By October 1944, 15, 000 Estonian men had been concentrated in Germany in the Neuhammer training camp, and the 20th Estonian SS-Division was formed. After the capitulation, the Estonian prisoners were based in two camps: Eastern Germany (Soviet Zone) and Western Germany (U.S., British, French). About 6,000 were held by the Western allies; up to 5,500 by the Soviets. Those in the Soviet camps were either repatriated or imprisoned; in the Western territory the refugees were placed in displaced persons (DP) camps, under supervision of UNRRA. They totalled 32,219; of those, 27,096 emigrated to other countries. 4,000 remained in Germany.

During the second Soviet occupation years 1944-1953, human losses continued under various “operations”. Starting in autumn 1944, a total of 53,000 political arrests were made. On August 28th, 1944, 2,500 men were mobilized. In 1944-1953, 25,000-30,000 persons were sent to prison; circa 11,000 disappeared. Mass deportations continued. During March 1949, 20,702 persons were deported (70% were women, children, or elderly people). 3,000 died on the way to Siberia. “Enemies” were hunted down even in the schools. Proceedings against students lasted until mid-1950s. However, from these numbers some people did return, mostly from the Soviet Union.

As a reaction to repression, an armed resistance movement (known as Brethren of the Woods or Forest Brothers) was operative during 1944-1953, with an estimated 16,000 - 30,000 fighters. Their enemies were regular and NKVD troops, militia and Soviet activists. Their losses were heavy: during Nov. 1944 - Nov. 1947, 8,468 fighters perished.

After Stalin's death 1953, during the years 1954 -1991, the acts of mass repression were replaced by individual acts: 1954 - 1983 at least 350 persons were arrested for political reasons. Then, a large scale release from camps and forced exile began in 1956. 27,835 persons returned home.

The paper estimates that the number of repressed during the second Soviet occupation is 56,500, of whom 16,000 perished.

III — Health Care
The health care problems paper outline states:
“In 1939-1953 Estonia lost at least 735 doctors (ca 79% of their total in 1939), including 25 lecturers of the Faculty of Medicine of the University of Tartu. In the beginning of the second Soviet occupation period, quantitative increase was considered important, and only gradually the attention turned to the quality and content of medical care. Issues of social care also often remained to be solved by the health care system. In this survey, characteristic health care problems and the dynamics of important numerical indicators are analyzed, development of health care network is described, and some demographic data during three different occupation periods are presented. Life expectancy in Estonia in 1940 was 58.4 years (in Finland 57.3), and in 1991, 70 years (in Finland 75.5).”

This is an important chapter, with regard to the impact of the occupation on the physical and mental health of the nation. Measurement of impact using the numerical data provides some difficulties because the statistical data were compiled from different bases. By 1991, the number of doctors in Estonia had increased little more than six times since 1940; the number of mid-level staff nine times; number of hospitals had doubled. However, this is a generalization, not reflecting the individual situations, as to be described below.

During the first Soviet occupation, private medical institutions, laboratories, large pharmacies, and stores of medical and optical equipment were nationalized. 12 private hospitals in Tallinn were made public. The greatest harm to the Estonian health care system was caused by the loss of 229 doctors (57 as victims of repressive measures, 89 fled to the Soviet Union when Germans came, 17 were mobilized, etc.) The incurred violence damaged the mental health of the population. This may last for generations.

During the German occupation, 1941-1944, the health care organization was subjected to what was comparable in the conquered territories. Medical aid civilians came second. Malnutrition was prevailing. Typhus and venereal disease became more frequent. Suffering under the German repressive measures was not as extreme as under the Soviet occupation. 19 doctors were executed. 39 doctors were conscripted into the German army. When Estonia was occupied by Soviets again in 1944, 312 doctors left Estonia, 389 remained.

The health care during the second Soviet occupation, 1944-1991, is described in various segments.

a) In 1944, the health plan foresaw the following; registry, health care workers, opening of medical institutions, isolating patients with infectious diseases, and hygienic control. The lack of specialists necessitated employment of medical assistants and senior students (besides doctors), as the heads of health departments — provided they were members of the Communist Party... In parallel, the mass arrests started — up until 1953, at least 54 Estonian doctors fell victims to repression.

b) During 1944-1949, the Tartu medical school was restored, Tallinn's Medical College continued. Due to shortage of human resources, Soviet specialists were imported, with low qualifications and no Estonian language skills. This created some antipathy. In March 1945, it was ascertained that there were 1,645 places for doctors and 245 places for dentists in the health care network: 26.9 % and 26.1 % were filled, respectively. At the Tartu State University, there were 11 chairs without scientific degree; the places for assistants were filled with senior years students. In Tartu, several hospitals were established; of the 272 rest homes and spas in 1941, 186 had been preserved during the war.

c) In 1946, there were 579 doctors in Estonia, who had to take care of 871 positions... Many vacant positions were filled with people with low qualifications (and poor language skills). The situation with tuberculosis was poor — every month, 15-25 patients died. The problem was that seriously ill people were not isolated. By the end of 1950, there were 138 hospitals in the country, but the repressions still continued, resulting in arrests of several doctors in Tallinn and Tartu.

These brief lines indicate that though during those three time periods there was a resemblance of general health care, its detailed implementation was in need of improvement.
(to be continued)

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