26 Dec 2022

The Curse of the Algorithm


Thomas Klikauer



Photo by and machines

Increasingly – and often by stealth as they work inside your innocent-looking search engine – algorithms have entered not just our computers and working lives. They also govern more and more eventualities of life in so-called advanced societies and elsewhere.

The existence of algorithms might be a sign of civilization, but it might also be a sign of what French philosopher Foucault calls madness. As human decision-making is handed over to machines, these machines can make rather irrational, discriminatory, and outright mad decisions.

Long gone is the time when algorithms were only used in mathematics, IT, software, and computer science. Historically, the word “algorithm” is an Arabic term meaning a decimal notation of numbers, while in Greek, arithmos is simply a number. Our modern-day arithmos or algorithm came to us via Latin’s algorismus.

In any case, an algorithm is a finite sequence of rigorous instructions. These are used to solve a class of specific problems. Algorithms can also be used to perform computations with feedback loops. Often, they are applied to complete calculations and data processing. More advanced algorithms can even execute automated reasoning.

They are also used in mathematical and logical tests for corporate recruitment purposes. None other than Alan Turing relied on the human-like characteristics as descriptors of a machine that cracked the Nazi code. Later he was driven to suicide by the English establishment, after, of course, he had deciphered the Enigma code, saving thousands of lives.

One of the best and most current definitions of algorithms comes from Cathy O’Neil, who noted that algorithms are opinions put into a mathematical formula. In other words, there is a person who sets up the algorithm for a specific purpose.

It remains imperative to remember that virtually all – rather scientific-looking – algorithms are plagued by hidden interests – often the interest of the users who usually asked an algorithm to be created, e.g., a company like Amazon. In other words, in many cases it is capitalism that drives the design of algorithms.

As a consequence of all this, algorithms increasingly sidestep the role of the subject and even human subjectivity when constructing knowledge, the automatic data analysis based on a mathematical formula. This chisels away the humanist project of the self. Philosophy calls this personhood.

In short, the application of algorithms weakens our ability to form and articulate what we think (e.g., search engine algorithms), what we like (Facebook algorithms), and what we want (Amazon’s algorithms).

Worse, this version of algorithmic knowledge destabilizes a core process in the construction of subjectivity. It eliminates self-reflection by deducing – or even eliminating – the active participation of the individual in the creation of knowledge. Beyond that, algorithms also endeavor to create positivistic and even behavior-manipulating knowledge. Algorithms can eradicate nearly all self-reflective and communicative facets of knowledge creation.

As algorithms are becoming more sophisticated – and are spiced up by artificial intelligence – they have the true potential of becoming independent agents in the formation of our social – and more importantly – our democratic and political society.

It may well be almost inevitable that algorithmic knowledge will attempt to compete with and potentially even bypass, a particular and above all – still! – the unique aspect of being human: our individuality, agency, and subjectivity.

Most deceptively, the apostles of algorithm assure the user that algorithms will grow the realm of personal freedom as these systems offer a richer, much more truthful, and much more precise form of knowledge. The positivist ideology of neutrality is always a helpful vehicle when  corporate interests need to be camouflaged through engineering-like “techno-solutionism” – they misbelieve that all problems have a technical solution.

Essentially algorithms contain the deeply ideological promise to make our workplace and society freer, filled with more emancipated human beings. In reality, algorithms can very easily do the exact opposite. Algorithms – mostly automatically – order data and things. They create a new, and most importantly automated, order of things – the order of the automatic algorithm. Potentially, this might be even worse than what French philosopher Foucault outlined in his seminal masterpiece “The Order of Things”.

In other words, algorithms establish – if not cement and solidify – an existing social and economic order. For algorithms to work, it requires no subjects at all. Instead, human subjects are turned into objects of power, as outlined by the Polish-British philosopher Bauman, though they do not live up to Wittgenstein’s dream of leaving everything as it is.

Wittgenstein may not like it, but algorithmic computer systems do constitute an entirely new regime of knowledge  based on opinions turned into mathematical equations. And these new systems have – and will continue to have – a huge impact on contemporary work, management as well as social and, of course, consumer life. While gaining increasing importance, the world of algorithms remains largely unregulated and exists outside of the domain of democratically assured regulation.

Almost inherently, many – if not most – algorithms are, in fact, future-oriented. They are designed to predict future behavior and worse, control and manipulate human behavior. One of the most sophisticated uses of algorithms can be found in Amazon. Some might be tempted to claim that Amazon knows that you will buy condoms or diapers before you do!

To do that, the people behind algorithms need to construct a particular type of a human being. This is a human being that is predictable – and hopefully controllable. In turn, these data produced by human beings and collected, analyzed, and used against human beings can be used to refine the algorithm further.

This is done in the hope that all this will lead to, among other things, improved crime fighting, euphemistically known as predictive policing, that often replicates entrenched prejudice. Algorithms are also used to improve corporate profits, as in the case of Amazon.

For algorithms to deliver on this, corporations like Amazon need to know who we are, where we live, what we like and don’t like, and what we want and buy. Beyond that, algorithms also like to assume a dormant subjectivity, a subject that is really more of an object – the hidden object inside us – that can be commercialized and turned into something useful to corporations.

Such an individual becomes structured within the contours of a mathematical formula that is used in an algorithmic environment. Worse, such an individual whose behavior can be predicted, measured, controlled, and ideally manipulated can rather easily become an Uber-engineered human being. This algorithm-driven individual is imagined to be radically different from the way an individual was once imagined under modernity.

Since the people who set up algorithms create a kind of knowledge-making machine, they see human reality in a very particular way. This reality is radically different from the who and what we are today. This represents an entirely new Malaise of Modernity.

Of course, such algorithms have already become a new form of a kind of non-democratic – and, if you will, corporate-driven – governing agent that predicts, manages, controls, and even manipulates human life, consumers, and perhaps even entire populations.

This can be done without the need for any form of what might be called knowledge of critical subjectivity. This is what German philosopher Adorno calls the mündige individual, a self-reflective, self-critical, mature, and autonomously acting individual.

Almost necessarily, algorithms need to work behind the backs of those “for” (or better “against”) whom they are designed. These systems remain opaque while their invisible script runs behind a colorful computer screen.

Meanwhile, their ramifications are increasingly apparent to all of us. Algorithms already make not just an aesthetic judgment for you but also hiring decisions for the human resource manager, among others.

Perhaps even more damaging is the fact that algorithms make those decisions not “with” you but “for” or, in many cases, “against” you. Consequently, algorithms promote a mode of non-communicative knowledge. This is the utter destruction of what German philosopher Habermas calls communicative action and ideal speech.

A world where Habermas’ ideal speech hardly exists but which is increasingly governed by algorithms is the world of corporate management. Overall, one might say that the level of algorithmic management differs from company to company, perhaps with  bottle-peeing Amazon on the “full-scale” end of the spectrum.

The Society of Automotive Engineers has introduced a useful categorisation of algorithmic management (AlgoM). They note six levels:

While it might be hard to predict where management is going even in the near future, one might like to argue that management’s self-interest is not to move to level 6 of full AlgoM. This might render a large section – or even management as such – obsolete.

On the other hand, corporate accounting demands greatest profits with the least people, so revenue goes up. Hence, Musk fired 5,000 Twitter workers very recently.

And for that, top management might replace middle management and workers by moving towards full AlgoM. At this level, algorithms define virtually all performance, evaluation, and control functions “without” the involvement of real managers.

Whether in management as AlgoM, at the police, or in corporations such as Amazon, algorithms offer a radically new and very different way of knowing, understanding, shaping, and manipulating the world and – worse – the individual.

Algorithms have the power to change the very foundations of what it means to know, to understand, and to reach decisions. Yet, it remains imperative that these algorithms and the purpose-built knowledge they create are not solely understood in mathematical, engineering, and technical terms. As opinions are placed in mathematical formulas, algorithms increasingly underwrite many operations in business and in society.

Algorithms provide a very different conception of what it means to be human. Algorithms break the human-knowledge link as they seek – and, in fact, do – create knowledge that is gradually disconnected from subjective individuals.

As a consequence of all this, algorithms need to be understood not just as one of the most recent, but also as perhaps the most severe threat to human life as we know it.

23 Dec 2022

Moscow’s Leverage in the Balkans

John P. Ruehl



Photograph Source: Generic Mapping Tools – CC BY-SA 3.0

Since September, Kosovo’s fragile stability that has endured since 1999, following intervention by the North Atlantic Treaty Organization (NATO), has grown progressively precarious. Clashes between ethnic Serbians and Kosovo security forces saw Serbia’s military placed on high alert in November. Several high-profile Serbian officials, including President Aleksandar Vučić, announced that the Serbian military could be deployed to northern Kosovo to protect the ethnic Serbs, who make up the majority of the population in the region.

Moscow has natural incentives to provoke the crisis. An unraveling of regional security would create more obstacles for Serbia’s EU aspirations, optimistically slated for 2025. The West’s support for Kosovo has historically undermined Serbia’s European integration effort, and 51 percent of Serbs polled by Belgrade-based pollster Demostat in June 2022 said they would vote against EU membership in a national referendum.

But by escalating tensions, Russia can also prevent further EU and NATO expansion in the region, and potentially reduce Western pressure on Russian forces in Ukraine by diverging resources from Kyiv to the Balkans.

Throughout the 1990s, NATO took a leading role in the breakup of Yugoslavia, perceived to be dominated by Serbia. While the West supported Bosnian and Croatian independence initiatives and Kosovan autonomy, Serbia was supported by Russia. These policies led to considerable tension between NATO and Russia, with the Kremlin’s occupation of Kosovo’s Slatina airport in 1999 leading to “one of the most tense standoffs between Russia and the West since the end of the Cold War.”

However, Russia was too weak to adequately support Serbia in the 1990s. And after then-Yugoslavian President Slobodan Milošević was overthrown in 2000 and Russian forces withdrew from Kosovo in 2003, Serbian political elites instead pursued cautious integration with Europe while keeping the U.S. at arm’s length. At the same time, Serbia and Russia forged closer relations through growing economic ties, embracing their common Slavic Orthodox heritage, and sharing resentment toward NATO’s role in their affairs.

Territories under Serbian control continued to secede in the 2000s, with Montenegro peacefully voting for independence in 2006 and Kosovo in 2008. Yet unlike other secession initiatives in the former Yugoslavia, Kosovo’s failed to gain universal recognition. Almost half of the UN General Assembly refused to recognize Kosovo’s independence, with NATO/EU members Spain, Greece, Slovakia, and Romania among them.

Moscow was firmly against Kosovo’s independence, and prior to the February 2008 declaration of independence, the Kremlin warned of geopolitical consequences if it were to move forward. Six months later, Russia invoked the “Kosovo Precedent” to invade Georgia and recognized the separatist territories of Abkhazia and South Ossetia as independent. The Kremlin is now using the same paradigm to justify its support for Russian-backed separatist territories in Ukraine.

Currently bogged down in Ukraine, the Kremlin is exploring fomenting additional unrest in the Balkans by exploiting Serbian nationalist sentiment. Doing so will undoubtedly redirect some Western political, economic, and military efforts away from Ukraine.

Russia’s influence over Serbia has grown in recent years, and Serbian politicians have become more assertive regarding northern Kosovo. Though overall trade between Russia and Serbia is negligible in comparison to the EU, Russia provides one-quarter of the oil imported to Serbia, while Gazprom finalized 51 percent share in Serbia’s major oil and gas company, Naftna Industrija Srbije (NIS), in 2009.

Russia’s veto power at the UN Security Council has prevented greater international recognition of Kosovo, demonstrating Moscow’s usefulness as a diplomatic ally. Putin has, meanwhile, become Serbians’ most admired international leader, with pro-Putin and pro-Russia rallies having been held in Serbia since the invasion of Ukraine. According to recent polling, almost 70 percent of Serbians hold NATO responsible for the conflict.

Balancing Putin’s popularity and Serbia’s relations with Europe has been a delicate task for Serbian President Vučić. Though he condemned the Russian invasion of Ukraine, he refused to implement sanctions against the Kremlin, prompting German Chancellor Olaf Scholz to signal that Vučić had to make a choice between Europe and Russia in June.

But the Serbian leader had already signed a three-year gas deal with Russia in May, and in September agreed to “consult” with Moscow on foreign policy issues. Other ventures, such as doubling flights from Moscow to Belgrade, have demonstrated Serbia’s willingness to assist Russia in undermining Western sanctions.

More concerning to Western officials is Russia’s attempts over the last decade to alter the military balance between Serbia and Kosovo. A Russian humanitarian center located in the Serbian city of Niš, which is close to the Kosovo border and opened in 2012, is suspected of being a secret Russian military base “set up by the Kremlin to spy on U.S. interests in the Balkans.” Additionally, Serbia has increased imports of Russian weaponry, while joint military exercises between Russia, Belarus, and Serbia (labeled “Slavic Brotherhood”) have been held annually since 2015.

Russian-backed non-state actors have in turn become increasingly present in Serbia. In 2009, Russian private military and security companies, as well as organizations composed of Russian military veterans, began conducting, in coordination with Serbian counterparts, military youth camps in Zlatibor, Serbia. These were seen as attempts to develop the next generation of fighters and were eventually shut down by the local police in 2018.

Russia’s Night Wolves biker gang, which has played a pivotal role in the 2014 seizure of Crimea and the unrest that has followed in Ukraine since, also opened a Serbian chapter and conducted road trips in the region for years. And in December, a cultural center was opened by the Russian private military company Wagner—which is similarly fighting in Ukraine—in Serbia, “to strengthen and develop friendly relations between Russia and Serbia with the help of ‘soft power.’”

Using these forces to threaten a low-level insurgency in Kosovo would cause enormous alarm in NATO and the EU. But Russia’s efforts to fan the flames of Serbian nationalism will also be directed toward Bosnia and Herzegovina. The country’s Serb-dominated territory, Republika Srpska, accepted power-sharing stipulations as part of the Dayton Peace Agreement in 1995, and Russian forces similarly withdrew from the country in 2003.

Nonetheless, Milorad Dodik, president of Republika Srpska (who was also the president from 2010-2018), has increasingly allied himself with the Kremlin and has taken greater steps toward declaring his region’s independence from the rest of Bosnia and Herzegovina over the last decade. Republika Srpska security forces are now well-equipped with Russian weaponry, while Moscow has given subtle approval to supporting and developing Republika Srpska paramilitary groups. A Bosnian-Serb militia group called Serbian Honor is believed to have received training at the humanitarian center in Niš and the Night Wolves have also repeatedly held rallies in the territory.

Since the beginning of the Russian invasion of Ukraine, Dodik has expressed his support for Russia, raising alarm over his ability to instigate unrest in Bosnia and Herzegovina with limited Russian state and non-state support. In response, the EU’s peacekeeping mission in the country, EUFOR or Operation Althea, almost doubled its presence from 600 to 1,100 since the invasion in February.

Yet this still pales compared to the NATO-led Kosovo Force (KFOR), which has roughly 3,700 troops in a country with a smaller population and less territory than Bosnia and Herzegovina, and is further aided by the EU Rule of Law Mission in Kosovo (EULEX). Pushing Republika Srpska’s independence initiative to a point where Russia can officially recognize and support it may in turn rapidly overwhelm the smaller international force there. It would also provoke calls for independence among Bosnia and Herzegovina’s ethnic Croatian minority, whose leaders have close relations with Moscow.

Disagreements in the Western alliance over the collective approach to the Balkans have been revealed in recent months. While the UK and the U.S. placed sanctions on “various Bosnian politicians who are threatening the country’s territorial integrity,” the EU chose not to, notably due to opposition by Slovenia, Croatia, and Hungary. And while Croatia was accepted into the Schengen area in December, Romania, and Bulgaria, already EU members since 2007, were denied entry by Austria, while the Netherlands similarly opposed Bulgaria being part of the Schengen area.

Effectively managing potential violence in the former Yugoslavia while continuing the integration efforts of other Balkan EU/NATO members would prove to be a difficult procedure for the Western alliance. Billions of dollars in aid and assistance have already been provided to Ukraine in 2022. Confronting additional instability in the Balkans would also highlight the flaws of NATO policy in the region since the 1990s and the lack of a viable, long-term solution to confront the issues plaguing the Balkans.

Yet regional integration efforts have picked up in recent months. In July, the EU restarted membership talks of bringing Albania and North Macedonia into the organization, Bosnia and Herzegovina was officially accepted as a candidate on December 15, and Kosovo applied for EU membership on December 14. NATO membership for both Kosovo and Bosnia and Herzegovina remains largely on hold, however, and is currently out of the question for Serbia, which considers NATO its “enemy.”

Considerable work will be required to integrate these divided states into the Western alliance, and recent attempts to speed up this process have been largely unsuccessful. The scheme by former President Donald Trump’s administration to change the Serbia-Kosovo border amounted to little, while the proposed Association of Serb Municipalities in Kosovo has been criticized for outlining the creation of another Republika Srpska.

The role of Russian intelligence and Serbian nationalists in the attempted coup in Montenegro in 2016, which sought to derail the country’s NATO accession, reveals the lengths to which Moscow will go to achieve its aims. Western officials must, therefore, remain wary of Russia’s potential in the region. Escalating unresolved Balkan conflicts is now a major part of the Kremlin’s attempts to stall Western integration in Europe and take pressure off its war with Ukraine.

Libyan citizen kidnapped and flown to US to face Lockerbie charges

Steve James


A 71-year-old Libyan, Abu Agila Mohammad Mas’ud Kheir Al-Marimi, appeared in a US federal court in Washington DC this month to face charges related to the bombing of Pan Am Flight 103, December 21, 1988, over Lockerbie, Scotland.

The bombing killed 270 people (259 on the flight and 11 ground fatalities).

The remains of the forward section from Clipper Maid of the Seas on Tundergarth Hill [Photo by Air Accident Investigation Branch - Air Accident Investigation BranchReport No: 2/1990 - Report on the accident to Boeing 747-121, N739PA, at Lockerbie, Dumfriesshire, Scotland on 21 December 1988Report name: 2/1990 Boeing 747-121, N739PAhttp://www.aaib.gov.uk/publications/formal_reports/2_1990_n739pa.cfmAppendix B, Image B-9 "Photograph of nose and flight deck"http://www.aaib.gov.uk/cms_resources.cfm?file=/2-1990%20N739PA%20Append.pdf, OGL 2, https://commons.wikimedia.org/w/index.php?curid=30369951]

Mas'ud is accused of two counts of destruction of an aircraft resulting in death and one of destruction of a vehicle used in foreign commerce, resulting in death. Mas'ud, who followed proceedings in court on December 12 through an interpreter, made no plea. The US Department of Justice (DoJ) will return to court later this month to detain Mas'ud pending trial.

The DoJ allege that Mas'ud worked from 1973 until 2011 for the intelligence agencies of murdered former Libyan leader, Colonel Muammar Gaddafi, including as a “technical expert in building explosive devices”. In late 1988 Mas'ud was allegedly instructed to fly to Malta with a “prepared suitcase” where he was instructed by the only man found guilty of the Lockerbie attack, Abdelbaset Ali Mohmed Al Megrahi, to “set the timer on the device for the following morning”. The DoJ also accuse the only man acquitted of any involvement in the bombing, Al Amin Khalifa Fhimah, of placing the suitcase on an aircraft luggage conveyor belt in Malta's Luqa airport.

US Attorney General Merrick Garland hailed Mas'ud's appearance as “an important step forward in our mission to honor the victims and pursue justice on behalf of their loved ones.” Garland’s predecessor, William Barr, informed the BBC that in his view the original 2001 trial at which Megrahi was convicted should have been held in the US because the death penalty would have been available.

Barr, in a previous stint in office, was directly responsible for the shift in focus of the Lockerbie investigation towards Libya, at the same time as he was whitewashing all those involved in the Iran/Contra scandal of the late 1980s. The Lockerbie attack took place after the 1987 murder by the USS Vincennes of 290 innocent passengers and crew in IranAir Flight 655 and, prior to charges laid against Libyans, was assumed to be an Iranian sponsored revenge attack.

The DoJ case against Mas'ud, like the case against Megrahi and Fhimah, is a concoction. He has effectively been kidnapped and subjected to extraordinary rendition. The DoJ's purpose is to maintain the official line, upheld on both sides of the Atlantic, regarding the origins and perpetrators of the atrocity.

Whatever misdeeds Mas'ud may have on his conscience, the Lockerbie attack is not one of them. The DoJ charges seek to place Mas'ud in Malta at the same time as Megrahi. But this only proves Mas’ud had nothing to do with Lockerbie because the suitcase bomb in PA103's hold was placed there in London's Heathrow Airport long before the feeder flight from Frankfurt—which would have been carrying Mas'ud, Megrahi and Fhimah's alleged Malta casehad even landed. This is detailed in the book Adequately Explained by Stupidity? Lockerbie, Luggage and Lies by Dr. Morag Kerr of the Justice for Megrahi campaign, a work which has never been refuted.

Megrahi was tried in a non-jury show trial, held under Scots law in a disused army base at Camp Zeist, the Netherlands in 2000. Its purpose was to allow the then Gaddafi government to be brought in from the cold of international isolation in which it had been languishing for years by taking the rap for Lockerbie. In 2004, Gaddafi and then British Prime Minister, Tony Blair, concluded their “deal in the desert” allowing Libyan oil fields to open up to the operations of US and European oil companies.

The politically motivated verdict, delivered in 2001, ignored countless inconsistencies, evidence having been tampered with, CIA witness coaching and found Megrahi guilty while his alleged accomplice, Fhimah, walked free.

In 2009, renowned UK human rights lawyer, Gareth Peirce, whose clients have included the Birmingham Six, and Guildford Four—falsely accused of IRA bombings—and Moazam Begg, who was held for years in Guantánamo Bay, described the verdict as “profoundly shocking”. She wrote in the London Review of Books, “Al-Megrahi’s trial constituted a unique legal construct, engineered to achieve a political rapprochement, but its content was so manipulated that in reality there was only ever an illusion of a trial.”

Megrahi died in 2012, protesting his innocence. A second posthumous appeal against his conviction was thrown out last year by Scottish judges who upheld Maltese shop owner Tony Gauci's identification of Megrahi despite evidence of coaching and $2 million changing hands.

In 2011, eight months of continuous bombing by the US-NATO laid waste to whole swathes of Libya, while the US and the European powers utilized Al Qaeda-linked militias as their proxy ground troops in a war for regime-change that ended in the torture and murder of Gaddafi.

The formerly relatively advanced country collapsed into a fractured and hellish civil war landscape of competing heavily armed militias, both equally committed to torturing and enslaving large numbers of people in pursuit of the patronage of one or other major power. Despite various peace efforts, there are currently two governments, one in Tripoli, the other in Sirte and Tobruk.

Meanwhile, the US and Scottish authorities have sought to maintain the threadbare and collapsing case against Megrahi by pursuing his supposed accomplices. Part of the evidence against Mas'ud appears to be a confession extracted in 2012 under unknown conditions when he was in the brutal hands of one of the militias.

An official told AP that the US government had been pressing the Tripoli government for Mas'ud for months. “Every time they communicated, Abu Agila [Mas'ud] was on the agenda”. According to the Guardian, the government, led by Abdul Hamid Dbeibah, offered up Mas'ud shortly after he was released from a 10-year prison sentence. Mas'ud was held without charge or any pretence of a legal extradition process until he was handed over to the US.

Masud’s nephew told the Observer, “We have filed a complaint with the attorney general’s office and demanded an investigation of the people who kidnapped him and those who handed him over. We want them to face justice. This is an assault on a citizen in his home.”

The kidnapping is reported to have been carried out by a local militia, led by Abdel Ghani al-Kikli, accused by Amnesty International of administering beatings, denying medical care, and starving and enslaving people caught at a migrant detention centre outside Tripoli.

Libya does not have an extradition treaty with the US, nor is any Libyan court known to have examined an extradition request.

None of this caused the Scottish legal authorities to bat an eyelid. Lord Advocate, Dorothy Bain KC welcomed the DoJ “progress towards a legal breakthrough”, endorsing Mas'ud's illegal kidnapping and rendition.

Dr. Jim Swire, whose daughter Flora died in the tragedy and who subsequently came to view Megrahi as another innocent victim, warned of any trial taking place in the US or Scotland.

“There are so many loose ends that hang from this dreadful case, largely emanating from America, that I think we should... seek a court that is free of being beholden to any nation directly involved in the atrocity itself.” Swire continued “in view of what we now know about how Scotland handled the case, it should not take place in Scotland.”

There are signs of an unraveling as earlier lies come into conflict with current ones. Aamer Anwar, the lawyer for the family of Megrahi, noted that one aspect of the US case against Mas'ud claims that he had confessed to buying clothes which Megrahi had previously been identified by Tony Gauci as buying. Anwar asked, “How can both Megrahi and Mas'ud both be held responsible?”

German ambulance services overwhelmed by calls, short staffing

Tino Jacobson & Markus Salzmann


For weeks, emergency medical services (EMS) across Germany have been on the verge of collapse. Extremely high rates of deployments and scant staffing are pushing ambulance crews to their limits daily, at mortal risk to patients.

Ambulances on assignment [Photo by Frank Schwichtenberg / CC BY 3.0]

For months now in Hamburg, EMS teams have responded to more than 1,000 calls per day. Many of the city’s 80-plus ambulances have exceeded 20 daily deployments. So many rescue missions once occurred only on New Years Eve. According to the Komba trade union, there are near daily resignations of ambulance staff who have been taxed beyond their means.

The situation is particularly dramatic in the capital. In Berlin’s Marzahn district, a patient had to wait over three hours for an ambulance on the night of December 10. On that Saturday night, as on so many others, “exceptional circumstances in emergency medical services” prevailed. This state of emergency is declared as soon as 80 percent of the ambulances are on assignment and the prescribed 10 minute response time can no longer be met. These exceptional circumstances have all but become the rule.

As a result, fire truck crews have been reassigned to ambulances. As a result, the fire department is understaffed, a recipe for disaster in the case of simultaneous and serious fires.

One firefighter said of the Marzahn case, “I suspect our colleagues in dispatch were overwhelmed and this somehow slipped by them.” He continued, “The tools they have are not meant to permanently maintain a state of emergency.”

On that same Saturday night, a serious accident in the Lankwitz neighborhood killed a 15-year-old and seriously injured a 14-year-old. The two teenagers had been hit by a Berlin city bus, pinning both of them. An emergency doctor was at the scene of the accident in nine minutes, but the ambulance required fully 20 minutes to arrive.

An “exceptional circumstance” had likewise prevailed in Berlin just the day before. Of 94 available ambulances, at times every last one was in use. In the Reinickendorf neighborhood that evening, an elderly man required emergency assistance. First responders from the fire department arrived about eight minutes after the emergency call, but the ambulance had to drive from the Friedrichshagen district, that is, from the east across the city to northwest Berlin, taking 42 minutes. All ambulances in the vicinity were already on assignment.

The shortage of ambulances and personnel is long known. In Berlin, EMS deployments increased by nearly 40 percent between 2013 and 2021, from 305,000 to 425,000 per year.

Since the abolition of protective measures against the coronavirus, cities and counties have seen massive increases in EMS deployment counts. In the city of Dortmund, the fire department was called to 13,378 more emergencies between January and November of this year than in the same period last year. This represents an increase of around 20 percent. At the same time, 115 positions in the city’s fire department are vacant.

Understaffing in emergency services is commonplace across the country. In Frankfurt, there is an official shortage of 26 paramedics and 33 emergency doctors. In addition, there are acute absences due to infections with the coronavirus or influenza. This is a consequence of an intentional policy of mass infection. At the onset of the winter wave, the last remaining protective measures have been repealed.

Frank Flake of the German Professional Association of Emergency Medical Services (DBRD) said of the drastic situation, 'The pressure to act is enormous. It’s five past 12, the system is collapsing. It is happening evermore often so that no one can drive out to an emergency.' The reasons for this, he said, are a lack of specialized personnel as well as overburdened emergency rooms.

“Just a few years ago, it was unthinkable that you would treat a patient for an hour in an ambulance outside an emergency room because hospitals were so overloaded. And now there are downright traffic jams there sometimes,” Flake added.

He assessed the consequences for the medical staff: “It can’t be that in a 24-hour shift you drive to 15, sometimes 20 calls with an average duration of one hour per call. There's no time to eat or sleep.” That’s the cause of the current “occupational exodus,” he said.

Emergency rooms have been hopelessly overloaded for months. Several emergency rooms, such as the one at Leipzig University Hospital, have appealed in recent days for patients to come only in urgent cases. Cancellations of emergency services are the order of the day nationwide. Emergency rooms can deregister from emergency care for a short time in extreme situations, but this is being done more and more frequently as care can no longer be assured. In some cases, patients must be driven to far distant clinics.

The city of Hamburg recently reacted to the catastrophic situation by summarily prohibiting the clinics from deregistering. The obvious consequence is that the patients admitted are not adequately cared for and the staff is even further overburdened.

The dramatic situation in emergency rooms was long foreseeable. In 2019, even before the coronavirus pandemic, a study found that 94 percent of Germans consider emergency rooms at German hospitals to be overloaded. Among those over 60, who have had more frequent experiences with emergency rooms, the figure was as high as 98 percent. The main reason identified was the shortage of staff in emergency care.

It is obvious that the miserable and dangerous situation in emergency care is deliberately accepted. It is therefore not surprising that federal and state governments have done nothing despite the tense situation. The Berlin Senate, consisting of the Social Democrats, Greens and the Left Party, now means to pass a new rescue service law. It has long been the case that Berlin's rescue service has been unable to meet the prescribed quality criteria generally to be at the scene of an accident within 10 minutes.

It would be necessary to invest massively in personnel and equipment, yet the state coalition government has instead decided to extend an existing exemption until 2029. It allows less-intensively trained assistant paramedics to be deployed in emergency vehicles instead of the fully trained emergency paramedics required by law. Moreover, vehicles from patient transport companies are to be more frequently permitted in emergency situations. In short, the response of the government to its self-inflicted situation is to permanently lower the quality of emergency care.

The indifference of the established parties to human life can be seen in the state of the entire health care system. Hospitals, especially pediatric hospitals, are in dire straits due to a wave of respiratory infections from this year’s respiratory syncytial virus (RSV) surge and the coronavirus.

Intensive care beds in children's hospitals across Germany are at full occupancy, resulting in some critically ill children having to travel far and wide to find an intensive care bed. Meanwhile, doctors and hospital staff must to resort to triage, forcing them to choose which patients to treat, or not.