In Anne Frank's diaries, the theme of health comes up regularly. The people in hiding suffered from various ailments. The helpers were not spared either, and Johannes Kleiman in particular suffered serious health problems. Anne also writes about her physical development and (pending) menstruation.

The people in hiding

To begin with, Anne herself had several health issues. By her own account, she was not allowed to eat any salt,^[1] which is possibly explained by Otto Frank's later statements about his daughter's heart problems.^[2] In addition, Ernst Schnabel wrote in 1958, based on conversations with former neighbour girl Toos Buiteman-Kupers, that Anne could not do a handstand.^[3] In her diary, Anne wrote that her arms and legs dislocated during physical exercises.^[4] She was therefore never allowed to go to gymnastics classes either.^[5] A classmate at the Montessori school related decades later that Anne could dislocate her own arm.^[6] Otto Frank wrote in the 1970s that she did take rhythmic gymnastics lessons.^[2]

In October 1942, 13-year-old Anne wrote that she expected to have her first period soon.^[7] The average age for the first menstruation at that time was around 14.1 years, according to a German study from 1954.^[8] She returned to the subject in January 1944, and by then it had 'only happened three times'.^[9] She also studied her vagina, noting that it was getting wider.^[10] Around the same time, she noted that she had gained 8½ kilos since coming to the Secret Annex.^[11] There was not much wrong with her health and development at that time.

Anne also noted the weight of the other people in the Secret Annex, when they had all been on the scales. Still, of course, conditions were not optimal. In late October 1942, Anne and Margot had bad colds.^[12] Anne was then sick in bed for two more days.^[13] A year later, she was bedridden with 'flu for another week and a half. She reluctantly allowed herself to be examined by Fritz Pfeffer, who was, after all, a doctor.^[14] In April 1944, she had a sore throat, and to make matters worse, Margot and her parents also caught it from her.^[15] A few days later, Mrs Van Pels was also ill.^[16]

The hiding situation also put pressure on the mental well-being of those in hiding. Anne took valerian to combat anxiety and depression.^[17] One valerian pill was among her 1943 Saint Nicholas presents.^[18]

Anne complained of headaches several times in her diary.^[19] In the B version, she also writes about the deterioration of her vision: 'I have become very short-sighted and ought to have had glasses for a long time already [...]'. According to this note, her parents even toyed with the idea of asking Ms Kleiman to take her to an ophthalmologist. However, this was deemed too risky.^[20] Her mother did not want Anne to participate in a calligraphy course because of the condition of her eyes.^[21]

As mentioned, Pfeffer was the doctor of the group. He initially studied medicine and then dentistry.^[22] As an experienced dentist, he naturally concerned himself with the teeth of the others. Anne's writings show that he offered oral care to at least Anne, Peter and Mrs Van Pels.^[23]

The helpers

When several helpers were ill at the same time, this immediately brought problems. Once, Miep Gies and Jo Kleiman were both ill while Victor Kugler was due to be sent to carry out digging work in Hilversum. At that time only Bep was available, and the warehouse was closed to provide some relief for the people in hiding.^[24] Miep was absent for some time during this period; she had caught a bad cold during Henk van Beusekom's wedding in the Westerkerk.^[25]

About Kleiman, Anne writes that he had regular stomach ulcers.^[26] In a letter to Yad Vashem, Otto Frank made a link between Kleiman's stomach complaints and the tensions surrounding going into hiding.^[27] Those tensions must not have done him any good either. However, Kleiman had been struggling with these complaints for years, and would undergo major ulcer surgery in 1951. After that, he did well and had no more bleeding.^[28]

At the end of '43, Bep was absent because one of her sisters had diphtheria. In Amsterdam, over 7,500 people were infected with that disease in 1943, about three-quarters of whom were nursed at home.^[29] Because of the danger of infection, housemates of these patients were naturally cautious. Consequently, Bep did not come to work.

Bep's father Johan worked in the warehouse and had made the bookcase.^[30] However, illness forced him to resign that position.^[31] The diary discusses the serious deterioration of his condition.^[32]

Other issues

The general theme of health also included the health of the animals in the building. Mouschi had been brought in by Peter as a pet. The other cats were there for the purpose of controlling rodents, and thus for the benefit of hygiene in the company. Although Peter took on much of the care of the warehouse cats, they were in fact part of the 'machinery' of Opekta and Gies & Co. - and thus belonged to the world of the helpers. In early 1944, company cat Boche was ill, and was taken to the 'dog and cat clinic' by Miep. The vet determined that Boche had an intestinal issue and prescribed a medicinal drink.^[33]

During the two years in the Secret Annex, there was of course a risk that one of the people there would die. There is no mention of this in the diary, but Kugler later claimed that arrangements had been made about what to do in the event of a death.^[34] There are examples of such problems. Among them, Presser mentions some police reports that concerned people who died while in hiding.^[35] That the risk of a death was discussed is quite conceivable, but apart from Kugler, none of those involved spoke out about it. Nor did the situation arise. As to how things would have been resolved, of course, we can only speculate.

With eight people in a damp and moderately ventilated house, always staying indoors and not optimally fed, it was hardly surprising that colds and flu occurred regularly. Diary entries show that this was a regular occurrence. The people in the Secret Annex depended on their helpers for medicines and the like, and on Pfeffer for more serious medical care.

Other health-related issues were experiencced by the three teenagers growing up. They faced puberty issues, and Anne writes about how she experienced her own physical and sexual development. In the case of Margot and Peter, this remains unclear. Anne's texts are also inconclusive about the related tensions and problems, both in the children and in the adults. Epidemic diseases like diphtheria and scarlet fever, certainly not unknown phenomena in Amsterdam during the war years, were kept at bay partly due to the caution of the helpers.