This Wall Street Journal article is very interesting. "Eastern Europe in Dire Need of Doctors."

Wall Street Journal

‘It’s Like the Second World War.’ Covid-19 Is Tearing Into the Parts of Europe That Lack Doctors

Europe’s crisis is moving into poorer states that have exported doctors for decades. Now the bill from that exodus is coming due.

By Drew Hinshaw and Natalia Ojewska

November 27, 2020

MIĘDZYCHÓD, Poland—So many new doctors left Poland for better-paying jobs in Europe’s west that when Łukasz Rotnicki decided to stay behind he often found himself working 36-hour shifts, sleeping on the brown pullout sofa of a small-town hospital with too few staff.

That was before Covid-19.

On a recent Monday, the 36-year-old surgeon was on his 74th consecutive hour of treating coronavirus patients, broken by only a few short naps.

At the same hospital, a local nurse had recently been hospitalized, feverish and short of breath. Yet the staffing crunch was so dire that she kept working in the very Covid-19 ward where she was meant to recover, feeding the sick and turning them onto their stomachs before returning to her own bed in the same room.

Europe’s Covid-19 crisis is moving eastward, from the wealthiest and best-prepared countries on the continent into the poorer states that have exported doctors for decades. Now, as Covid-19 cases soar, the bill from that long exodus is coming due.

With 238 physicians per 100,000 people, Poland has the lowest such ratio in the European Union, nearly half the level of Germany, whose relative success in handling the virus owes much to its foreign staff. The average age of Polish nurses is 53, just seven years short of retirement.

Largely spared during the spring surge, Hungary, Slovakia, Poland and Romania braced for autumn by stocking up on ventilators. But they lack people to operate the equipment. As cases pile up, shifts that often spanned two full days before the pandemic are now stretching the limits of human endurance.

“It’s hard times, I think, it’s like the Second World War,” said Dr. Rotnicki, who arrived on a recent Friday morning at the Independent State Healthcare Hospital in Międzychód in western Poland and didn’t clock out until the following Monday. Hours later, three of his patients died. “I had to go home because I thought, I will maybe kill somebody,” he said.

The shortages, which have prompted strict stay-at-home orders through Christmas in Poland, are the consequence of a borderless Europe that has seen prosperous countries—particularly in Western Europe—soak up talent from regions that offer lower pay.

As a result, Italian and British hospitals are coping with Covid-19 with help from Polish, Romanian and Hungarian staff.

Back home, doctors and nurses who stayed behind are working dayslong shifts.

Katarzyn Koch-Brzozowska, head nurse at the Międzychód hospital, said that her nurses threaten daily to quit, but she has successfully fought to keep them. “I call them a million times a day, and I bake them cookies with every day off,” she said.

In Hungary, physiotherapists can earn five times their $600-a-month entry salary pulling shorter shifts in Germany, and in Estonia doctors can quintuple their pay by crossing over to Finland. In western Poland, headhunters drive in from Germany, blanketing windshields with pamphlets that promise five times more pay, two years of free language classes and housing.

As incomes have risen in the region, nursing has become a less attractive profession. Schools that were once selective are now struggling to recruit enough students. In Slovakia, a third of all graduates immediately leave the country, said Jana Bendova, a board member of the Slovak Society of General Practice.

The staff who remain in the region tend to be older and were educated under communism, when schools taught less English, or have returned after years abroad

At western Poland’s Healthcare Center in Bolesławiec, three-fourths of nurses have fallen ill. Nearly half of nurses have contracted the virus at the nearby Drezdenko hospital, where one recent morning, a visibly sick receptionist greeting guests complained of a fever. Nationwide, about a 10th of Polish nurses were quarantined as suspected Covid-19 cases last month.

Officially, the Drezdenko hospital has 126 beds, but only enough staff to handle about 80 patients, a number they have already breached. Shortly before the pandemic, the hospital had managed to convince two daughters of its own nurses, both medical-school graduates, to join the staff. But within a few weeks, both left for the U.K.

Authorities have drafted troops, nuns and lifeguards to help. At Polish hospitals, soldiers take temperatures of visitors and input data into computers.

At one hospital in eastern Poland, staff recruited nine lifeguards from neighboring Ukraine. But they were unable to do anything more than basic CPR; most of them soon tested positive for Covid-19.

Hospitals have sent maternity-ward doctors, pediatricians and even physiotherapists into Covid-19 wards where many patients die. In Dr. Rotnicki’s hospital one recent morning, a pediatric nurse, used to caring for young children, sobbed during her break after a patient had died alone, the staff stretched too thin to sit with him.

“They’re not used to working with death,” said a nearby nurse, getting ready to don head-to-toe protective equipment.

For years, regional governments have tried to entice medical-school graduates to stay behind, sometimes with pay increases. Many doctors survived on cash given to them by patients. Just before the pandemic struck, those pay hikes had begun to help, and emigration started to slow.

But problems remain. To staff public hospitals, Hungary’s government is pressuring doctors to give up private practice and their right to choose which hospital they serve, a move widely opposed by doctors. A survey from June by the Hungarian Medical Chamber found six out of 10 medical-school graduates intend to leave Hungary.

“We’d rather be cashiers at Aldi or Tesco,” said one doctor, who is barred from government rules from speaking out. “We’d earn more and at least have our weekends free.”

When Dr. Rotnicki graduated in 2010, a stream of classmates crossed the border to take work in Germany, in hospitals where he estimates as much as half the staff is Polish.

In October, the regional government called to negotiate how many beds the hospital would be able to take at once, settling on 40. Within weeks of the arrival of the first patient, 15 medical staff were out sick.

Dr. Rotnicki began working marathon hours. On a recent day, ambulances had brought 10 seriously ill patients by the afternoon. Two needed intubation and another, a diabetic, was already unconscious. Many required oxygen and had to be carefully rolled onto their stomachs repeatedly to assist their breathing.

Meanwhile, 100 miles south, construction workers were racing to finish a new 65-bed hospital exclusively for Covid-19 patients overflowing regional hospitals. In about a month, the builders expected to finish an infectious-disease clinic on a muddy lot, complete with oxygen lines and CCTV cameras in every room.

The problem, medical staff said, is who will work there.

“If I have one new nurse,” said Ms. Koch-Brzozowska, the nursing director, “it means another hospital has one nurse less.”

Appeared in the November 28, 2020, print edition as 'Eastern Europe in Dire Need of Doctors.'

"At 14, Sheindi Miller kept a journal while in the Nazi camp. Now 90, she has finally decided to share it with the world."

Sheindi Miller in her Jerusalem apartment in 2019, holding cards she used for her diary in Auschwitz.

Ms. Miller in 1947. 

Wall Street Journal - A Survivor’s Diary Emerges From Auschwitz

By Bojan Pancevski

January 24, 2020

Shortly after arriving at Auschwitz on June 14, 1944, 14-year-old Sheindi Ehrenwald stood with other inmates, naked, her head shaved and dripping with disinfectant.

An SS officer was present. After inspecting the group, he ordered the wardens to take Sheindi’s 12-year-old sister, Dori, to his quarters. The man, she later realized, was Josef Mengele, a physician notorious for conducting grotesque experiments on Jewish prisoners, many of them children. Dori never made it out of the camp.

The episode is part of the diary that Sheindi Miller, as she is now called, secretly kept while she was a prisoner in Auschwitz, the most notorious Nazi extermination camp. At the risk of her life, Ms. Miller wrote down the details of her ordeal, including her work as a slave laborer for an arms manufacturer. Written in Hungarian, it is a rare and possibly unique document, recording the plight of European Jews toward the end of World War II, as Nazi Germany redoubled its efforts to exterminate them.

This week, Ms. Miller’s diary was exhibited to the public for the first time at the German History Museum in Berlin. The exhibition, which includes a film about her life, is part of Germany’s official commemoration of the 75th anniversary of the liberation of Auschwitz by the Red Army, on Jan. 27, 1945.

Ms. Miller’s diary starts where the diary of Anne Frank stopped, said Thomas Jander, who co-curated the exhibition. Frank’s famous diary broke off when she and her family were arrested in Amsterdam and deported to Auschwitz, while Ms. Miller’s tells the story of what happened after she arrived there.

Ms. Miller, 90, survived World War II and emigrated to Israel, where she kept her journals in the kitchen cupboard of her Jerusalem home for 70 years. For decades, she said, she was unable even to speak to her children about the Holocaust, let alone seek publication of her writings.

They might have stayed there, forgotten, if it hadn’t been for a friend of the family who mentioned the diary to reporters at Bild, Germany’s highest-circulation newspaper, last year. The journalists visited Ms. Miller in Jerusalem and persuaded her to publish it in Bild.

She agreed, she said, partly because of her anxiety about the current resurgence of anti-Semitism in Europe. “When I was writing the diary, my greatest fear was that a German would read it,” Ms. Miller said this week. “Today, 76 years later, my greatest joy is that Germans are reading it.”

Wolfgang Schäuble, president of the German parliament, who inaugurated the exhibition on Wednesday, said that the diary was an invaluable bulwark in the fight against anti-Semitism. “Today every word of your densely written manuscript on the yellowed index cards of the arms factory is a unique document for posterity—54 pages of priceless historic value, emotional vehemence and a legacy against oblivion,” Mr. Schäuble said.

The publication of the diary comes as Germany is experiencing a rise in anti-Semitic crimes, from verbal abuse of Jews to threats and physical attacks. Last year on Yom Kippur, the most sacred Jewish holiday, a gunman attempted to attack a synagogue in Halle, leaving two dead.

Ms. Miller began to keep her diary in March 1944, on the day that German troops invaded Hungary. Over the next three months, more than 400,000 Hungarian Jews were transported to Auschwitz, with eager assistance from local authorities. Most of them were killed on arrival.

“In the night there was a loud banging on the door,” Ms. Miller wrote in April 1944. “My father opened and there were three Hungarian gendarmes in front of him and they ordered him to leave the house. He turned round with tears and said: ‘Don’t cry, be strong. We’ll return soon.’ But we never returned.”

The diary offers a graphic account of the train transport to Auschwitz. Ms. Miller and her family were thrown into cattle cars with dozens of other people. When an infant died of exhaustion, she recounts, Nazi soldiers snatched the corpse away from her mother and threw it off the train. “The poor mother…won’t even know where she’ll be buried,” she wrote. “Life is hard and humans can take more than animals.”

When the transport arrived in Auschwitz, Ms. Miller’s grandparents, parents and two of her siblings were deemed unfit for work and taken to the gas chambers. The next morning, she awoke to the suffocating smell of burned human bodies. “We’re burning your parents now,” a soldier told the prisoners.

On index cards that she hid in the dank walls of her prison barrack, Ms. Miller described further ordeals. The female inmates were made to undress in front of soldiers: “We undressed. The men ran around the room laughing, we stood around naked and deeply ashamed.”

Ms. Miller survived in part because she was assigned to work in a factory, making grenades and bombshells for Karl Diehl, a German arms manufacturer that still exists today. In 1998, Diehl Stiftung & Co. KG, as the company was later renamed, paid her the equivalent of around $5,000—without admission of legal responsibility, according to letters by company representatives now included in the exhibition.

“There is no question that the Diehl reparation fund was created late, but it still was the first of its kind in Germany,” a company spokesman said in a statement. “The company took a step that most of the German industry was at the time not prepared to take.” He added that Diehl welcomed the new exhibition and documentary.

Before World War II, the Jewish population of Galanta, Ms. Miller’s hometown, was around 1,500. She was one of only 150 survivors to return; four of her seven siblings perished. In 1949, she moved to the newly founded state of Israel, where, she said, life was hard in the early years. Her oldest son, a paratrooper, died in the Yom Kippur War in 1973, at age 20.

Last week, Ms. Miller traveled to Berlin in the company of 24 members of her extended family, including two of her 40 great-grandchildren. She summoned them on stage at the exhibition’s opening on Wednesday. “Until my daughter married, I had not had more than a few weeks of happy times. But now, looking at my big family, I think my life was worth it—and I am still young, only 90!” she exclaimed.

She added that the publication of her diaries in Germany is the crowning achievement of her long struggle. “We have won,” she said.