Photo Gallery: Moving Beyond Hate
Hospital of Hope City Marred By Xenophobia Seeks to Reinvent Itself
By 11 a.m., as the fog slowly lifts and crows circle above the communist-era highrises, matters of life and death have begun to mark the day in the eastern German town of Hoyerswerda -- as they do so often. Chief Physician Robert Donoval, a 36-year-old from Prague, stands next to a patient he thinks is suffering from stomach cancer. He's about to perform an endoscopy. The syringe is ready and, in a comforting sing-song voice that puts elderly women at ease, he says: "You sleep nicely and I'll do the work for you."
In the obstetrics and gynecology department, one floor above the physician from Prague, a Lebanese doctor is running an ultrasound transducer across the belly of a pregnant woman who is experiencing premature contractions. On his monitor, he is searching the fetus for a pair of testicles, to no avail. Then, suddenly, he spies a small vulva. "I see a girl," he says, smiling. The mother sheds tears of joy.
In the pediatrics ward next door, 36-year-old Senior Physician Tarik Galil, from Sudan, listens to a child's bare belly using Günter, the talking stethoscope. Günter tickles and the doctor speaks in a Mickey Mouse voice. The child giggles.
Helping to deliver life and to delay death is the daily business at this hospital in Hoyerswerda, a city 160 kilometers (100 miles) south of Berlin. The clinic is located in a remodeled, concrete box with six floors; it is surrounded by residential buildings, a small supermarket and a fitness club. The revolving door deposits people inside the hospital -- healthy ones carry flowers and chocolates, the ill or injured can be seen in dressing gowns, head bands, arm slings or with bandaged wounds. Quite a few are in wheelchairs.
A Dubious Honor
After the collapse of communism in 1989, there was less of everything here -- less coal mining and fewer people, with half moving away. With an exodus of youth, the city quickly grew old. One 2011 study found that Hoyerswerda had become home to the highest share of dementia patients of any city in Germany, with one-third of the local population aged 65 or older.
Built as a model socialist concept city by the Communist Party, Hoyerswerda was home to 70,000 residents during the East German days. That meant the construction of lots of drab, gray buildings, many of which are now tagged for demolition. The city now has a population of less than 35,000 and dandelions have begun taking over unused lots. The craters in the lunar landscape surrounding the city, left behind by years of strip mining, are now being flooded with water, part of plans to create one of Europe's largest lake districts.
Wolves have been sighted in the area, with 12 packs known to be living in in the surrounding Lausitz region. Nature, it seems, is reclaiming the area. These days, city planners and sociologists travel here to study the effects of population exodus and demographic transformation and to see if something can be learned from this shrinking city.
A Bold Experiment in a City with a Past
The hospital, though, has remained. It is the primary healthcare provider for the region, a mid-sized facility with 440 beds, 131 doctors, around 20,000 inpatients and 40,000 outpatients per year. It's also the city's largest employer. In order to prevent it from going under, administrators have launched an experiment -- that of hiring foreign doctors to fill vacant positions. Today, one out of three doctors in the facility is not German. Around 50 doctors from 16 different nations work here, not counting those who have already become naturalized citizens.
The region will continue to waste away and it is too late to turn things around. But medical workers and doctors from Eastern Europe, the Muslim world and Africa are at least helping this transformation take place with dignity -- and helping in the search for recipes to address the shortage of doctors and nurses experienced elsewhere in Germany as well.
As an added bonus, the experiment may even help curb the xenophobia that has plagued the region for decades. Hoyerswerda, after all, has a dark past -- one well known to most in Germany. In 1991, just two years after the fall of the Berlin Wall, xenophobic riots in the city saw right-wing mobs attack hostels for foreign contract workers and asylum seekers. Dozens were injured and the city became a no-go area for foreigners.
Detectable Xenophobia
A typical day of patient visits with pediatrician Galil shows that xenophobia is still present. "The hostility is latent, but it is there," says Galil, who adds that his European colleagues don't have a problem. "It's because of the color of my skin." Almost as if to prove it, he begins calling in his young patients. They aren't the problem, it's their parents.
Fabian, 5, a child wearing green rubber boots with a runny nose and a terrible cough, walks into the room with his mother, a heavy-set woman with lavender streaks running through her blonde hair. When she sees the doctor, she guffaws. Galil bears a slight resemblance to the younger Michael Jackson, back when his skin was still dark. He wears a white lab coat -- and wears his thick curls in an Afro. "Look Fabian," the mother says, "the man's hairdryer blew up in his face."
The father of little Max, the next patient, who appears to be suffering from a stomach ache after eating too many potato chips, is almost aggressive in his ironic tone. "You must have had to learn a lot from us -- the language, how to behave and now to become a nurse -- respect!"
Senior Physician Tarik Galil is familiar with all such reactions and sometimes he says he feels like a development aid worker. He once considered going to Africa with Doctors without Borders, but he instead landed at this hospital in the state of Saxony, which he says is comparable.
He had just arrived in Germany as a 12-year-old when he first heard of Hoyerswerda. The city was featured on the news on TV and his mother made him promise that he would never go there.
He had fled the civil war in Sudan with his parents and his four siblings and they were living at the time as asylum seekers in Germany near the Dutch border. Sure, he says, they heard racial epithets, but they generally grew up among tolerant, liberal people. At home, the family only spoke German and his dad even kept a dictionary at the dinner table in case they needed to look up words. Of the five, one is a law professor and several others are doctors. Tarik became a senior physician in the western state of North Rhine-Westphalia and all of the siblings have since become German citizens.
The pediatrician wound up in Hoyerswerda despite his mother's warnings. Now the father of two small children and with a mortgage to pay, Galil came to check out the town by covering for other doctors on vacation. On the day of his arrival, he says he asked for directions to the hospital at the train station, only to have people turn away from him. He says he seldom left his hotel, where he still lives today. "The 30- to 60-year-olds are okay," he says. "Those who are younger are skinheads and the older ones are old Nazis. It's sad, but that's how I see it." He says racism in Germany was also one of the reasons he decided to specialize in pediatrics. "You can still help kids to change -- you're working towards life, not against death," he says.
The Prelude to a Bad Chapter in German History
The events that make Galil's mother so fearful back then -- and which continue to traumatize Hoyerswerda to this day -- took place on five autumn days 23 years ago. On Sept. 17, 1991, a pair of young German men began beating up Vietnamese workers. The immigrants barricaded themselves inside a hostel for East German-era contract workers from Vietnam and Mozambique at a local brown coal processing plant. Assailants threw rocks and Molotov cocktails, injuring 32 people at the contract worker hostel and a hostel for asylum seekers. The riots raged out of control for days, with hundreds of locals shouting hateful slogans in front of the hostels. Finally, authorities decided to transport the foreigners out of the city in buses. The mob on the street screamed epithets at the immigrants and cheered their departure. They declared Hoyerswerda to be "free of foreigners."
If you ask people today, whether in eastern or western Germany, about what happened back then in Hoyerswerda, they are often fuzzy on the facts. At the time, a politician said the riots were "about the worst" thing to happen in Germany since Kristallnacht, as the anti-Semitic pogroms of November 1938 are called.
Yet the hostels of Hoyerswerda were not burned and nobody was killed. That came later, mostly in the West.
Hoyerswerda, in fact, was the first in a series of xenophobic attacks in early 1990s-Germany. It was as though the riots there had opened a valve, making the worst imaginable things possible, including arson and murder. One year after Hoyerswerda, local residents set fire to a hostel for foreign workers in Rostock. In November 1992, two homes belonging to a Turkish family were set on fire in the city of Mölln in Schleswig-Holstein in northwestern Germany, killing the grandmother and two granddaughters. Finally, in May 1993, three days after Germany's asylum laws were tightened, four young men committed an arson attack on the home of Turkish immigrant workers in Solingen in North Rhine-Westhphalia, resulting in the deaths of five people, including three children. The victims either burned to death or died trying to jump out of the window.
It appeared that dark Germany had regained the upper hand, and there was considerable outrage worldwide. Just after the attacks, then-SPIEGEL reporter Matthias Matussek wrote extensively about Hoyerswerda. He said the city had become a synonym for neo-Nazi rot where "the ugly German has had his coming-out."
A City Sets Out to Reinvent Itself
The city's image after the attack couldn't get any worse, leaving residents with a choice: either pack up and go, or reinvent themselves. Andreas Grahlemann, the longtime CEO of the Hoyerswerda hospital, sensed this as well. The proactive 61-year-old civil engineer is sitting in the Hotel Achat, the same place where pediatrician Galil spends his evenings avoiding local Nazis.
Grahlemann took over management of the hospital in 2006 and ran it for eight years, until last summer. He started working there at a time when the clinic could barely afford to pay its workers' salaries. Entire wards at the hospital were abandoned, doctors had moved out and new people didn't want to come to replace them. His predecessors received special allowances for their willingness to work in the east, but they ultimately were unable to stop the facility's deterioration.
It was Grahlemann's idea to recruit foreign doctors to the area. Without the Czechs, Slovaks, Poles and doctors from the Middle East, he is fond of saying, the hospital would have to close.
First of all, though, Grahlemann decided to change the hospital's name. The name of the city, with its troubled past, had to disappear so he instead focused on something more positive -- the new lake district being created in the area. Grahlemann decided to rename it the Lausitzer Lake District Clinic: The Academic Teaching Hospital of the Dresden Technical University. Hoyerswerda now only appears in the fine print, in the line that includes the address. The hospital executive also designed a chic and friendly new logo that includes elements representing the water, the forest and the sky.
Attracting doctors proved to be a more difficult task. "What does a doctor want to do?" Grahlemann asked himself. "A doctor wants to work ... perform operations, establish a career, enjoy the nature and then go home for the weekend. That's something we can offer." Grahlemann worked together with a dozen headhunters and also went on promotional tours, spending years sitting at small stands at annual medical conferences in Prague, Bratislava and Budapest.
A Toxic City for Germans
Most foreigners were unaware of Hoyerswerda's past and expressed interest in working there, but Germans shunned his charms. On one occasion, Grahlemann says, he received 15 applications in response to a job ad placed in Germany. Once it became clear to applicants that the position was in Hoyerswerda, however, 13 withdrew their applications. "It's clear that German doctors have a problem with Hoyerswerda," Grahlemann says. At the same time, he argues that German medical students are less committed, saying they are more interested in working part time or focusing on their free time. "They prefer to go into the pharmaceutical industry or research," he says.
Grahlemann's recruitment tour was not made necessary just because his hospital was located in Hoyerswerda. The healthcare industry in Germany has suffered from a migratory phenomenon for many years now, making hospitals and practices in rural areas increasingly dependent on foreign workers. Currently, around 35,000 foreign doctors are working in Germany and several thousand positions remain vacant. The Bavaria Clinic in Kreischa, a town also located in the state of Saxony, employs almost exclusively nurses from Spain, a country where one out of two people under the age of 25 is jobless. But even as Germany draws in foreign healthcare workers, German doctors are going abroad to Scandinavia, Britain or Switzerland, where they can command significantly higher salaries.
The Lake District Clinic has since improved the services it offers to its foreign workforce. There's a "Welcome Day," German language instruction is offered on site, the hospital pays for hotel rooms as new employees search for apartments and it helps with administrative formalities. Summer BBQs are also hosted in which each doctor brings specialties from his or her home region. The hospital says it has only had to send two foreign workers home so far. One was a Chinese man whose accent was too strong for German patients to understand. Another, an Italian man who wanted to become a surgeon, didn't meet their standards. The rest have stayed.
Addressing Germany's Labor Market Problems
Sitting in the Hotel Achat, Grahlemann is thoughtful when asked if it is right for Germany to address its labor market problems by recruiting workers from low-income countries or war-torn regions. Still, he enthuses, "here, they have the possibility to become anything, even chief physician."
At 36, Robert Donoval is the youngest chief physician at the hospital and the first to have come from abroad. He originally planned to stay for only two years -- and he initially suffered from homesickness for Prague and missed his apartment on the city's famous Wenceslas Square. Now, though, he has been here for seven years and, after becoming a chief physician a few weeks ago, he wants to stay. Donoval is a general practitioner responsible for 40 beds and, often, gravely ill patients. A skinny, wiry man with close cropped hair, he speaks very quickly and is constantly moving. His phone rings every few minutes.
Donoval says such a rapid rise through the ranks would not have been possible in Prague where, he says, there's "too much nepotism and all the good posts are already taken." But, he says, he is under a lot of pressure here and that he has to be "twice as motivated" as his German colleagues -- otherwise he wouldn't be able to handle the workload. "We chose the right boss," whispers a nurse, full of praise. But it's a tough job: Donoval's office is stacked with files and he doesn't get much time to spend at home with his wife, a Slovakian who followed him to Hoyerswerda and works as a nutritionist, and their two children, who were born here.
When asked if he feels disadvantaged as a foreigner or if he has ever had problems with right-wing radicals, Donoval laughs. He says he's a huge fan of Germany and praises its "order," "industriousness" and Richard Wagner, the composer of his favorite opera, "Rienzi", a CD of which he keeps in his car. At home, he has a copy of "Germany Does Away with Itself" on his shelf, the bestselling book by firebrand populist Thilo Sarrazin that made headlines a few years back with its highly controversial theories about immigrants, Germany's declining birthrate and Islam. Donoval says he liked it a lot.
The Better German
Dr. Donoval does his best to be the better German. He's a typical example of immigrants who have fought hard for their success and show little pity for slackers, regardless of where they come from. He then cites a few examples, saying he gets annoyed when Angela Merkel "is cursed as a Nazi by the Greeks just because she knows how to save. What impertinence." Then, his phone rings and he rushes back to the ward.
Not far from the hospital, in the old city center on the other side of the river, Dr. Lauand Ali, 43, a Syrian from besieged Kobani, sits at a plastic table in a hostel with a cup of coffee and cookies. He's surrounded by a Syrian family that has come to seek his advice. Ali is examining the anti-depressants and blood pressure medication prescribed to them by their doctors.
Dr. Ali is an anesthesiologist in the intensive care unit, a serious man with melancholy eyes who is generally the most important man in the operating room. Normally, it's his job to ensure that people don't feel very much, but here he has compassion and exhibits his anger. When meeting with the refugees, Ali is first and foremost a Syrian trying to help out fellow Syrians in need. Like him, they had to flee the bombings, and these weekly visits aren't easy on him.
Ali is sitting in Hoyerswerda's new asylum seekers' hostel, the first to open here since the 1991 riots. The number of asylum seekers in Germany has grown so dramatically in the past three years that the state of Saxony was forced to find new places to shelter them. Some 130 asylum seekers got assigned to the city and they moved into the quarters -- a remodeled former school for the handicapped that is located far away from the location of the 1991 riots. The people living here are African who crossed the Mediterranean by boat, Syrians, Iranians and an Iraqi woman with triplets who had been persecuted by her husband.
This too -- the opening of an asylum hostel in Hoyerswerda -- is an experiment. But can it end well? Will the "ugly German" hold back this time? Does the "ugly German" even exist? In "Hoyerswerda of all places," the newspapers wrote. It is a "city on probation." Germany and the world are paying close attention.
'Hoyerswerda Never Forgets'
In contrast to his colleague from Prague, Dr. Ali is no fan of Thilo Sarrazin. He says his responsibility as a doctor begins even before people get sick and the Syrian doctor is the only one providing assistance at the asylum seekers hostel. He says he wants to give them the kind of support he was given after arriving in Germany. His wife also used to help, but she stopped coming after a pair of young men from North Africa harassed her.
The Ali family came to Hoyerswerda a year and a half ago. Everything that was important to them was left behind in their homeland: their relatives, friends, a three-story villa and his wife's pharmacy. They came to Germany with four suitcases and two daughters, aged seven and nine. Today they live in a middle-class apartment building with no neighbors under the age of 70. It's an uptight place, with signs in the hallway prohibiting various things. A cleaning schedule is also on display.
The price for their new lives in Germany is high: bureaucracy, visits to the authorities and vast amounts of paperwork. Dr. Ali was successful largely because of the assistance provided by the hospital, but his wife still has to go through it all. She'll have to take classes to learn German, obtain a license to practice and undergo a traineeship program despite the fact that she already ran her own pharmacy. Otherwise, they live almost like everyone else here. The war is far away, they BBQ in the summer, they go to town festivals and have German friends. Recently Peri, their youngest daughter, asked her teacher when the foreign children living in the asylum seekers hostel would finally be allowed to attend their school.
Sitting at a table in the asylum seekers' hostel, a family from Homs, Syria is complaining about sundry things. There are the Germans who give them dirty stares when they greet them. They say one of the men from the hostel got attacked in the town square and that their son is now wetting his bed at night. Dr. Ali understands their fears, but he also says, "Don't complain. Be thankful. This is an opportunity for you. A war is taking place in our country. What do you expect from these people?Certainly not unconditional love." He then rushes back to the patients at the hospital.
These two groups of foreigners, who have come together here by chance, have few similarities. On the one side, you have refugees who appear to be powerless, and stranded in the furthest eastern corner of Germany. On the other, you have doctors who are helping to save a town. They are adjusting to their surroundings and showing what may soon be the fate of other outlying regions in Europe. The population is dying off, immigrants are coming in to take over unfilled jobs and are even transforming dying places like Hoyerswerda into multicultural cities in the heart of the EU.
Making Up for a Wrong
It more or less works because Hoyerswerda isn't just home to right-wing rowdies. There are also people like Grit Maroske, a 44-year-old who was born here and whose family has deep roots in the city. When she's not taking care of her five kids and her grandson, she can be found sitting in the office of a local citizens' initiative fighting xenophobia called Hoyerswerda Helps with Its Heart.
With the support of a local pastor, the organization can rapidly mobilize some 50 people and deploy them against neo-Nazis in front of the hostel should it become necessary. Maroske says she stood by in 1991 as her former husband screamed at foreigners to leave town. She says wants to make up for that wrong through "better prevention, clarification and dialogue."
Maroske leads a reporter through the apartment complex she grew up in, located just behind the hospital, where she had her appendix removed as a child. As she walks, she talks effusively about her life back then. She points to abandoned playgrounds where hundreds of children used to play and to the neighborhood bar -- boarded up today -- where her father used to drink beer. She points out the cleaners where workers at the local coal mine would leave their clothes washed. After the closure of the strip mine, everyone lost their jobs. And, with the fall of the Wall, the asylum seekers arrived. Envy of the newcomers quickly turned into hatred. At the time, people could be heard saying things like, "They're taking away our work and our women and they are getting more from the state than we are." Maroske says people still use the same arguments today. But, she adds, no one would dare to attack foreigners, not even after the recent anti-Muslim Pegida protests in Dresden. It sounds like a promise.
On this particular autumn day, a monument is being dedicated in the town to commemorate the riots. Backers of the monument, the local commissioner for foreigners' affairs, television teams and the new hospital director have all gathered to inaugurate it. No doctors are present; they have too much to do. A gateway made of black basalt reads, "Autumn 1991. Hoyerswerda Never Forgets."
But just as the mayor begins to speak about a "culture of welcoming" and a "cosmopolitan town," five neo-Nazis position themselves directly in the line of the cameras. One has "Hoyerswerda" tattooed on his right forearm. They want to be seen and begin chanting so as to disrupt the proceedings.
Looking away from them, though, one can look through the memorial at the hospital in the distance. Dusk is descending and the clinic's lights shine bright -- it's hard to tell if it is real, or an illusion.
