"It was really bad. It had nothing whatsoever to do with a hospital or medical care," said Elke* of what happened to her over 50 years ago in a sexual health clinic in the German Democratic Republic(GDR).
Women and girls from the age of 12 were rounded up by the East German criminal police on suspicion of having sexually transmitted infections — in reality, Elke said, it was a form of punishment or "reeducation" because "they didn't fit into the system."
The women and girls were taken to secure sexual health clinics (then called "Venerologische Stationen" or "venereal wards") where they were detained for weeks at a time and systematically abused. The testimonies of women held in the clinics include accounts of rape and torture.
"It was the systematic abuse of power by a political system," said Florian Steger, chair of the Institute of the History, Philosophy and Ethics of Medicine at Ulm University.
Steger interviewed over 100 women and former staff members and examined the "endlessly more detailed" documentation archived by agencies like the Ministry for State Security (Stasi).
The women and girls — never men or boys — who were targeted, Steger said, were considered different from mainstream society because they wanted to live their lives freely. That meant, he said, they may have done something like skipping school or hitchhiking to get to the disco on Saturday night. Many were accused of being sex workers.
Medical system instrumentalized to discipline and punish
"The aim was to mold socialist women who would live regular lives, who would go to work, eventually have a husband, have a child and then work themselves," Steger explained.
And so, a part of the medical system was instrumentalized for ideological ends: Clinics were used to abuse women and girls, to discipline and punish, under the pretext that they were carrying STIs.
"It's important to note that these women don't have a good platform, because they often come from difficult circumstances," Steger said. "Many of these women had already experienced abuse in their childhood and teenage years."
After her parents died, 12-year-old Elke entered into the state children's care home system. At the age of 16, Elke said she was raped by a Russian officer which resulted in a pregnancy.
She reported the officer to Russian authorities and was questioned several times. Later, however, she found that the documents with her statements had disappeared from her file.
She was quite rebellious, she said, but never skipped work, never stole or engaged in sex work. Without any state support and struggling to make ends meet, she just wanted to take care of herself and the child, whom she refused to give up for adoption, though he was taken away.
Just turned 18, Elke was at work in a department store when the police came for her "one fine morning" in 1970.
They said they wanted to clear up a police matter, but Elke was taken to a clinic in Halle where she was forced to hand over her belongings, given a gray gown to wear and locked in an overcrowded ward where some "patients" slept on the floor.
Internal examinations and cocktails of drugs
Elke was told she had gonorrhea — a lie, she said. "I had no husband, no boyfriend, I had nothing. I was consumed by the rape and [taking care of] a child, I didn't get to have people around me," she said.
Research suggests that only around 20% of those held in the clinics were actually infected with an STI. The women and girls in the clinics had their hair shaved off. Those who stepped out of line were given painful injections of an unknown substance that resulted in aching limbs.
After one such incident, Elke was transferred to another clinic in Leipzig, one of a network in cities throughout the GDR, including Dresden, Rostock and East Berlin.
Elke described how detainees were subjected to daily gynecological examinations where a speculum heated with a Bunsen burner was inserted into the vagina up to the cervix.
She recalled being given a cocktail of drugs that left her incapacitated for three days. She still wonders whether that caused the chronic kidney disease that has plagued her since the age of 20.
It's difficult to give an exact number for how many women and girls passed through the clinics, but the tally runs into the thousands — up to 5,000 in the city of Halle alone.
But while the widespread abuse that took place in East German children's homes and juvenile detention centers (the notorious "Jugendwerkhöfe") has been well-researched and documented, little is widely known about what happened in the secure clinics.
Lasting physical and psychological consequences
"It's a particularly dark chapter in history. No one really wants to hear about it," said Christine Bergmann, a member of the Independent Commission on Child Sexual Abuse and the only person on the commission born and raised in the GDR.
"They called these clinics 'Tripperburgen' ('Clap Castles') and people might have laughed about it because it wasn't known what really went on there," she said.
Aside from the stigma attached to the clinics, women were forced to sign nondisclosure agreements and forbidden from talking about what happened to them there.
Established by a resolution in the Bundestag in 2016, the Independent Commission on Child Sexual Abuse investigates the extent, nature and consequences of child sexual abusein the Federal Republic of Germany and the GDR.
The commission has already conducted investigations and hearings on physical and sexual abuse in the GDR. Now its focus has turned to secure institutions like the clinics.
The severe trauma of what happened in the clinics meant many of the victims could not complete their education or ended up in state care homes and suffered lasting physical and psychological consequences.
Sleep disorders and difficulty establishing long-term relationships are also common. For decades, many were too terrified to seek professional help.
"What needs to be made clear is that no one has been held accountable for this, no one has been punished for this anywhere," said Bergmann.
The statute of limitations has expired, meaning legal proceedings can no longer be brought. Many of the witnesses, victims and perpetrators have also passed away.
The hope is that more research can be conducted, which would enable more women to speak out, to document and acknowledge what happened to them so that this dark chapter in GDR history is never forgotten.
Experts are calling for more research into the subject, better access to archived material and an expanded support system for those affected, including compensation and counseling.
Speaking from her home in Saxony-Anhalt, Elke said she was lucky. By losing her parents at a young age and growing up in the children's home system, she learned to be strong and fight her way through life.
After a pause, she continued. "The only thing I had was psychological. I was devastated because I just couldn't stand so much injustice," she said, slowly breaking down into tears.
(*Name changed to protect anonymity.)
Edited by: Rina Goldenberg
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