Study into Warsaw Ghetto starvation left the world an unparalleled study of hunger still applied today
In addition to the many diabolical methods the Nazis came up with to achieve their goal of the Final Solution, which included torture, hard labour, executions and gassing, a slower but equally effective tool was starvation.
Introducing food rationing in Occupied Poland in January 1940, the Germans made sure that the Jews were assigned the lowest rations.
The official daily calorie allowance in Poland was 2,600 kcal for Germans, 699 kcal for Poles, and just 180 kcal for Jews.
The policy was carefully calibrated so that Jews in Poland would receive calories “less than the minimum for preserving life”.
By the end of 1941, all food reserves that supplemented the inadequate rations had run out and the Warsaw Ghetto was starving.
In February 1942 a group of Jewish doctors headed by Izrael Milejkowski decided to use the starvation to study the physiological and psychological effects of hunger.
The report named the Warsaw Ghetto Hunger Study was an unparalleled act of heroism, resistance and determination and left the world a study of hunger that had not been possible before nor achieved since.
The results of the study were far ahead of scientific knowledge at the time and are still applied in science today.
Often described by scientists and historians who come across it for the first time as ‘forgotten’ or ‘'rediscovered’, for the Warsaw Ghetto Museum, which has held its own copy for several years, the study is anything but forgotten.
The museum is due to open in around two years in the building of the former Bersohn and Bauman hospital, one of the two hospitals of the ghetto where the doctors carried out the research.
David Berman from the museum told TFN: “What the doctors did was heroic, and they did it for humanity. They were studying an illness that they were suffering from themselves.
“Although they treated the patients, they were just prolonging their death, and they also knew that their own lives would also come to an end soon.”
The study was the brainchild of Dr. Israel Milejkowski, the head of the health department for the Judenrat.
He gathered 28 doctors from the ghetto and set up an organising committee in November 1941 to develop a plan of work, to find resources and to give doctors their assignments.
In Dr. Milejkowski's own words: “The work was originated and pursued under unbelievable conditions. I hold my pen in my hand and death stares into my room.
“It looks through the black windows of sad empty houses on deserted streets littered with vandalized and burglarized possessions. … In this prevailing silence lies the power and the depth of our pain and the moans that one day will shake the world’s conscience.”
Dr. Julian Fliederbaum created a state-of-the-art research platform, which ensured that the results would have incontrovertible scientific validity.
Although the two hospitals were relatively well equipped from before the war, many other materials including blood test kits had to be smuggled from outside the ghetto.
“The situation was unique. At no other time in modern history had there existed such localized mass starvation. Despite the privations of the Warsaw Ghetto the hospitals had comparatively good medical facilities. What’s more, they had had excellent doctors, many of whom were world renowned,” Berman said.
By February 1942, the study was ready to be launched. The scale of the research project was immense with more than 100 participants. Anyone who was found to have been suffering from a different disease was omitted from the study.
Patients were divided into two groups: children from six to twelve years old and adults between 20 and 40.
The study had two phases. In phase one, all patients admitted to the hospital with a primary diagnosis of hunger disease were examined and findings noted.
Hunger disease meant having a caloric intake of fewer than 800 kcal per day for adults and no other disease. For children, the definition of low caloric intake was based on the child’s age.
“Although the official ration for Jews was only 180 calories, this was often supplemented by smuggling and soup kitchens,” said Michal Kowalski from the museum’s research department.
In phase two, metabolic and cardiovascular effects, as well as behavioural, ophthalmologic, dermatologic, and immunologic effects were studied.
The doctors made meticulous notes of the changes that took place in the subjects - the slow heartbeat, the low temperature, the lack of movement, the shallow and slow breathing.
They noted that the body itself began to provide fuel. First, the carbohydrate stored in the liver and muscles, glycogen, was used up.
Then fat became the primary fuel. Finally, protein was broken down, and muscle tissue began to waste away. Bones became soft as the body mined them for the minerals they stored.
In children, the earliest signs of starvation were apathy, slow movement, and no interest in play. They were sad and became argumentative. Intellectual development stopped.
In the later stages preceding death, they adopted the foetal position.
One of the study’s key findings was to re-feed people slowly. At the end of the war, allied soldiers eagerly provided food as quickly as possible to concentration camp survivors, which often proved fatal and many of the emaciated people died.
On July 22, 1942, the study was interrupted when mass deportations from the ghetto to Treblinka began. All the data was hastily gathered together and carefully hidden.
The doctors then met in one of the buildings of the Jewish cemetery to systematise and edit the data to create a rough draft of their final report.
They believed that their own lives would soon end but they hoped that their work on hunger would be of use to future generations.
Shortly before the final liquidation of the ghetto in 1943, the manuscript was smuggled out and handed with a letter from the doctors to Professor Witold Orlowski from the Warsaw University hospital.
He safeguarded it for the rest of the German occupation and one of the Jewish doctors, Emil Apfelbaum, reclaimed it and passed it on in 1945 to the American Joint Distribution Committee, a charity whose main purpose was to help Jewish survivors.
In 1948 and 1949, the American Joint Distribution Committee made 1,000 copies of the report and distributed it to hospitals, medical schools, libraries and universities across the United States.
The project’s instigator, Izrael Milejkowski, was sent to Treblinka in 1943.The majority of the other researchers of the hunger disease in the Warsaw ghetto did not live to see the end of the war.
Dr. Apfelbaum obtained false papers and escaped from the ghetto at the end of January 1943. He remained in hiding until the liberation of Warsaw. He died suddenly, possibly of a heart attack, on the street in Warsaw on January 12, 1946.
Another doctor, Henryk Fenigstein, was captured by the Nazis in 1943 and sent to Auschwitz, before going to Dachau, where he was liberated by the U.S. Army on April 30, 1945.