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. 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.
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.
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The annual sum planned for the hospital ship had been 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 , 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. 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, Red Cross nurses all female , and male nurses and technicians, thus nearly expatriates.
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. West German aid to Vietnam was neither restricted to these two large projects by humanitarian organisations and nor to the health sector.
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.
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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. In , 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.
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. 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.
This became evident again after the victory of the North and the reunification of Vietnam in In , 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. This developed into a medical issue after the rapid departure of nearly all the Belgian medical doctors on the establishment of independence in 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.
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. The first power of the German workers and farmers stands behind you. You are travelling to Congo as ambassadors of this state. 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. The ICRC, however, did not tolerate such national diplomatic activities under the guise of humanitarian action. Thus the GDR delegation came under closer scrutiny.
Members of the medical teams, among them surgeon Schmauss on a new mission, achieved public attention and honours in the GDR. 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.
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. 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.
Der Tag im Überblick
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. 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. Such aid projects mostly comprised emergency relief, that is, they were confined to temporary measures or were run with minimal contact with local structures. 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.
Relations between socialist countries were by definition considered to be of mutual benefit and based on humanism. 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 —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. 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.
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