Across Europe, tensions between refugees and their host countries are creating fissures for doctors as well.
The freezing fog comes up from the Danube and slides up the avenues into Vienna. The chill forces folks to pull their collars closer, but it settles into the bones. Walking quickly, those that linger on street corners are not tourists. They are beggars or flüchtlingen (asylum seekers). Caught between worlds and not welcome in either. The flüchtlingen have arrived from Syria, Afghanistan, Iran, Somalia, Nigeria and other parts of the Middle East and Africa. Ninety thousand are registered in Austria.
A deconstruction is in progress. Europe, and perhaps the rest of the world, is disassembling into three predominant factions. The theocrats and their followers, the nationalists and their followers, and the globalists; caught between are the refugees. The theocrats rage about the moral and spiritual high ground and drive divisiveness. The nationalists rattle sabers and demand patriotic fervor and drive divisiveness. The globalists are not the multi-national corporations but rather those folks who just want to go along to get along. They don’t pay attention to those in power, they just want to feed and raise their kids, and sit down to dinner with them at the end of the day. Sadly, the pressure of the times is forcing the EU globalists to take sides.
The Christmas markets have rolled up and gone home. It is just as well for the flüchtlingen, as the sight of joy and happiness there only underlined their despair. In Syria, they want to turn their civil war into a world war. In Africa, they want to turn murder into genocide to safeguard their beliefs. At first, asylum was about security, but now it’s also about escaping poverty. It is why the pressure in the EU is on Germany, Austria, Sweden, France and England, the prosperous countries. Yet even in “Little Syria” in Allentown, PA, a survey of those immigrant citizens show that refugees are not welcome. With winter, the numbers entering the EU are dwindling. It is just as well, as the cold is increasing; the snow and the faces are hostile on both sides. Respiratory infections are spreading rapidly through encampments in Croatia as exhausted and overextended flüchtlingen have become susceptible due to decreased resistance. The Red Cross is struggling with the numbers.
Where I volunteer with the Österreich Rotes Kreuz (Red Cross), conditions have improved. The folks I look after have been moved into CONEX (Container Express – in military speak), or shipping containers converted for living space. They are actually more comfortable than the one I stayed in while in Afghanistan on base. The CONEXes have bathrooms inside, whereas I went to an outhouse. The refugee numbers at this site have swelled to over a hundred. Donations from the summer and autumn have assured them socks and warm clothes, and the privacy has reduced contagion. After three years, however, they will be dismantled and removed, as they are temporary, and the refugees will need to find their own work and shelter.
The benevolence of the Austrian government has waned over the last few months. The chancellor, Werner Faymann, now demands that all flüchtlingen must be registered in the EU or suffer detainment and deportation. This is a change from the open border policy. Similarly, Sebastian Kurz, the current foreign minister, and now integration minister, has demanded the closure of Islamic kindergartens nationwide since visits revealed they were not teaching German, and advocating divisiveness rather than integration into society. Further complicating the current situation, school teachers have been forced to accept flüchtlingen children with no language skills into their classes, causing the education of the rest of the students to be compromised. Offered no translators or extra assistance, teachers are expected to maintain standards that are increasingly out of reach. The additional burden on them is being reflected by the parents as they witness their children’s lessons lagging, and there is real concern that this will be seen in lower test scores in the annual national final exams in the spring.
Yet the flüchtlingen have also pushed back. When they demanded separate competency testing facilities for women and men at the Wirtschaftskammer (or Chamber of Commerce), Sebastian Kurz responded that “it is not the way we conduct business in this country.” In places like Canada and the United States, beliefs are accommodated, but these policies are about cultural survival and European heritage. If the asylum seekers hope to stay, choosing to integrate and work at their chosen profession is key. Those registered in Austria are currently receiving government support that exceeds the amount received by the majority who have worked all their lives in Austria and are on pension (or Social Security). The comments section in the local newspapers elicit the frustration nationals feel over this, and pensioners struggle with lack of cost of living increases as the government claims budget constraints.
Life at the borders is still difficult not only for the refugees but also for the medical staff supporting them. A recent letter from a Czech physician working in a Munich Hospital describes the problems:
The Muslim men refuse to see female staff and Muslim women refuse to see male staff. The refugees expect that medical care should be free, as it often is in their own countries. However, they not only demand free care, they also demand good outcomes and act out when that is not possible.
This type of behavior is egregious. I have been fortunate, as my patients remain polite. I reach out to them, we share experiences, and my kindness is rewarded in kind. The Rotes Kreuz staff, however, are losing patience. They were primarily assigned to cover emergencies and transports before the Asylum “Crisis,” and now they have daily responsibilities in watching over refugees that make them short-tempered and irritable. They are interventionalists, not ongoing caregivers by nature. Just as individuals are having difficulty adjusting, the Austrian government is also struggling to accommodate the refugees. The government has witnessed other cultures failing to integrate in Austria.
Experience with the Turkish community demonstrates one group’s unwillingness to integrate fully into the society, which is the government’s big concern with the refugees. In the 16th district (or Bezirk) of Vienna, a Turkish ghetto has grown around the Brunnenmarkt, a traditional street market devoted to Turkish cuisine. Unlike the Jewish ghetto, where the Jews were required to live, the Turks, which number around 300,000 in Vienna, chose this community to reduce exposure to the society at large, partly in an attempt to avoid fully integrating into Austrian society. This chosen isolation has resulted in in-fighting among subgroups that attempt to carry on their traditional ways. A trauma surgeon colleague in Meidling (another Bezirk of Vienna) was required to wade through Cobra unit personnel (similar to SWAT) to treat “holy” men, following gun and knife attacks between Turkish religious sects several years ago. Viennese culture is fairly fragile, and the addition of “Little Syria,” “Little Afghanistan” and “Little Nigeria” does not play well. The dilution of Austrian culture is apparent in the Naschmarkt (or City street market) where Austrian cuisine once predominated and has now been mostly displaced by Oriental spice stands.
Of course, this desire to retain cultural identity is not wholly the providence of the Turks or the flüchtlingen. Austria is a strongly Catholic country, and Vienna is highly stratified by class. The Turks were invited in as guest workers in the ’60s and ’70s, and were offered citizenship as a reward for good service. However, everyone remains in their class, and one must stay in their lane. The only way out of one’s birth class is through money, title or both. Where and how the flüchtlingen find their position in this kind of environment will determine their success or failure. The winter here is much colder, and it is not just the weather, it is the undercurrent of discontent.