Kate Docking, University of Kent The UKAHN Bulletin
Volume 8 (1) 2020

*This article was updated at the authors request on 17. NOV. 2020*


Martha Haake, a member of the Reichsbund der Freien Schwestern (the Reich Association of Free Nurses) was posted to work at Ravensbrück concentration camp in August 1943.1 At this camp, which interned only female prisoners, Haake administered lethal doses of Luminal (a brand name for phenobarbital – a strong sedative) to thirty inmates.2 Helena Goudsmit, a former prisoner of the camp, also remarked that Haake frequently beat prisoners.3 This particular nurse thus behaved in a cruel manner that entirely violated long-standing, widely-held conceptualisations of nursing as a force for good. At the fourth Ravensbrück concentration camp trial, which was conducted by British military authorities between May and June 1948 and tried some of the former camp personnel, Haake was convicted of murder and ill-treatment of inmates, and was sentenced to ten years’ imprisonment.4 The story of Haake, briefly sketched here, is not exceptional. Approximately twelve other nurses worked at Ravensbrück concentration camp during the Third Reich, and, like Haake, some utilised their positions as nurses in the camp to maltreat prisoners by, for example, administering lethal injections or deliberately refusing them medication.

How might we explain the actions of Haake, and the other Ravensbrück nurses? Thomas Foth, Jochen Kuhla and Susan Benedict have noted that the strong, long-standing emphasis on obedience within the nursing profession in Germany ensured that, during the Third Reich, nurses did not question the power structures that made them subordinate. Indeed, as the aforementioned scholars have noted, obedience was a long-standing trait of the nursing profession prior to the outbreak of Nazism; from the nineteenth century, the motherhouse system demanded the submission of nurses to the will of the pastor. These scholars stress that obedience to doctors led nurses to participate in the ‘euthanasia’ programme in Nazi Germany, which entailed the extermination of as many as 200,000 people considered ‘unworthy of life’ due to physical disabilities, mental illness or hereditary diseases.5

With regard to the Ravensbrück nurses in particular, Susan Benedict has indicated that the nurses who worked at the camp perpetrated atrocities due to dedication to National Socialist ideology and obedience to doctors.6 Yet stressing that nurses practiced maleficence during the Nazi regime because they were obedient to doctors does not sufficiently account for other factors that propelled the actions of individual nurses in particular settings, which might have been more important than the rather free-floating, vague notion of ‘obedience’. Placing too much emphasis on ‘obedience’ as an explanation of nurses’ actions imposes a blanket theory that obscures the nuances of individual situations. Simply stressing the obedience of nurses to their superiors in Nazi Germany (or stressing that nurses were only ‘doing their duty’) and utilising that to explain why nurses behaved in the ways they did in a sense minimises their culpability in the atrocities they often freely chose to commit, on their own volition. Furthermore, the ‘obedience’ argument does not fully explain how the Ravensbrück nurses actually came to violate traditional conceptualisations of nursing, which we need to analyse if we want to obtain a nuanced and detailed insight into their behaviour.

While the nurses at Ravensbrück were hierarchically subordinate to the male doctors who worked at the camp as part of the gendered hierarchy in the Third Reich, and in a lowly position in relation to both male and female doctors at Ravensbrück in general owing to the medical hierarchy, they were far from powerless. Rather, these individual nurses possessed a fluctuating degree of agency in their day-to-day roles in the camp hospital at Ravensbrück.

More broadly, this power can be situated amongst the scope for action many German women possessed during the Third Reich, in spite of the patriarchal structures that rendered them hierarchically subordinate. The position of German women during the Nazi regime is aptly summarised by the historian Ute Frevert: ‘Women who satisfied the political, racial, and social requirements (of the regime) – and the vast majority did – did not perceive the Third Reich as a woman’s hell. Much of what it introduced was doubtless appealing, the rest one learned to accept’.7 It was often not just a case of women merely accepting the regime, however. While it would be going too far to label German women collectively as ‘perpetrators’ of Nazism – as the historian Claudia Koonz has argued – and we must bear in mind their ‘complex social realities’, in line with the contention of the historian Atina Grossmann – some women certainly aided Nazi policies of persecution.8 For example, in addition to working as nurses in concentration camps, women also worked as guards who perpetrated violence in these spaces and as female doctors who promoted Nazi racial ideology.9 The degree of agency German women in the Third Reich in general were able to possess was important in ensuring that the individual nurses who worked at Ravensbrück had some power. Yet the jurisdiction these women obtained – and thus the scope they had for the maltreatment of prisoners – was more immediately related to the spatial development of the hospital over time, rather than their position as women in the Third Reich more generally.

In order to fully elucidate how nurses came to violate medical conventions, then, it is necessary to look at the specific conditions in the camp hospital – in terms of medical practice there and its physicality – at particular times during its existence, and how these factors might have influenced the behaviour of nurses. What follows differs from the contention of Foth, Kuhla and Benedict regarding the obedience of nurses, then, in that it emphasises the immediate factors that led the Ravensbrück nurses to commit atrocities on a more micro level – that were generally specific to the situation in the camp hospital at a specific time – as opposed to broader structural factors. Since most of the existing literature has emphasised the obedience of nurses as a significant factor that led them to violate traditional conceptualisations of nursing in Nazi Germany, this article fills a lacuna by suggesting other reasons that explain why nurses behaved in the ways they did, utilising the Ravensbrück nurses as a case study.

It is pertinent to contextualise the maltreatment of prisoners practiced by some of the Ravensbrück nurses more specifically within the environment in which they were operating. This entails looking more closely at the camp hospital at different times during its existence. It means noting the ways in which the changing nature of the hospital, in terms of its physical structure and how it functioned, more broadly framed the actions of the nurses who worked there, and potentially facilitated them. Taking stock of the particular micro-setting of the Ravensbrück concentration camp hospital also necessitates analysing the relationships between nurses and the doctors who worked there, and considering how these interactions might have influenced their behaviour.

This article will consider the Ravensbrück nurses on an individual basis, drawing out the differences in how particular women came to commit atrocities and locating individual nurses ‘in their social context’, in line with the approach of James Hinton.10 In this case, the broader social context is the hospital at Ravensbrück. The situation at Ravensbrück was historically specific, so caution is needed when considering the extent to which the case study of the Ravensbrück nurses can illustrate the sorts of conditions that might facilitate the capacity of nurses to commit atrocities in the broader, somewhat differing contexts of war today. Yet, this article does aim to provide at least an indication of the sort of factors which might prompt individual nurses to violate traditional medical and ethical codes in a more contemporary context.

This article uses some documentation originating from the Third Reich, mostly pertaining to the organisation of the nursing profession in Nazi Germany more generally, procured from the Bundesarchiv (Federal Archive) in Berlin, but its main source is post-war material, primarily legal documents from the British-conducted Ravensbrück concentration camp trials, housed at the National Archives in London. Some of the nurses were surprisingly open about their actions in spite of the legal context and thus the expectation that they might have tried to minimise their culpability in atrocities at Ravensbrück, which makes this material useful when analysed carefully. For example, Martha Haake admitted in proceedings conducted as part of the fourth Ravensbrück trial that she administered a white powder to prisoners that caused some deaths, even though she claimed not to have known that this was a lethal dose of Luminal.11

Nursing in Nazi Germany: Organisation and Ideology

The organisation of nursing in Germany had started to change in the early twentieth century. In 1903, the Berufsorganisation der Krankenpflegerinnen Deutschlands (the Association of Nursing Professionals in Germany) was founded, representing somewhat of a break from the rigid structure of the religious motherhouse organisations that had existed since the nineteenth century, and paved the way for the greater professionalisation of nursing.12 When the National Socialist government came to power in 1933, the organisation of the nursing profession changed rapidly. In May 1934, the NS-Schwesternschaft (the National Socialist Nursing Organisation) was created, arising out of the Roten Hakenkreuzschwestern (Red Swastika Nurses), which itself had been created only a year earlier, in 1933.

Nursing underwent further organisational changes during the Nazi regime. In 1936, the Reichsbund der Freien Schwestern was founded in order to represent the economic and professional interests of frei (free) nurses.13 Nazi Party membership was apparently not required for nurses who wished to join the Reichsbund der Freien Schwestern, whereas it was a pre-requisite for the NS-Schwesternschaft.14 A substantial organisational change to nursing occurred in April 1942, when the NS-Schwesternschaft merged with the Reichsbund der Freien Schwestern und Pflegerinnen to form the NS-Reichsbund Deutscher Schwestern (the National Socialist Association of German Nurses).15 This merged association contained nurses who were both members and non-members of the Nazi Party, and it appears that women who joined the NS-Reichsbund Deutscher Schwestern to train as nurses after 1942 were not required to be Party members; a recruitment notice did not stipulate this as a requirement.16

The generally religious outlook of nursing as a profession in Germany that remained in spite of its increased professionalisation in the early twentieth century shifted to focus more prominently on the Volksgemeinschaft (the people’s community) with the advent of the National Socialist regime. As Mary Lagerwey has noted, the idea of subordinating individual health needs to the collective health status of the state can be traced to the second half of the nineteenth century.17 This eugenics-based outlook was embraced by the nursing profession in Germany to some extent before the Nazi regime came to power. For example, one nurse named Minna Bahnson stated in 1930 that money invested in caring for people with disabilities was ‘worthless’.18 Yet, in reality, nursing practice itself generally embodied the importance of caring for all. The case of psychiatric nursing exemplifies this; as the scholar Bronwyn McFarland-Icke has demonstrated, this type of nursing in the Weimar period was guided by the moral purpose of ‘helping the helpless’.19 When the Nazi regime came to power, increased emphasis was placed on the health of the Volksgemeinschaft. In 1933, the Minister of the Interior, Friedrich Bartels, called for a shift in focus away from individual patient care towards collective prevention of diseases, exhorting nurses to ‘secure and promote a genetically sound, valuable race… and not to expend an exaggerated effort on the care for genetically and racially inferior people… at the cost of the more valuable people’.20 This nursing practice in Nazi Germany concentrated on improving the overall health of the Volk (people), rather than on providing for sick individuals; this marked a shift in general mainstream nursing practice. In this guise, the regime strongly encouraged community nursing, as this was where nurses were perceived to have the greatest influence in promoting such ideology. As Christoph Schweikardt has remarked, community care as an NS-Schwesternschaft priority meant that nurses could be in a key position to implement National Socialist policy on a local level.21

‘A place of fear and terror’: the Ravensbrück concentration camp hospital
Erika Buchmann, a former political prisoner of Ravensbrück concentration camp, remarked in her book, Die Frauen von Ravensbrück (The Women of Ravensbrück) that ‘Everyone thinks of the word “infirmary” as a long, still corridor with clean, white beds, busy doctors and friendly nurses. For the prisoners of the women’s concentration camp Ravensbrück, the Revier was like every corner of the camp: a place of fear and terror’.22 Indeed, Buchmann’s statement encapsulates what this particular place symbolised to the inmates of the camp. To them, the Revier – the name prisoners, doctors and nurses used to refer to the camp hospital – was a space that contrasted completely with conventional notions of hospitals as calm and hygienic, with doctors and nurses striving to do their best to treat patients. It is important to contextualise the Revier in the broader context of Ravensbrück concentration camp itself. Ravensbrück was located about 50 miles outside of Berlin. Only women were interned at this institution; female political prisoners, such as communists, were incarcerated in the camp, as were Jehovah’s Witnesses, ‘asocials’, Roma and Sinti (‘Gypsies’), and Jews.23 As Nazi policies of persecution intensified, more people were deemed racially, politically or socially unfavourable by the regime and were sent to concentration camps, and Ravensbrück developed physically in response to the increasing influx of inmates.24 From 1942, prisoners considered ‘unfit for work’ were sent to nearby ‘euthanasia’ stations to be killed and gas chambers were constructed on site in 1945.25 Doctors, and at least one nurse, participated in the selections of prisoners to be gassed.26

In alignment with the camp more generally, the hospital at Ravensbrück also evolved, both in terms of its buildings, and with regard to how it functioned as a medical institution. As the historian Romana Santis has noted, the Revier was not a static, unchanging entity.27 It is crucial to conceptualise the hospital as such, since its development – in both a physical and functional sense – affected the levels of agency some of the nurses were able to obtain, and, to an extent, some of their actions as medical workers in the camp. The number of Revier blocks increased steadily over time. When the camp was opened in May 1939, it initially consisted of just one administrative block.28 In 1942, an operating theatre was added, and a further two new hospital blocks were opened in 1943. These developments were due to an increase in prisoners who needed treatment; Herta Oberheuser, a female doctor who worked at Ravensbrück, remarked that ‘the hospital was constantly being enlarged as the number of patients increased’.29 In 1944 the need for even more hospital buildings was so acute that a further seven of the existing barrack blocks were converted into sick blocks. The final phase of Revier development occurred in 1945, with the addition of a maternity block. By the end of the war, there were eleven main Revier blocks, with different wards and rooms within these blocks.30

The provision of medical care at Ravensbrück also changed over the course of its existence. In the early years some treatment was administered to prisoners at the camp, and doctors were employed to provide this care and to help contain epidemics such as typhus. Gerda Weyand, one of the doctors who worked at Ravensbrück between 1939 and 1941, appears to have behaved in line with the Hippocratic Oath (which stipulates that doctors should ‘do no harm’ and strive to treat patients to the best of their ability) according to the testimony of Ravensbrück survivors. Fedi Wawczyniak, a former prisoner of the camp, remarked that this particular doctor used her medical knowledge to treat her jaundice and pneumonia.31

However, as time progressed, medical treatment at Ravensbrück generally grew worse; conventional medical practice became superseded by the perpetration of medical atrocities. From 1943 onwards, lethal injections were administered to prisoners by both doctors and nurses.32 Human experiments also took place at the camp during and after 1942, which were performed without the consent of those who were operated on.33 Some of the nurses at Ravensbrück assisted in various aspects of these experiments, particularly in the preparation of patients to be experimented on. For example, Jadwiga Dzido, a Polish political prisoner who was operated on, remarked that a German nurse shaved her legs and gave her something to drink before she underwent the experiments.34

The medical staff structure at Ravensbrück generally remained fairly rigid throughout the hospital’s existence, and mirrored that of other concentration camps. There was a Standarzt (Head Doctor), who was under the supervision of the chief medical officer in the Inspektion der Konzentrationslager (IKL), which was later absorbed into the SS-Wirtschafts-und Verwaltungshauptamt (WVHA, the SS Main Economic and Administrative Office) in 1942.35 In addition, at any one time, there were also several camp doctors at Ravensbrück, and a handful of nurses.

The actual composition of the medical and nursing staff changed constantly, and for the nursing staff this was reflected in the organisations nurses hailed from. Nurses were initially sent from the NS-Schwesternschaft when the Revier was constructed in 1939, but were later replaced by nurses from the Reichsbund der Freien Schwestern at the end of 1940 or the beginning of 1941.36 This was probably because the Reichsbund der Freien Schwestern was a larger organisation and thus had more nurses available to work at Ravensbrück than the NS-Schwesternschaft.37 More nurses would have been required to work at the camp at this particular time due to the increasing influx of prisoners and therefore a likelihood of more disease. After the Reichsbund der Freien Schwestern and the NS-Schwesternschaft had merged in 1943, nurses who were members of the NS-Reichsbund Deutscher Schwestern came to work at the camp.38 While nurses were conscripted to Ravensbrück throughout the camp’s existence, some did not object to their conscription and welcomed a job at the camp for a variety of different reasons, such as the prospect of a good salary.39

From 1941, the Head Doctor used prisoner nurses and doctors in the Revier, due to shortages of state-employed nurses and doctors.40 The medical and nursing staff at Ravensbrück also frequently changed; they generally worked at the camp for one or two years. Male doctors were often posted to the front to fight, and it appears that nurses only had to undertake a year of compulsory service at the camp. When this year was over, they were often transferred to other places of work.41

Assessing the actions of the Ravensbrück nurses

Why did some nurses commit atrocities when they worked at Ravensbrück? It is likely that at least two nurses contravened medical practice while working at the camp partly as a result of their dedication to Nazi ideology, which stipulated that ‘asocials’ and others considered outside of the Volksgemeinschaft (people’s community) – such as the women who were interned in Ravensbrück – should be persecuted. Most of the nurses who worked there were trained during the Third Reich, and had undertaken courses on so-called ‘racial biology’, which emphasised Aryan supremacy, so it is possible that, influenced by this, they put these ideals into practice at Ravensbrück.42 This links to Susan Benedict’s argument with regard to the nurses who participated in the ‘euthanasia’ that took place at Hadamar psychiatric hospital; she has noted that some of these nurses genuinely believed that what they were doing was contributing to strengthening the German race by eliminating those who fell outside of the ‘Aryan’ ideal.43

One nurse who committed atrocities at Ravensbrück at least partly due to dedication to these ideals was Elizabeth Marschall, the Oberschwester (Head Nurse, or matron, according to older hierarchies of nursing) at Ravensbrück between 1943 and 1945. During proceedings at the first Ravensbrück trial, it became apparent that Marschall had selected prisoners to be gassed, assisted in the human experiments that took place at Ravensbrück by injecting victims with morphine, and deliberately withdrew Red Cross food parcels from sick inmates.44 Marschall’s decision to hide these packages illustrates her determination to exercise cruelty when the opportunity presented itself; this was an action that could have been avoided, but Marschall utilised her position as Oberschwester in the camp to behave in an unnecessarily cruel manner.

Marschall joined the Nazi Party in 1931.45 Caution must be taken not to equate Party membership alone with dedication to Nazi creed, even if, as in the case of Marschall, the individual had joined before the Third Reich came to power, indicating that their decision to join may not have been for opportunistic career reasons.46 However, a statement by Sylvia Salvesen, a former Norwegian political prisoner at Ravensbrück who assisted in the distribution of drugs and bandages in the Revier, indicates Marschall’s commitment to Nazi ideology.47 In her memoir Forgive but do not forget, published in 1958, Salvesen remarked that ‘To her [Marschall] Germany was everything, and Hitler was the Führer who was to make Germany ruler of the world’.48 Marschall may thus have genuinely been committed to the notion of ‘Aryan’ German supremacy and the persecution of those who did not conform to this ideal; this commitment probably influenced her behaviour towards prisoners at Ravensbrück. Indeed, Erika Buchmann noted that Elizabeth Marschall was ‘particularly spiteful to the foreigners amongst us’, indicating that she treated non-German prisoners more harshly.49

Liesbeth Krzok was another nurse who had joined the Nazi Party relatively early, in 1928.50 Krzok also violated traditional conceptualisations of nurses as striving to do their best to aid the health of patients, giving lethal injections to mentally ill inmates.51 Like Marschall, Krzok also treated non-German prisoners with particular contempt; Jacqueline Prat, a French prisoner at Ravensbrück, remarked that Krzok ‘used to say that the French women could die’ as far as she was concerned, and that ‘she called us dirty pigs, dirty French women’.52 It is highly likely that Krzok, along with Marschall, committed atrocities at Ravensbrück as a result of their dedication to the National Socialist cause.

But these are only two examples, and dedication to Nazi ideology does not fully account for the cruel behaviour of the majority of nurses at Ravensbrück. Martha Haake remarked that she ‘did not become a member of the Nazi Party’, but this nurse still administered lethal doses of Luminal to patients.53 Furthermore, not all nurses who trained during the Third Reich and then worked at Ravensbrück embodied the Nazi ideals they were taught. Gerda Schröder was such a nurse; she strived to help prisoners at Ravensbrück despite all her training which would have taught her they were racially and politically undesirable.54 Keith Mant, a British forensic pathologist who collected evidence about the medical conditions at Ravensbrück for the Ravensbrück trials, remarked that ‘She [Schröder], according to all nationalities of the camp, behaved the whole time as a nurse should, and often risked her own safety to help patients’.55 Salvesen recalled that Schröder stole medicine for prisoners, and ‘gave our comrades injections of sugar or grape juice or other things that helped us’. While an injection of grape juice was, and is, outside of conventional nursing practice (in this sense, Schröder did not behave ‘as a nurse should’, contrary to Mant’s statement), it is likely that this particular nurse was striving to supply nutrition to malnourished inmates. Schröder succeeded, to a certain extent, in her aim to help prisoners; Salvesen remarked that ‘It is impossible to say how many hundreds owe their lives to her’.56

Nurse Erna Böhmer also apparently strived to aid prisoners at the camp, although no survivor testimony confirms this. Böhmer recalled in an examination conducted as part of the fourth Hamburg-Ravensbrück trial (she was not a defendant, but rather a witness) that she was sent away from Ravensbrück in October 1944 because she had smuggled letters from a Polish doctor prisoner to another camp.57 With such examples, it is clear that nurses were not passive recipients of Nazi ideology that was simply forced upon them; they possessed the capacity to think freely and critically, and could make choices. Such evidence challenges the emphasis placed by some historians on the passivity of nurses as an explanation for their behaviour, as argued for instance by Hilde Steppe, Michael Burleigh, Bronwyn Macfarlande-Icke and Jochen Kuhla. They have suggested that while nursing as a profession was becoming increasingly professionalised, its status as neither strong nor well-organised before the Second World War contributed to the involvement of nurses in the ‘euthanasia’ programme, since there was no organisation that would have supported any individual objections of nurses to the programme.58 Yet some of the Ravensbrück nurses certainly felt able to avoid participating in the broader policies of persecution at the camp, despite the prospect of a lack of support from their nursing organisations regarding this choice (and the absence of any organisation that would have supported them had they refused to commit medical atrocities). In order to fully elucidate why those nurses who perpetrated atrocities at Ravensbrück did so, we need to look more closely at the specific context of the camp, rather than evoke general statements such as those produced by the aforementioned scholars that do not account for the particular circumstances of individuals.

Immediate, circumstantial factors, which were specific to the Revier, may have motivated some individual nurses to violate medical conventions. Focussing on the day-to-day relations between male doctors and nurses in the camp, for instance, reveals other factors which might have facilitated such behaviour. This can be illustrated in the example of one nurse at Ravensbrück who appeared to perpetrate atrocities due to a romantic interest in a doctor. Salvesen noted that ‘Sister V’, the nurse in question, had fallen in love with Percy Treite, a doctor in the camp hospital, and that she was ‘so infatuated with Dr. Treite that she was willing to do everything to attract his attention’.59 This meant, according to Salvesen, that she obeyed his ‘slightest wish, even giving the death injection to those who were hopelessly ill but who were not dying quick enough…’60 While Salvesen notes that ‘Sister V’ was obeying the male doctor in this instance, she implied that she did so because the sister was infatuated with him. ‘Sister V’ was not simply obeying the wishes of the doctor due to the medical hierarchy when she committed atrocities; rather, other motivations could, and did, come into play. In other words, specific circumstances that surrounded the ‘obedience’ of nurses to doctors need to be taken into account in order to fully understand why some women perpetrated cruelty in the camp hospital at Ravensbrück, whilst others did not. It is not enough to say, as Benedict and other scholars have done, that the long-standing obedience of nurses to doctors fully explains their actions. Such an argument does not take into account other potential causes, causes which might be much more personal and individual.

However, analysing individual motivations does not fully explain the actions of the nurses in the Revier. It is important to also examine how the development of the Revier over time, in terms of its physical size and its function, influenced the actions of the nurses who worked there. Looking at how nurses came to commit atrocities, as well as why, sheds further light on the violations of ‘normal’ nursing conventions that took place at Ravensbrück. The spatial development of the camp hospital was a significant factor which provided nurses more agency in their day-to-day roles; while theoretically subordinate to doctors, they could often act independently to influence the conditions of prisoners without oversight or influence of doctors. The expansion of the Ravensbrück Revier, which began in 1942, left nurses in sole charge of individual Revier blocks, as was noted by Keith Mant.61 Yvonne de Soignes, a former camp prisoner, also noted that nurses were often alone in their blocks.62 The fact that nurses were increasingly in sole charge of individual Revier blocks as it expanded meant that it was they who decided who was eligible to see a doctor, apparently without permission of the Oberschwester (Head Nurse, or matron).

Nurses often used this power to maltreat the prisoners under their ‘care’; the spatial development of the Revier over time was thus a factor that could influence the behaviour of nurses. The fact that nurses were in day-to-day charge of some blocks, as opposed to doctors, meant that they had the power to decide if a prisoner could be admitted to that particular block or not, and, in some cases, whether they would live or die. Helena Goudsmit, a former prisoner of the camp, remarked that nurse Erika Milleville repeatedly refused admission of one woman to the main hospital on the grounds that she was not sufficiently ill.63 Elisabeth De Ripper, a former prisoner of the camp, recalled that ‘never did a doctor come to my block to certify death’, and added that when Martha Haake gave a ‘rapid glance at the body and without even touching the bodies, she would order them to be removed with a monosyllabic “Ab” [meaning in this context, ‘away’] full of disdain and disgust’.64 This behaviour of Haake was not exceptional but was representative of how other nurses behaved; Annette Eeckman, another former prisoner, remarked that ‘death was certified by the SS-Schwestern and not by a doctor’ and that they ‘stayed some distance away and just gave the body a glance. It was known to everybody that it happened that bodies placed in the morgue “came back to life”’.65 Such callous and careless attitudes were embodied by some of the Ravensbrück nurses. With regard to Haake specifically, De Ripper also remarked that she ‘was most inhuman towards the patients and was strongly opposed to the use of drugs for those who were old or unlikely to be able to work after recovery’, clearly violating traditional, pre-Nazi, understandings of a nurse’s role.66

The rapid growth of the Revier also meant that nurses could become responsible for multiple blocks, giving them an increased level of agency in the sense that they were responsible for a greater number of prisoners without oversight. Martha Haake recalled in her deposition produced for the fourth Hamburg-Ravensbrück trial that in autumn 1944 she took over blocks seven and eight of the Revier in addition to the block she was already in charge of. Haake’s jurisdiction over the three blocks afforded her a significant level of power, which she used to maltreat prisoners.67 According to the testimony of Elisabeth De Ripper, the unsupervised Haake was able to change the discharge status of prisoners in block eight, causing more to be discharged, in spite of the orders of Dr. Lucas, one of the camp doctors, for them to remain as inpatients due to their poor state of health.68 While it is possible that Haake discharged patients she considered well enough in order to relieve overcrowding on her wards, it is also highly likely that she was fully aware of the fate that waited them (they would be sent to the gas chambers) and was entirely comfortable with this.69

Haake’s actions reflect the power nurses possessed ‘on the ground’ in the Revier to act on their own volition, disregarding the orders of doctors to whom they were hierarchically subordinate. Obedience was undoubtedly an important part of nursing culture in Germany (and in other countries, such as the United States and Britain), but this did not mean that nurses always obeyed doctors, nor that the Ravensbrück nurses behaved in the ways they did because of this broader culture of obedience. Since Haake seemingly acted on her own volition – she did not follow the orders of a superior, instead deliberately defying him – this traditional, historical explanation of obedience cannot sufficiently explain Haake’s (or indeed others’) actions. The problem with evoking the ‘obedience’ argument is that it does not allow for situations where nurses deliberately disobeyed their superiors to perpetrate atrocities (or, indeed, to perform kind acts for prisoners, as we have seen in the case of Schröder). As Thomas Foth and Susan Benedict have noted, from the early twentieth century, nurses were in fact beginning to possess an independent sphere of action apart from doctors, even if they remained hierarchically subordinate to them and a culture of obedience still prevailed.70 But this emergence of growing independence from doctors does not sufficiently explain how the Ravensbrück nurses were able to act in the ways they did in the specific context of the camp. The spatial development of the Revier provided Haake and others with the ability to behave cruelly.

Although Elizabeth Marschall was probably ideologically motivated to violate medical conventions in her role as a nurse at Ravensbrück, this does not fully explain how she was able to put her beliefs into practice at Ravensbrück. It is therefore important to also consider the specific time when particular nurses were at the camp as a factor that facilitated their violation of conventional ideas about medicine and nursing. The decision of leading SS officials in 1942 to take prisoners from Ravensbrück to other locations to be gassed, and then to gas them on site from 1945, allowed Marschall to personally participate in these selections, and she was found guilty at the first Hamburg-Ravensbrück trial of selecting prisoners to perish in this manner.71 Marschall admitted this in her deposition: ‘It is true that I was present at some selections, and carried out some selections for working transports myself’.72 The inclusion of the word ‘working’ here is a misnomer, used to conceal the real purpose of these transports, which sent prisoners to their deaths. While the situational factors discussed in this article cannot fully explain why nurses personally chose to do the things they did – a question that is impossible to fully answer – and certainly cannot be evoked to mitigate the actions of nurses, they do indicate what directly facilitated some of their behaviour.

However, sometimes the actions of individual nurses were not always facilitated by the spatial development of the Revier nor by the particular time in which they worked at Ravensbrück, but could also be borne out of the particular positions they held in the camp hospital. Some posts in the camp hospital from the very beginning, even before expansion began, provided nurses with the opportunity to exercise cruelty. The fact that Erika Milleville was in charge of the pharmacy, as Keith Mant noted in a report about the medical services at the camp, meant that she was in the position to withdraw medication. Milleville had the power to choose who, if anyone, was entitled to the limited supplies of medicine the pharmacy received from the main sanitary office in Berlin, and she frequently refused treatment to ill patients. Yvonne de Soignies noted that Erika Milleville was ‘callous’ in her decision-making, ignoring how ill prisoners were when deciding if a patient should receive medicines or not.73 Sylvia Salvesen confirmed this as she recalled that ‘The quantity of drugs and bandages I received depended on Sister Erika who was in charge of the dispensary and she issued them according to her mood’.74 Elizabeth Marschall’s position as Oberschwester enabled her to have a say in selections for prisoners to be gassed, and gave her the freedom to commit other atrocities. Sometimes, then, it was the intermeshing of different circumstantial factors that facilitated the actions of individual nurses at Ravensbrück.


Gerda Schröder stated in an interview conducted in 1995, fifty years after she left her job as a nurse at Ravensbrück, that she ‘never naturally’ believed that she would be in ‘such a situation’, referring to her position as a nurse at the camp.75 While Schröder did not contravene conventional nursing practice, some of the other nurses who worked at Ravensbrück did. Whether the Ravensbrück nurses deliberately sought opportunities to be cruel is questionable. Elizabeth Marschall and Erika Milleville almost certainly did, since they refused to administer available medication to inmates. The case of Martha Haake, on the other hand, is different; the British military court that tried her after the war was not convinced that she had given Luminal to prisoners with full knowledge of its capabilities.76 However, Sylvia Salvesen later remarked (in an admittedly somewhat sensationalist manner) that ‘the sick who took her sleeping powder did not see her evil smile’, indicating that Haake had been aware that she was poisoning prisoners.77 Furthermore, other actions Haake committed in the Revier that so contravened conventional nursing practice – such as discharging patients without the permission of doctors – were deliberate and calculated. These cases certainly suggest that the agency of the Ravensbrück nurses, and the fact that they had choices, must always be kept in mind when trying to determine what was happening in the camp hospital.

In order to fully understand how the Ravensbrück nurses were able to perpetrate such medical atrocities, it is necessary to delve deeper into their working environments, through spatial and temporal lenses. The physical development of the Revier provided nurses with a considerable degree of agency, since they were in charge of their own sick blocks, with little or no supervision, and some of these women had jurisdiction over multiple blocks. This afforded them the freedom to treat prisoners as they wished, and some undoubtedly utilised the jurisdiction they possessed over inmates to maltreat them. Nurses were thus often able to act without the permission or influence of doctors, going beyond their theoretically subordinate position as part of the medical hierarchy. More broadly, then, when situated within a relatively unregulated work environment, medical and nursing personnel can, and did, act in a manner at odds with ‘normal’ medical practice. The Ravensbrück Revier – and its spatial development over time – enabled nurses to exercise power, and some took this to its extreme by administering lethal injections, withdrawing medication, and physically hitting or otherwise maltreating prisoners.

For at least one nurse, the specific time in which they were at the camp created a unique additional opportunity for power. Elizabeth Marschall happened to be there when the gassing of prisoners at Ravensbrück itself was introduced, thus she was able to participate in the selection of prisoners for the gas chambers. Ultimately, however, it was the spatial development of the Revier that provided the majority of the Ravensbrück nurses with the opportunity to exercise cruelty. This has broader implications for how scholars consider space in relation to women in history; the social scientist and geographer Doreen Massey has noted that the spatial limitation of women’s mobility has been in some cultural contexts a ‘crucial means of subordination’.78 Yet particular spaces ought to be conceptualised as not just limiting women’s social mobility and subordinating them, but as enhancing their agency and status, as was the case with regard to the Ravensbrück nurses. Lastly, it is worth reiterating that inserting the physicality of the Revier into an analysis of the actions of the Ravensbrück nurses does not intend to absolve them of their behaviour or to take away their individual agency as historical actors with choices. Rather, taking this approach enables a more detailed insight into the everyday factors that framed the actions of these female medical personnel, beyond simply the over-hashed themes of ideology and obedience. When we look at why nurses behaved cruelly in other historical contexts, then – beyond the Third Reich – we ought to look at the particular circumstances in which they operated in if we want to glean a nuanced understanding of what sparked their behaviour.


  1. The National Archives (hereafter TNA), WO 309/416, ‘Deposition of Martha Haake’, 1 August 1947.
  2. TNA, WO 309/416, ‘Report by Field Investigation War Crimes Group’, 18 April 1946.
  3. TNA, WO 309/416, ‘Deposition of Helena Goudsmit’, 9 July 1947.
  4. TNA, WO 309/416, ‘Report by Field Investigation War Crimes Group’, 18 April 1946.
  5. Thomas Foth, Jochen Kuhla and Susan Benedict, ‘Nursing during National Socialism’, in Susan Benedict and Linda Shields (eds.), Nurses and Midwives in Nazi Germany (London: Routledge, 2014), 34, 29.
  6. Susan Benedict, ‘The Nadir of Nursing’, Nursing History Review, 11 (2003), 142. Prisoner nurses, in addition to state-employed nurses, also worked in the camp hospital. Some of these nurses committed medical atrocities, but since their motivations were different – for example, survival – they do not form part of the discussion in this article.
  7. Ute Frevert, Women in German History (New York: Berg Publishers, 1997), 58.
  8. Claudia Koonz, Mothers in the Fatherland (New York, 1987), 5. Atina Grossmann, ‘German Women Doctors from Berlin to New York’, Feminist Studies, 19 (1993), 66.
  9. Elisa Mäilander, Female SS Guards and Workaday Violence (Michigan, 2015). Melissa Kravetz, Women Doctors in Weimar and Nazi Germany (London: University of Toronto Press, 2019).
  10. James Hinton, Nine Wartime Lives (Oxford: Oxford University Press, 2011), 18.
  11. TNA, WO 309/416, ‘Report by Field Investigation War Crimes Group’, 18 April 1946. According to Keith Mant, the British forensic pathologist who gathered evidence about the medical crimes committed at Ravensbrück, Haake probably gave a dose of 5 grams of pure Luminal powder to prisoners; a lethal dose (the therapeutic dose being one and a half to two grams). See TNA, WO 235/315, Letter from Keith Mant to Major Stewart, ‘Analysis of “white powder” used in Ravensbrück’, 24 March 1947.
  12. Foth, Kuhla and Benedict (eds.), ‘Nursing during National Socialism’, 34.
  13. Alison O’Donnell, Susan Benedict and Linda Shields, ‘Nursing During National Socialism’, in Bev Clucas, Gerry Johnston and Tony Ward (eds.), Torture: Moral Absolutes and Ambiguities (Baden-Baden: Nomas, 2009), 155, 103.
  14. Bundesarchiv Berlin (hereafter BArch Berlin), NS 37/1036, Soziales Amt, Der Leiter des Sozialen Amtes, gez. Axmann, ‘BDM und Schwesternnachwuchs’, 25 November 1936. TNA, WO 235/530, Martha Haake Duly Sworn Defence Statement’, undated.
  15. BArch Berlin, NS 37/1040, ‘Der N.S.R.S’, undated, but probably written in 1943.
  16. TNA, WO 235/530, Martha Haake Duly Sworn Defence Statement’, undated.
  17. Mary Lagerwey, ‘The Third Reich in the Pages of the American Journal of Nursing’, Nursing History Review, 14 (2006), 64.
  18. Thomas Foth, ‘Understanding caring through biopolitics’, Nursing Philosophy, 14 (2013), 291.
  19. Bronwyn McFarlande-Icke, Nursing in Nazi Germany (Princeton: Princeton University Press, 1999), 34.
  20. Mary Lagerwey, ‘Nursing Ethics at Hadamar’, Qualitative Health Research, 9 (1999), p.764.
  21. Christoph Schweikardt, ‘The National Socialist Sisterhood’, Nursing Inquiry, 16 (2009), 105.
  22. Cited in Ramona Santis, ‘Topografien der medizinischen Versorgung durch Häftlinge im Lagerkomplex Ravensbrück‘, in Ramona Santis and Christl Wickert (eds.), “Unmöglich, diesen Schrecken aufzuhalten”. Die medizinische Versorgung durch Häftlinge im Frauen-KZ Ravensbrück’(Metropol Verlag: Berlin, 2017), 31.
  23. Elissa Mailänder, ‘The Violence of Female Guards’, Online Encyclopaedia of Mass Violence, 5 February 2015, 5.
  24. Jack Morrison, Ravensbrück (Princeton: Wiener, 2000), 14. Benedict, ‘The Nadir of Nursing’, 130.
  25. TNA, WO 235/305, ‘Opening Speech of the First Ravensbrück Trial by Major Stewart’, 3 December 1946.
  26. TNA, WO 309/416, ‘Report by Field Investigation War Crimes Group’, 18 April 1946.
  27. Santis, ‘Topografien der medizinischen Versorgung durch Häftlinge im Lagerkomplex Ravensbrück‘, 43.
  28. TNA, WO 309/149, Major Arthur Keith Mant RAMC, Special Medical Section War Crimes Group, H.Q. B.A.O.R, ‘Ravensbrück Concentration Camp report on the Medical Services, Human Experimentation and various other atrocities committed by medical personnel in the camp’. The final version of this report was produced on 1 September 1949, but other earlier versions appear to have been written before the start of the Ravensbrück trials in December 1946.
  29. Nuremberg Medical Trial, ‘Examination of Dr. Herta Oberheuser’, 3 April 1947, microfiche number 061.
  30. TNA, WO 309/149, ‘Ravensbrück Concentration Camp report on the Medical Services…’.
  31. Rheinland-Pflaz Landesarchiv (hereafter Landesarchiv Speyer), R 18 Nr. 17451, ‚Beglaubigte Abschrift‘, Fedi Wawczyniak, 2 November 1949.
  32. The report of Keith Mant, a British forensic pathologist who was head of the Medical Section of the British War Crimes Group in the immediate post-war period, provides useful information about the development of the Revier’s infrastructure over time. See TNA, WO 309/149, ‘Ravensbrück Concentration Camp report on the Medical Services…’ For the changing function of the Revier, see TNA, WO 235/769, JAG Report, 24 June 1948. The changing nature of the Revier is also noted in numerous testimony given by survivors of the cam
  33. For more on the human experiments that occurred at Ravensbrück, see Ulf Schmidt, ‘The Scars of Ravensbrück: Medical Experiments and British War Crimes Policy’, German History, 23 (2005), p20-49. See also: Freya Klier, Die Kaninchen von Ravensbrück (Munich: Droemer Knaur, 1994) and Alexander Mitscherlich and Fred Mielke, Doctors of Infamy (New York: Henry Schuman, 1949).  
  34. Nuremberg Medical Trial, ‘Extracts from the Testimony of Prosecution Witness Jadwigo Dzido’, 20 December 1947, fiche no. 062.
  35. Nikolaus Wachsmann, KL: a history of the Nazi concentration camps (London: Little Brown, 2015), 111.
  36. This change probably occurred because the Reichsbund der Freien Schwestern was a larger organisation with more nurses available to be posted. Furthermore, NS-Schwesternshaft nurses usually initially appeared to work mostly in Nazi welfare groups, such as the Mutter und Kind (Mother and Child) organisation.
  37. BArch Berlin, NS 37/1040, ‘Der N.S.R.S’ (‘The National Sozialistische Reichsbund Deutscher Schwestern’), Undated, but  probably  written  in 1943.
  38. Bundesarchiv Ludwigsburg, B162/461, ‘Zentrale Stelle der Landesjustizverwaltungen Ludwigsburg, Zur Person: Doris Maase’, 4 January 1972.
  39. TNA, WO 235/530, ‘Martha Haake Duly Sworn Defence Statement’, undated.
  40. Santis, ‘Topografien der medizinischen Versorgung durch Häftlinge im Lagerkomplex Ravensbrück‘, 42.
  41. Mahn- und Gedenkstätte Ravensbrück archive (MGR), RAV-VA/107, Interview with Gerda Schröder, April 1995.
  42. BArch Berlin, NS 37/1036, Soziales Amt, Der Leiter des Sozialen Amtes, gez. Axmann, ‘BDM und Schwesternnachwuchs’, 25 November 1936.
  43. Susan Benedict, ‘Killing while caring’: The Nurses of Hadamar’, Issues in Mental Health Nursing, 24 (2003), 75. Over 10,000 people with physical and mental disabilities were killed by nurses and doctors at Hadamar between the years of 1941 and 1945 as part of the ‘euthanasia’ programme.
  44. TNA, WO 236/317, ‘Deposition of Elizabeth Marschall’, 27 November 1946. TNA, 235/318, ‘Second Deposition of Helena Plasecka’, undated. Benedict, ‘The Nadir of Nursing’, 137.
  45. TNA, WO 235/308, ‘Major Stewart’s address’, 30 January 1947.
  46. Herta Oberheuser and Gerda Weyand, two of the female doctors who worked at Ravensbrück, likely joined the Nazi Party in 1937 and 1938 respectively – close to when they graduated from medical school – because doing so would enhance their medical careers, since many doctors were Party members. See Stadtarchiv Düsseldorf, 0-1-5 Bestand V Personalakten, 0-1-5-11609.0000, Herta Oberheuser, ‘Fragebogen über Zugehörigkeit zu politischen Parteien usw.’, 30 June 1939 and RPL, R 18 Nr. 17451, Gouvernement Militaire en Allemagne, ‘Fragebogen’, 30 September 1949.
  47. TNA, WO 235/318, ‘Deposition of Sylvia Salvesen’, 15 September 1946.
  48. Sylvia Salvesen, Forgive but do not forget (London: Hutchinson, 1958), 211.
  49. TNA, WO 235/318, ‘Deposition of Erika Buchmann’, 8 May 1946.
  50. TNA, WO 235/530, ‘Liesbeth Krzok Duly Sworn Defence Statement’, undated. TNA, WO 309/416, ‘Deposition of Liesbeth Krzok’, 1 August 1947.
  51. TNA, WO 309/416, ‘Report by Field Investigation War Crimes Group’, 18 April 1946.
  52. TNA, WO 235/304, ‘Deposition of Jacqueline Prat’, 26 November 1947.
  53. TNA, WO 235/530, Martha Haake Duly Sworn Defence Statement’, undated.
  54. TNA, RW/7/22, ‘Deposition of Gerda Schröder’, 25 September 1946.
  55. TNA WO 309/149, ‘See TNA, WO 309/149, ‘Ravensbrück Concentration CamA report on the Medical Services…’.
  56. Salvesen, Forgive but do not forget, 126, 124.
  57. TNA, WO 235/307, ‘Examination of Erna Böhmer by Dr. Von Metzler’, 18 January 1947.
  58. Shields and Foth, ‘Setting the Scene’, 8.
  59. Salvesen, Forgive but do not forget, 144.
  60. Ibid.
  61. TNA, WO 309/149, ‘Ravensbrück Concentration Camp report on the Medical Services’…’
  62. TNA, WO 309/416, ‘Deposition of Yvonne de Soignies’, 7 July 1947.
  63. TNA, WO 309/416, ‘Deposition of Helena Esther Goudsmit’, 9 July 1947.
  64. TNA, WO 309/692, ‘Deposition of Elizabeth De Ripper’, 16 July 1947.
  65. TNA, WO 309/416, ‘Deposition of Annette Eeckman’, 8 July 1947.
  66. TNA, WO 309/692, ‘Deposition of Elizabeth De Ripper’, 16 July 1947.
  67. TNA, WO 235/530, Martha Haake Duly Sworn Defence Statement’, undated. TNA, WO 235/531, ‘Closing Address for the accused Martha Haake’, undated.
  68. TNA, WO 309/692, ‘Deposition of Elizabeth De Ripper’, 16 July 1947.
  69. TNA, WO 309/416, ‘Report by Field Investigation War Crimes Group’, 18 April 1946.
  70. Foth, Kuhla and Benedict (eds.), ‘Nursing during National Socialism’, 34.
  71. Anise Postel-Vinay, ‘Gaskammern und die Ermordung durch Gas im Konzentrationslager Ravensbrück’, in Sigrid Jacobeit and Grit Philipp (eds.), Ravensbrück (Stiftung Brandenburgische Gedenkstätten, 1997), 37. TNA, WO 235/305, ‘Opening Speech of the First Ravensbrück Trial by Major Stewart’, 3 December 1946.
  72. TNA, WO 236/317, ‘Deposition of Elizabeth Marschall’, 27 November 1946.
  73. TNA, WO 309/416, ‘Deposition of Yvonne de Soignies’, 7 July 1947.
  74. TNA, WO 235/318, ‘Deposition of Sylvia Salvesen’, 15 September 1946.
  75. MGR, RAV-VA/107, Interview with Gerda Schröder, conducted by Sigrid Jacobeit, April 1995.
  76. TNA, WO 235/769, ‘Prosecutor’s Report’, undated.
  77. Salvesen, Forgive, but do not forget, 119.
  78. Doreen Massey, Space, Place and Gender (Cambridge: Polity Press, 1994), 179.