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The Persistence of Disabled Children and Their Allies During Aktion T4 and the Holocaust

Published on Thu, 03/06/2025

A man with white hair and a jacket walks with a cane - his reflection appears in the glass of the T4 memorial
BBC photo of T4 memorial in Berlin - AFP

“Completely Healthy Children” - The Persistence of Disabled Children and Their Allies During Aktion T4 and the Holocaust

By Wyatt Edwards

In Mikaël Ross’s graphic novel The Thud, the main character Noel, who has a developmental disability and has just arrived at a care facility in Germany, learns from an older woman named Irma about how her brother once told her the story of how the buses came to take disabled children. He was later taken himself and the Nazis killed him at one of Adolf Hitler’s so-called medical centers. Irma’s story is tragic and amazing because she is a survivor of Hitler’s genocide of disabled people. As a child, she hid in the woods from a Nazi raid. Her brother’s observation saved her life. 

From 1933 to 1945, the Nazis ran the Krankenmorde, or “murder of the sick,” and the mass murder campaign Aktion T4 in Germany, Austria, occupied Poland, and the region now known as the Czech Republic. The programs resulted in the forced sterilization of more than 400,000 sick and disabled people and the murder of more than 300,000 sick and disabled people. While the T4 program was publicly dismantled in 1941, Hitler’s personnel continued to carry out secret killings until the Allies defeated the Nazis in 1945. 

The Nazis sought to eliminate all disabled people in their pursuit of racial hygiene. Racial hygiene is the pursuit of a pure race of human beings. The Nazis were trying to exclude the traits of physical or mental disability and illness from the gene pool. They killed children and adults by lethal injection, lethal gas in a chamber, gunshots, and starvation. As the first targets of the Nazi campaign of human evil, children and teenagers with disabilities tried to and in some cases did persevere as the German fascists singled them out in their hygiene policies for “polluting” the human gene pool as individuals and a group and sought their destruction and elimination. The victims also found humanitarian support from child and teen allies and adults. 

Before Hitler’s rise to power, children and adults with disabilities in Germany had more rights and freedom of speech in the early decades of the 20th century. Disabled adults organized themselves and created supportive groups and resources. However, by 1933, the Nazi Party passed the Law for the Prevention of Hereditarily Diseased Offspring, which stipulated compulsory forced sterilization of disabled children and adults who were affected by conditions such as autism, epilepsy, Down syndrome, cerebral palsy, and schizophrenia. The Nazis sought to keep disabled people from having children of their own because they believed in racial “integrity.” They targeted people in prisons, nursing homes, care facilities, mental institutions, and schools with the intent to eliminate their ability to reproduce. 

1941 photo from above shows dozens of people in jackets and hats standing in a cobbled courtyard near a bus parked with the door open
Nazi Aktion T4 program bus carrying disabled people to be killed. 1941.

Within six years, the fascist government took their next violent step and began removing disabled children and adults from their homes and killing them under the Aktion T4. In 1939, the parents of five-month-old Gerhard Kretschmar wrote to Hitler asking that the government “euthanize” their son. Kretschmar was born with disabilities and his parents considered him a “monster.” The Nazis then moved ahead with government policy to murder all children under the age of three with illness or disability. Kretschmar was the first child killed by lethal injection under their plan. 

The acronym T4 comes from Tiergartenstraße 4, an address in Berlin where the German chancellery recruited medical personnel to carry out their widespread genocide of disabled people. The director of Hitler’s private chancellery Philipp Bouhler and Hitler’s attending physician Karl Brandt led the German war crimes against disabled people. Nazi leaders established a panel of medical experts whose role it was to approve the so-called “euthanasia” of children and adults as “mercy killings.” The government would send parents an official letter saying that their child must be sent to an institution. In actuality, they sent most disabled children and adults by bus and train to killing centers. 

The Nazis did not tell the families directly that they would be killing their children. Instead, the parents would later receive deceitful letters stating that their child had died of illness. Some families received death certificates with false causes of death and ashes taken from a common crematorium pile that they were told were those of their loved ones. The program quickly became an open secret. The model Hitler used for killing people with disabilities served as his blueprint for the whole Holocaust.

Stories

In this research paper, I will look at the stories of a few disabled children who tried to survive in Nazi Germany’s institutions and killing centers, and those who stood up for all children, including disabled children, teachers, and clergy, as Hitler enacted his party’s Holocaust. 

Young Anita Rosemarie Hart was born on September 1, 1938, five years after Hitler established the Law for the Prevention of Hereditarily Diseased Offspring. Early in her life, she became sick from meningitis, an infection that weakens the membranes around the brain and spinal cord. She survived the illness, but she experienced blindness and permanent brain damage. Medical professionals told her parents that she might be “unteachable” and that she might have to be institutionalized. She stayed with her Catholic parents until she was almost school age. At this point, the military drafted her father into service for the German forces. Unfortunately, her pregnant mother gave in to the pressures of the government and they placed Anita in an institution. The Nazi officials wrote many official letters to Anita’s parents saying she was doing well. However, in the summer of 1943, Anita’s mother received a telegram saying that her child had died of pneumonia due to influenza. In truth, the Nazis killed Anita with a lethal overdose of a medication. She was one of 209 children who the medical professionals murdered at the Kaufbeuren killing facility in Bavaria, Germany, between 1941 and 1945. Hart’s young life tells us that she thrived until the forces of evil overpowered her. 

Brass plaque details the institutionalization and murder of Reinhard Beyth 1923-1940. Details in image credits.
Reinhard Beyth, murdered at 17

The story of Lisa and Elvira Hempel is one of rejection, loss, and survival. After eight-year-old Elvira’s neglectful, impoverished parents contacted officials to get rid of her, the Nazis declared her “feeble-minded” and took her by bus to Uchtspringe State Hospital. At the mental institution, she observed that most of the people there were disabled. She met her younger sister Lisa, age three, for the first time. Lisa had been put under the state’s authority right after she was born in 1935 because her mother refused to take her home from the hospital. Lisa never lived with her family. In a certain wing of the hospital, Elvira recalled hearing babies behind locked doors and their screams. On the day Elvira left the hospital, she said no babies remained, only bare mattresses. She remembered seeing that babies who cried too much or made strange noises were “quieted” when a nurse went into their rooms with a syringe. Later, this man, referred to as Totenmann, or “death man” in German, wrapped the babies in white sheets and took them away. To protect Lisa, who was routinely punished for bedwetting due to her severe developmental delays having grown up deprived of care in the institution, Elvira would take her into her bed each night to leave the sheets in the other bed dry. In her telling, Elvira was deeply traumatized and described how she could not figure out what her crime had been that had put her there. The Nazis took Lisa to Brandenburg, one of the killing facilities, before she turned five. They killed her with lethal gas. Somehow Elvira persevered. The Nazis later transported her to Brandenburg in 1940. More than 9,000 people—age two to 87—were murdered in the gas chamber there. A known Nazi doctor somehow chose to turn Elvira away when they brought her to the small room adjoining the chamber. In an inexplicable turn of events, Elvira lived and became a key eye witness to the atrocities. Her oral history stories are some of the only primary sources we have from a survivor of the early genocide of disabled people. In one of her stories during the Russell Tribunal on international war crimes, she exclaimed that they were all “completely healthy children!” She later wrote a book and described how it was about her “revolting life.” 

Born in 1934 in what is today the Czech Republic to a large, poor Jewish farming family, Harry Dunai is a remarkable Deaf survivor of the Holocaust. In 1940, his mother enrolled him in a Jewish Deaf school, one of only 16 Deaf schools in Hungary. Surrendering him to the school’s care, she left him without saying goodbye at the school principal’s direction. In 1944, the Nazis had deported more than 400,000 people from Hungary to their deaths. The fate of the Jewish children at the Deaf school was bleak: the school closed and they were either sent home or sent into Nazi hands. Dunai was sent to an orphanage. Shortly after, the Nazis bombed the building and the children were now fully homeless. The children were left to roam the streets looking for care. Dunai’s former teacher cared for him for several months until it became too dangerous to do so. In an effort to save him, she brought him to a Red Cross camp where the fascists could not enter. The Nazis invaded the camp regardless, looking for Jewish people. Dunai saw a deaf child who could not hear the warning about the Arrow Cross raid shot dead by the Nazis. The Nazis put those who survived the raid into a ghetto. In 1945, the Russians liberated the ghetto and freed 11-year-old Dunai. Officials told him of the deaths of his parents and two of his brothers, and enrolled him at a Communist-sponsored Deaf school, a school like those where many disabled survivors found help during and after the Holocaust. At 16, Dunai became an apprentice at a mechanics company. Later, he traveled to live near extended family in Sweden, and then journeyed to many European countries and Israel. He eventually settled in Los Angeles with his wife, who was also Deaf, and raised three daughters. One of his daughters recorded his story and wrote his biography. 

Under the most dire circumstances, all children, including disabled children, during the Holocaust actively tried to do what they could to survive, to seek their basic human rights and freedom, and to protect and care for one another when possible. Their stories and the documents related to their experiences demonstrate some of the Nazis most destructive atrocities and war crimes. In addition to focusing on the children as victims and survivors themselves, it is necessary to also highlight the courageous people who spoke up on behalf of children and how they endeavored to speak out for children’s humanity and to save as many young lives as they could. We can look to the voices of child heroes who wrote their stories at the time, children who participated in rebellions at the killing centers, teachers who risked their lives to save children, and clergy who used their public positions to speak out. 

Many know the story of Anne Frank, a former Montessori student who kept a diary of her experience hiding from the Nazis in Amsterdam. Frank wrote, “Although I’m only fourteen, I know quite well what I want, I know who is right and who is wrong. I have my opinions, my own ideas and principles, and although it may sound pretty mad from an adolescent, I feel more of a person than a child, I feel quite independent of anyone.” Like Frank, there are stories of children who would not be silenced and who took action for themselves and disabled children in the Holocaust. Many children and teens—boys and girls alike—participated armed and unarmed as resistors and some even supported secret newspapers to spread word. Even the youngest practiced acts of defiance by sharing food and basic goods. 

One incredible story is that of young people at the Sobibór killing center, many whose names we do not know now, and who joined up with adults in revolts and uprisings against the Nazis and their genocidal policies. One teenager who lived to tell about his experiences was Berel Dov Freiberg. The Nazis selected fourteen-year-old Freiberg to labor at the killing center in German-occupied Poland. The fascists set up the Sobibór institution originally as part of Aktion T4 and they killed many disabled people there. In 1943, after 17 torturous months of work and starvation, Freiberg participated in killing 11 German and Ukrainian guards after raiding the Sobibór arsenal. The rebels received fire from more than 450 armed men. Some of the armed prisoners did not make it. Freiberg made his courageous escape into the woods by foot with 23 adults and children. He joined a Jewish partisan unit in Lublin and later testified at the war crimes trials of Adolf Eichmann and John Demjanjuk. Photographs of Sobibór only surfaced in 2020 and they are now in the collection of the United States Holocaust Memorial Museum. Included among them were images of Demjanjuk that proved he was at the killing center. 

Another awe-inspiring story is of an adult, the Dutch Montessori principal and Protestant pacifist Johan “Joop” Westerwheel and his wife Wilhemina. The Westerwheels had ties with the Jewish community, including Jewish child refugees, near Amsterdam. In August 1943, the Westerwheel group, as they had become known, found hiding spaces for more than 50 people. Thirty-three people survived and the Dutch deported the others for betrayal. The Westerwheels were not deterred and strategized about how to leave the Netherlands. In 1943, they led a group through dangerous territory to France. Before leaving the refugees in France, Joop urged them to remember the suffering in the world at large and his last words to them were, “No more war.” By 1944, the Dutch arrested Wilhelmina and a collaborator, and imprisoned them in what is now the Hague. Joop placed his four children with family, quit his Montessori job, and went underground. He continued to attempt to move Jewish people to safety. In March 1944, Joop and a collaborator were trying to move two Jewish women to safety when the Nazis arrested them, sent them to the Herzogenbusch killing center, and tortured them. His last words to the world outside were a poem about beauty and inner conviction. In August, the German fascists murdered Joop in front of Wilhemina. She survived and lived to tell their stories. In Israel, Joop and Wilhemina’s children have carried on their legacies. 

In August 1941, Catholic bishop Clemens August Count von Galen became the most outspoken adult voice on behalf of disabled children and adults who the Germans were persecuting and murdering. As the Nazis expanded their programs from the very young to all disabled people in Germany and beyond, some church leaders, judges, parents, and physicians began to speak out. Galen wrote a sermon that would become historic. He delivered these words based on the biblical commandment not to kill: 

    It is simply because that according to some doctor, or because of the decision of some committee, [disabled people] have no longer a right to live because they are “unproductive citizens.” . . . If you establish and apply the principle that you can kill “unproductive” fellow human beings then woe betide us all when we become old and frail! . . . it is only necessary for some secret edict to order that the method developed for the mentally ill should be extended to other “unproductive” people. 

Galen circulated more than a thousand copies of the sermon in Germany and among German troops. Hitler and the Nazis put him under house arrest, but did not take further action against him due to his high status in the Catholic Church. They did, however, persecute priests who read the sermon to their congregations after, including using violence against three of them. As a result, within weeks, the Nazis claimed that Aktion T4 was halted. In reality, the killings continued, just by different, more secretive means. In 2005, Galen was beatified by the Catholic Church for his moral actions. 

Today, it is a race against time to help the living disabled survivors of Aktion T4 and the Holocaust. The International Organization for Migration (IOM), a United Nations–related organization, has led a concerted effort with more than 360 organizations across Europe and Asia to identify disabled survivors who became refugees as a result of the earliest days of Hitler’s Holocaust. While very few disabled survivors lived, IOM continued extensive research. By 2004, IOM had assisted more than 1,800 disabled beneficiaries with material goods, homecare, and medical, legal, and social assistance. Many of the stories of these survivors remain untold. In addition to aid, historians must act to gather their stories now before they are lost. 

The legacies of these heroic victims, survivors, and humanitarian responders from the era of Aktion T4 and the Holocaust live on in the disabled advocacy community today from Europe to the United States. Disabled rights advocacy leader Judy Heumann herself was the grandchild of Holocaust victims. Both sets of her grandparents died at the hands of the Nazis. Her life stands as a testament to belief in humanity and human rights as she changed the lives of disabled people in America and internationally. Similarly, Holocaust survivor Dr. Hilda Freundlich Rothschild, who studied with Maria Montessori, created the first Montessori teacher training program in the United States in 1965 and helped to set up the first Montessori school in the nation. Rothschild was the founder of the Montessori movement in America. Following in the footsteps of Maria Montessori, the first students she worked with after settling in Cincinnati were preschoolers with cerebral palsy who were thought to be “unteachable.” Arguably, Rothschild set up the path for generations of American students to find similar conviction as Anne Frank, the Westerwheels, and the many believers in peace during and after the Holocaust. Like the historical fiction of the graphic novel The Thud, we need to tell the stories of disabled people before, during, and after the Holocaust so that we may remember them and learn from the mistakes of those who sought their elimination. 

 

Bibliography

Primary Text Source (Interview, Memoir, Etc.) Referenced in Secondary Source

  • Dunai, Eleanor C. Surviving in Silence: A Deaf Boy in the Holocaust; the Harry I. Dunai Story. Washington, DC: Gallaudet Press, 2002. 
  • Gitter, Lena. Oral History. “Collections Search - United States Holocaust Memorial Museum.” https://collections.ushmm.org/search/catalog/irn506691. 
  • Heberer, Patricia, ed. “Children in the Concentration Camp Universe,” Chapter 5, Children During the Holocaust. Lanham, MD: AltaMira Press in association with the United States Holocaust Memorial Museum, 2011. This chapter includes oral history of Berel Dov Freiberg, who at 15 years old was part of a children’s resistance movement within the Sobibor camp, which had many personnel from Aktion T4 (see pages 173–76). 
  • Heberer, Patricia, ed. “Children in the Web of Racial Hygiene Policy,” Chapter 6, Children During the Holocaust. Lanham, MD: AltaMira Press in association with the United States Holocaust Memorial Museum, 2011. This chapter includes letters from Nazi doctors to parents telling them that they were required to sterilize their disabled children as well as decrees and patient documents about euthanasia and images of disabled children who died at the hands of the Nazis by euthanasia. 
  • Heberer, Patricia, ed. “Children and Resistance and Rescue,” Chapter 9, Children During the Holocaust. Lanham, MD: AltaMira Press in association with the United States Holocaust Memorial Museum, 2011. This chapter includes further oral history from Berel Dov Freiberg who participated in the killing of several German and Ukrainian guards during a rebellion by child prisoners. It also includes an image and oral history from a woman who escaped to Belorussia (now Belarus) with women, children, and the elderly. 
  • Robertson, Michael, Astrid Ley, and Edwina Light. The First into the Dark: The Nazi Persecution of the Disabled. UTS ePRESS, 2019. www.jstor.org/stable/j.ctv1w36p9p. 
  • United States Holocaust Memorial Museum. Oral History Interview with Hilda Rothschild, 1981. https://collections.ushmm.org/search/catalog/irn511436. 

 

Primary Image Source (Photograph, Drawing, Etc.) Referenced in Secondary Source

 

Primary Media Source (Video, Audio, Etc.) Referenced in Secondary Source 

 

Secondary Sources

 

Article image credits:

 

A European American boy with medium-length hair and glasses wears sneakers and a sweatshirt as he sits on bench by a wooded lake in fall
Wyatt Edwards, student

 

Wyatt Edwards is a first-year high school student in Metrowest Boston and a proud graduate of Oak Meadow School in Littleton, MA. He’s passionate about history, disability and climate action, and music. He is very grateful to Mr. Scheurle, Mrs. Fox, Mr. Wilkins, Mr. Dauphinais, and his classmates who inspired him and supported him in writing this project (along with sometimes finding his puns and jokes funny!).

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Rich Cairn

Civics and Social Studies Curriculum and Instruction Specialist, Collaborative for Educational Services
Rich Cairn founded Emerging America in 2006, which features the Library of Congress Teaching with Primary Sources program at the Collaborative for Educational Services, and the National Endowment for the Humanities Landmarks of American History program, "Forge of Innovation: The Springfield Armory and the Genesis of American Industry." The Accessing Inquiry clearinghouse, supported by the Library of Congress TPS program promotes full inclusion of students with disabilities and English Learners in civics and social studies education.