Introduction

In the wake of the Second World War, most social infrastructure in Europe was in a state of collapse, and restoration was urgently required. For this reason, during the period spanning from 1945 to the 1960s, Belgium, France, and the Netherlands welcomed a substantial influx of foreign workers. Hanagan (2004) observed that transnational labor history studies result from labor market demand, state labor policies, the actions of workers, or the practices of working-class institutions. This definition is meant to be inclusive and accommodating but not so broad as to be meaningless. As a term, “transnational” avoids the Universalist implications inherent in the terms “global” or “international” and permits a focus on bi-state or multi-state intercourse (Hanagan 2004: pp. 455–456; Wilson 1994: pp. 269–278).

Amidst these trends, a “struggle for workers” broke out in West German companies (Pagenstecher 1995: p. 720). The shortage of workers was compensated for via “guest workers” (Gastarbeiter). The Federal Republic of Germany initially opted to recruit foreign workers from the Mediterranean region. This was prompted by the so-called economic miracle that occurred shortly after the Second World War and characterized the economic boom of post-war Germany. Throughout this period, numerous industries experienced growth, leading to an abundance of jobs and consequently a shortage of labor (Butterwege 2005). The guest workers were viewed as an “industrial reserve army” (Pagenstecher 1995: pp. 722–723), which could be utilized as required and to comprise of continuously rotating guest workers (Kim 2017).

During this period, Germany primarily faced a severe shortage of workers in the social care sector. Aside from the issue of the labor shortage on one side and the hopes for employment on the other, another factor proved to be significant: developmental support in the context of foreign relations during the Cold War (Knortz 2008). These relationships held significant importance. Consequently, workers from various countries, such as India, Taiwan, the Philippines, Trinidad, Ecuador, and Mauritius, arrived under the pretext of educational assistance programs. Kolben (2011) suggests that governance theories of regulation can offer valuable insights into describing and conceptualizing new forms of transnational labor regulation that have emerged in the context of a weak state regulatory capacity (see also McCallum 2013). He argued that the prominent governance models that have been applied to transnational labor regulation, namely systems theory, responsive regulation, and new governance, are ill-suited for addressing the exigencies of labor regulation in developing countries.

At this time, it was this very scheme—developmental aid—that facilitated labor migration from South Korea to West Germany. During the 1950s, in the aftermath of the Korean War, South Korea became the largest recipient of developmental assistance globally. With the onset of the Cold War, developmental aid emerged as a critical mechanism employed by powerful states. Strong states are characterized by a consolidation of power and stress on economic over political rights. Notably, strong states like the US and Soviet Union, as significant global powers, were able to address and advocate for the political and economic concerns of nations aligned with their respective blocs, guided by robust leadership and authoritarian principles (Frey 2005; Stöver 2007). This confirmed and reinforced the importance of bilateral partnership between Korea and Germany, with Korean nursing students and trainee technicians participating in the flow of migrant labor (Lee 2006). Both parties regarded these set of developments as arising from a suitable pretext and as a pragmatic alternative to previous circumstances.

On December 13, 1961, a developmental aid plan was initiated, followed by the commencement of a Korean–German investment guarantee agreement that began on February 4, 1964. Subsequently, on April 9, a trade agreement was enacted between the two nations (Choe and Daheim 1987; Yang 2008). To assist with technical development, the German government began receiving small cohorts of Korean technical trainees. In 1963, Korean miners were sent to Germany to acquire mining skills as part of their qualification. However, there was minimal distinction between a mining technical trainee and a formal worker.

The Korean War (1950–1953) served as the primary catalyst for dispatching the nursing workforce. Germany opted to extend educational aid in the form of international monetary and non-direct aid in cooperation with the United States (USOM). The intention behind sending Korean miners and nurses to Germany was not to recruit them as workers but to educate them as trainees (Ausbildung) (Yi 2009; Na 2013, 2016; Yang 2008).

The dispatch of Korean nurses to West Germany commenced in the late 1950s and persisted until January 1966. Subsequently, from March 1966 to 1969, the nurses were dispatched through a collaborative effort between the government and a private initiative. Additionally, between 1970 and 1976, the government implemented the first and second Nursing Agreements. Initially, during the first period from the late 1950s until January 1966, the private sector, in collaboration with figures such as Catholic Church Father Eichinger, Dr. Lee Jong Soo, and Dr. Lee Su Gil, facilitated an unofficial dispatch of nursing personnel to Germany. Their arrangement could be perceived as primarily educational, entailing Korean nurses traveling to Germany to receive nursing education. However, during the second period (March 1966–1969), the government and the private sector collaborated with Korea’s overseas development agency, indicating the emergence of political motives in the process. The focus of the agreement gradually shifted from providing educational assistance to engaging in labor trade. This transition prompted criticism from major media outlets both within and outside Germany, as well as from East Germany, North Korea, and China, labeling the dispatch of Korean nurses to Germany as “slave trade.” The Japanese Sisters Association voiced their disapproval to the German recruitment measures, highlighting the challenges Korea also encountered as a result of nursing shortage. By the third period, 1970 and 1976, Germany received 7033 Korean nurses, bringing the total number of nurses dispatched between 1965 and 1976 to 10,032 (Choe and Daheim 1987; Garz 2014; Hong 2009; Kim et al. 2009; Na 2013, 2016; Noh 2014; Winkler 2009; Yu 2014).

This was not the first instance of South Korean nurses receiving education and training from Western European states. When the Korean War erupted, several countries dispatched medical support groups as humanitarian aid to the United Nations. Among these contributors were three Scandinavian countries, Sweden, Denmark, and Norway, which not only dispatched their medical personnel to tend to immediate medical threats but also established the Scandinavian education hospital in South Korea to train Korean nurses, offering a more enduring solution to South Korea’s war-torn healthcare system (Park 2010; Östberg 2014). The fundamental contrast between the case of Scandinavian medical aid and the labor migration of Korean nurses to Germany in the 1960s and 1970s is the nurses who went to Germany were not recruited by the government for post-war reconstruction purposes. Korean nurses were compelled by the government in any way to apply for positions in Germany; however, the aggregate number of recruited personnel surpassed 10,000. Additionally, unlike in the Scandinavian arrangement, the labor contract offered to the Korean nurses recruited for Germany was that of trainees, despite their official certification in South Korea.

Sending Korean nurses to Germany has been denounced as akin to “slave trade” despite being a form of development support. The contemporary definition of slave trade entails a 3-year contract between state governments, where contractors are compelled to work in designated workplaces under unjust conditions (Choi and Lee 2005: pp. 739–740). Reports from East Germany indicate significant debate and criticism prior to the dispatch of nurses, focusing on the nature of development aid provided by West Germany to South Korea. Gerhard Reuter, the press attaché of the GDR’s Embassy in North Korea, criticized on March 2, 1961, that a supply contract for cheap labor forces concluded with West German monopolists under the pretext of “training South Korean specialists in West Germany.” The representative of the GDR Embassy emphasized that even rural press in West Germany covered the story of foreign workers subjected to poor living and working conditions. With these critiques in mind, this study aims to investigate whether the dispatch of nurses to West Germany truly constituted “development support” or rather resembled “labor trade” (Fortney 1970: pp. 217–232).

The study refutes prevailing belief that Korean nurses traveled to Germany under the guise of educational assistance. Its objective is to illustrate that the agreement between the two nations was not genuinely oriented towards educational goals, but rather towards providing labor support.

This paper will explore the educational, economic, political, and sociocultural reasoning behind this perspective. In particular, by comparing the various aspects of the two countries, such as their respective education systems, this study will scrutinize the challenges encountered by Korean nursing trainees. It will probe into the question: why did they pursue education in Germany only to confront disillusionment and obstacles? Were there contractual obligations of which they were unaware? The discussion will be based on previous studies, and will draw from relevant historical documents, including the archives from the National Institute of Korean History and the German Federal Archives in Koblenz. Moreover, oral sources will complement these archives and previous studies, acknowledging the potential limitations of available data.

Comparison of nursing education in Germany and Korea

Despite facing difficulties in a competitive environment, Korean nurses opted to pursue opportunities in Germany, envisioning that exposure to a developed country would offer superior educational and income prospects. To begin with, it is imperative to scrutinize the nature of education and training provided to these nurses in Korea, followed by a comparative analysis of their experiences in nursing education between German and Korea.

The nursing education curriculum in Korea has been widely implemented across various educational institutions. College programs typically spanned 3 years, whereas university programs extended over 4 years. The associate degree program, a 3-year nursing education track, evolved from the diploma nursing programs, requiring students to hold a high school diploma or its equivalent for admission (Koh, 2011). In the mid-1960s, there were an insufficient number of German nurses to fulfill the demands of the German social welfare policy. Germany has a rich history of formal nursing education dating back over a century. Before 1850, concerted efforts were made to establish the nursing profession, practiced by both Catholics and Protestants under the names Frauenorden and Diakonie, respectively (Na 2012; Shin et al. 2008). Nursing education in Germany was historically decentralized, with individual hospitals responsible for their own training standards. Oversight of training and supervision fell under the purview of each jurisdiction’s health center, which supervised official hospitals, Red Cross facilities, and affiliated official and private organizations.

All of these organizations provided educational opportunities operating in accordance to the same order, laws, ordinances, and supervision. However, comparing these programs with other educational organizations is challenging due to their unique labor structure, overseen by the school and chamber. According to nursing law, the location where instruction occurred was termed a “school,” though this was not the typical school as per our contemporary understanding, settled by the federal court of social justice. The knowledge essential for nursing and childcare was not solely acquired in the “school” but also through practical training experiences. These practical training sessions, known as German Ausbildung, were conducted in hospitals, where Korean nurses also participated upon arriving in Germany. Thus, German nursing education primarily occurred not within a “school,” but within an official hospital setting (Seidler 1966; Yoo 1975). The difficulties of nursing education were mitigated by practical training, often referred to as “basic nursing” in hospital settings, rest homes, and sanatoriums. “Basic nursing” encompassed a range of activities including progressive patient care (Haldeman 1959; Lockward et al. 1960), personal hygiene, household cleaning, patient observation, and internships. Practical training was supervised by a superior (Oberin), who also had the authority to represent the general work of a nurse in a hospital room. In Hamburg, a similar master’s examination with a dual-degree program in nursing education and training was conducted which roughly corresponded with the master’s test (Meisterprüfung) in the dual system of nursing education. According to German nursing statutes (Der § 7 Abs. 2 des Krankenpflegegesetzes), a superior, senior nursing force (leitende Krankenpflegekraft), or doctor (Arzt) oversaw all training. However, merely overseeing practical nursing training does not suffice to ascertain pedagogical education attainment. In Germany, nursing education lasted approximately 3 years (please note that in Germany, the term “practical activity” was not defined legally) with practical activities commencing prior to the graduation examination (within 32 months). The theoretical training phase lasted approximately 1200 h, constituting a quarter of the total theoretical training duration undertaken by Korean nurses during their college education, which spanned 3 years (however, it is worth noting that the number of school hours could vary based on individual curriculum arrangements).

Educational aid despite difference in academic background

As demonstrated above, there were notable distinctions in nursing education between the two countries. The German and Korean systems employed unique training methodologies and significant differences in the scope of responsibilities assigned to nurses. German nurses were trained within the nursing schools affiliated with individual hospitals while Korean nurses were mandated to attain a level equivalent of Abitur (Diploma in German Gymnasium, i.e., university entrance qualification) and pursue higher education at a college or university.

The 2008 report from the Korean “Truth and Reconciliation Commission,” revealed that between the 1960s and 1976, 11,057 individuals went to Germany (Truth and Reconciliation Commission, 2008). However, according to the Korean Nursing Assistant Association, the figure for the same period was 10,564, revealing a minor numerical difference. Out of the 10,564 individuals, 4051 were nursing assistants dispatched to West Germany, constituting 40% of the total (Korean Licensed Practical Nurses Association 2010).

While German hospitals and Korean applicants celebrated this agreement, it was not universally welcomed. One reason was that sending officially qualified nurses exacerbated the shortage of nurses in Korea (Jeong and Park 1988, p. 127). Another reason was the push to send personnel trained through development aid programs to work in German hospitals. Consequently, both officially qualified nurses and nursing assistants were sent to Germany, but interestingly, the newly introduced position of nursing assistant was particularly appealing to Korean nursing personnel. This was partly due to the fact that nursing students received only minimal compensation during their training, while nursing assistants enjoyed regular salaries (Na 2009, pp. 263–264).

Before Korean nurses and nursing assistants were dispatched to Germany, they attended a cultural orientation program known as the “Korea Program.” The President of the Federal Labor Office conducted German culture lessons utilizing educational materials such as the language instruction film “Good Day” (Guten Tag) along with accompanying study materials, slide projectors, and tape recorders (NIKH)Footnote 1. A letter from the German Hospital Association (Mr. Lauterbacher) to the German Labor Social Service Department (Bundesminister für Arbeit und Sozialordnung, Mr. Dr. Ernst) emphasized the need for pre-training Korean nurses before their arrival in Germany. This initiative subsequently led the Korea Overseas Development Corporation (KODCO) to offer comprehensive education, incorporating German language courses among other aspects (Yoo 1975).

The German Hospital Association expressed concern that “The Korean side have been facing significant difficulties in the recent implementation of the abovementioned program, which have had a notably adverse impact on the staffing strategies of German hospitals, particularly impeding efforts to address the shortage of nursing staff in the Federal Republic. The program is no longer or only partially completed by the Korean side” (NIKH)Footnote 2.

How did Korean nurses navigate the unfamiliar environment? The challenges they faced during their tenure in Germany are beyond our immediate grasp. Ruth Elster, the president of the German Nurses Association (Deutsche Schwesterngemeinschaft), highlighted that the adjustment and adaptation period for foreign nurses was protracted, extending far beyond mere weeks or months to encompass years. Consequently, by the time these nurses adjusted to their new circumstances in Germany, their contract would be concluding, carrying profound implications for both the countries concerned and the nurses themselves (NIKH)Footnote 3.

The German Caritas Association acknowledged “the manifold difficulties arising from the presence of these girls from overseas, i.e. from the fact that the houses primarily want to compensate for their shortage of labor, while the girls expect quality education. German nursing education is not recognized in Korea, it is only equivalent to a secondary education. Further difficulties arise from the difficulties of converting to completely unfamiliar work, a different rhythm of life and unknown forms of society. The girls have a difficult-to-understand mentality, which, together with the language difficulties, often leads to very disappointing misunderstandings” (ADCV) Footnote 4.

As shown in Fig. 1, in Korea, the term “nurse” encompasses professionals working across various healthcare settings such as general hospitals, sanatoriums, or nursing homes. Their tasks and responsibilities include (a) providing comprehensive patient care to the point patients reach a healthy psychological and mental well-being, (b) managing financial and administrative tasks within the hospital, and (c) fostering a compassionate and patient-centric work environment among colleagues. The differentiation between nurses and nursing assistants in Korea lies in the level of professional responsibility. To qualify as a nurse, individuals must undergo six to eight semesters of college or university education, whereas nursing assistants require only 9 months of vocational school training, following completion of Junior High School. Nursing assistants primarily serve as auxiliary personnel and must pass an exam overseen by the provincial governor (Yoo 1975). Dr. Covey emphasized in her report that “the distinction between nurses and nursing assistants must not be ignored. In fact, nursing assistant training programs were initially set up only due to the demand of Germany and with specific job opportunities in Germany in mind” (NIKH)Footnote 5.

Fig. 1
figure 1

Administrative hierarchy of nurses in Korea (Yoo 1975; Yu 2014)

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In Germany, nurses had a broad spectrum of duties, including basic nursing, healing nursing, administration work, caregiving, and home care, and numerous other related tasks.

As depicted in Fig. 2, ward nurses in Germany were placed under the supervision of doctors (Burger and Seidenspinner 1979). Their tasks were administration, organization, personnel management, medical treatment, and basic treatment. A second nurse would be responsible for medical treatment, basic treatment, and guiding of student nurses. In the German system, nursing was categorized into two main categories: basic nursing (Grundpflege), which focused on rest and sleep, and treatment nursing (Behandlungspflege), which emphasized providing support colleagues.

Fig. 2
figure 2

Administrative hierarchy of nurses in Germany (Yoo 1975; Yu 2014)

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In Korea, both nurses and patients’ guardians were involved in providing basic nursing care to patients, whereas in Germany, this task was conducted solely by nurses. Also, Korean nurses were supervised by both doctors and the nursing department, while in the case of Germany, nurses were directly supervised by doctors only (Burger and Seidenspinner 1979; Yoo 1975).

The duties assigned to nurses highlight their functional differences. Korean nurses primarily focus on progressive patient care which involves organizing medical and nursing care according to the severity of illness and the hospital’s care requirements. This approach includes elements such as intensive care, intermediate care, self-care, long-term care, and organized home care. In contrast, German nurses concentrate more on the fundamentals of nursing known as basic nursing. Consequently, Korean nurses were unable to perform their progressive patient care role in German hospitals, where the hierarchical system and subordinate relationship regulations differ from those in Korea. Similarly, German nurses were not trained for this function because they work in a hierarchically oriented system with subordinate relationship regulations whereas Korean nurses work with a labor team that is functionally connected to a team of doctors (Na 2009; Yoo 1975). Ruth Elster of the German Nurses Association pointed out that the care process is due to the significant role played by the patient’s family in Germany, where relatives often provide care, bring food, and even cook for the patients (NIKH)Footnote 6.

Yoo’s (1975) study, which involved interviews with 146 dispatched Korean nursing staff, uncovered widespread dissatisfaction among respondents regarding the information provided and the quality, scope, and content of German language instruction. Overall, they arrived in Germany with minimal information and language skills. Moreover, the provision of ongoing education, particularly language education, was carried out differently across German hospitals. Further preparatory measures, particularly language courses, in the Federal Republic were uncoordinated and left to the discretion of employers. The public institutions generally fared better in this regard, while private ones were notably deficient, and denominational institutions fell somewhere in between.

The analysis of the work situation revealed the following findings: Among the Koreans surveyed, 18.7% expressed satisfaction with their work conditions, 44.4% reported partial satisfaction, and 37% indicated dissatisfaction. The dissatisfaction is believed to arise from the misalignment between the tasks assigned to them and the organizational structure of the workplace, in contrast to what the nurses’ initially anticipated. In reality, they attended to more patients in South Korea because basic patient care was being handled by family members and assistants. The situation was further aggravated due to their lack of language proficiency. One nursing assistant complained about her experience, stating, “Cleaning is my daily bread in the workplace and this has been going on for almost a year now. I am now just used to cleaning up. That’s only half as bad. What’s worse is the behavior of my colleague, the cleaning lady, who frequently makes unfounded claims. If anything goes wrong on the ward, she would falsely inform the nurse “I would have done that” or “that’s my doing” (nursing assistant, born in 1953, entered Germany 1972).”

The cited statements reveal that dissatisfaction in the workplace is not solely attributed to inadequate language skills, as asserted by the Germans, but also on job classification and biases. Initially, the Koreans found the work disheartening because their roles were defined differently from those in South Korea. Unlike in South Korea, where roles are distinctly separated, the division of tasks between nurses and nursing assistants in Germany was less clear. While in South Korea, tasks such as assisting with toileting and feeding were typically handled by nursing assistants, German nurses directly performed all patient care duties. Moreover, while nursing education in Korea emphasized theoretical knowledge, Germany placed greater emphasis on practical training. Initially, the Korean nurses were apprehensive and uneasy about patient-centered care, concerned that their Asian background or limited proficiency in German would disadvantage them (Joung et al. 2017, p. 76). Such facts were largely unknown to German sisters and physicians, resulting in frequent misunderstandings that were difficult to address due to language barriers. Consequently, this led to conflict between German and Korean nurses, as well as within the Korean nursing staff, hindering cooperation and often disrupting the peace of mind (Yoo 1975).

German–Korean contract and criticisms of sending Korean nurses to Germany

There was widespread criticism both domestically and internationally regarding Korea’s dispatch of nurses to Germany. At the time, there was considerable speculation about the specifics of the contract between the Korean and German governments. This was due to the fact that the procedures carried out by Germany for the influx of foreign labor were not properly executed compared to those with other countries. Typically, such exchanges involve formal agreements between nations, the establishment of relevant organizations in both countries, and various established protocols. However, in the case of receiving nursing personnel from Korea, these procedures were delayed. Despite interest and acknowledgment from German hospitals and labor agencies about the possibility of Korean nursing personnel going to Germany, there was curiosity on the Korean side due to the absence of a governing body overseeing the matter. It was not until August 1969, after the Overseas Development Corporation was established in 1966, that formal agreements between the two countries were made. Furthermore, contracts written in bilingual format regarding Korean nursing personnel were not finalized until 1970. In fact, selecting nursing as the profession for education to support Korea’s development at that time could not be expected as a path to yield meaningful results. The nursing standards in Korea were higher than those in Germany, and individuals were receiving education as more specialized medical professionals (Bundesarchiv-Koblenz, B. 149. 22428Footnote 7; Na 2009, pp. 275–276). In fact, some in Germany believed that this was not an issue of development aid but rather driven by Germany’s labor market policies. They argued that since nursing education and re-education for nurses in Germany held no significance for Korea, it was an inappropriate view to consider it as aid (Na 2009, p. 277). Thus, in order to gain a comprehensive understanding of this development aid, it is imperative to thoroughly examine the feed record in Germany regarding these contracts.

To understand the educational disparity between Korea and Germany, it is necessary to scrutinize the firsthand account of a German nurse who visited Korea during that period. Between May 14 and June 12, 1967, the German Nurses Association observed nursing education across several Asian countries, including Japan, Taiwan, the Philippines, and Hong Kong. Upon her return to Frankfurt, Ruth Elster of the German Nurses Association documented her observations and reported it on June 20, 1967. Her motive for visiting Asian countries, including South Korea, reveals that the nursing shortage in Germany had been growing in recent years and staffing hospitals had become increasingly difficult; since 1965, various efforts had been made in different locations to recruit nurses from abroad to work in Germany. Over 1000 sisters were recruited from Korea alone and transported to Germany by chartered flights. Ms. Elster elaborated precisely on her purpose for visiting and Germany’s pressing need: recruitment. She states that “recruitment did not follow uniform guidelines under the same conditions; this led to certain difficulties.” She noted dissatisfaction from the Korean side regarding these recruitment methods, with complaints also coming from international organizations and state governments involved in development aid. “There were complaints from Korea about the German arrival or better-said “recruitment” as the country itself was in a sister shortage. Similar complaints came from international organizations and state governments that were active in various countries in the context of development aid and now saw that their promotion was now apparently in favor of Germany.” Despite the objections raised, recruitment activities persisted. She elucidated that “Conversely, government, private individuals, representatives, churches, travel agencies, sister associations, etc. have continued to offer sisters from Korea, Taiwan, and the Philippines, sometimes numbering up to 500–600 per year. It was also evident that ‘money transactions’ were occurring on various channels regarding the mediation of foreign sisters, leading to instances where untrained personnel were sent to Germany posing as trained sisters.” She emphasized that these issues resulted in numerous difficulties and complexities, although they were not thoroughly documented. Consequently, she grasped that “among the responsible ministries, the German hospital society, the sister associations, other such organizations, and the German diplomatic representatives had finally reached the conviction that things could not continue like this” (NIKH)Footnote 8.

Ms. Elster and her team visited the German Embassy in Seoul, the Korean Ministry of Health, and the Korean Nurses Association and commented:

“I have gained a good impression of the Korean Nurses Association. I think that it works reliably and impeccably. (…) The Korean Nurses Association was also known, with which money transactions are made due to the ‘sister export.’ During my visits to nursing schools, hospitals, receptions, and others, I was asked the same questions as in Japan. Again, the terms ‘human trafficking’ and ‘slave trade in a modern form’ were used several times. It has been confirmed to me that complaints about the “export” of Korean sisters to Germany have been sent to the WHO, the embassies of the countries hosting Missionary Hospitals in Korea, and others” (NIKH)Footnote 9.

Since 1966, the analysis of second-phase contract research has shown a shift away from viewing it solely as an educational endeavor to regarding it more as a labor export initiative. Ms. Elster had a meeting at the German Embassy in Seoul on May 20–24, 1967.

“I had a very short conversation with Hern Schäfer and was then forwarded to Mr. Fritz Schmidt, who had taken over the handling of the ‘sister’s question’ a week ago from his predecessor. Mr. Schmidt said very clearly that the embassy was unable to verify the papers of the Korean sisters in Germany. The embassy had also received no documents except those necessary for issuing a visa. People could also buy diplomas in Korea; everything could be achieved with money. It was also impossible for the German embassy to determine whether a Korean sister had been educated at a mission school or a school.” This dialogue highlights Germany’s preference for well-trained nurses as German authorities were expressing concerns about receiving inadequately trained nurses and sought evidence of their educational qualifications.

Ms. Elster, at a meeting with the Korean Ministry of Health, stated, “At the Korean Ministry of Health, I was received by Mr. Won Kyn Kim and nurse Mrs. Won. The meeting was unsatisfactory and I did not receive any written documentation about Korea’s healthcare system. The German sample employment contract for non-European nurses was not known by the Ministry of Health” and the “‘Overseas Development Corporation’ was responsible for the selection of sisters for Germany, with whom I would negotiate. Mr. Kim then said in response to my question about the 300 sisters who—according to the press release—wanted to go to Germany, that of those 300, only 50 had a full nursing education, the others being assistants” (NIKH)Footnote 10. KODCO and the Korean Ministry of Health stressed that more nurses and nursing assistants should be sent to Germany (NIKH)Footnote 11.

On June 25, 1970, the German Hospital Association signed a contract with KODCO which was approved by the council of Korean government ministers on August 6, 1970. According to this contract, at least 2200 nurses who had passed the national exam and 9800 nursing assistants were to be sent to West Germany between 1971 and 1974 (Choe and Daheim 1987; Shim 1974). In 1971, the German Hospital Association signed an agreement with KODCO regarding the Korean program for nursing staff in German hospitals and agreed to conclude negotiations by mid-February.

Based on Ms. Elster’s documentation, Dr. Conroy, the Head of the Training Committee at the Korean Nurses’ Association, wrote a letter to the German Embassy on March 17, 1971, addressing the nurse dispatch program in the Korean Times. This letter stated that the discussion of the advantages and disadvantages of this program had its roots in different priorities. While the program aligned with the Korean government’s focus on economic development and foreign exchange, there were concerns about its implications for humanitarian efforts. Dr. Conroy criticized the Korean government for excessively sending nurses to Germany, emphasizing that the solution to the issue of insufficient nursing care rests with Korean government. Additionally, Dr. Conroy noted that the allure of financial benefits from overseas employment and limited opportunities for talented nurses in Korea beyond its capital, Seoul, contributed to this situation. The uneven distribution of nurses across hospitals in Korea and the perception of an excess of nurses were the outcomes of this situation. Dr. Conroy concluded that addressing this “brain drain” posed a challenging task with no specific group or country deserving blame. Instead, the primary responsibility lies with the Korean government, which must actively monitor and commit to the country’s economic development. While this conclusion was not directly drawn by Dr. Conroy, it was indirectly inferred from her contributions; at any rate, a cessation of sister export would not resolve the issue of inadequate nursing care, especially in rural areas where the problem is more intricate. Tackling this dilemma requires considerable improvements in healthcare infrastructure to enhance the appeal of the nursing profession (NIKH)Footnote 12.

In these instances and with prior investigation testimony, the German authorities shifted their focus away from educational considerations to examine the validity in terms of labor exports and imports. They acknowledged the existence of an implicit labor export, contrary to the expectations of Korean nurses, who had anticipated educational support as part of the initiative.

Anti-communist solidarity and flexibility of labor in neoliberalism

North Korean and Chinese media condemned the dispatch of Korean nurses to Germany as the “slave trade” of Park Jung Hee, former president of South Korea. The German magazine Stern also echoed this sentiment, labeling the situation as slave trading. However, this arrangement represented West Germany’s method of providing developmental aid to Korea. In terms of development aid projects, this encompassed assistance directed towards countries in its own camp. Furthermore, the US swiftly called upon the prospering Federal Republic to contribute to development cooperation efforts as part of “burden sharing” in the global fight against communism. Strategically, this was driven by the understanding that economically disadvantaged populations were susceptible to communist ideology, potentially altering the balance of power in the East–West conflict unfavorably to the United States (Gieler 2011, pp. 10–11). Politically, West Germany had several motives for assisting South Korea. First, it aimed to strengthen alliances with anti-communist regimes. German Chancellor Ludwig Erhard was alert of the Soviet Union supporting impoverished nations and sought to forge an anti-communist alliance in Southeast Asia and the Far East, leading to continued support for Korea throughout the Cold War. Second, West Germany stood to benefit from the competitive dynamics within system. It is crucial to recognize the competition between regimes when discussing the connection between developmental aid and manpower transfer between Korea and West Germany during this time. Specifically, West Germany had to consider its rivalry with East Germany, as East Germany was actively involved in the reconstruction of North Korea (Heinemann 2013, pp. 73–98; Jeong 2014, pp. 136–139). Third, West Germany viewed international cooperation as crucial. Despite the lack of direct ties between West Germany and South Korea, cooperation at an international level allowed the United States to exchange necessary manpower. Given the high unemployment rates at the time, social instability posed a significant risk, potentially sparking a crisis that could pave the way for communist ideology during the Cold War era. Therefore, West Germany acknowledged the anti-communist stance of the Korean dictatorship and incorporated Korea into the developmental aid programs of 32 countries, recognizing its importance aligning with the West (Jeong 2014, pp. 123–125; Noh 2011, pp. 314–315).

In West Germany, there was a consensus between labor and management that the nation should prevent any hindrance to its economic growth due to labor shortage (Lee 2003). Acceptance of vocational training for Korean miners and nurses could be viewed as a form of developmental aid (Entwicklungshilfe) for South Korea. However, employment, vocational education, and developmental aid may have conflicting meanings. In the context of German vocational education, Korean female nurses were recruited for practical work and remunerated, a practice which Koreans misunderstood as education. In this case, this arrangement represented a mutually beneficial economic exchange, including the unilateral financial assistance from West Germany to South Korea. However, a deeper rationale for such training lies elsewhere: the value of short-term-contract migrant labor in fulfilling basic labor needs, as demonstrated in the case of West Germany’s labor dispatch. This form of labor resembles the flexible labor market policies of neoliberalism rather than technical aid.

On the German side, Germany urgently required a social welfare workforce. The German Caritas Association’s archive document that “private individuals, religious communities, and priests took the initiative, in part at the request of local priests and bishops. They offered girls from India and Korea the opportunity to work in German hospitals, to complete nurse training, and to support their families in their homeland with their earnings. Currently, about 5,000 Koreans live in German institutions, including trained nurses, nursing students, and nurse assistants. For the past three years, mediation has only been officially carried out in cooperation between the German Embassy in Korea, which works in close contact with the Korean state, and the German Hospital Association. In 1971, 2,000 auxiliary sisters are planned for Germany.” This illustrates the process through which Korean nurses were recruited for employment in German hospitals (ADCV)Footnote 13.

Moreover, regarding the objectives of development policy on the German side, the utilization of development aid policy was viewed as an unavoidable strategy in handling the German nursing staff shortage. “Of course, there were also critical voices against this procedure. Because it could not be overlooked that people were thrown from a completely different culture, with language difficulties and a provisional expectation that had to be overcome slowly in the middle of our situation, in which individuals seemed to have less time for others because they were especially concerned with themselves, their advancement, their career, and their education. The opinion, expressed occasionally, that development aid could be provided for Third-World countries on this road, was justified criticism; this is not development aid, to abuse well-trained professionals from these countries to make up for our deficient Social Services in prosperous Germany!” (ADCV)Footnote 14.

On the Korean side, the Korean media such as Dong-A-Ilbo and the Korea Times reported in detail the negotiations held on March 8, 1971, in Seoul between the manager of the German Hospital Association, Mr. Lautenbacher, and KODCO. The negotiation primarily revolved around determining the optimal number of registered Korean nurses and nursing assistants to be sent to Germany. The Korean delegation aimed to minimize the number of nurses while maximizing the number of nursing assistants (NIKH)Footnote 15.

Conclusion

Early in 1960, West Germany announced its intention to provide substantial financial aid to the Third World in the subsequent 5 years. This commitment materialized with the formulation of a plan in 1961, followed by an investment guarantee in 1964, through which West Germany provided South Korea developmental support primarily in the form of educational aid. Between 1966 and 1976, over 10,000 Korean nurses were dispatched in three phases, 1950–1965, 1966–1969, and 1970–1976, to Germany through government and private initiatives in the name of educational aid, as trainees and foreign workers. The intent of this cause was to provide better nursing education as part of a 3-year contractual arrangement. Initially, several individuals were mediated for educational advancement, but after the first, second, and third rounds of negotiations, the objective of this program shifted from educational purposes to providing labor aid based on each country’s political and economic landscape. The shift was particularly apparent during the Cold War, where short-term labor served as a vital tool for securing advantages in the competition between East and West Germany and as a buffer against West Germany’s unemployment rate. The aim of South Korea was to align with the anti-communist bloc and address unemployment and social instability, thereby making its political and economic goals the primary driving force.

With this critique in mind, this article seeks to examine whether the dispatch of nurses to West Germany truly qualified as authentic “developmental support” or resembled a form of “labor trade.” This paper explored this perspective by considering of political, economic, educational, and sociocultural factors.

A political hypothesis suggests that this initiative aimed to consolidate the alliance between the anti-communist authorities of West Germany, South Korea, and America through international cooperation. This allowed for the exchange of essential labor between the United States, West Germany, and South Korea through coordinated international relationships. Economically, the flexibility of labor in neoliberalism and the utility of short-term contract migrant labor for basic labor drove this collaboration. The short-term contract foreign labor in West Germany served as an “economic buffer” in the labor market, offering flexibility in hiring and firing during economic fluctuations, making the situation the nurses faced resemble the principles of labor market flexibility in neoliberal policies rather than technical aid. Hence, this has been termed “reverse developmental aid.”

The majority of Korean nurses possessed university training and practical experience in the field, indicating they were not genuine trainees but rather qualified professionals. The fact that most of them were not truly there to learn was observed during the second and third phases and corroborated by German investigations led by Dr. Covey and Ruth Esther. Thus, what was termed “educational aid” could be more accurately described as a form of “labor trade” because highly educated nurses were forced to accept positions with lower wages than their qualifications warranted. Moreover, the direction of nursing education in Germany and the job of nurses were strictly distinct from that of a doctor in the hospital. The basic tasks of nurses included patient care alongside various auxiliary duties such as cleaning, causing confusion among the Korean nurses regarding the division of labor. This confusion stemmed from the fact that cleaning was a task typically performed by dedicated cleaning staff in South Korea (Hartmann 2016; Lee 2006).

Dr. Covey and Elisabeth Ruth had previously pointed out that it could be a “sister deal” and that accepting Korean nurses as trainees could be viewed as a beneficial arrangement saving on labor and education costs. This observation allows us to address the question posed in the introduction regarding whether the Korean nurses were recipients of “developmental aid” or participants in “labor trade.” One cannot completely avoid the conclusion that these nurses were not solely beneficiaries of aid, but also participants of labor trade. The German Caritas Association pointed out that Germany primarily recruited Korean nurses for employment purposes rather than educational ones (ADCV)Footnote 16.

The development aid to both South and North Korea was used as an important tool for the Cold War struggle between the East and West. Despite appearing to respond to pressure from the United States by supporting democracy and providing development aid, the aid to South Korea, in reality, was somewhat misleading and served as a form of reversed development aid for the economic benefit of West Germany. The scholarships and apprenticeship positions that South Korea desperately required were either severely limited or not provided by West Germany whatsoever. The German and Korean governments agreed to accept labor contracts under the slogan of “education assistance” as long as it helped regulate the labor market and generate foreign currency according to each country’s needs and circumstances (Lee b 2010, pp. 205–208).

This led to a significant number of Korean women returning to their homeland upon completing their 3-year employment contracts, only to face subsequent unemployment (Hong 2009). While Germany was more than pleased with the seemingly inexhaustible reservoir of nurses (Hong 2009) and South Korea responded in turn to the great demand for its workers (Hong 2009; Kim 2017; Na 2009), the experience was a bitter failure for some returning to Korea. Their education in Germany was not recognized in Korea because the German nursing system was fundamentally different from that of Korea and because they ended up demoting themselves in terms of tasks conducted, opposed to advancing their careers. For the most part, economic factors motivated Korean nurses to go to Germany. Thus, the purpose and role of West Germany’s development support to South Korea were not primarily focused on educational aid but rather served as a mechanism for labor trade with which both countries utilized to pursue their respective political and economic objectives.