HHH Column: Who belongs Where? Debating the ‘’Kleine Stadt’’ for Contergan Victims by Floris Plak
The HHH column is a monthly blog where members, researchers, and historians interested in themes related to history, health and healing share their thoughts on research, current affairs, or anything related to the history of medicine. Each edition features a different contributor, this month the column is written by Floris Plak, PhD researcher at Vrije Universiteit Amsterdam. He is currently working on a project about Het Dorp, an accessible neighbourhood for physically disabled people in Arnhem, which he studies as a space of transnational encounters against the backdrop of global developments since the 1960s, a topic he has explored in more detail in a previous HHH column on Het Dorp. This column addresses a different topic, albeit still related to Het Dorp, namely the idea that emerged in Germany to establish a similar community for Contergan victims.
Who belongs Where? Debating the ‘’Kleine Stadt’’ for Contergan Victims
By Floris Plak
Perhaps the neurologist and science writer Thomas Regau was the most outspoken advocate of the “Kleine Stadt” concept, devised by publicist Frederic W. Nielsen, for the young victims of the so-called Contergan drug. This drug, developed in Germany, was prescribed to pregnant women between 1957 and 1961 and caused severe congenital malformations in newborns, particularly affecting the arms and legs. On 1 February 1963, the weekly newspaper Die Zeit published the article “Handeln — nicht heucheln” (“Act—Don’t Pretend”), in which the author argued that children affected by Contergan should be permanently housed in one or more closed institutions for the purposes of treatment, upbringing, and education.[i] Within the seclusion of their own facilities, these children would not have to measure themselves against their healthy, performance-oriented peers. They would be better protected from the “harshness of modern urban life” and could grow up in a community of equals, without being constantly confronted with their differences and perceived shortcomings.[ii] According to this line of reasoning, a certain reduction in “familial warmth” and maternal affection would have to be accepted as a trade-off, since this was considered less harmful than a childhood marked by humiliation and feelings of inferiority.[iii] The resulting “hatred and compulsion neuroses of the early impaired,” it was argued, were, after all, widely recognised.[iv]
Thomas Regau presented himself to newspaper readers as an outspoken advocate of the plan that Nielsen had circulated in January 1963 among members of the Bundestag, ministerial officials, and the press. In a pamphlet, Nielsen had called for the establishment of a “Kleine Stadt for Contergan children,” evoking idyllic images of a sheltered and fulfilling existence outside mainstream society.[v] Nielsen’s proposal operated at the intersection of pragmatism and idealism. It was pragmatic because he argued that existing provisions, such as care institutions, orthopaedic homes, and small specialised wards with twenty or thirty beds, were inadequate to provide timely and effective assistance to the large number of victims scattered across the country.[vi] It was idealistic because such a “small town” would offer these physically impaired children an environment in which they would feel less excluded, a living world with houses, schools, and workshops fully tailored to their needs, where they could move about independently using wheelchairs or prostheses. According to Regau and Nielsen, a lesson could also be drawn from the lives of people with dwarfism. What would they prefer: a life as ridiculed and second-class individuals among the “tall,” or an existence among themselves, within a community of peers that also provides protection?[vii]
The proposal put forward by Nielsen, the views of Regau, and the reactions they provoked reflect a broader socio-political debate about how and where people with disabilities should live, what place they should occupy in society, and how they ought to participate in social life. At the same time, this discussion touches on wider questions, including the capacity and limits of communities, and the extent to which society itself is able to change and adapt. Nielsen and Regau regarded the world of the “normal” as too harsh, too cold, and too humiliating for Contergan children. In that “normal” world, they argued, these children would be confronted daily with the piercing stares of others and repeatedly with their own difference.[viii] Moreover, they believed that these children were effectively destined to fail in a society in which paid employment constituted the norm. As the German disability historian Elsbeth Bösl has convincingly shown, these ideas fit within a broader pattern of institutional thinking that gained increasing ground around 1960.[ix] For those who were not considered capable of paid employment, placement in residential institutions and spatial segregation appeared to be the most appropriate solution.
These ideas were by no means confined to Germany. Both Nielsen in his pamphlet and Regau in his article explicitly referred to the success of the Dutch fundraising campaign Open het Dorp (“Open the Village”), initiated by television presenter Mies Bouwman and rehabilitation physician Arie Klapwijk. On the night of 26 to 27 November 1962, they succeeded in raising more than 21 million Dutch guilders for the construction of Het Dorp, a wheelchair-accessible residential neighbourhood in Arnhem intended for approximately four hundred residents with disabilities.
For Nielsen, the initiative led by Arie Klapwijk served as a direct model for the town he envisioned in Germany. However, his understanding was based on incorrect assumptions. He claimed that Het Dorp would also accommodate children and elderly people with disabilities, and expressed the hope that the twenty-five Dutch Contergan victims would likewise find a place there.[x] In reality, Klapwijk’s concept was explicitly intended for adult persons with disabilities who, after completing their rehabilitation, saw no realistic prospects for integration into society.[xi] Regau, by contrast, focused primarily on the financial success of the Dutch television campaign. In his view, the custodians of the public purse in the economically stronger Federal Republic of Germany ought to reflect more critically on their position. If it had already been possible in the Netherlands to raise the equivalent of sixteen million marks, how much more might be achieved in Germany with the backing of a powerful industrial and pharmaceutical sector? According to Regau, the 1.65 million marks that had so far been allocated by the budget committee fell far short of what was needed to provide adequate financial compensation to all affected families.[xii]
In contrast to the Dutch Het Dorp, the German “Kleine Stadt” was never realised. From the outset, Frederic W. Nielsen’s plan encountered considerable criticism within Germany. This is evident, for example, in the article “Kein Ghetto für Kinder” (“No Ghetto for Children”), published by the editorial staff of Die Zeit in response to Regau’s piece.[xiii]Numerous readers, including the orthopaedists Friedrich Hauberg and Oskar Hepp, voiced strong objections to the idea of a “Kleine Stadt.” They pointed out that, already during the Second World War, there had been calls to concentrate people with arm or leg amputations and those with spinal cord injuries in centralised institutions. Anyone genuinely engaged in the rehabilitation of people with disabilities, and in their view Nielsen and Regau were not among them, understood that the security of one’s own family and the familiarity of the home environment were of crucial importance.[xiv] They further emphasised that, for later integration into working life, continued contact with “healthy” members of society remained indispensable. The debates surrounding the “Kleine Stadt” thus marked less a break with existing ways of thinking than a moment of reflection.[xv] The Contergan victim was still expected to adapt to prevailing labour norms, yet, it was argued, with the aid of technical devices “something could be made of the child” without the need for prolonged institutionalisation.
[i] Thomas Regau, “Handeln – nicht heucheln,” DIE ZEIT, 1 februari 1963; “Den Mut zum Leben erhalten,” DIE ZEIT, 1 februari 1963. I would like to thank Elsbeth Bösl for drawing my attention to these newspaper articles in the context of my dissertation. She herself has written on this debate: Elsbeth Bösl, “Was ist und wozu brauchen wir die Disability History?,” in Welt in der Welt: Heime für Menschen mit geistiger Behinderung in der Perspektive der Disability History, ed. Hans-Walter Schmuhl and Ulrike Winkler (Stuttgart: Verlag W. Kohlhammer, 2013), 21–41.
[ii] Ibid.
[iii] Ibid.
[iv] Anne Helen Crumbach, Sprechen über Contergan: Zum diskursiven Umgang von Medizin, Presse und Politik mit Contergan in den 1960er Jahren (Bielefeld: transcript Verlag, 2018), 186.
[v] Frederic W. Nielsen, Contergan. Ein Aufruf! Contergan-Opfer und ihre Zukunft (Stuttgart-Selbstveerag, 1983); Frederic W. Nielsen, Kleine Stadt – wozu? (Stuttgart-Sillenbuch, 1964).
[vi] Ibid.
[vii] Ibid.
[viii] Regau, ‘’Handeln — nicht heucheln,’’; Nielsen, Contergan. Ein Aufruf!
[ix] Bösl, ‘’Was ist und wozo brauchen wir die Disability History.’’
[x] Nielsen, Contergan. Ein Aufruf!
[xi] Jacqueline Kool, Floris Plak, Eline Pollaert, Zestig jaar streven naar inclusie: ‘’Met Het Dorp had je iets om je tegen af te zetten,’’ Support Magazine 1 (2023), 12-15.
[xii] “Den Mut zum Leben erhalten.’’
[xiii] “Kein Ghetto für Kinder,” DIE ZEIT, 22 februari 1963, 8:00 uur.
[xiv] Ibid.
[xv] Ibid.