the Federal Republic of Germany (FRG) instead commissioned teams of NGOs for several years and financed whole facilities. Ideological or even distorted interpretation of facts was more obvious in the East, opposition of health workers to the official line of their respective governments in the West. The FRG also introduced a distinction between neutral humanitarian and politically interested development aid whereas for the GDR all work was solidarity with socialist or liberated countries. Germany, humanitarian aid, Korea, Vietnam, Congo After the Second World War, the short-term deployment of medical teams in cases of emergency became a major field of European and North American intervention in the health care of former colonial territories in Africa and Asia. The transition from colonial to national administration was often accompanied or even caused by violent conflicts involving foreign powers and the United Nations. In such cases, the temporary delegation of medical doctors and other health workers was intended to secure medical care in health systems that had been regarded as insufficient by Western standards even before the emergency in question. Thus, in contrast to medical aid in the Global North after war, earthquakes or floods, medical assistance of this kind was also intended as a transfer of medical technologies and knowledge similar to that which had formerly been characteristic of colonial and mission medicine and was now becoming part of ‘development aid’. Existing historical studies on humanitarian intervention during emergencies usually focus either on their beginnings before 1900 or on the decades immediately following the profound changes which occurred in the relationship between the state and civil society during the late 1960 s. Therefore, they mostly cover the Red Cross, in its founding period as well as its role in the two world wars.1 Alternatively, historical studies concentrate on periods after the Biafran war, that is, the time of détente and post-1989.2 Temporary expatriate health work after emergencies in Asia and Africa during the 1950 s and 1960 s, by contrast, has scarcely been researched. This is all the more surprising as these interventions were also highly politicised.3 Notwithstanding the officially required neutrality of the agents, such as the Red Cross Societies or the Order of Malta, humanitarian intervention was a state-related activity that received considerable diplomatic, administrative, financial and logistic support from the governments of the countries where the aid organisations came from. Several competing features that deserve detailed study are involved here. On one side were the political aims of the different governments involved in the Cold War. On the other, there was the ethos of the health professions and the humanitarian law, both of which were codified in these years. The World Medical Association had declared universal medical ethics in the 1948 Geneva Declaration, including the obligation of non-discrimination of any kind. In 1949, the four Geneva Conventions initiated by the Red Cross formulated rules of humanitarian assistance, making specific reference to the short-term goals of emergency relief, which differed from the requirements of what came to be generally known as ‘development’ at that time. The question therefore arises as to whether and how the agents involved in humanitarian aid expressed, discussed and negotiated the various aims, strategies and motives with each other. Such agents included representatives of different governments, officials of aid organisations, expatriate health workers and, as far as possible, the local politicians, staff and population. What were the instances that prompted decisions to send medical teams? Who welcomed and supported, who opposed the plans? How were these communicated, both internally and to the public? Were there conscious distinctions in health work between development and emergency aid, between politically neutral assistance to those most in need and political cooperation concerning health? How far did these distinctions influence decisions and daily work? These questions concern the factors that may have shaped the missions analysed here, both as individual events and as possible models for future humanitarian and development work. This article will attempt to answer the above-mentioned questions by looking at the two German states during the post-war period and up to 1970, the Federal Republic of Germany (FRG) in the West and the German Democratic Republic (GDR) in the East. Studying responses to the same emergencies by a West European and an East European state with the same colonial history and medical past is a useful way of analysing different political backgrounds as conditions for differing types of aid. It shows how health assistance in and after emergencies functioned in respective Cold War politics and how this work was shaped by the civil society. German activities in international health after 1945 have rarely been studied in detail. The few comparative historical studies on East and West German activities to date—apart from the above-mentioned and most recent work by Young-Sun Hong—focus on development aid in general or medical education and training as organised by the two German states.4 This paper therefore sets out to investigate the missions performed by German organisations in the field of medicine and health during emergencies in a series of countries before 1970 thereby drawing on published and archival sources from the two German states and non-governmental organisations as well as newspaper and journal articles, memoirs, and previous studies. Early Humanitarian Aid: East and West Germany As the only industrialised nation divided between the two sides in the early years of the Cold War, Germany is an interesting case for comparing international health work. Still rebuilding their own political and economic systems in the 1950 s, both German states were latecomers to international aid. Good relations with many other countries were essential prerequisites for both states in view of their desired membership in international organisations. The choice of partners and of areas for aid was determined by ideological preferences as well as by practical necessities. Thus, both German governments made political use of aid (agencies) to serve their own international ambitions. Societal and economic conditions were quite different in the two states. In the FRG, the Christian mission societies continued their health work in colonial and decolonised territories, increasingly supported by federal government funds, and sent more health workers than ever before.5 In addition, hundreds of German doctors who were having difficulty in finding attractive positions at home or who wanted to work abroad found employment with the new national governments in the Middle East or Indonesia and with the WHO.6 The West German government had contributed financially to UN agencies for development and health since the early 1950 s.7 In the mid-1950 s, the Western allies urged West Germany to become engaged in direct assistance for so-called ‘underdeveloped countries’, not least as a means to spread the Western model and to fight communism.8 Funds that had been received from the European Recovery Programme were to be forwarded to other world regions. Changes in German society also played a role. Having been cut off from information about other world regions for many years, Germans were now shocked by photographs of starving children, lepers and blind beggars.9 The population had also been moved by the experience of Western aid to war-devastated Germany and the rapid effect it had had on the German ‘Economic Miracle’ (Wirtschaftswunder). After suppression under National Socialism, the churches regained, and even exceeded their former importance in politics and in social services such as health care, education and poor relief.10 As a result, the Catholic bishops and the Protestant welfare organisation started major fund-raising campaigns in 1958 against ‘hunger and disease in the world’. The first campaigns—those from the Protestant organisations even taking place in both parts of Germany—collected about 53 million Deutschmarks, a sum higher than the governmental budget for ‘development aid’ in the West. Two large aid organisations for development were founded at this time, the Catholic Misereor and the Protestant Brot für die Welt (‘Bread for the World’), as well as smaller specialised agencies for sending volunteer lay professionals or for supporting the education of students, initially mainly medical students, from ‘developing countries’ in West Germany.11 In 1961, the West German government founded a ministry for ‘development aid’—the ‘federal ministry for economic cooperation’—which assumed overall responsibility for all governmental development programmes in the late 1960 s.12 From that time onwards, health projects were increasingly expected to contribute to economic development rather than to be merely ‘humanitarian’.13 The East German situation was different in several ways. Due to Soviet domination, the government did not accept funds from the European Recovery Programme nor did it implement the US idea of ‘development aid’. Instead, it sought to support liberation movements striving for independence from Western powers, at the same time looking for support from decolonised countries in its ambitions for international diplomatic recognition, especially membership in the WHO and UN.14 The number of countries that allowed cooperation with East Germany was much smaller than that for West Germany, and there was also competition within the Eastern bloc itself. As all previous or newly founded civic organisations in the GDR, such as the Red Cross Society, trade unions, youth associations or aid committees, had to be part of or represented in the Nationale Front, they were tightly controlled by the Socialist Unity Party (SED) and the government.15 As will be demonstrated by the cases discussed in this article, medical assistance given to decolonised nations was exploited in the mass media as proof of the superiority of socialism. Activities such as stipends for medical students from Africa or Asia—often paid for by enforced contributions from the working population—played a role as aid from the state and socialist society.16 As factories for pharmaceuticals and medical equipment were state-owned in the GDR, procuring export markets for such goods was also a task for medical experts sent by the government to foreign countries.17 Financial aid was not possible due to the lack of a globally convertible currency, with the result that the free delivery of pharmaceuticals and equipment became a common form of aid. Additionally, sending qualified doctors abroad was hampered by poor knowledge of Western languages and by the shortage of doctors.18 Keeping these differences in mind, this article will present and analyse the aid provided in three conflicts following decolonisation, in the chronological order of their initiation. The voices of the different participants—officials of governments and of aid organisations, senior and junior staff in the missions—will be presented in detail as they allow insights into the dynamics of the projects, thereby enriching our understanding of fundamental changes and differences in the period studied. The highly complicated histories of these wars or internal struggles have already been documented and analysed in several easily accessible studies and will therefore only be touched upon here when and insofar as they are relevant for the medical aid provided by the two German states. Post-war Korea: a West German Hospital and East German Reconstruction Work (1953–1959) The Korean War (1950–53) started with the invasion of the South by North Korea, which was supported by China and the Soviet Union. The reaction of the UN Security Council was a resolution that led to military support for South Korea from 22 UN member states under US leadership.19 Many East European and West European countries that did not participate in military action sent medical and other humanitarian aid. Sweden and Norway sent field hospitals, Denmark provided a hospital ship and Italy ran a Red Cross Hospital in Seoul.20 Thus, when pressed during his visit to the USA in 1953, West German Chancellor Konrad Adenauer promised a German field hospital. However, the war ended before the arrival of the equipment and staff in late 1953. The project therefore became a hospital service for the civilian population of the Korean harbour town of Pusan (Busan) where destruction due to the war had been concentrated. It initially involved 86 German staff members and was completely financed by the German government with 3.6 million Deutschmarks per year over five years.21 The senior doctors selected for this mission had already gathered considerable medical and international experience. The medical head of mission was Professor Günther Huwer (1899–1992), a gynaecologist whose many years of academic and clinical work in China had earned him the title ‘Old China hand’ from his juniors.22 The head of the department for internal medicine, Professor Wolfdietrich Germer (1911–96), had worked in tropical medicine in London, Brazil (Rockefeller Foundation on yellow fever) and Liverpool, as well as in the Balkans during the Second World War. He would go on to become Medical Superintendent of a large hospital in West Berlin immediately after his stay in Korea.23 The head of the surgical department, Dr Eberhard Daerr (1912–2005), had previously worked for six months in London, for a further six months with the British occupation army, and also in the National Public Health Service of Liberia for two years. After his work in Korea, he joined the newly founded German army, eventually becoming its highest medical officer (Inspekteur). After his retirement in 1972, he took up the position of Chief Medical Officer (Bundesarzt) of the German Red Cross.24 The first three heads of the mission and departments can therefore be regarded as medical doctors with a level of foreign experience and career ambition far above the German average. Huwer recalled the situation more than 30 years later: ‘Since Germany did not have any status internationally we were subordinated to the UN—in effect the Americans; the Red Cross was a showcase [Aushängeschild].’25 In his memoirs, Huwer complained about repeated orders ‘without knowledge of the subject’ from the German Foreign Office that would have jeopardised the mission and were given against the explicit advice of people with experience on the ground.26 He maintained that the hospital was an exclusively civilian one, with no American support in the rehabilitation of the designated school buildings and with no military function: ‘No victim of war was ever treated.’27 However, several photographs of Huwer with various US generals—first during his departure from Germany, then in front of the hospital and finally when being awarded the Medal of Freedom—hint at a closer relationship with the military.28 Another doctor recounted that he had to wear the Red Cross uniform, ‘as required by the Geneva Convention’, that they were subordinated to the American army, especially their medical superiors, and that the German doctors had an ‘equivalent rank’.29 The balancing act of giving an explanation for a civilian humanitarian mission that took place within a military context and had been demanded by a combating nation was palpable even decades later. Not only the context, but also the internal affairs of the hospital had military connotations, as the German investigative weekly magazine Der Spiegel wrote in 1959. The magazine article raised the question as to whether the Chief Medical Officer of the German Red Cross, a retired high-ranking government health official, had given precedence to military discipline over the investigation of serious accusations. Two junior doctors in Pusan, Hans Hannak and Hans Bommert, had accused the then head of surgery Harald Friedrichs of having falsified the causes of death in nine cases after unsuccessful surgery, of having caused damage and fatal outcomes by misdiagnosis and of having beaten patients.30 The charges were even taken up along the shores of the Pacific Ocean, and reported as ‘atrocities’ in a Sydney newspaper.31 Two further charges in German articles were omitted by the Australian press: the description as an ‘island’ where ‘obstinate, incorrigible Nazis’ had taken refuge, and the accusation of ‘intolerable moral behaviour’ that led to more than just the local population viewing it as a ‘brothel for human wrecks’.32 The accusing party Dr Franz-Joseph Rosenbaum, the new head of the department of internal medicine, later conceded that his remark on immorality had been too harsh. But he did not alter his remark on Nazi attitudes, and his comment was supported by complaints from others regarding the ‘Führerprinzip’ as the style of team leadership. In several later letters to the Deutsches Ärzteblatt, the German medical journal, Huwer, a former member of the NSDAP, showed that he had not completely distanced himself from the thinking of Germany’s Nazi past, as was commented on in the influential weekly journal Die Zeit.33 He claimed that none of the people he had asked had known of mass murder under National Socialism and that the Germans would not therefore need ‘forgiveness’—apart from some ‘hundred, perhaps a few thousand in prominent political positions’.34 In the debate on compensation for psychiatric patients who had been persecuted during National Socialism, Huwer maintained that the victims of enforced sterilisation had been ‘human beings lacking any feeling of social responsibility’.35 Thus, Rosenbaum’s impression may have contained a certain truth. Nevertheless, he was dismissed in 1959 for lack of loyalty by the Red Cross Chief Medical Officer, Otto Buurmann (1890–1967). Buurmann, although at the time affiliated to the Protestant welfare service, had also been an open supporter of the Nazi sterilisation programme and had been the public health officer for the Ghetto in Krakow.36 Thus the senior medical officials of the German Red Cross, both at home and in Korea, could be shown to have shared a certain philosophy on the allegedly inferior biological quality of some groups. Investigations by the German embassy and by a German Red Cross delegation confirmed that there were good grounds for at least some of the charges and the hospital was finally closed in March 1959.37 The metaphor of an ‘island’ for the German hospital was used not only by Huwer’s opponent, but also by one of his adherents, who described the hospital not as an island of professional and moral inferiority, but one of superiority. In his book dedicated to Huwer, surgeon Walter Drescher complained about this ‘kind of island’ (Inselhaftigkeit) that forced its inhabitants ‘under the sign of the Red Cross … to behave more righteously than was good for human nature’ whereas those ‘outside remain in the attitude of the eternally needy and desiring which is even worse’.38 The sharp contrast between those who helped and were expected to show superhuman virtue and those who were regarded as dependent on aid excluded any encounter on equal terms and thereby hindered one of the desired results of decolonisation. Despite the isolated character of the hospital as a foreign institution, mistreatment and conflicts within the team and the paternalist arrogance of several West German doctors, the mission was regarded as a medical success in several other ways by both German and Korean observers. Patients using the medical facilities of Korean physicians usually had to pay for services, making them unaffordable for most of the population, which consisted of refugees and people with little means. The German hospital therefore offered free treatment to poor patients. All the beds were constantly occupied throughout the project and treatment was in such high demand that the no-cost access tickets were even traded on the black market.39 The hospital provided more than just emergency aid. It also introduced postgraduate training for about 60 Korean doctors as well as nursing education.40 Drescher portrayed this formal and informal training as development work aimed at bringing about a fundamental change in medical care in Korea and reflected this in extensive speculations on differences between Asian and Western peoples, doctors and families, on opportunities for sustainable technical innovations and for new ways of thinking.41 Others saw the presence of local doctors as exploiting a highly qualified Korean workforce without giving the promised training, as all out-patients from 1956 onwards were treated by Korean doctors only.42 The qualification in nursing that Korean nurses acquired at the hospital in Pusan led some of them to undertake postgraduate training and work in ‘mother houses’ of the German Red Cross Sisters.43 These first visits initiated a programme that, over the years, took 12,000 Korean nurses, both religious sisters and unmarried secular nurses, to West Germany. This in turn was interpreted as either exploitation of foreign labour or as capacity-building.44 On the other side of the front in North Korea, the GDR also sent ‘volunteer hospital units’ to Manchuria ‘in support of the Communist troops fighting there’, as did other East European states such as Romania and Hungary.45 The main East German contribution was in terms of materials: more than 150 tons of medicines, another 200 tons of medical equipment and two ambulances were provided in the period up to 1954.46 Equalling a value of 60 million East German Marks by 1957, material aid was delivered in six ‘solidarity trains’ (1954–56) with more than 160 wagons containing consumer goods and medical supplies as well as the equipment for a polyclinic for dermatology and venereology in Pyongyang (1955–57).47 The construction of a tuberculosis hospital, handed over in 1961, was part of the GDR’s largest project—the reconstruction of the bombed city of Hamhung between 1955 and 1962.48 This project included the work of the hygienist Dr Walter Muschter, a specialist in accommodation and cities, the reconstruction of a hospital and the construction of a medical school.49 Among the East European states, the GDR thus played a leading role, second only to that of the Soviet Union, in the reconstruction of devastated North Korea as a model socialist country.50 As the GDR Foreign Office country files on Korea concerning health do not contain any documents before 1960, it remains unclear whether any medical staff were ever sent. There is no mention of German clinical staff in East German newspapers that regularly reported on Hamhung between 1956 and 1960.51 When the GDR wanted to export pharmaceuticals and technical dental equipment in 1960, the North Koreans were already pursuing a strict policy of self-reliance (Juche) and of trust in traditional East Asian medicine, both of which excluded imports from Europe.52 The Two Germanys in the Vietnam War (1955–1975): Various Hospital Projects A further reason for East German abstinence from medical assistance in North Korea was the increasing prominence of another place where injured persons were more in need of care. During the other major Asian wars of decolonisation and Cold War rivalry, the Indochina War (1946–54) and the Vietnam War (1955–75), the GDR engaged in health care in North Vietnam. In 1954, the ‘Korea aid committee’ of the Nationale Front became the ‘Solidarity committee for Korea and Vietnam’ and efforts were divided between Korea and Vietnam in a ratio of 1:2. Korea was finally given up by the solidarity committee in 1957.53 In 1956, East Germany financed, equipped and temporarily staffed the rehabilitation of a former French colonial university hospital for surgery in Hanoi, which was then named Viet-Duc, the Vietnamese-German friendship hospital.54 As the oldest of the five major East German hospital projects abroad, it figured prominently in international solidarity work until the end of the GDR.55 The most lively source of information on the hospital is the diary of the surgeon and head of mission Professor Richard Kirsch (1915–71), published as a series of articles in the party newspaper and as an award-winning book for children under the title ‘Mosquitoes, Bamboo and Bananas’, with the subtitle ‘As a doctor in Vietnam’.56 The images on the inner title pages, however, show neither exotic flora and fauna nor a doctor at clinical work, but large transport boxes with numbers indicating that they run to several hundreds, and both European and Asian staff handling and opening them. This drawing is characteristic of this project as well as of East German international health cooperation in general. The team’s main task here was to accompany the gift of 3,200 boxes of hospital equipment and to put this equipment to use. Besides this function, the East German doctors, nurses and technicians worked with their Vietnamese counterparts in patient care during their stay of nine months. The fact that they regularly met Vietnamese officials, including president Ho Chi Minh, was the main message of the published extracts from Kirsch’s diary. Medical technology made in the GDR was not only important as a gift, but also for promoting exports. A chapter of the children’s book entitled ‘The hospital—a trade fair in miniature’ describes Vietnamese interest in the prices and availability of East German medical supplies, accompanied by special applause from Soviet colleagues who were pursuing a similar purpose.57 Kirsch’s next visit to the country, three years later, was even prompted by an industrial exhibition, a feature of salesmanship also found in the archival records for several other medical experts.58 The hospital project was far more than humanitarian aid, it was also intended to establish and strengthen political and economic ties with an important ally in Asia. The special focus on the prosthetic rehabilitation of war injuries for the so-called ‘heroes of the liberation war’ was especially welcomed.59 Another East German surgeon, Professor Albert Schmauss (1915–2010), stayed from 1956 to 1958 for surgery in Hanoi and later travelled to Vietnam 14 times.60 Kirsch, Schmauss and other team members were highly honoured by the governments in Vietnam and East Germany.61 By contrast, West German medical assistance in Vietnam started much later, initially attempting to be less one-sided than that provided previously in Korea. Including international Red Cross channels, West German material and financial aid reached or at least tried to reach civilian populations on both sides of the front. Compared to the East German Red Cross (6,000 Swiss Francs) and the GDR government (nil), the West German Red Cross (25,000 Swiss Francs) and the West German government (54,000 Swiss Francs) together contributed considerably to the funds of the International Committee of the Red Cross (ICRC) in 1963.62 From these funds, a total of 50,000 Swiss Francs were also used for humanitarian aid to Communist North Vietnam via the East German Red Cross and to the South Vietnamese territory ‘under the control of the National Front for the Liberation of South Vietnam’ via the British Red Cross.63 The West German Catholic aid organisation Caritas, which was responsible for material rather than personal foreign aid, also offered assistance to North Vietnam. This was, however, declined.64 The unexpected prolongation of the war changed conditions regarding neutrality. Chancellor Ludwig Erhard’s visit to the USA in December 1965 functioned as the starting point for another mission of the West German Red Cross. President Lyndon B. Johnson, under severe pressure from Congress for the expense of the Vietnam War, urged the German government to provide substantial aid not only financially, but also by sending medical and technical army corps.65 This was accompanied by the threat of a transfer of US soldiers from Germany to Vietnam and thus less protection for West Berlin. Defence minister Robert McNamara even demanded combat troops from Germany. However, both international and national law as well as the political climate ruled out the sending of soldiers to areas outside NATO territory, even for medical care or logistics—although the West German foreign minister Gerhard Schröder had seriously discussed it.66 Instead, the government decided to send a civilian hospital ship to South Vietnam and to commission the Red Cross with this mission. Again, it was quite an ambitious message to the international and national public, a balancing act of diplomacy, to emphasise that the mission was an act of solidarity demanded by the USA, and at the same time a completely neutral humanitarian project. The chosen vessel, a spa ship named Helgoland, had already been prepared for possible use as a lazaretto ship during its construction. But upgrading it to a full-fledged hospital ship for qualified medical care, nursing and rehabilitation took several months. Additionally, contract and international law had to be considered: which of the four Geneva conventions was best suited for the purpose?67 The choice was between the first convention protecting the wounded and sick members of the armed forces, the second for conditions at sea—as the mission consisted of a ship, and the fourth, which regulated care of civilian victims of armed conflicts. The latter was finally chosen. Seven federal ministries were involved in the planning and it thus took an equal number of months before the ship left Hamburg for Saigon. In Saigon, the West German ministry of health referred to the previous Red Cross mission: ‘Our lazaretto in Korea had treated 250,000 out-patients. This ship will prove successful in the same way.’68 The official mission was, according to a letter by Secretary of State and later German Federal President Karl Carstens, ‘to provide free medical care to sick and wounded civilians affected by events in Vietnam’: The German Red Cross will carry out its activities in Vietnam without regard to race, nationality, religion or political views. The ship, her medical personnel, crew, and the materials on board and in the ambulance will not be used for purposes other than those permitted by the Geneva Convention and the principles of the Red Cross. … The Chief Medical Officer and the other members of the medical personnel, as well as the crew, are civilians.69 The restriction to the treatment of civilians only was justified with the argument that ‘according to the agreed view of all institutions asked, especially the foreign medical teams in Vietnam, the medical care for combatants functioned well and it was just the civilian population which required our help’.70 However, when accused of collaboration with the US American forces by the (North) Vietnamese Red Cross, the West German Red Cross offered ‘to provide its aid also to members of the People’s Republic of Vietnam and the Vietcong [the National Liberation Front (NLF) of Southern Korea; WB] as far as is wished’—a proposal commented upon in a handwritten question in the Foreign Office: ‘i.e. armed forces, not only civilians?’71 The hospital ship and its out-patient department on the mainland, which was provided by the Vietnamese Red Cross, were to be protected by the Vietnamese police and supplied—if needed—by the Vietnamese government. But an additional agreement with the US American embassy assured that the Americans would ‘protect ship and out-patient department like their own facilities when necessary’ and grant their staff the same personal facilitation as the ‘staff of civilian American institutions and other institutions of the free world’.72 Most of the events surrounding the departure of the Helgoland have already been studied in much detail.73 Among the remaining questions are those concerning the relationship between relief operation and possible elements of development aid and that between claimed humanitarian neutrality and other political motives. The West German Missions to Vietnam: Emergency Relief or ‘Development Aid’? In contrast to the Korea mission, the initial members of the West German medical staff in Vietnam were quite young. None of them held the title of professor, as against at least two in the previous team sent to Korea, and—apart from a few months when the team leader Heimfried Christoph Nonnemann had worked in Ethiopia before—none of the doctors seems to have had long-term experience of working abroad.74 Such experience only came with Dr Otto Jäger, who took over medical responsibility as the third head of mission later. Jäger had previously worked in Iran and on a WHO mission in Iraq and Ethiopia for more than 15 years, and would go on to head the seminar program of the German Foundation for Developing Countries (DSE).75 As also observed by the press and by politicians, it had become more difficult to find suitable doctors than in the early 1950s when highly qualified doctors returning from war and overseas work and those fleeing from the East had been desperately looking for jobs. Thus, this time, the doctors who were available would not have been well suited for training local colleagues or fulfilling other tasks beyond curative care. They remained, rather, a temporary substitute for the lack of local health workers. Differing from later debates on ‘Linking relief, rehabilitation and development’, the decision to provide an expensive provisional health facility instead of rehabilitating existing or constructing and developing new facilities was largely unanimous. Just one member of the West German parliament, Heinrich Gewandt, questioned the idea of merely sending doctors and paramedics on a ship, pleading instead for more support of a permanent hospital on the mainland, such as the one in Hué (see below).76 Gewandt was at that time vice-president of the DSE and therefore one of the few experts and proponents of ‘development aid’.77 Costs were not a decisive argument in the debate, although the difference was quite obvious. The annual sum planned for the hospital ship had been 10.6 million Deutschmarks for the first year, and this finally turned out to be 7.5 million for the first year and 9 million for the following year.78 A permanent hospital of the same size was calculated at 9 million Deutschmarks for construction and equipment and at 2.5 million Deutschmarks for operating costs each year. American and Vietnamese authorities expressed their interest in a German ‘contribution to the extension of the health system’.79 In the end, both approaches—off-shore and on-shore aid for short-term and mid-term periods—were adopted and financed, as yet another agency had entered the picture. Two days after the government’s decision to send the Helgoland had been published, Max Adenauer, the third son of the former chancellor and also Secretary-General of the Catholic Order of Malta aid organisation Malteser, offered to provide the hospital ship with medical staff from his organisation.80 The ministry of health, however, declined the offer. In view of the conflicts in South Vietnam between Catholic refugees from the North and the former Catholic minority government of Diem on the one side and a vast Buddhist majority on the other, church organisations were not to be employed. The interdenominational Red Cross was a more neutral choice. Yet the Malteser aid organisation managed to establish its own medical projects in the same year, also financed by the West German government. It took over responsibility for the entire devastated province of Quang Nam with its more than 600,000 inhabitants. At the start, the organisation employed a German staff of 43 health and technical workers, about ten of them medical. Thus, this project required about half the staff and allegedly only a fifth of the costs of the hospital ship.81 Later, the Malteser organisation was commissioned to build a hospital in Da nang, which was destined to replace the hospital ship at its departure. It also set up two more rural hospitals (Hoi an and An hoa) and some smaller health facilities. A comparison between the humanitarian missions of the Red Cross and Malteser in terms of input and output shows that their use of expatriate staff and finances was remarkably similar, although they differed in the duration and output of their work: over five years, the Red Cross hospital ship employed a German staff of about 50 doctors, 122 Red Cross nurses (all female), and 100 male nurses and technicians, thus nearly 300 expatriates.82 During its seven years, the Malteser mission also included about 300 German aid workers, nearly half of them Protestant.83 The Malteser organisation contributed approximately 1.1 million Deutschmarks from private donations and was financed by the German government with 51.4 Million Deutschmarks for the seven years—about the same sum as the government funds for the Red Cross hospital ship over five years. Thus the mainland project with its establishment of three hospitals and its responsibility for an entire province worked for two years longer than the hospital ship in the harbour while requiring about the same amount of funds and German staff. Off-shore medical relief was clearly an expensive enterprise. Concerning the distinction between emergency and development aid, the Malteser mission purposely undertook and inspired both. The construction of hospitals in the project already went beyond pure emergency relief. The project as a whole combined short-term and long-term aid while also including preventive medicine for a whole geographical area, thereby being the first case of German responsibility for the health care of an entire tropical province since the First World War. Small medical teams cared for refugees and leprosy patients, visited scattered settlements and inspected the hygiene and immunisation facilities as well as those for the treatment of diseases. The German hygienist Dr Erich K. Kröger regarded the Malteser project as the ‘establishment of a comprehensive health system’ in the province and explicitly called it ‘development aid’.84 Yet, from his experiences during the project, Kröger also developed proposals for international assistance in catastrophes at both German and international level.85 Regarding the Red Cross hospital ship, the West German minister for development cooperation refused to take it into his budget in 1971 when requested to do so by his colleague for health.86 He thus confirmed that it was not in line with West German development policies, but clearly just constituted emergency aid. West German aid to Vietnam was neither restricted to these two large projects by humanitarian organisations and nor to the health sector. In 1966, West Germany had become—after the USA—the second largest donor country in South Vietnam, providing more than 90 million Deutschmarks (85 million of capital/financial aid and 8.7 million of what was known as technical assistance, i.e. manpower and material), including 32 ambulances, donations of medicines as well as the medical work and teaching at the University of Hué by a team of three German doctors and a lab technician from the University of Freiburg.87 Humanitarianism and Neutrality in Vietnam Contemporary judgements on the humanitarian, that is, neutral, character of the Red Cross and Malteser projects and their teams vary widely. The North Vietnamese Red Cross Society had protested at the ICRC against the Helgoland. It saw the ship as participating in US ‘aggression’ and as ‘West German revanchists’ repeating the ‘abuse’ of the German Red Cross that the ‘National Socialist government’ had committed during the Second World War in order to prolong ‘its fascist war’.88 When confronted with the West Germany's claim of the humanitarian neutrality of the Red Cross mission, it repeated its protest and accusation by pointing to the alleged West German contribution to the war in the form of supplies to South Vietnamese armed forces, the production of bombs and chemical weapons and the sending of military staff and mercenaries in great numbers.89 The East German media also continued to depict both West German missions as part of US aggression.90 A book on Vietnam, published by the East German military publishing house, described the hospital ship as a substitute for the open military action of which West Germany was afraid, as a mission to gather military experience for later use in Germany and as a contribution to US biological and chemical warfare.91 West German and Vietcong views and realities were more differentiated. Since the Malteser team members took over or erected dispensaries and hospitals, they had more contact with Americans and Vietnamese than the Red Cross staff on the hospital ship. In the remote areas close to the demarcation line where their project was situated, they even received food and transportation from the Americans, which made them suspect in the eyes of some German and Vietnamese groups. However, both the South Vietnamese population and, most of the time, the Vietcong, were able to make a distinction: the Malteser medical team could travel without any trouble on the same river where the US forces lost 16 soldiers.92 American army medical teams used evidence from gunshot wounds to gather intelligence and only treated patients who held a South Vietnamese identity card proving that they did not belong to the Vietcong. The Germans, by contrast, treated patients irrespective of the person’s background and in strict confidentiality.93 This practical neutrality did not, however, guarantee complete protection. In 1969, five members of the Malteser team who had unwittingly entered Vietcong territory on a trip during their leisure time were kidnapped by the Vietcong—only two survived captivity and were released after long negotiations.94 A similar loss occurred within the medical team at the University of Hué: three West German doctors and the head of mission’s wife were kidnapped and later killed during the Vietcong’s Têt Offensive in 1968.95 This happened despite the fact that their former team colleague, Dr Erich Wulff, had friends among the Vietcong and had previously accused the US and—according to the East German media—even members of the Helgoland team of war crimes when speaking at the Russell Tribunal in Denmark.96 For many years, Wulff claimed that his colleagues had been murdered by disguised agents provocateurs for ‘black propaganda’ against the Vietcong,97 despite evidence known to him that they had been shot by their confused Vietcong guard.98 Wulff only acknowledged this fact in 2009.99 At the team’s funeral in 1968, the prime minister of the West German federal state of Baden-Württemberg, Hans Filbinger, a former member of the NSDAP and merciless navy judge, emphasised that the team members had not been a means of politics and ideology but had acknowledged that human progress must benefit all peoples equally.100 The presidents of West German universities spoke of them as ‘exercising their humanitarian duties’.101 The rhetoric of humanitarianism beyond ideology was established in rather conservative circles while many of the younger generation preferred partiality for those they saw as oppressed. Different notions of a humanitarian ethos circulated. While the East German press and publications accused the West German doctors of supporting US aggression, the latter considered their own position to be one of humanitarian neutrality.102 Both Red Cross chief physicians, Nonnemann and Dr Klaus Wagner, emphasised the need for equal distance to all political sides. Wagner wrote: ‘Development aid motivated by power politics never makes sense.’103 By contrast, the last chief physician, Jäger, who had already been responsible for reconstructing health care in East Berlin after the Second World War and was therefore experienced in East–West tensions, openly admitted to friendly contact with the Vietcong.104 In general, the attitudes and reflections of the West German doctors were less bound to Western ideology, less paternalist and less Eurocentric than they had been ten years earlier in Korea. A Red Cross nurse, Elisabeth Arkenberg, explained her motivation this way: ‘We wanted to show the Vietnamese that not all Westerners approved of the course of the US government.’105 While denying that anti-Communism was a motive and emphasising the disregard of any creed of patients, Count Truszczynski, a member of the Order of Malta and senior official of its aid organisation Malteser, suggested that the apolitical West German aid workers in Vietnam might become politicised: ‘If someone is there for four months and has experienced the terror of the Vietcong, he occasionally starts to think.’106 Yet, as seen before, the junior staff sometimes felt the opposite way. One of the Malteser nurses, Monika Schwinn, who had been held hostage by the Vietcong for four years, was more concerned about Napalm victims, and said that despite her disapproval of what the Vietcong had done to her and her fellows, three of whom had died in captivity, she could not hate them since this would have been contrary to her ‘moral principles’.107 A strictly humanitarian, moral and idealistic character of the Malteser team is acknowledged and even praised in the very critical report of 1967 on Vietnam by the US feminist writer Mary MacCarthy, who also expressed sympathies with the Vietcong.108 Having published memories of her depressing Catholic childhood, she could not be suspected of harbouring general sympathies with Catholicism.109 Besides such attitudes for and against the US or the Vietcong, and the altruistic wish to help the needy, there were also some individuals for whom the work was primarily an interesting job. The memoirs of a German doctor specialised in tropical medicine who was first a staff member of the Helgoland for one year and subsequently medical superintendent of the Malteser Hospital in Da nang mainly reveal his indulgences in gourmet, alcoholic and sexual experiences. Refraining from political remarks or a more detailed description of the professional relationship with patients, he insinuated that humanitarian organisations followed financial interests and he—as a self-confessed ‘idealist’—felt ‘no strong ties’ with the Malteser team.110 Support of one’s own political side was not the only motivation in West German aid. This became evident again after the victory of the North and the reunification of Vietnam in 1976. In 1978, according to the eyewitness Wulff, two delegates of the Order of Malta, Counts Landsberg and Truczinsky, offered to undertake the rehabilitation of the former Malteser hospital in Da nang with West German funds.111 East and West German Medical Assistance in the Congo Crisis (August 1960–June 1961) Another conflict where both German states became medically involved took place in the period between the West German missions to Korea and Vietnam: the Congo crisis. This developed into a medical issue after the rapid departure of nearly all the Belgian medical doctors on the establishment of independence in 1960. The WHO classified this acute shortage of medical care in many hospitals as a state of emergency and asked the ICRC to bridge the gap until a sufficient number of physicians could be employed.112 The ICRC forwarded the call to the national Red Cross societies and coordinated the missions. East Germany, more than any other state in the world, saw this situation as an opportunity to demonstrate its solidarity with decolonised countries as well as to show the high quality of its medical care and pharmaceutical products.113 The priorities were expressed in a Foreign Office note: ‘As West Germany has not yet sent a team, everything has to be done to arrive before them.’114 The diplomatic task was to establish links with the Congolese minister of health or his staff but it had ‘to be made sure that this is done without the knowledge of the WHO counsellors’.115 Deputy minister for health, Professor Friedberger, said at the farewell ceremony for the second team: ‘Bring aid! The first power of the German workers and farmers stands behind you. You are travelling to Congo as ambassadors of this state.’116 East German officials and participating doctors did not call the motivation ‘humanitarian’, but always spoke of ‘humanist’ or ‘humanism’ since the ‘denominational or political creed of the individual was not decisive for the mission but his medical ability and his attitude, while our opinion is that the idea of true humanism can only be realised in socialism’.117 Memoirs of this mission by the Vice-President of the East German Red Cross, the physician Dr Wolfgang Weitbrecht (1920–87), were published as a book and in a series of articles in the GDR Red Cross monthly journal. These writings mirrored the need and wish to prove the superiority of the GDR on nearly every page: The East German delegation was larger than any other, had a professor as its head and a Red Cross official as a member, had received a farewell ceremony from state and Red Cross representatives and had flown in a comfortable Ilyushin—in contrast to the West Germans, who had had to sit on their baggage in a Canadian transporter. The members of the delegation had, moreover, brought with them an expensive delivery of pharmaceuticals as a gift and had been heartily welcomed by the Slovakian embassy as a substitute for an East German embassy—whereas the West Germans only had a short technical visit to their embassy.118 There are many discrepancies between Weitbrecht’s memoirs, on the one hand, and previously published West German reports and archived East German internal correspondence, on the other.119 Writing to his foreign ministry, East German Red Cross president Ludwig expressed a strong suspicion that the Western dominance in the Red Cross wanted to obstruct the East Germans.120 The conflict centred on a point where the GDR team differed from the other national teams, that is, Weitbrecht’s unofficial mission to establish relationships with Congolese authorities. The ICRC, however, did not tolerate such national diplomatic activities under the guise of humanitarian action. Thus the GDR delegation came under closer scrutiny. The requirements by the ICRC and the Congolese authorities for the three GDR teams had been quite clear: surgeons and nurses only. The delegation was confirmed to possess the required qualifications—which was untrue in two cases since Weitbrecht was a hygienist only and Mrs Kühtz, the medical head’s wife, was a laboratory technician. In order to minimise the damage, the authorities in East Berlin ordered the immediate withdrawal of Weitbrecht and Mrs Kühtz, a defeat for the diplomatic ambitions and one that would be excused by errors in translation. In his memoirs, however, Weitbrecht justifies his sudden departure with the completion of his work and with Mobutu’s anti-socialist policy, directed even against doctors from socialist countries, furthermore claiming credit for the subsequent East German concentration on sending surgeons only.121 In pandering to such fantasies, Weitbrecht was not only a loyal functionary, but also foreshadowed his later career as a well-known writer of science fiction.122 Another result of ideological influence was that cooperation between East and West was kept secret from the East German public and even punished by the government. Members of the medical teams, among them surgeon Schmauss on a new mission, achieved public attention and honours in the GDR.123 The GDR media, however, failed to mention that one of the team members, male nurse W. Zinck, had to be accompanied by West German doctor Bechmann on an air transport from Congo to East Berlin due to severe illness and that another member of the team, Dr Hans Beerhalter from Magdeburg, had defended and treated—together with Bechmann—white farmers who had been attacked and imprisoned by Congolese fighters.124 Beerhalter had also arranged a Christian burial for two murdered Belgians and had reported the belief among the Congolese, even including nurses, that Belgians devoured the body of the first prime minister of independent Congo Patrice Lumumba in Brussels.125 Beerhalter was ultimately punished for his courage and openness. When the ICRC sent 19 memory medals for ‘every one’ of the GDR teams on 10 August 1961, only 18 were later handed over and Beerhalter’s name was missing from the list.126 He had had to leave the GDR secretly on 11 August 1961 as his cooperation with local forces, which his West German colleague had mentioned publicly, had been interpreted as ‘interference with the legitimate government Gizenga’ by the East German authorities.127 This also gave him the opportunity to continue emergency surgical work in Africa, with the WHO in the West Cameroons. The expectations of what East German doctors were to tell the public at the ceremony for their return had been clearly formulated by the Foreign Ministry: ‘The report by Dr Aderholt shall contain some general remarks on the consequences of colonial rule, especially in the field of health care, as well as opinions of the Congolese on achieving their national independence and a short overview on the activity of our groups.’128 Differing from the diplomatic troubles and distortionary propaganda, the medical side of the GDR mission operated without obvious flaws. The teams adapted to the challenges of rural hospitals in Africa and claimed to operate well with the African staff, who were characterised as well-educated and trained in both published and internal reports, despite the general tendency to describe the health system as completely insufficient.129 Internally, however, critical remarks were also made about Congolese nurses: ‘Not all are excellent’.130 Some conditions were felt to be in need of change: ‘Following the Chinese model, we initiated the establishment of a committee of staff and parties which was to improve cleanliness.’131 In fact, cooperation was obviously not always smooth, since the medical delegate of the ICRC wrote in his report on the hospital of one of the GDR teams: Relationship with the medical helpers is good, but the doctors—as everywhere—have to take questions of discipline, work schedule and cleanliness very seriously. The director of the hospital is a politician who—whenever a remark is made on the non-functioning of the Congolese nursing care—points out that the regime has changed. He has introduced an 8-hour-day without considering night duties and without guaranteeing a permanent service.132 The number of surgical procedures performed by the four surgeons proved that the work was accepted by the population. In contrast to their colleagues from the East, the West German doctors were not accompanied by nurses and they did publicly mention difficulties with some Congolese. They described the general attitude of the population as extremely friendly and thankful but ultimately unpredictable. For the hospital in Goma, Bechmann, who could compare the work with his previous experience in South America, wrote: ‘We had to carry out treatment under suspicion from the Congolese nurses and medical assistants, who imagined themselves to be doctors after the departure of the Belgian doctors’. In Butembo, by contrast, ‘the nurses knew quite a lot and were not arrogant in any way, but grateful, courteous, and friendly’.133 Staying in the more remote hospital of Lubero proved to be particularly dangerous: two doctors, Dr Pelzer from Hamburg and surgeon Dr Kurt Benz from Heidelberg University Hospital, were imprisoned by ‘rebels’ and had to be released by UN forces.134 Benz’ predecessor bacteriologist, Dr Gert Willich, who had had previous experience in Iran, had been beaten up by a father who was not satisfied with the deep cuts made in order to successfully treat and save his son’s gangrenous leg.135 The head of mission, 62-year-old female paediatrician Dr Margaret Hasselmann-Kahlert, wife of the Director of the University Dermatological Hospital in Erlangen and likewise experienced in tropical medicine due to more than 20 years in the Philippines, did not work at a hospital but was responsible for the supervision of nutrition, drug supply and health care at 21 small out-patient clinics and hospitals.136 There was far less media coverage in West Germany this time. Besides the negative experiences from Korea, one reason for the silence of the West German Red Cross may have been that an emphasis on the true reason for the mission, that is, the sudden departure of the Belgian staff, might have been detrimental to relations with a good neighbour and ally. The East German team, on the other hand, repeatedly pointed out alleged devastation by colonialism and the unethical behaviour of doctors deserting their patients.137 The latter view was, in fact, shared in the West German press, while it was also stated that the health service had ‘functioned excellently under the Belgians’ and that some Belgian doctors were an exception from the exodus of nearly all Belgian officials.138 Conclusions German aid projects resulting from wars of decolonisation often showed features of both development and emergency aid, before these categories as distinctive areas for international medical assistance had been established in the 1970 s. Such aid projects mostly comprised emergency relief, that is, they were confined to temporary measures or were run with minimal contact with local structures. If projects were more directly negotiated with the respective government, however, they were in a position to improve the long-term situation regarding medicine and health, thereby complying with the Western concept of socioeconomic ‘development’. When West German development agencies started to adopt an additional approach involving public health and health systems, thereby differing from the continuing East German preference for clinical teaching, hygiene education and the supply of materials, it became possible for aid in forms such as the Malteser project in Vietnam to integrate curative and preventive services as well as small and large health care institutions for an entire province. While the civilian character of the missions was emphasised, neutrality was not a major concern in the early years. For senior staff especially, work on the side of the respective political allies was a matter of course. Impartiality, however, that is, treatment of patients without regard to political or religious creed, was guaranteed. Financial contributions and offers of assistance from West Germany could even reach hostile territory due to a certain independence of West German civil society and its organisations from the state. In contrast to Western ‘aid’, ‘solidarity’—the overriding label in the East—did not have to distinguish between selfless humanitarian assistance in acute emergencies and development cooperation for political and economic purposes. Relations between socialist countries were by definition considered to be of mutual benefit and based on humanism. In the late 1960 s, health workers—clearly recognisable only in the West—became increasingly concerned at the idea that their work should serve political ends. Emergency aid ceased to be an unambiguous tool for governments. This is indicated by the fact that—after the construction of the Berlin Wall in 1961—GDR did not send any more considerable numbers of Red Cross health workers abroad while in the West, private support for non-governmental aid work increased. The distinction between emergency and development work, so central for ministerial budgets, health policies and aid organisations, proved to be less important for the health workers themselves. An emotional difference was made between humanitarianism and political self-interest, emotions that the more rational and technical distinction between emergency relief and development aid could not establish in the minds of a general public and many aid workers. Nevertheless, this distinction between humanitarian aid and development work would become marked in the politics of the 1970 s,139 before the boundaries were blurred again in the late 1990 s with the call for ‘development-oriented emergency aid’.140 This rapprochement also concerned the opposition between neutrality and political interest: with the end of the East–West conflict, development cooperation was to be more politically neutral, less dependent on bilateral political interests and more responsive to the actual needs than before. The early medical emergency aid of the 1950 s and 1960 s had already contained the tensions which are obvious today: the humanitarian motivation of aid workers and private donors versus the political interest of governments as well as the requirements of rapid relief versus the long-term perspectives of development. Seen in historical terms, however, the monopoly of the state in commissioning and financing the medical teams of humanitarian organisations remained a rather temporary phenomenon: The ‘rise and rise of European humanitarian NGOs’, which started out of the context of UN developmental issues, resulted in their also providing medical emergency relief.141 Emphasising either continuities and similarities or discontinuities and differences between medical humanitarianism during the Cold War and today remains a question of perspective among both historians and aid workers in their present debates on neutrality and the link of humanitarian aid to development. Acknowledgements I would like to thank my colleague in the project Iris Borowy, now Shanghai, for essential material and support, the Political Archive in Berlin for access to the records of the FRG and GDR Foreign ministries, Carolyn Kenny for careful language editing and the anonymous reviewers for valuable comments on earlier versions. Funding This work was supported by the German Research Foundation DFG [BR 2522/3-1]. Footnotes 1 John Hutchinson, ‘Rethinking the Origins of the Red Cross’, Bulletin of the History of Medicine, 1989, 63, 557–78; John Hutchinson, Champions of Charity: War and the Rise of the Red Cross (Boulder: Westview, 1996); David P. Forsythe, The Humanitarians: The International Committee of the Red Cross (Cambridge: Cambridge University Press, 2005). 2 Bertrand Taithe, ‘Reinventing (French) Universalism: Religion, Humanitarianism and the “French doctors”’, Modern & Contemporary France, 2004, 12, 147–58; Gordon Cumming, French NGOs in the Global Era. A Distinctive Role in International Development (New York: Palgrave Macmillan, 2009); Peter Redfield, Life in Crisis: The Ethical Journey of Doctors Without Borders (Berkeley: University of California Press, 2013). 3 This paper had been presented and submitted for publication in 2014 before the comprehensive monograph of Young-sun Hong, Cold War Germany, the Third World, and the Global Humanitarian Regime (New York: Cambridge University Press) covering the same three emergencies came out in 2015. 4 Young-Sun Hong, ‘The Benefits of Health Must Spread Among All. International Solidarity, Health, and Race in the East German Encounter with the Third World’, in Katherine Pence and Paul Betts, eds, Socialist Modern. East German Everyday Culture and Politics (Ann Arbor: The University of Michigan Press, 2008), 183–210; Hubertus Büschel, ‘In Afrika helfen. Akteure westdeutscher “Entwicklungshilfe” und ostdeutscher “Solidarität” 1955–1975’, Archiv für Sozialgeschichte, 2008, 48, 333-65. 5 For federal government funding, see Horst Dumke, Anfänge der deutschen staatlichen Entwicklungspolitik (Bonn: Konrad-Adenauer-Stiftung, 1997), 37. For the levels of deployed health workers, see ‘Statistik’, in Samuel Müller, ed., Ärzte helfen in aller Welt. Das Buch der Ärztlichen Mission (Stuttgart: Evangelischer Missionsverlag, 1960), 241. 6 Alfred Virnich, ‘Deutsche Ärzte im Irak’, Deutsche Medizinische Wochenschrift, 1954, 79, 1691–3; Gertrud Menne and Joachim-Peter Collin, ‘Merdeka—(Freiheit) oder Nach dem Zweiten Weltkrieg’, in Hans-Joachim Freisleben and Helga Petersen, eds, Sie kamen als Forscher und Ärzte. 500 Jahre deutsch-indonesische Medizingeschichte (Koeppe 2016), 203–14. 7 Bundesministerium für wirtschaftliche Zusammenarbeit, ed., Journalisten-Handbuch Entwicklungspolitik 1977 (Bonn: BMZ, 1977), 18. 8 John White, ‘West German aid to developing countries’, International Affairs 1965, 41, 74–88; Jack L. Knusel, West German Aid to Developing Nations (New York: Praeger, 1968); Karel Holbik and Henry Allen Myers, West German Foreign Aid 1956–1966. Its Economic and Political Aspects (Boston: Boston University Press, 1968). 9 E.g. the thematic issue Alfons Erb and Ernst Schnydrig, eds., ‘Weltelend vor dem christlichen Gewissen’ of the journal Lebendige Kirche (Freiburg/Br.: Lambertus Verlag, 1959). 10 Sylvie Toscer, Les catholiques allemands à la conquête du développement (Paris: Harmattan, 1997). 11 Ulrich Koch, Meine Jahre bei Misereor 1959–1995 (Aachen: MVG Medien, 2003); Christian Berg, ‘Brot für die Welt. Bemerkungen zur Entstehung und Bedeutung einer ökumenischen Aktion der evangelischen Christenheit in Deutschland‘, in Gemeinde Gottes in dieser Welt (Berlin: Evangelische Verlagsanstalt, 1961), 159–70; Ludwig Watzal, Die Entwicklungspolitik der katholischen Kirche in der Bundesrepublik Deutschland (Mainz: Grünewald/München: Kaiser, 1985) 249–57. 12 Ingo Haase, Handlungsspielräume einer quasi-staatlichen Entwicklungshilfe-Organisation—der Deutsche Entwicklungsdienst (Münster: Lit, 1991), 56; Bastian Hein, Die Westdeutschen und die Dritte Welt. Entwicklungspolitik und Entwicklungsdienste zwischen Reform und Revolte 1959–1974 (München: Oldenbourg, 2006), 45–8, 104–16. 13 Dr Hasselblatt, ‘Deutsche Gesundheitsprojekte im Lichte der entwicklungspolitischen Konzeption der Bundesrepublik Deutschland’, GAWI-Rundbrief, 1968, 3, 6–10. 14 Jörg Bärschneider, ‘Die Entwicklungspolitik der DDR—gegenseitiger Nutzen oder einseitiger Vorteil?’, in Hannsgeorg Beine, ed., Die Entwicklungspolitik unserer Nachbarn (Münster: Lit, 1985), 25–47. 15 ‘Nationale Front der DDR’, in Bundesministerium für innerdeutsche Beziehungen, ed., DDR-Handbuch (Köln: Verlag Wissenschaft und Politik, 1979), 751–2; Ilona Schleicher, ‘Elemente entwicklungspolitischer Zusammenarbeit in der Tätigkeit von FDGB und FDJ’, in Hans-Jörg Bücking, ed., Entwicklungspolitische Zusammenarbeit in der Bundesrepublik Deutschland und der DDR (Berlin: Duncker und Humblot, 1998), 111–38, here 112 and 121. 16 Ibid., 115–16. 17 For China cf. correspondence in PAAA [Politisches Archiv des Auswärtiges Amtes/Political Archive of the Foreign Office, Berlin], MfAA [Foreign Ministry of the GDR], 8849; for Burma/Myanmar and India cf. Kirsch, ‘Bericht über eine im Auftrage der DIA[Deutscher Innen- und Außenhandel; WB]-Chemie durchgeführte Reise nach Burma und Indien, 9 February 1959’; Trade representation of the GDR in Rangoon to MfAA, 15 February 1959; Lämmel to trade representation, 24 February 1959, all: PAAA, MfAA, A 14983; for Brazil cf. ‘Abschlußbericht der Dienstreise “Brasilien” vom 10.4. bis 30.5.1963’, BArch [Bundesarchiv Koblenz/Federal Archive of Germany,], DQ 1/2493. 18 Anna-Sabine Ernst, Die beste Prophylaxe ist der Sozialismus (Münster: Waxmann, 1997), 55. 19 Allan Reed Millett, The Korean War (Washington, DC: Potomac, 2007), 141–3. 20 Introduction to Imelda Wieners, ‘Im Land der Kirschblüten und Reisfelder’, in Oberinnen-Vereinigung im Deutschen Roten Kreuz , ed., Der Ruf der Stunde. Schwestern unter dem Roten Kreuz (Stuttgart: Kohlhammer Verlag, 1963), 143–7, here 143. 21 ‘DRK-Lazarett. Nase zukneifen’, Der Spiegel, 28 January 1959, 33–4, here 33. 22 Stefan W. Escher (alias Walter Drescher), Das Jahr in Pusan (München: Piper, 1959), 50. 23 Gotthard Schettler, ‘Gestorben: Prof. Dr. med. Wolfdietrich Germer’, Deutsches Ärzteblatt, 1996, 93, A-1214. 24 ‘Gestorben: Generaloberstabsarzt a. D. Dr. med. Eberhard Daerr’, Deutsches Ärzteblatt, 2005, 102, A-2190; Bundesarchiv, ed, ‘Die Inspekteure des Sanitätsdienstes’, http://www.bundesarchiv.de/DE/Content/Virtuelle-Ausstellungen/Die-Inspekteure-Des-Sanitatsdienstes-Der-Bundeswehr-1955-1976/die-inspekteure-des-sanitatsdienstes-der-bundeswehr-1955-1976.html, last accessed 25 March 2018. 25 Günther Huwer, ‘Korea: Korrekturen’, Deutsches Ärzteblatt, 1985, 82, A-698. 26 Günther Huwer, ‘Als Arzt in Korea zwischen 1954 und 1959. 1. Teil’, Studienwerk Deutsches Leben in Ostasien-Info, April 2007, 23–6, here 24. 27 Huwer, ‘Korea: Korrekturen’, A-698. 28 Huwer, ‘Als Arzt in Korea’, 28. 29 Escher, Jahr, 35 and 227. 30 ‘DRK-Lazarett’, 33–4. 31 ‘Two doctors charged: ‘Atrocities’ in hospital—Korean deaths’, The Sun-Herald, 5 July 1959, 29. 32 ‘Kritik am Deutschen Krankenhaus in Korea. Scharfe Angriffe eines Arztes/Berichte an Außenminister von Brentano’, Frankfurter Allgemeine Zeitung, 17 January 1959, 17; ‘DRK-Lazarett’, 34. 33 Monika Köhler, ‘Keinerlei Art von Zensur. Das “Deutsche Ärzteblatt” fühlt sich auch rechtsextremen Lesern verpflichtet’, Die Zeit, 1989, 19, 83. 34 Günter Huwer, ‘Angelastete Schuld’, Deutsches Ärzteblatt, 1987, 84, A-2104-6, A-2106. 35 Günther Huwer, ‘Leserbrief’, Deutsches Ärzteblatt, 1989, 86, A-146. 36 Ernst Klee, Die SA Jesu Christi. Die Kirche im Banne Hitlers (Frankfurt: Fischer, 1989), 95–6; Sigrid Stöckel, ‘The West German Public Health System and the Legacy of Nazism’, in Philipp Gassert and Alan E. Steinweis, eds, Coping With the Nazi Past. West German Debates on Nazism and Generational Conflict (Oxford: Berghahn, 2006), 128–43, 142 FN 42. 37 ‘Kritik am Deutschen Krankenhaus’; ‘DRK-Lazarett’, 34; Hong, Cold War Germany, 103. 38 Escher, Jahr, 57. 39 Sabine Dauth, ‘Seoul, den 10. Dezember 1901 ‘Liebe Eltern … ’, Deutsches Ärzteblatt, 1985, 82, A-169-170, A-170. 40 ‘DRK-Hospital in Korea’, Deutsches Rotes Kreuz Bonn Jahresbericht, 1955, 23. 41 Escher, Jahr, 150–98 and 227–46. 42 Hong, Cold War Germany, 100. 43 ‘Auslandseinsatz’, Deutsches Rotes Kreuz Bonn Jahresbericht, 1958, 51; ‘Neun Koreanerinnen zu Besuch in Bonn‘, Deutsches Rotes Kreuz. Zentralorgan des DRK in der Bundesrepublik Deutschland [in the following DRK Bonn],1961, 8, 20–2. 44 Hong Young-Sun, ‘Germany’s Forgotten Guestworkers: Korean Nurses and the Transnational (Re) production of the German Nursing Force’, in Sylvelyn Hähner-Rombach, ed., Alltag in der Krankenpflege: Geschichte und Gegenwart (Stuttgart: Franz Steiner, 2009), 183–200. 45 Paul M. Edwards, Korean War Almanac (New York: Facts on File, 2008), 528; ‘Romania’s “Fraternal Support” to North Korea during the Korean War, 1950–1953’ (Webcast of a Panel with Radu Tudorancea at the Wilson Center, 12 December 2011), https://www.wilsoncenter.org/event/romanias-fraternal-support-to-north-korea-during-the-korean-war-1950-1953#sthash.BXCmEChK.dpuf, last accessed 25 March 2018. 46 Rüdiger Frank, Die DDR und Nordkorea. 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For the data on materials, see Working results of the Solidarity Committee for Korea and Vietnam with the National Council regarding Korea, undated, PAAA, MfAA, C 152/75 (cited after Wilson centre). 48 Liana Kang-Schmitz, Nordkoreas Umgang mit Abhängigkeit und Sicherheitsrisiko—Am Beispiel der bilateralen Beziehungen zur DDR (unpublished PhD thesis, University of Trier, 2010), 253–62. 49 Frank, DDR und Nordkorea, 52–4, 95, 118 and 151. 50 Tuk Chu Chon, Die Beziehungen zwischen der DDR und der Koreanischen Demokratischen Volksrepublik (1949–1978) unter besonderer Berücksichtigung der Teilungsproblematik in Deutschland und Korea sowie der Beziehungsstruktur zwischen einem sozialistischen Mitgliedsstaat des Rates für gegenseitige Wirtschaftshilfe sowie d. Warschauer Paktes und einem sozialistischen Staat im Einflußbereich der Volksrepublik China (Munich: Minerva, 1982); Zhihua Shen and Yafeng Xia, ‘China and the Post-War Reconstruction of North Korea, 1953–1961’, North Korea International Documentation Project of the Wilson Centre Working Paper, 2012, IV, 5–6; Bernd Schafer, ‘Weathering the Sino–Soviet Conflict: The GDR and North Korea, 1949–1989’, CWIHP Bulletin, 2003–2004, 14/15, 25–71; Charles Armstrong, ‘“Fraternal Socialism”: The International Reconstruction of Korea, 1953–62’, Cold War History, 2005, 5, 161–87; Charles Armstrong, ‘The Destruction and Reconstruction of North Korea, 1950–1960’, Asia-Pacific Journal: Japan Focus, 2009, 7, http://apjjf.org/-Charles-K.-Armstrong/3460/article.html, accessed 26 August 2016. 51 Search for ‘Hamhung’ and ‘Arzt’, ‘Ärzte’, ‘Krankenhaus’, ‘Klinik’, ‘Medizin’, ‘Tuberkulose’, ‘Hautkrankheiten’, ‘Geschlechtskrankheiten’, ‘Dermatologie’ or ‘Venerologie’ in www.nd-archiv.de. 52 Charles K. Armstrong, ‘Juche and North Korea’s Global Aspirations’, North Korea International Documentation Project of the Wilson Centre Working Paper, 2009, 4, 3; Dr [Wolfgang] Weitbrecht, Bericht über den Besuch einer Delegation des Deutschen Roten Kreuzes der Deutschen Demokratischen Republik beim Roten Kreuz der Koreanischen Volksdemokratischen Republik in der Zeit vom 28. Mai bis 5. Juni 1963, 11–12, and Dr Fichtel, Deutsche Akademie der Wissenschaften zu Berlin, Forschungsgemeinschaft Institute für Medizin und Biologie, 29 June 1962, Stellungnahme zum Artikel: ‘Eine große Entdeckung’ von O. Hö Gyn in der Zeitschrift ‘Korea’ (russische Ausgabe) Bd. 67 (1962) Heft 2 Seite 16–19, both: PAAA, MfAA, A 17.017. 53 Liana Kang-Schmitz, Nordkoreas Umgang mit Abhängigkeit und Sicherheitsrisiko—Am Beispiel der bilateralen Beziehungen zur DDR (Trier: Diss. phil., 2010), 130–1. 54 ‘DDR-Krankenhaus für Hanoi‘, Neue Zeit, 7 January 1956, 1. 55 E.g. ‘Delegation nach Hanoi. Viet-Duc-Krankenhaus soll rekonstruiert werden’, Neue Zeit, 1970, 26, 1. 56 Richard Kirsch, ‘Vietnamesische Reisebilder’, Neues Deutschland, 24–28 July 1957, and 30 July–3 August, each 4; ‘Kinder- und Jugendbuchautoren ausgezeichnet’, Neues Deutschland, 1 June 1961, 5; on the history of the manuscript see Hong, Cold War Germany, 127–8. 57 Richard Kirsch, Moskitos, Bambus und Bananen. Als Arzt in Vietnam (Berlin: Der Kinderbuchverlag, no date), 78–9. 58 For Kirsch’s later visit, see ibid., 123. 59 Ibid., 79. 60 H. Wolff, ‘Laudatio anlässlich des 90. Geburtstags von Prof. Dr. A. Schmauss’, Zentralblatt für Chirurgie, 2005, 130, 503–5; ‘Zum Tode Von Albert K. Schmauss’, Berliner Ärzte, 2010, 47, 33. 61 ‘Vietnamesischer Orden für Prof. Dr. Schmauss’, Neues Deutschland, 26 January 1985, 3. 62 ‘Das IKRK in Genf’, DRK Bonn, 1965, 6, 27. 63 ‘Appell des Internationalen Komitees’, DRK Bonn, 1965, 9, 2. 64 Friedrich K. Kurylo, ‘Hilfsdienst: Vom Vietcong verschont. Eine Zwischenbilanz der Malteser-Hilfe in Vietnam‘, Die Zeit, 23 March 1973, 69. 65 Johannes Max Riemann, Die Entsendung des Hospitalschiffs Helgoland nach Saigon 1966: Alternative zu einem militärischen Engagement der Bundesrepublik Deutschland im Vietnamkrieg (Munich: Grin, 2009), 13–32. 66 ‘Lazarett-Dampfer. Schiff ohne Frauen’, Der Spiegel, 17 January 1966, 16–17. 67 Express Letter to the Federal Ministries of Health, Justice and Defence and the Red Cross concerning status of the ship in international law, Bonn, 28 January 1966, PAAA B85 827. 68 ‘Vietnam-Hilfe. Diese Leute’, Der Spiegel, 4 April 1966, 49–51. 69 Letter (Translation) Federal Minister for Foreign Affairs to President of ICRC, Bonn, 16 August 1966, PAAA B85 827. 70 Internal memo by special ambassador [Botschafter zbV] Hans Schmidt-Horix for Secretary of State, Foreign Office, 4 April 1966, PAAA B85 827, 1. 71 Letter Dr. Schlögel, Secretary-General of the [West] German Red Cross, 6 April 1966, PAAA B85 827. 72 Internal memo, 4 April 1966, PAAA B85 827, 2. 73 Riemann, Entsendung. 74 On Heimfried Christoph Nonnemann, see History, ‘Zeitzeugen’, Die Legion. Deutscher Krieg in Vietnam, http://www.history.de/sendungen/die-legion/zeitzeugen/dr-christoph-nonnemann.html, last accessed 25 March 2018. 75 ‘Otto A. Jäger 65 Jahre’, E+Z, 1965, 8/9, 38. 76 Riemann, Entsendung, 45. 77 Heinrich Gewandt, in Abgeordnete des Deutschen Bundestages, eds, Aufzeichnungen und Erinnerungen, several vols (Boppard am Rhein: Harald Boldt, 1988), V, 115–223, 193. 78 ‘Vietnam. Böses Blut’, Der Spiegel, 15 January, 1968, 21–2. 79 Gewandt, Aufzeichnungen, 193. 80 Riemann, Entsendung, 47. 81 Erich K. Kröger, ‘Die Malteser in Vietnam’, Deutsches Ärzteblatt—Ärztliche Mitteilungen, 1970, 67, 1648–54, 1649–50; ‘Nichts sagen und nichts fragen—nur danach, wo es weh tut’, documentary ca. 1967, http://www.60-jahre-mhd.de/1966-1975-einsatz-in-vietnam.html, last accessed 25 March 2018. 82 Stefan Schomann, Im Zeichen der Menschlichkeit. Geschichte und Gegenwart des Deutschen Roten Kreuzes (München: DVA, 2013), 303. 83 Kurylo, ‘Hilfsdienst’, 69. 84 For the first quote in this sentence, see Erich K. Kröger jr., ‘Morbiditätsverhältnisse und ihre Bedeutung für die Planung des Gesundheitswesens in Süd-Vietnam’, Zeitschrift für Tropenmedizin und Parasitologie, 1970, 21, 438–45; for the second, Kröger, ‘Zur Entwicklungshilfe auf dem Gebiet des Gesundheitswesens. Erfahrungen in Süd-Vietnam’, Gesundheitspolitik, 1970, 12, 193–202. 85 Erich K. Kröger, ‘Die Problematik medizinischer Hilfseinsätze im Ausland. Beitrag zur Konzeption deutscher humanitärer Hilfen’, Das öffentliche Gesundheitswesen, 1971, 33, 189–94; Erich K. Kröger, ‘Die Problematik internationaler Katastrophenhilfe’, Münchener Medizinische Wochenschrift, 1972, 114, 139–47; Erich K. Kröger, ‘Internationales Katastrophenzentrum. Vorschlag zur Organisation der internationalen Katastrophenhilfe’, Münchener Medizinische Wochenschrift, 1972, 114, 1405–9. 86 Correspondence between Minister of Health Strobel and Minister of Economic Cooperation Eppler, 24 April–27 May 1971, BArch B213/4960. 87 ‘Vietnam-Hilfe. Stacheldraht bewilligt’, Der Spiegel, 31 January 1966, 17–18. 88 Letter Dr Vu Dinh Tung, Président de la Societé de la Croix Rouge de la République Democratique du Viet Nam, to Président du CICR, Hanoi, 7 March 1966, PAAA B85 827, 505. 89 Letter Tran Thi Dich, Secrétaire générale de la Societé de la Croix Rouge de la République Democratique du Viet Nam, to Président du CICR, Hanoi, 26 May 1966, PAAA B85 827, 984. 90 ‘Bonn ist bei Jeder Aggression dabei’, Neues Deutschland, 8 June 1967, 7; ‘Bonn bewährte sich wieder als USA-Erfüllungsgehilfe: Scharfer Protest gegen Einreiseverweigerung für Repräsentanten Vietnams’, Neues Deutschland, 12 January 1970, 6; Ruth Niemann, ‘Samariter oder moderne Kreuzritter? Zur Rolle des “Malteser-Hilfsdienstes” in Südvietnam’, Berliner Zeitung, 13 April 1973, 7. 91 ‘Ein Schiff namens Helgoland‘, in Harry Thürk, ed., Stärker als die reißenden Flüsse. Vietnam in Geschichte und Gegenwart (Berlin: Deutscher Militärverlag, 1970), 277–8. 92 ‘Nichts sagen und nichts fragen—nur danach, wo es weh tut’, documentary ca. 1967. http://www.60-jahre-mhd.de/1966-1975-einsatz-in-vietnam.html, last accessed 25 March 2018. 93 Erich K. Kröger, ‘Die Malteser in Vietnam’, Deutsches Ärzteblatt—Ärztliche Mitteilungen, 1970, 67, 1648–54, 1649–50. 94 ‘Monika Schwinn über ihre Gefangenschaft beim Vietcong: “An mir beißt ihr euch die Zähne aus”’, Der Spiegel, 26 March 1973, 46–57. 95 Simon Reuter, Im Schatten von Tet: Die Vietnam-Mission der Medizinischen Fakultät Freiburg (1961–1968) (Frankfurt/M.: Peter Lang 2011), 144–72. 96 ‘Russell-Tribunal: USA des Völkermords schuldig. “Helgoland”-Personal an Menschenjagden beteiligt’, Neues Deutschland, 2 December 1967, 22, 8. 97 Georg W. Alsheimer (alias Erich Wulff), Vietnamesische Lehrjahre, 2nd edn (Frankfurt/M.: Suhrkamp, 1973), 451. 98 Georg W. Alsheimer (alias Erich Wulff), Eine Reise nach Vietnam, 2nd edn (Frankfurt/M.: Suhrkamp, 1980), 140. 99 Reuter, Schatten, 168. 100 Ibid., 161. 101 Ibid., 162. 102 ‘Bonner Schiffe auf Kurs Vietnam’, Neues Deutschland, 15 March 1967, 7; Klaus Wagner, Vietnam in jenen Tagen. Erlebt und erzählt von einem deutschen Arzt (Frankfurt/M.: R. G. Fischer, 1972), 28–9; Riemann, Entsendung, 51. 103 Heimfried C. Nonnemann, Wir fragten nicht, woher sie kamen. Arzt in Vietnam (Hamburg: Hoffmann & Campe, 1968); Wagner, Vietnam, 49. 104 On Jäger’s experience of East–West tension, see Wladimir Lindenberg, Himmel in der Hölle. Wolodja als Arzt in unseliger Zeit (München: Ernst Reinhardt, 1988), 242. On contact with the Vietcong, see ‘Vietcong-Dank’, Der Spiegel, 31 March 1969, 22. 105 Cited after Schomann, Geschichte, 303. 106 Kurylo, ‘Hilfsdienst’, 69. 107 ‘Monika Schwinn’, 57. 108 ‘Nichts wäre schlimmer als der Sieg: Mary McCarthy über Amerikas Krieg in Vietnam’, Der Spiegel, 24 July 1967, 60–72; Mary McCarthy, Vietnam (New York: Harcourt, Brace & World, 1967). 109 Mary MacCarthy, Memories of a Catholic Girlhood (New York: Harcourt, Brace & Jovanovich, 1957). 110 Detlev Wissinger, Erinnerungen eines Tropenarztes. Der Lebensweg eines Idealisten (Hamburg: Books on Demand, 2002), 231–4. 111 Alsheimer, Reise, 151. 112 ‘Rotkreuzdelegation zur medizinischen Hilfeleistung in den Kongo entsandt’, Monatsschrift des Deutschen Roten Kreuzes der DDR [in the following Monatsschrift DRK DDR], August 1960, 5; ‘Rotkreuz-Aktion im Kongo bleibt weiter unentbehrlich’, DRK Bonn, 1961, 6, 6–7. 113 Dr Weitbrecht, ‘Unsere Kameraden im Kongo-Einsatz’ and ‘Ärzte aus der DDR in Kongo hoch angesehen’, Monatsschrift DRK DDR, November 1960, 7–10; for the GDR mission see Hong, Cold War Germany, 165–8. 114 Seyfart [Ministry of Health], Department ‘Internationale Organisationen’, Betr.: Einsatz einer medizinischen Hilfsgruppe im Kongo, Vertraulich! [Confidential], 12 August 1960, PAAA, MfAA, C 801/74, 000060–1, 000061. 115 Seyfart, An die 4. Außereuropäische Abteilung, Streng vertraulich’ [Highly confidential], Berlin 10 August 1960, PAAA, MfAA, C 801/74, 000062–3, 000062. 116 ‘Zweite DDR-Ärztegruppe nach Kongo. Prof. Dr. Friedeberger beim Abflug: Sie sind Botschafter unseres Staates’, Neues Deutschland, 1 December 1960, 15, 5. 117 Karl Aderholt, ‘Im Namen der Menschlichkeit’, Monatsschrift DRK DDR, February 1961, 6–10, 7. 118 Wolfgang Weitbrecht, Kongo. Arzt unter heißem Himmel (Berlin: Verlag der Nation, 1964); Wolfgang Weitbrecht, ‘Kongo. Arzt unter heißem Himmel. Auszugsweiser Abdruck des gleichnamigen Erlebnisbuches’, Monatsschrift DRK DDR, February–October 1966. 119 Erich Bechmann, ‘Am Äquator hat die Menschlichkeit noch eine Chance’, DRK Bonn, 1961, 6, 9–12, 9. 120 Red Cross president Ludwig to Ministry of Foreign Affairs, 6 September 1960, PAAA, MfAA, C 801/74, 000050–3. 121 Weitbrecht, Kongo, 160–1. 122 E.g. Wolf Weitbrecht, Orakel der Delphine. Wissenschaftlich-phantastischer Roman (Rudolstadt: Greifenverlag, 1974); Wolf Weitbrecht, Stunde der Ceres. Wissenschaftlich-phantastischer Roman (Rudolstadt: Greifenverlag, 1975). 123 ‘Operation bei Petroleumlicht im Kongo’, Neue Zeit, 18 December 1960, 2; ‘Ueber Reiseerlebnisse aus dem Kongo spricht am Freitag, dem 5. Mai um 19 Uhr Oberarzt Dr. Albert Schmauss im Club der Kulturschaffenden in der Otto-Nuschke-Straße’, Neue Zeit, 3 May 1961, 8. 124 Bechmann, ‘Menschlichkeit’, 12; Telex LICROSS, Geneva, and DRK, Bonn, 12 November 1960, PAAA, MfAA, C 801/74, 000025; not mentioned in the article on Beerhalter’s return: ‘DDR-Ärzte halfen in Kongo’, Neues Deutschland, 16 March 1961, 16, 7. 125 Letter Bechmann to ICRC, Goma, 17 November 1961, PAAA B92 313. 126 ‘Aus der internationalen Arbeit’, Monatsschrift DRK DDR, October 1961, 9–11. 127 Personal communication by Dr Beerhalter to author, Saarbrücken, 8 January 2015. 128 Abteilungsleiter Büttner to Minister Schaub, Auszeichnung der ersten Einsatzgruppe des Deutschen Roten Kreuzes, Berlin 15 December 1960, PAAA, MfAA, C 801/74, 000011–12. 129 Aderholt, ‘Menschlichkeit’, 8; A. Stenger, ‘Die Krankenpflege im afrikanischen Busch’, Monatsschrift DRK DDR, April 1961, 12–13; Dr. Karl Aderhold [!], Bericht der Rotkreuz-Gruppe des Deutschen Roten Kreuzes der DDR—Kongolesisches Krankenhaus Shabunda—vom 1.—30.10.1960, Shabunda, 5 October 1960, PAAA, MfAA, C 801/74, 000036–7. 130 Ibid., 000036. 131 Dr. med. habil. Schmauss to GDR ministry of health, Shabunda, 15 December 1960, PAAA, MfAA, C 801/74, 00006–10, 00007. 132 Bericht des Dr. Fasel, medizinischer Delegierter des IKRK im Kongo [ … ] 18.–24. September 1969, PAAA, MfAA, C 801/74, 000045–6, 000046. 133 Bechmann, ‘Menschlichkeit’, 9–10. 134 ‘Deutsche Ärzte im Kongo in Sicherheit. Fortdauer der Rotkreuz-Ärzte-Mission’, DRK Bonn, 1961, 2, 2. 135 Bechmann, ‘Menschlichkeit’, 10. 136 ‘Nachschubprobleme, Ernährungssorgen … Eine deutsche Ärztin im Kongo berichtet’, DRK Bonn, 1961, 6, 8. 137 Aderholt, ‘Menschlichkeit’, 7–9. 138 ‘Der Präsident hat Angst vor der Armee. Besuch in der Kongoprovinz Equateur—Oberst Solihin sorgt für Ordnung’, Die Zeit, 11 November 1960, 2; Otto von Loewenstern, ‘Die eingemauerten Nonnen. Ein Bericht aus dem Kongo’, Der Spiegel, 3 August 1960, 38–9, herer 38. 139 Aufzeichnung des AA für den Unterausschuss Humanitäre Hilfe des Auswärtigen Ausschusses ‘Humanitäre Hilfe der Bundesregierung als spezifisches Instrument deutscher Außenpolitik’, 11 May 1977, BArch [Federal Archive] B213/4990; BMZ, ed., Journalisten-Handbuch Entwicklungspolitik 1976 (Bonn: BMZ, 1976), 84. 140 Official examples for such attempts are two communications from the European Commission to the Council and the European Parliament on Linking Relief, Rehabilitation and Development (LRRD): COM (1996)153 final of 30 April 1996 and COM/2001/0153 final. 141 Kevin O’Sullivan, ‘A “Global Nervous System”: The Rise and Rise of European Humanitarian NGOs, 1945–1985)’, in Marc Frey, Sönke Kunkel and Corinna R. Unger, eds, International Organizations and Development, 1945–1990 (Basingstoke: Palgrave Macmillan, 2014), 196–219. © The Author(s) 2018. Published by Oxford University Press on behalf of the Society for the Social History of Medicine. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Social History of Medicine Oxford University Press

Between Foreign Politics and Humanitarian Neutrality: Medical Emergency Aid by the Two German States before 1970

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Oxford University Press
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© The Author(s) 2018. Published by Oxford University Press on behalf of the Society for the Social History of Medicine.
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0951-631X
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Abstract

Summary During the armed conflicts of decolonisation in Korea, Vietnam and the Congo in the 1950 s and 1960 s, both German states joined the competition between East and West by sending medical teams to conduct aid work. West German numerical advantages in funds and available staff were countered by East German governmental command of human resources and productive capacities such as the pharmaceutical industry. As a result, the German Democratic Republic (GDR) preferred shorter stays and the supply of large amounts of equipment and materials whereas the Federal Republic of Germany (FRG) instead commissioned teams of NGOs for several years and financed whole facilities. Ideological or even distorted interpretation of facts was more obvious in the East, opposition of health workers to the official line of their respective governments in the West. The FRG also introduced a distinction between neutral humanitarian and politically interested development aid whereas for the GDR all work was solidarity with socialist or liberated countries. Germany, humanitarian aid, Korea, Vietnam, Congo After the Second World War, the short-term deployment of medical teams in cases of emergency became a major field of European and North American intervention in the health care of former colonial territories in Africa and Asia. The transition from colonial to national administration was often accompanied or even caused by violent conflicts involving foreign powers and the United Nations. In such cases, the temporary delegation of medical doctors and other health workers was intended to secure medical care in health systems that had been regarded as insufficient by Western standards even before the emergency in question. Thus, in contrast to medical aid in the Global North after war, earthquakes or floods, medical assistance of this kind was also intended as a transfer of medical technologies and knowledge similar to that which had formerly been characteristic of colonial and mission medicine and was now becoming part of ‘development aid’. Existing historical studies on humanitarian intervention during emergencies usually focus either on their beginnings before 1900 or on the decades immediately following the profound changes which occurred in the relationship between the state and civil society during the late 1960 s. Therefore, they mostly cover the Red Cross, in its founding period as well as its role in the two world wars.1 Alternatively, historical studies concentrate on periods after the Biafran war, that is, the time of détente and post-1989.2 Temporary expatriate health work after emergencies in Asia and Africa during the 1950 s and 1960 s, by contrast, has scarcely been researched. This is all the more surprising as these interventions were also highly politicised.3 Notwithstanding the officially required neutrality of the agents, such as the Red Cross Societies or the Order of Malta, humanitarian intervention was a state-related activity that received considerable diplomatic, administrative, financial and logistic support from the governments of the countries where the aid organisations came from. Several competing features that deserve detailed study are involved here. On one side were the political aims of the different governments involved in the Cold War. On the other, there was the ethos of the health professions and the humanitarian law, both of which were codified in these years. The World Medical Association had declared universal medical ethics in the 1948 Geneva Declaration, including the obligation of non-discrimination of any kind. In 1949, the four Geneva Conventions initiated by the Red Cross formulated rules of humanitarian assistance, making specific reference to the short-term goals of emergency relief, which differed from the requirements of what came to be generally known as ‘development’ at that time. The question therefore arises as to whether and how the agents involved in humanitarian aid expressed, discussed and negotiated the various aims, strategies and motives with each other. Such agents included representatives of different governments, officials of aid organisations, expatriate health workers and, as far as possible, the local politicians, staff and population. What were the instances that prompted decisions to send medical teams? Who welcomed and supported, who opposed the plans? How were these communicated, both internally and to the public? Were there conscious distinctions in health work between development and emergency aid, between politically neutral assistance to those most in need and political cooperation concerning health? How far did these distinctions influence decisions and daily work? These questions concern the factors that may have shaped the missions analysed here, both as individual events and as possible models for future humanitarian and development work. This article will attempt to answer the above-mentioned questions by looking at the two German states during the post-war period and up to 1970, the Federal Republic of Germany (FRG) in the West and the German Democratic Republic (GDR) in the East. Studying responses to the same emergencies by a West European and an East European state with the same colonial history and medical past is a useful way of analysing different political backgrounds as conditions for differing types of aid. It shows how health assistance in and after emergencies functioned in respective Cold War politics and how this work was shaped by the civil society. German activities in international health after 1945 have rarely been studied in detail. The few comparative historical studies on East and West German activities to date—apart from the above-mentioned and most recent work by Young-Sun Hong—focus on development aid in general or medical education and training as organised by the two German states.4 This paper therefore sets out to investigate the missions performed by German organisations in the field of medicine and health during emergencies in a series of countries before 1970 thereby drawing on published and archival sources from the two German states and non-governmental organisations as well as newspaper and journal articles, memoirs, and previous studies. Early Humanitarian Aid: East and West Germany As the only industrialised nation divided between the two sides in the early years of the Cold War, Germany is an interesting case for comparing international health work. Still rebuilding their own political and economic systems in the 1950 s, both German states were latecomers to international aid. Good relations with many other countries were essential prerequisites for both states in view of their desired membership in international organisations. The choice of partners and of areas for aid was determined by ideological preferences as well as by practical necessities. Thus, both German governments made political use of aid (agencies) to serve their own international ambitions. Societal and economic conditions were quite different in the two states. In the FRG, the Christian mission societies continued their health work in colonial and decolonised territories, increasingly supported by federal government funds, and sent more health workers than ever before.5 In addition, hundreds of German doctors who were having difficulty in finding attractive positions at home or who wanted to work abroad found employment with the new national governments in the Middle East or Indonesia and with the WHO.6 The West German government had contributed financially to UN agencies for development and health since the early 1950 s.7 In the mid-1950 s, the Western allies urged West Germany to become engaged in direct assistance for so-called ‘underdeveloped countries’, not least as a means to spread the Western model and to fight communism.8 Funds that had been received from the European Recovery Programme were to be forwarded to other world regions. Changes in German society also played a role. Having been cut off from information about other world regions for many years, Germans were now shocked by photographs of starving children, lepers and blind beggars.9 The population had also been moved by the experience of Western aid to war-devastated Germany and the rapid effect it had had on the German ‘Economic Miracle’ (Wirtschaftswunder). After suppression under National Socialism, the churches regained, and even exceeded their former importance in politics and in social services such as health care, education and poor relief.10 As a result, the Catholic bishops and the Protestant welfare organisation started major fund-raising campaigns in 1958 against ‘hunger and disease in the world’. The first campaigns—those from the Protestant organisations even taking place in both parts of Germany—collected about 53 million Deutschmarks, a sum higher than the governmental budget for ‘development aid’ in the West. Two large aid organisations for development were founded at this time, the Catholic Misereor and the Protestant Brot für die Welt (‘Bread for the World’), as well as smaller specialised agencies for sending volunteer lay professionals or for supporting the education of students, initially mainly medical students, from ‘developing countries’ in West Germany.11 In 1961, the West German government founded a ministry for ‘development aid’—the ‘federal ministry for economic cooperation’—which assumed overall responsibility for all governmental development programmes in the late 1960 s.12 From that time onwards, health projects were increasingly expected to contribute to economic development rather than to be merely ‘humanitarian’.13 The East German situation was different in several ways. Due to Soviet domination, the government did not accept funds from the European Recovery Programme nor did it implement the US idea of ‘development aid’. Instead, it sought to support liberation movements striving for independence from Western powers, at the same time looking for support from decolonised countries in its ambitions for international diplomatic recognition, especially membership in the WHO and UN.14 The number of countries that allowed cooperation with East Germany was much smaller than that for West Germany, and there was also competition within the Eastern bloc itself. As all previous or newly founded civic organisations in the GDR, such as the Red Cross Society, trade unions, youth associations or aid committees, had to be part of or represented in the Nationale Front, they were tightly controlled by the Socialist Unity Party (SED) and the government.15 As will be demonstrated by the cases discussed in this article, medical assistance given to decolonised nations was exploited in the mass media as proof of the superiority of socialism. Activities such as stipends for medical students from Africa or Asia—often paid for by enforced contributions from the working population—played a role as aid from the state and socialist society.16 As factories for pharmaceuticals and medical equipment were state-owned in the GDR, procuring export markets for such goods was also a task for medical experts sent by the government to foreign countries.17 Financial aid was not possible due to the lack of a globally convertible currency, with the result that the free delivery of pharmaceuticals and equipment became a common form of aid. Additionally, sending qualified doctors abroad was hampered by poor knowledge of Western languages and by the shortage of doctors.18 Keeping these differences in mind, this article will present and analyse the aid provided in three conflicts following decolonisation, in the chronological order of their initiation. The voices of the different participants—officials of governments and of aid organisations, senior and junior staff in the missions—will be presented in detail as they allow insights into the dynamics of the projects, thereby enriching our understanding of fundamental changes and differences in the period studied. The highly complicated histories of these wars or internal struggles have already been documented and analysed in several easily accessible studies and will therefore only be touched upon here when and insofar as they are relevant for the medical aid provided by the two German states. Post-war Korea: a West German Hospital and East German Reconstruction Work (1953–1959) The Korean War (1950–53) started with the invasion of the South by North Korea, which was supported by China and the Soviet Union. The reaction of the UN Security Council was a resolution that led to military support for South Korea from 22 UN member states under US leadership.19 Many East European and West European countries that did not participate in military action sent medical and other humanitarian aid. Sweden and Norway sent field hospitals, Denmark provided a hospital ship and Italy ran a Red Cross Hospital in Seoul.20 Thus, when pressed during his visit to the USA in 1953, West German Chancellor Konrad Adenauer promised a German field hospital. However, the war ended before the arrival of the equipment and staff in late 1953. The project therefore became a hospital service for the civilian population of the Korean harbour town of Pusan (Busan) where destruction due to the war had been concentrated. It initially involved 86 German staff members and was completely financed by the German government with 3.6 million Deutschmarks per year over five years.21 The senior doctors selected for this mission had already gathered considerable medical and international experience. The medical head of mission was Professor Günther Huwer (1899–1992), a gynaecologist whose many years of academic and clinical work in China had earned him the title ‘Old China hand’ from his juniors.22 The head of the department for internal medicine, Professor Wolfdietrich Germer (1911–96), had worked in tropical medicine in London, Brazil (Rockefeller Foundation on yellow fever) and Liverpool, as well as in the Balkans during the Second World War. He would go on to become Medical Superintendent of a large hospital in West Berlin immediately after his stay in Korea.23 The head of the surgical department, Dr Eberhard Daerr (1912–2005), had previously worked for six months in London, for a further six months with the British occupation army, and also in the National Public Health Service of Liberia for two years. After his work in Korea, he joined the newly founded German army, eventually becoming its highest medical officer (Inspekteur). After his retirement in 1972, he took up the position of Chief Medical Officer (Bundesarzt) of the German Red Cross.24 The first three heads of the mission and departments can therefore be regarded as medical doctors with a level of foreign experience and career ambition far above the German average. Huwer recalled the situation more than 30 years later: ‘Since Germany did not have any status internationally we were subordinated to the UN—in effect the Americans; the Red Cross was a showcase [Aushängeschild].’25 In his memoirs, Huwer complained about repeated orders ‘without knowledge of the subject’ from the German Foreign Office that would have jeopardised the mission and were given against the explicit advice of people with experience on the ground.26 He maintained that the hospital was an exclusively civilian one, with no American support in the rehabilitation of the designated school buildings and with no military function: ‘No victim of war was ever treated.’27 However, several photographs of Huwer with various US generals—first during his departure from Germany, then in front of the hospital and finally when being awarded the Medal of Freedom—hint at a closer relationship with the military.28 Another doctor recounted that he had to wear the Red Cross uniform, ‘as required by the Geneva Convention’, that they were subordinated to the American army, especially their medical superiors, and that the German doctors had an ‘equivalent rank’.29 The balancing act of giving an explanation for a civilian humanitarian mission that took place within a military context and had been demanded by a combating nation was palpable even decades later. Not only the context, but also the internal affairs of the hospital had military connotations, as the German investigative weekly magazine Der Spiegel wrote in 1959. The magazine article raised the question as to whether the Chief Medical Officer of the German Red Cross, a retired high-ranking government health official, had given precedence to military discipline over the investigation of serious accusations. Two junior doctors in Pusan, Hans Hannak and Hans Bommert, had accused the then head of surgery Harald Friedrichs of having falsified the causes of death in nine cases after unsuccessful surgery, of having caused damage and fatal outcomes by misdiagnosis and of having beaten patients.30 The charges were even taken up along the shores of the Pacific Ocean, and reported as ‘atrocities’ in a Sydney newspaper.31 Two further charges in German articles were omitted by the Australian press: the description as an ‘island’ where ‘obstinate, incorrigible Nazis’ had taken refuge, and the accusation of ‘intolerable moral behaviour’ that led to more than just the local population viewing it as a ‘brothel for human wrecks’.32 The accusing party Dr Franz-Joseph Rosenbaum, the new head of the department of internal medicine, later conceded that his remark on immorality had been too harsh. But he did not alter his remark on Nazi attitudes, and his comment was supported by complaints from others regarding the ‘Führerprinzip’ as the style of team leadership. In several later letters to the Deutsches Ärzteblatt, the German medical journal, Huwer, a former member of the NSDAP, showed that he had not completely distanced himself from the thinking of Germany’s Nazi past, as was commented on in the influential weekly journal Die Zeit.33 He claimed that none of the people he had asked had known of mass murder under National Socialism and that the Germans would not therefore need ‘forgiveness’—apart from some ‘hundred, perhaps a few thousand in prominent political positions’.34 In the debate on compensation for psychiatric patients who had been persecuted during National Socialism, Huwer maintained that the victims of enforced sterilisation had been ‘human beings lacking any feeling of social responsibility’.35 Thus, Rosenbaum’s impression may have contained a certain truth. Nevertheless, he was dismissed in 1959 for lack of loyalty by the Red Cross Chief Medical Officer, Otto Buurmann (1890–1967). Buurmann, although at the time affiliated to the Protestant welfare service, had also been an open supporter of the Nazi sterilisation programme and had been the public health officer for the Ghetto in Krakow.36 Thus the senior medical officials of the German Red Cross, both at home and in Korea, could be shown to have shared a certain philosophy on the allegedly inferior biological quality of some groups. Investigations by the German embassy and by a German Red Cross delegation confirmed that there were good grounds for at least some of the charges and the hospital was finally closed in March 1959.37 The metaphor of an ‘island’ for the German hospital was used not only by Huwer’s opponent, but also by one of his adherents, who described the hospital not as an island of professional and moral inferiority, but one of superiority. In his book dedicated to Huwer, surgeon Walter Drescher complained about this ‘kind of island’ (Inselhaftigkeit) that forced its inhabitants ‘under the sign of the Red Cross … to behave more righteously than was good for human nature’ whereas those ‘outside remain in the attitude of the eternally needy and desiring which is even worse’.38 The sharp contrast between those who helped and were expected to show superhuman virtue and those who were regarded as dependent on aid excluded any encounter on equal terms and thereby hindered one of the desired results of decolonisation. Despite the isolated character of the hospital as a foreign institution, mistreatment and conflicts within the team and the paternalist arrogance of several West German doctors, the mission was regarded as a medical success in several other ways by both German and Korean observers. Patients using the medical facilities of Korean physicians usually had to pay for services, making them unaffordable for most of the population, which consisted of refugees and people with little means. The German hospital therefore offered free treatment to poor patients. All the beds were constantly occupied throughout the project and treatment was in such high demand that the no-cost access tickets were even traded on the black market.39 The hospital provided more than just emergency aid. It also introduced postgraduate training for about 60 Korean doctors as well as nursing education.40 Drescher portrayed this formal and informal training as development work aimed at bringing about a fundamental change in medical care in Korea and reflected this in extensive speculations on differences between Asian and Western peoples, doctors and families, on opportunities for sustainable technical innovations and for new ways of thinking.41 Others saw the presence of local doctors as exploiting a highly qualified Korean workforce without giving the promised training, as all out-patients from 1956 onwards were treated by Korean doctors only.42 The qualification in nursing that Korean nurses acquired at the hospital in Pusan led some of them to undertake postgraduate training and work in ‘mother houses’ of the German Red Cross Sisters.43 These first visits initiated a programme that, over the years, took 12,000 Korean nurses, both religious sisters and unmarried secular nurses, to West Germany. This in turn was interpreted as either exploitation of foreign labour or as capacity-building.44 On the other side of the front in North Korea, the GDR also sent ‘volunteer hospital units’ to Manchuria ‘in support of the Communist troops fighting there’, as did other East European states such as Romania and Hungary.45 The main East German contribution was in terms of materials: more than 150 tons of medicines, another 200 tons of medical equipment and two ambulances were provided in the period up to 1954.46 Equalling a value of 60 million East German Marks by 1957, material aid was delivered in six ‘solidarity trains’ (1954–56) with more than 160 wagons containing consumer goods and medical supplies as well as the equipment for a polyclinic for dermatology and venereology in Pyongyang (1955–57).47 The construction of a tuberculosis hospital, handed over in 1961, was part of the GDR’s largest project—the reconstruction of the bombed city of Hamhung between 1955 and 1962.48 This project included the work of the hygienist Dr Walter Muschter, a specialist in accommodation and cities, the reconstruction of a hospital and the construction of a medical school.49 Among the East European states, the GDR thus played a leading role, second only to that of the Soviet Union, in the reconstruction of devastated North Korea as a model socialist country.50 As the GDR Foreign Office country files on Korea concerning health do not contain any documents before 1960, it remains unclear whether any medical staff were ever sent. There is no mention of German clinical staff in East German newspapers that regularly reported on Hamhung between 1956 and 1960.51 When the GDR wanted to export pharmaceuticals and technical dental equipment in 1960, the North Koreans were already pursuing a strict policy of self-reliance (Juche) and of trust in traditional East Asian medicine, both of which excluded imports from Europe.52 The Two Germanys in the Vietnam War (1955–1975): Various Hospital Projects A further reason for East German abstinence from medical assistance in North Korea was the increasing prominence of another place where injured persons were more in need of care. During the other major Asian wars of decolonisation and Cold War rivalry, the Indochina War (1946–54) and the Vietnam War (1955–75), the GDR engaged in health care in North Vietnam. In 1954, the ‘Korea aid committee’ of the Nationale Front became the ‘Solidarity committee for Korea and Vietnam’ and efforts were divided between Korea and Vietnam in a ratio of 1:2. Korea was finally given up by the solidarity committee in 1957.53 In 1956, East Germany financed, equipped and temporarily staffed the rehabilitation of a former French colonial university hospital for surgery in Hanoi, which was then named Viet-Duc, the Vietnamese-German friendship hospital.54 As the oldest of the five major East German hospital projects abroad, it figured prominently in international solidarity work until the end of the GDR.55 The most lively source of information on the hospital is the diary of the surgeon and head of mission Professor Richard Kirsch (1915–71), published as a series of articles in the party newspaper and as an award-winning book for children under the title ‘Mosquitoes, Bamboo and Bananas’, with the subtitle ‘As a doctor in Vietnam’.56 The images on the inner title pages, however, show neither exotic flora and fauna nor a doctor at clinical work, but large transport boxes with numbers indicating that they run to several hundreds, and both European and Asian staff handling and opening them. This drawing is characteristic of this project as well as of East German international health cooperation in general. The team’s main task here was to accompany the gift of 3,200 boxes of hospital equipment and to put this equipment to use. Besides this function, the East German doctors, nurses and technicians worked with their Vietnamese counterparts in patient care during their stay of nine months. The fact that they regularly met Vietnamese officials, including president Ho Chi Minh, was the main message of the published extracts from Kirsch’s diary. Medical technology made in the GDR was not only important as a gift, but also for promoting exports. A chapter of the children’s book entitled ‘The hospital—a trade fair in miniature’ describes Vietnamese interest in the prices and availability of East German medical supplies, accompanied by special applause from Soviet colleagues who were pursuing a similar purpose.57 Kirsch’s next visit to the country, three years later, was even prompted by an industrial exhibition, a feature of salesmanship also found in the archival records for several other medical experts.58 The hospital project was far more than humanitarian aid, it was also intended to establish and strengthen political and economic ties with an important ally in Asia. The special focus on the prosthetic rehabilitation of war injuries for the so-called ‘heroes of the liberation war’ was especially welcomed.59 Another East German surgeon, Professor Albert Schmauss (1915–2010), stayed from 1956 to 1958 for surgery in Hanoi and later travelled to Vietnam 14 times.60 Kirsch, Schmauss and other team members were highly honoured by the governments in Vietnam and East Germany.61 By contrast, West German medical assistance in Vietnam started much later, initially attempting to be less one-sided than that provided previously in Korea. Including international Red Cross channels, West German material and financial aid reached or at least tried to reach civilian populations on both sides of the front. Compared to the East German Red Cross (6,000 Swiss Francs) and the GDR government (nil), the West German Red Cross (25,000 Swiss Francs) and the West German government (54,000 Swiss Francs) together contributed considerably to the funds of the International Committee of the Red Cross (ICRC) in 1963.62 From these funds, a total of 50,000 Swiss Francs were also used for humanitarian aid to Communist North Vietnam via the East German Red Cross and to the South Vietnamese territory ‘under the control of the National Front for the Liberation of South Vietnam’ via the British Red Cross.63 The West German Catholic aid organisation Caritas, which was responsible for material rather than personal foreign aid, also offered assistance to North Vietnam. This was, however, declined.64 The unexpected prolongation of the war changed conditions regarding neutrality. Chancellor Ludwig Erhard’s visit to the USA in December 1965 functioned as the starting point for another mission of the West German Red Cross. President Lyndon B. Johnson, under severe pressure from Congress for the expense of the Vietnam War, urged the German government to provide substantial aid not only financially, but also by sending medical and technical army corps.65 This was accompanied by the threat of a transfer of US soldiers from Germany to Vietnam and thus less protection for West Berlin. Defence minister Robert McNamara even demanded combat troops from Germany. However, both international and national law as well as the political climate ruled out the sending of soldiers to areas outside NATO territory, even for medical care or logistics—although the West German foreign minister Gerhard Schröder had seriously discussed it.66 Instead, the government decided to send a civilian hospital ship to South Vietnam and to commission the Red Cross with this mission. Again, it was quite an ambitious message to the international and national public, a balancing act of diplomacy, to emphasise that the mission was an act of solidarity demanded by the USA, and at the same time a completely neutral humanitarian project. The chosen vessel, a spa ship named Helgoland, had already been prepared for possible use as a lazaretto ship during its construction. But upgrading it to a full-fledged hospital ship for qualified medical care, nursing and rehabilitation took several months. Additionally, contract and international law had to be considered: which of the four Geneva conventions was best suited for the purpose?67 The choice was between the first convention protecting the wounded and sick members of the armed forces, the second for conditions at sea—as the mission consisted of a ship, and the fourth, which regulated care of civilian victims of armed conflicts. The latter was finally chosen. Seven federal ministries were involved in the planning and it thus took an equal number of months before the ship left Hamburg for Saigon. In Saigon, the West German ministry of health referred to the previous Red Cross mission: ‘Our lazaretto in Korea had treated 250,000 out-patients. This ship will prove successful in the same way.’68 The official mission was, according to a letter by Secretary of State and later German Federal President Karl Carstens, ‘to provide free medical care to sick and wounded civilians affected by events in Vietnam’: The German Red Cross will carry out its activities in Vietnam without regard to race, nationality, religion or political views. The ship, her medical personnel, crew, and the materials on board and in the ambulance will not be used for purposes other than those permitted by the Geneva Convention and the principles of the Red Cross. … The Chief Medical Officer and the other members of the medical personnel, as well as the crew, are civilians.69 The restriction to the treatment of civilians only was justified with the argument that ‘according to the agreed view of all institutions asked, especially the foreign medical teams in Vietnam, the medical care for combatants functioned well and it was just the civilian population which required our help’.70 However, when accused of collaboration with the US American forces by the (North) Vietnamese Red Cross, the West German Red Cross offered ‘to provide its aid also to members of the People’s Republic of Vietnam and the Vietcong [the National Liberation Front (NLF) of Southern Korea; WB] as far as is wished’—a proposal commented upon in a handwritten question in the Foreign Office: ‘i.e. armed forces, not only civilians?’71 The hospital ship and its out-patient department on the mainland, which was provided by the Vietnamese Red Cross, were to be protected by the Vietnamese police and supplied—if needed—by the Vietnamese government. But an additional agreement with the US American embassy assured that the Americans would ‘protect ship and out-patient department like their own facilities when necessary’ and grant their staff the same personal facilitation as the ‘staff of civilian American institutions and other institutions of the free world’.72 Most of the events surrounding the departure of the Helgoland have already been studied in much detail.73 Among the remaining questions are those concerning the relationship between relief operation and possible elements of development aid and that between claimed humanitarian neutrality and other political motives. The West German Missions to Vietnam: Emergency Relief or ‘Development Aid’? In contrast to the Korea mission, the initial members of the West German medical staff in Vietnam were quite young. None of them held the title of professor, as against at least two in the previous team sent to Korea, and—apart from a few months when the team leader Heimfried Christoph Nonnemann had worked in Ethiopia before—none of the doctors seems to have had long-term experience of working abroad.74 Such experience only came with Dr Otto Jäger, who took over medical responsibility as the third head of mission later. Jäger had previously worked in Iran and on a WHO mission in Iraq and Ethiopia for more than 15 years, and would go on to head the seminar program of the German Foundation for Developing Countries (DSE).75 As also observed by the press and by politicians, it had become more difficult to find suitable doctors than in the early 1950s when highly qualified doctors returning from war and overseas work and those fleeing from the East had been desperately looking for jobs. Thus, this time, the doctors who were available would not have been well suited for training local colleagues or fulfilling other tasks beyond curative care. They remained, rather, a temporary substitute for the lack of local health workers. Differing from later debates on ‘Linking relief, rehabilitation and development’, the decision to provide an expensive provisional health facility instead of rehabilitating existing or constructing and developing new facilities was largely unanimous. Just one member of the West German parliament, Heinrich Gewandt, questioned the idea of merely sending doctors and paramedics on a ship, pleading instead for more support of a permanent hospital on the mainland, such as the one in Hué (see below).76 Gewandt was at that time vice-president of the DSE and therefore one of the few experts and proponents of ‘development aid’.77 Costs were not a decisive argument in the debate, although the difference was quite obvious. The annual sum planned for the hospital ship had been 10.6 million Deutschmarks for the first year, and this finally turned out to be 7.5 million for the first year and 9 million for the following year.78 A permanent hospital of the same size was calculated at 9 million Deutschmarks for construction and equipment and at 2.5 million Deutschmarks for operating costs each year. American and Vietnamese authorities expressed their interest in a German ‘contribution to the extension of the health system’.79 In the end, both approaches—off-shore and on-shore aid for short-term and mid-term periods—were adopted and financed, as yet another agency had entered the picture. Two days after the government’s decision to send the Helgoland had been published, Max Adenauer, the third son of the former chancellor and also Secretary-General of the Catholic Order of Malta aid organisation Malteser, offered to provide the hospital ship with medical staff from his organisation.80 The ministry of health, however, declined the offer. In view of the conflicts in South Vietnam between Catholic refugees from the North and the former Catholic minority government of Diem on the one side and a vast Buddhist majority on the other, church organisations were not to be employed. The interdenominational Red Cross was a more neutral choice. Yet the Malteser aid organisation managed to establish its own medical projects in the same year, also financed by the West German government. It took over responsibility for the entire devastated province of Quang Nam with its more than 600,000 inhabitants. At the start, the organisation employed a German staff of 43 health and technical workers, about ten of them medical. Thus, this project required about half the staff and allegedly only a fifth of the costs of the hospital ship.81 Later, the Malteser organisation was commissioned to build a hospital in Da nang, which was destined to replace the hospital ship at its departure. It also set up two more rural hospitals (Hoi an and An hoa) and some smaller health facilities. A comparison between the humanitarian missions of the Red Cross and Malteser in terms of input and output shows that their use of expatriate staff and finances was remarkably similar, although they differed in the duration and output of their work: over five years, the Red Cross hospital ship employed a German staff of about 50 doctors, 122 Red Cross nurses (all female), and 100 male nurses and technicians, thus nearly 300 expatriates.82 During its seven years, the Malteser mission also included about 300 German aid workers, nearly half of them Protestant.83 The Malteser organisation contributed approximately 1.1 million Deutschmarks from private donations and was financed by the German government with 51.4 Million Deutschmarks for the seven years—about the same sum as the government funds for the Red Cross hospital ship over five years. Thus the mainland project with its establishment of three hospitals and its responsibility for an entire province worked for two years longer than the hospital ship in the harbour while requiring about the same amount of funds and German staff. Off-shore medical relief was clearly an expensive enterprise. Concerning the distinction between emergency and development aid, the Malteser mission purposely undertook and inspired both. The construction of hospitals in the project already went beyond pure emergency relief. The project as a whole combined short-term and long-term aid while also including preventive medicine for a whole geographical area, thereby being the first case of German responsibility for the health care of an entire tropical province since the First World War. Small medical teams cared for refugees and leprosy patients, visited scattered settlements and inspected the hygiene and immunisation facilities as well as those for the treatment of diseases. The German hygienist Dr Erich K. Kröger regarded the Malteser project as the ‘establishment of a comprehensive health system’ in the province and explicitly called it ‘development aid’.84 Yet, from his experiences during the project, Kröger also developed proposals for international assistance in catastrophes at both German and international level.85 Regarding the Red Cross hospital ship, the West German minister for development cooperation refused to take it into his budget in 1971 when requested to do so by his colleague for health.86 He thus confirmed that it was not in line with West German development policies, but clearly just constituted emergency aid. West German aid to Vietnam was neither restricted to these two large projects by humanitarian organisations and nor to the health sector. In 1966, West Germany had become—after the USA—the second largest donor country in South Vietnam, providing more than 90 million Deutschmarks (85 million of capital/financial aid and 8.7 million of what was known as technical assistance, i.e. manpower and material), including 32 ambulances, donations of medicines as well as the medical work and teaching at the University of Hué by a team of three German doctors and a lab technician from the University of Freiburg.87 Humanitarianism and Neutrality in Vietnam Contemporary judgements on the humanitarian, that is, neutral, character of the Red Cross and Malteser projects and their teams vary widely. The North Vietnamese Red Cross Society had protested at the ICRC against the Helgoland. It saw the ship as participating in US ‘aggression’ and as ‘West German revanchists’ repeating the ‘abuse’ of the German Red Cross that the ‘National Socialist government’ had committed during the Second World War in order to prolong ‘its fascist war’.88 When confronted with the West Germany's claim of the humanitarian neutrality of the Red Cross mission, it repeated its protest and accusation by pointing to the alleged West German contribution to the war in the form of supplies to South Vietnamese armed forces, the production of bombs and chemical weapons and the sending of military staff and mercenaries in great numbers.89 The East German media also continued to depict both West German missions as part of US aggression.90 A book on Vietnam, published by the East German military publishing house, described the hospital ship as a substitute for the open military action of which West Germany was afraid, as a mission to gather military experience for later use in Germany and as a contribution to US biological and chemical warfare.91 West German and Vietcong views and realities were more differentiated. Since the Malteser team members took over or erected dispensaries and hospitals, they had more contact with Americans and Vietnamese than the Red Cross staff on the hospital ship. In the remote areas close to the demarcation line where their project was situated, they even received food and transportation from the Americans, which made them suspect in the eyes of some German and Vietnamese groups. However, both the South Vietnamese population and, most of the time, the Vietcong, were able to make a distinction: the Malteser medical team could travel without any trouble on the same river where the US forces lost 16 soldiers.92 American army medical teams used evidence from gunshot wounds to gather intelligence and only treated patients who held a South Vietnamese identity card proving that they did not belong to the Vietcong. The Germans, by contrast, treated patients irrespective of the person’s background and in strict confidentiality.93 This practical neutrality did not, however, guarantee complete protection. In 1969, five members of the Malteser team who had unwittingly entered Vietcong territory on a trip during their leisure time were kidnapped by the Vietcong—only two survived captivity and were released after long negotiations.94 A similar loss occurred within the medical team at the University of Hué: three West German doctors and the head of mission’s wife were kidnapped and later killed during the Vietcong’s Têt Offensive in 1968.95 This happened despite the fact that their former team colleague, Dr Erich Wulff, had friends among the Vietcong and had previously accused the US and—according to the East German media—even members of the Helgoland team of war crimes when speaking at the Russell Tribunal in Denmark.96 For many years, Wulff claimed that his colleagues had been murdered by disguised agents provocateurs for ‘black propaganda’ against the Vietcong,97 despite evidence known to him that they had been shot by their confused Vietcong guard.98 Wulff only acknowledged this fact in 2009.99 At the team’s funeral in 1968, the prime minister of the West German federal state of Baden-Württemberg, Hans Filbinger, a former member of the NSDAP and merciless navy judge, emphasised that the team members had not been a means of politics and ideology but had acknowledged that human progress must benefit all peoples equally.100 The presidents of West German universities spoke of them as ‘exercising their humanitarian duties’.101 The rhetoric of humanitarianism beyond ideology was established in rather conservative circles while many of the younger generation preferred partiality for those they saw as oppressed. Different notions of a humanitarian ethos circulated. While the East German press and publications accused the West German doctors of supporting US aggression, the latter considered their own position to be one of humanitarian neutrality.102 Both Red Cross chief physicians, Nonnemann and Dr Klaus Wagner, emphasised the need for equal distance to all political sides. Wagner wrote: ‘Development aid motivated by power politics never makes sense.’103 By contrast, the last chief physician, Jäger, who had already been responsible for reconstructing health care in East Berlin after the Second World War and was therefore experienced in East–West tensions, openly admitted to friendly contact with the Vietcong.104 In general, the attitudes and reflections of the West German doctors were less bound to Western ideology, less paternalist and less Eurocentric than they had been ten years earlier in Korea. A Red Cross nurse, Elisabeth Arkenberg, explained her motivation this way: ‘We wanted to show the Vietnamese that not all Westerners approved of the course of the US government.’105 While denying that anti-Communism was a motive and emphasising the disregard of any creed of patients, Count Truszczynski, a member of the Order of Malta and senior official of its aid organisation Malteser, suggested that the apolitical West German aid workers in Vietnam might become politicised: ‘If someone is there for four months and has experienced the terror of the Vietcong, he occasionally starts to think.’106 Yet, as seen before, the junior staff sometimes felt the opposite way. One of the Malteser nurses, Monika Schwinn, who had been held hostage by the Vietcong for four years, was more concerned about Napalm victims, and said that despite her disapproval of what the Vietcong had done to her and her fellows, three of whom had died in captivity, she could not hate them since this would have been contrary to her ‘moral principles’.107 A strictly humanitarian, moral and idealistic character of the Malteser team is acknowledged and even praised in the very critical report of 1967 on Vietnam by the US feminist writer Mary MacCarthy, who also expressed sympathies with the Vietcong.108 Having published memories of her depressing Catholic childhood, she could not be suspected of harbouring general sympathies with Catholicism.109 Besides such attitudes for and against the US or the Vietcong, and the altruistic wish to help the needy, there were also some individuals for whom the work was primarily an interesting job. The memoirs of a German doctor specialised in tropical medicine who was first a staff member of the Helgoland for one year and subsequently medical superintendent of the Malteser Hospital in Da nang mainly reveal his indulgences in gourmet, alcoholic and sexual experiences. Refraining from political remarks or a more detailed description of the professional relationship with patients, he insinuated that humanitarian organisations followed financial interests and he—as a self-confessed ‘idealist’—felt ‘no strong ties’ with the Malteser team.110 Support of one’s own political side was not the only motivation in West German aid. This became evident again after the victory of the North and the reunification of Vietnam in 1976. In 1978, according to the eyewitness Wulff, two delegates of the Order of Malta, Counts Landsberg and Truczinsky, offered to undertake the rehabilitation of the former Malteser hospital in Da nang with West German funds.111 East and West German Medical Assistance in the Congo Crisis (August 1960–June 1961) Another conflict where both German states became medically involved took place in the period between the West German missions to Korea and Vietnam: the Congo crisis. This developed into a medical issue after the rapid departure of nearly all the Belgian medical doctors on the establishment of independence in 1960. The WHO classified this acute shortage of medical care in many hospitals as a state of emergency and asked the ICRC to bridge the gap until a sufficient number of physicians could be employed.112 The ICRC forwarded the call to the national Red Cross societies and coordinated the missions. East Germany, more than any other state in the world, saw this situation as an opportunity to demonstrate its solidarity with decolonised countries as well as to show the high quality of its medical care and pharmaceutical products.113 The priorities were expressed in a Foreign Office note: ‘As West Germany has not yet sent a team, everything has to be done to arrive before them.’114 The diplomatic task was to establish links with the Congolese minister of health or his staff but it had ‘to be made sure that this is done without the knowledge of the WHO counsellors’.115 Deputy minister for health, Professor Friedberger, said at the farewell ceremony for the second team: ‘Bring aid! The first power of the German workers and farmers stands behind you. You are travelling to Congo as ambassadors of this state.’116 East German officials and participating doctors did not call the motivation ‘humanitarian’, but always spoke of ‘humanist’ or ‘humanism’ since the ‘denominational or political creed of the individual was not decisive for the mission but his medical ability and his attitude, while our opinion is that the idea of true humanism can only be realised in socialism’.117 Memoirs of this mission by the Vice-President of the East German Red Cross, the physician Dr Wolfgang Weitbrecht (1920–87), were published as a book and in a series of articles in the GDR Red Cross monthly journal. These writings mirrored the need and wish to prove the superiority of the GDR on nearly every page: The East German delegation was larger than any other, had a professor as its head and a Red Cross official as a member, had received a farewell ceremony from state and Red Cross representatives and had flown in a comfortable Ilyushin—in contrast to the West Germans, who had had to sit on their baggage in a Canadian transporter. The members of the delegation had, moreover, brought with them an expensive delivery of pharmaceuticals as a gift and had been heartily welcomed by the Slovakian embassy as a substitute for an East German embassy—whereas the West Germans only had a short technical visit to their embassy.118 There are many discrepancies between Weitbrecht’s memoirs, on the one hand, and previously published West German reports and archived East German internal correspondence, on the other.119 Writing to his foreign ministry, East German Red Cross president Ludwig expressed a strong suspicion that the Western dominance in the Red Cross wanted to obstruct the East Germans.120 The conflict centred on a point where the GDR team differed from the other national teams, that is, Weitbrecht’s unofficial mission to establish relationships with Congolese authorities. The ICRC, however, did not tolerate such national diplomatic activities under the guise of humanitarian action. Thus the GDR delegation came under closer scrutiny. The requirements by the ICRC and the Congolese authorities for the three GDR teams had been quite clear: surgeons and nurses only. The delegation was confirmed to possess the required qualifications—which was untrue in two cases since Weitbrecht was a hygienist only and Mrs Kühtz, the medical head’s wife, was a laboratory technician. In order to minimise the damage, the authorities in East Berlin ordered the immediate withdrawal of Weitbrecht and Mrs Kühtz, a defeat for the diplomatic ambitions and one that would be excused by errors in translation. In his memoirs, however, Weitbrecht justifies his sudden departure with the completion of his work and with Mobutu’s anti-socialist policy, directed even against doctors from socialist countries, furthermore claiming credit for the subsequent East German concentration on sending surgeons only.121 In pandering to such fantasies, Weitbrecht was not only a loyal functionary, but also foreshadowed his later career as a well-known writer of science fiction.122 Another result of ideological influence was that cooperation between East and West was kept secret from the East German public and even punished by the government. Members of the medical teams, among them surgeon Schmauss on a new mission, achieved public attention and honours in the GDR.123 The GDR media, however, failed to mention that one of the team members, male nurse W. Zinck, had to be accompanied by West German doctor Bechmann on an air transport from Congo to East Berlin due to severe illness and that another member of the team, Dr Hans Beerhalter from Magdeburg, had defended and treated—together with Bechmann—white farmers who had been attacked and imprisoned by Congolese fighters.124 Beerhalter had also arranged a Christian burial for two murdered Belgians and had reported the belief among the Congolese, even including nurses, that Belgians devoured the body of the first prime minister of independent Congo Patrice Lumumba in Brussels.125 Beerhalter was ultimately punished for his courage and openness. When the ICRC sent 19 memory medals for ‘every one’ of the GDR teams on 10 August 1961, only 18 were later handed over and Beerhalter’s name was missing from the list.126 He had had to leave the GDR secretly on 11 August 1961 as his cooperation with local forces, which his West German colleague had mentioned publicly, had been interpreted as ‘interference with the legitimate government Gizenga’ by the East German authorities.127 This also gave him the opportunity to continue emergency surgical work in Africa, with the WHO in the West Cameroons. The expectations of what East German doctors were to tell the public at the ceremony for their return had been clearly formulated by the Foreign Ministry: ‘The report by Dr Aderholt shall contain some general remarks on the consequences of colonial rule, especially in the field of health care, as well as opinions of the Congolese on achieving their national independence and a short overview on the activity of our groups.’128 Differing from the diplomatic troubles and distortionary propaganda, the medical side of the GDR mission operated without obvious flaws. The teams adapted to the challenges of rural hospitals in Africa and claimed to operate well with the African staff, who were characterised as well-educated and trained in both published and internal reports, despite the general tendency to describe the health system as completely insufficient.129 Internally, however, critical remarks were also made about Congolese nurses: ‘Not all are excellent’.130 Some conditions were felt to be in need of change: ‘Following the Chinese model, we initiated the establishment of a committee of staff and parties which was to improve cleanliness.’131 In fact, cooperation was obviously not always smooth, since the medical delegate of the ICRC wrote in his report on the hospital of one of the GDR teams: Relationship with the medical helpers is good, but the doctors—as everywhere—have to take questions of discipline, work schedule and cleanliness very seriously. The director of the hospital is a politician who—whenever a remark is made on the non-functioning of the Congolese nursing care—points out that the regime has changed. He has introduced an 8-hour-day without considering night duties and without guaranteeing a permanent service.132 The number of surgical procedures performed by the four surgeons proved that the work was accepted by the population. In contrast to their colleagues from the East, the West German doctors were not accompanied by nurses and they did publicly mention difficulties with some Congolese. They described the general attitude of the population as extremely friendly and thankful but ultimately unpredictable. For the hospital in Goma, Bechmann, who could compare the work with his previous experience in South America, wrote: ‘We had to carry out treatment under suspicion from the Congolese nurses and medical assistants, who imagined themselves to be doctors after the departure of the Belgian doctors’. In Butembo, by contrast, ‘the nurses knew quite a lot and were not arrogant in any way, but grateful, courteous, and friendly’.133 Staying in the more remote hospital of Lubero proved to be particularly dangerous: two doctors, Dr Pelzer from Hamburg and surgeon Dr Kurt Benz from Heidelberg University Hospital, were imprisoned by ‘rebels’ and had to be released by UN forces.134 Benz’ predecessor bacteriologist, Dr Gert Willich, who had had previous experience in Iran, had been beaten up by a father who was not satisfied with the deep cuts made in order to successfully treat and save his son’s gangrenous leg.135 The head of mission, 62-year-old female paediatrician Dr Margaret Hasselmann-Kahlert, wife of the Director of the University Dermatological Hospital in Erlangen and likewise experienced in tropical medicine due to more than 20 years in the Philippines, did not work at a hospital but was responsible for the supervision of nutrition, drug supply and health care at 21 small out-patient clinics and hospitals.136 There was far less media coverage in West Germany this time. Besides the negative experiences from Korea, one reason for the silence of the West German Red Cross may have been that an emphasis on the true reason for the mission, that is, the sudden departure of the Belgian staff, might have been detrimental to relations with a good neighbour and ally. The East German team, on the other hand, repeatedly pointed out alleged devastation by colonialism and the unethical behaviour of doctors deserting their patients.137 The latter view was, in fact, shared in the West German press, while it was also stated that the health service had ‘functioned excellently under the Belgians’ and that some Belgian doctors were an exception from the exodus of nearly all Belgian officials.138 Conclusions German aid projects resulting from wars of decolonisation often showed features of both development and emergency aid, before these categories as distinctive areas for international medical assistance had been established in the 1970 s. Such aid projects mostly comprised emergency relief, that is, they were confined to temporary measures or were run with minimal contact with local structures. If projects were more directly negotiated with the respective government, however, they were in a position to improve the long-term situation regarding medicine and health, thereby complying with the Western concept of socioeconomic ‘development’. When West German development agencies started to adopt an additional approach involving public health and health systems, thereby differing from the continuing East German preference for clinical teaching, hygiene education and the supply of materials, it became possible for aid in forms such as the Malteser project in Vietnam to integrate curative and preventive services as well as small and large health care institutions for an entire province. While the civilian character of the missions was emphasised, neutrality was not a major concern in the early years. For senior staff especially, work on the side of the respective political allies was a matter of course. Impartiality, however, that is, treatment of patients without regard to political or religious creed, was guaranteed. Financial contributions and offers of assistance from West Germany could even reach hostile territory due to a certain independence of West German civil society and its organisations from the state. In contrast to Western ‘aid’, ‘solidarity’—the overriding label in the East—did not have to distinguish between selfless humanitarian assistance in acute emergencies and development cooperation for political and economic purposes. Relations between socialist countries were by definition considered to be of mutual benefit and based on humanism. In the late 1960 s, health workers—clearly recognisable only in the West—became increasingly concerned at the idea that their work should serve political ends. Emergency aid ceased to be an unambiguous tool for governments. This is indicated by the fact that—after the construction of the Berlin Wall in 1961—GDR did not send any more considerable numbers of Red Cross health workers abroad while in the West, private support for non-governmental aid work increased. The distinction between emergency and development work, so central for ministerial budgets, health policies and aid organisations, proved to be less important for the health workers themselves. An emotional difference was made between humanitarianism and political self-interest, emotions that the more rational and technical distinction between emergency relief and development aid could not establish in the minds of a general public and many aid workers. Nevertheless, this distinction between humanitarian aid and development work would become marked in the politics of the 1970 s,139 before the boundaries were blurred again in the late 1990 s with the call for ‘development-oriented emergency aid’.140 This rapprochement also concerned the opposition between neutrality and political interest: with the end of the East–West conflict, development cooperation was to be more politically neutral, less dependent on bilateral political interests and more responsive to the actual needs than before. The early medical emergency aid of the 1950 s and 1960 s had already contained the tensions which are obvious today: the humanitarian motivation of aid workers and private donors versus the political interest of governments as well as the requirements of rapid relief versus the long-term perspectives of development. Seen in historical terms, however, the monopoly of the state in commissioning and financing the medical teams of humanitarian organisations remained a rather temporary phenomenon: The ‘rise and rise of European humanitarian NGOs’, which started out of the context of UN developmental issues, resulted in their also providing medical emergency relief.141 Emphasising either continuities and similarities or discontinuities and differences between medical humanitarianism during the Cold War and today remains a question of perspective among both historians and aid workers in their present debates on neutrality and the link of humanitarian aid to development. Acknowledgements I would like to thank my colleague in the project Iris Borowy, now Shanghai, for essential material and support, the Political Archive in Berlin for access to the records of the FRG and GDR Foreign ministries, Carolyn Kenny for careful language editing and the anonymous reviewers for valuable comments on earlier versions. Funding This work was supported by the German Research Foundation DFG [BR 2522/3-1]. Footnotes 1 John Hutchinson, ‘Rethinking the Origins of the Red Cross’, Bulletin of the History of Medicine, 1989, 63, 557–78; John Hutchinson, Champions of Charity: War and the Rise of the Red Cross (Boulder: Westview, 1996); David P. Forsythe, The Humanitarians: The International Committee of the Red Cross (Cambridge: Cambridge University Press, 2005). 2 Bertrand Taithe, ‘Reinventing (French) Universalism: Religion, Humanitarianism and the “French doctors”’, Modern & Contemporary France, 2004, 12, 147–58; Gordon Cumming, French NGOs in the Global Era. A Distinctive Role in International Development (New York: Palgrave Macmillan, 2009); Peter Redfield, Life in Crisis: The Ethical Journey of Doctors Without Borders (Berkeley: University of California Press, 2013). 3 This paper had been presented and submitted for publication in 2014 before the comprehensive monograph of Young-sun Hong, Cold War Germany, the Third World, and the Global Humanitarian Regime (New York: Cambridge University Press) covering the same three emergencies came out in 2015. 4 Young-Sun Hong, ‘The Benefits of Health Must Spread Among All. International Solidarity, Health, and Race in the East German Encounter with the Third World’, in Katherine Pence and Paul Betts, eds, Socialist Modern. East German Everyday Culture and Politics (Ann Arbor: The University of Michigan Press, 2008), 183–210; Hubertus Büschel, ‘In Afrika helfen. Akteure westdeutscher “Entwicklungshilfe” und ostdeutscher “Solidarität” 1955–1975’, Archiv für Sozialgeschichte, 2008, 48, 333-65. 5 For federal government funding, see Horst Dumke, Anfänge der deutschen staatlichen Entwicklungspolitik (Bonn: Konrad-Adenauer-Stiftung, 1997), 37. For the levels of deployed health workers, see ‘Statistik’, in Samuel Müller, ed., Ärzte helfen in aller Welt. Das Buch der Ärztlichen Mission (Stuttgart: Evangelischer Missionsverlag, 1960), 241. 6 Alfred Virnich, ‘Deutsche Ärzte im Irak’, Deutsche Medizinische Wochenschrift, 1954, 79, 1691–3; Gertrud Menne and Joachim-Peter Collin, ‘Merdeka—(Freiheit) oder Nach dem Zweiten Weltkrieg’, in Hans-Joachim Freisleben and Helga Petersen, eds, Sie kamen als Forscher und Ärzte. 500 Jahre deutsch-indonesische Medizingeschichte (Koeppe 2016), 203–14. 7 Bundesministerium für wirtschaftliche Zusammenarbeit, ed., Journalisten-Handbuch Entwicklungspolitik 1977 (Bonn: BMZ, 1977), 18. 8 John White, ‘West German aid to developing countries’, International Affairs 1965, 41, 74–88; Jack L. Knusel, West German Aid to Developing Nations (New York: Praeger, 1968); Karel Holbik and Henry Allen Myers, West German Foreign Aid 1956–1966. Its Economic and Political Aspects (Boston: Boston University Press, 1968). 9 E.g. the thematic issue Alfons Erb and Ernst Schnydrig, eds., ‘Weltelend vor dem christlichen Gewissen’ of the journal Lebendige Kirche (Freiburg/Br.: Lambertus Verlag, 1959). 10 Sylvie Toscer, Les catholiques allemands à la conquête du développement (Paris: Harmattan, 1997). 11 Ulrich Koch, Meine Jahre bei Misereor 1959–1995 (Aachen: MVG Medien, 2003); Christian Berg, ‘Brot für die Welt. 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Vietnam in Geschichte und Gegenwart (Berlin: Deutscher Militärverlag, 1970), 277–8. 92 ‘Nichts sagen und nichts fragen—nur danach, wo es weh tut’, documentary ca. 1967. http://www.60-jahre-mhd.de/1966-1975-einsatz-in-vietnam.html, last accessed 25 March 2018. 93 Erich K. Kröger, ‘Die Malteser in Vietnam’, Deutsches Ärzteblatt—Ärztliche Mitteilungen, 1970, 67, 1648–54, 1649–50. 94 ‘Monika Schwinn über ihre Gefangenschaft beim Vietcong: “An mir beißt ihr euch die Zähne aus”’, Der Spiegel, 26 March 1973, 46–57. 95 Simon Reuter, Im Schatten von Tet: Die Vietnam-Mission der Medizinischen Fakultät Freiburg (1961–1968) (Frankfurt/M.: Peter Lang 2011), 144–72. 96 ‘Russell-Tribunal: USA des Völkermords schuldig. “Helgoland”-Personal an Menschenjagden beteiligt’, Neues Deutschland, 2 December 1967, 22, 8. 97 Georg W. Alsheimer (alias Erich Wulff), Vietnamesische Lehrjahre, 2nd edn (Frankfurt/M.: Suhrkamp, 1973), 451. 98 Georg W. Alsheimer (alias Erich Wulff), Eine Reise nach Vietnam, 2nd edn (Frankfurt/M.: Suhrkamp, 1980), 140. 99 Reuter, Schatten, 168. 100 Ibid., 161. 101 Ibid., 162. 102 ‘Bonner Schiffe auf Kurs Vietnam’, Neues Deutschland, 15 March 1967, 7; Klaus Wagner, Vietnam in jenen Tagen. Erlebt und erzählt von einem deutschen Arzt (Frankfurt/M.: R. G. Fischer, 1972), 28–9; Riemann, Entsendung, 51. 103 Heimfried C. Nonnemann, Wir fragten nicht, woher sie kamen. Arzt in Vietnam (Hamburg: Hoffmann & Campe, 1968); Wagner, Vietnam, 49. 104 On Jäger’s experience of East–West tension, see Wladimir Lindenberg, Himmel in der Hölle. Wolodja als Arzt in unseliger Zeit (München: Ernst Reinhardt, 1988), 242. On contact with the Vietcong, see ‘Vietcong-Dank’, Der Spiegel, 31 March 1969, 22. 105 Cited after Schomann, Geschichte, 303. 106 Kurylo, ‘Hilfsdienst’, 69. 107 ‘Monika Schwinn’, 57. 108 ‘Nichts wäre schlimmer als der Sieg: Mary McCarthy über Amerikas Krieg in Vietnam’, Der Spiegel, 24 July 1967, 60–72; Mary McCarthy, Vietnam (New York: Harcourt, Brace & World, 1967). 109 Mary MacCarthy, Memories of a Catholic Girlhood (New York: Harcourt, Brace & Jovanovich, 1957). 110 Detlev Wissinger, Erinnerungen eines Tropenarztes. Der Lebensweg eines Idealisten (Hamburg: Books on Demand, 2002), 231–4. 111 Alsheimer, Reise, 151. 112 ‘Rotkreuzdelegation zur medizinischen Hilfeleistung in den Kongo entsandt’, Monatsschrift des Deutschen Roten Kreuzes der DDR [in the following Monatsschrift DRK DDR], August 1960, 5; ‘Rotkreuz-Aktion im Kongo bleibt weiter unentbehrlich’, DRK Bonn, 1961, 6, 6–7. 113 Dr Weitbrecht, ‘Unsere Kameraden im Kongo-Einsatz’ and ‘Ärzte aus der DDR in Kongo hoch angesehen’, Monatsschrift DRK DDR, November 1960, 7–10; for the GDR mission see Hong, Cold War Germany, 165–8. 114 Seyfart [Ministry of Health], Department ‘Internationale Organisationen’, Betr.: Einsatz einer medizinischen Hilfsgruppe im Kongo, Vertraulich! [Confidential], 12 August 1960, PAAA, MfAA, C 801/74, 000060–1, 000061. 115 Seyfart, An die 4. Außereuropäische Abteilung, Streng vertraulich’ [Highly confidential], Berlin 10 August 1960, PAAA, MfAA, C 801/74, 000062–3, 000062. 116 ‘Zweite DDR-Ärztegruppe nach Kongo. Prof. Dr. Friedeberger beim Abflug: Sie sind Botschafter unseres Staates’, Neues Deutschland, 1 December 1960, 15, 5. 117 Karl Aderholt, ‘Im Namen der Menschlichkeit’, Monatsschrift DRK DDR, February 1961, 6–10, 7. 118 Wolfgang Weitbrecht, Kongo. Arzt unter heißem Himmel (Berlin: Verlag der Nation, 1964); Wolfgang Weitbrecht, ‘Kongo. Arzt unter heißem Himmel. Auszugsweiser Abdruck des gleichnamigen Erlebnisbuches’, Monatsschrift DRK DDR, February–October 1966. 119 Erich Bechmann, ‘Am Äquator hat die Menschlichkeit noch eine Chance’, DRK Bonn, 1961, 6, 9–12, 9. 120 Red Cross president Ludwig to Ministry of Foreign Affairs, 6 September 1960, PAAA, MfAA, C 801/74, 000050–3. 121 Weitbrecht, Kongo, 160–1. 122 E.g. Wolf Weitbrecht, Orakel der Delphine. Wissenschaftlich-phantastischer Roman (Rudolstadt: Greifenverlag, 1974); Wolf Weitbrecht, Stunde der Ceres. Wissenschaftlich-phantastischer Roman (Rudolstadt: Greifenverlag, 1975). 123 ‘Operation bei Petroleumlicht im Kongo’, Neue Zeit, 18 December 1960, 2; ‘Ueber Reiseerlebnisse aus dem Kongo spricht am Freitag, dem 5. Mai um 19 Uhr Oberarzt Dr. Albert Schmauss im Club der Kulturschaffenden in der Otto-Nuschke-Straße’, Neue Zeit, 3 May 1961, 8. 124 Bechmann, ‘Menschlichkeit’, 12; Telex LICROSS, Geneva, and DRK, Bonn, 12 November 1960, PAAA, MfAA, C 801/74, 000025; not mentioned in the article on Beerhalter’s return: ‘DDR-Ärzte halfen in Kongo’, Neues Deutschland, 16 March 1961, 16, 7. 125 Letter Bechmann to ICRC, Goma, 17 November 1961, PAAA B92 313. 126 ‘Aus der internationalen Arbeit’, Monatsschrift DRK DDR, October 1961, 9–11. 127 Personal communication by Dr Beerhalter to author, Saarbrücken, 8 January 2015. 128 Abteilungsleiter Büttner to Minister Schaub, Auszeichnung der ersten Einsatzgruppe des Deutschen Roten Kreuzes, Berlin 15 December 1960, PAAA, MfAA, C 801/74, 000011–12. 129 Aderholt, ‘Menschlichkeit’, 8; A. Stenger, ‘Die Krankenpflege im afrikanischen Busch’, Monatsschrift DRK DDR, April 1961, 12–13; Dr. Karl Aderhold [!], Bericht der Rotkreuz-Gruppe des Deutschen Roten Kreuzes der DDR—Kongolesisches Krankenhaus Shabunda—vom 1.—30.10.1960, Shabunda, 5 October 1960, PAAA, MfAA, C 801/74, 000036–7. 130 Ibid., 000036. 131 Dr. med. habil. Schmauss to GDR ministry of health, Shabunda, 15 December 1960, PAAA, MfAA, C 801/74, 00006–10, 00007. 132 Bericht des Dr. Fasel, medizinischer Delegierter des IKRK im Kongo [ … ] 18.–24. September 1969, PAAA, MfAA, C 801/74, 000045–6, 000046. 133 Bechmann, ‘Menschlichkeit’, 9–10. 134 ‘Deutsche Ärzte im Kongo in Sicherheit. Fortdauer der Rotkreuz-Ärzte-Mission’, DRK Bonn, 1961, 2, 2. 135 Bechmann, ‘Menschlichkeit’, 10. 136 ‘Nachschubprobleme, Ernährungssorgen … Eine deutsche Ärztin im Kongo berichtet’, DRK Bonn, 1961, 6, 8. 137 Aderholt, ‘Menschlichkeit’, 7–9. 138 ‘Der Präsident hat Angst vor der Armee. Besuch in der Kongoprovinz Equateur—Oberst Solihin sorgt für Ordnung’, Die Zeit, 11 November 1960, 2; Otto von Loewenstern, ‘Die eingemauerten Nonnen. Ein Bericht aus dem Kongo’, Der Spiegel, 3 August 1960, 38–9, herer 38. 139 Aufzeichnung des AA für den Unterausschuss Humanitäre Hilfe des Auswärtigen Ausschusses ‘Humanitäre Hilfe der Bundesregierung als spezifisches Instrument deutscher Außenpolitik’, 11 May 1977, BArch [Federal Archive] B213/4990; BMZ, ed., Journalisten-Handbuch Entwicklungspolitik 1976 (Bonn: BMZ, 1976), 84. 140 Official examples for such attempts are two communications from the European Commission to the Council and the European Parliament on Linking Relief, Rehabilitation and Development (LRRD): COM (1996)153 final of 30 April 1996 and COM/2001/0153 final. 141 Kevin O’Sullivan, ‘A “Global Nervous System”: The Rise and Rise of European Humanitarian NGOs, 1945–1985)’, in Marc Frey, Sönke Kunkel and Corinna R. Unger, eds, International Organizations and Development, 1945–1990 (Basingstoke: Palgrave Macmillan, 2014), 196–219. © The Author(s) 2018. Published by Oxford University Press on behalf of the Society for the Social History of Medicine. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices)

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Social History of MedicineOxford University Press

Published: Apr 9, 2018

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