WHEN Chana Szabo hears the clatter of the commuter train near her adopted home in Canada, she remembers the three-day transport in a cattle car that took her to Auschwitz.

When she sees a small round loaf at the bakery, she recalls the crusts of bread she was forced to eat at the extermination camp.

When she goes to the hairdresser, it reminds her how her head was shaved during her six months as a Nazi slave.

As the world prepares to commemorate the 60th anniversary of the liberation of the Auschwitz death camp, Holocaust survivors such as Mrs Szabo struggle with unbidden reminders of the agonies they endured. Now mostly in their late seventies or eighties, the remaining survivors again find themselves vulnerable and, often, institutionalised.

Dementia has robbed many of them of their short-term memory, casting them back to a time of unbearable trauma.

Even the simplest aspect of a normal life can plunge them back into the darkness — a shower, a queue at a bus stop, a visit to the doctor. Now 85, Mrs Szabo is a member of a day-care group at Baycrest Centre for Geriatric Care in Toronto, one of the largest groups of Holocaust survivors in the world and a pioneer in techniques for looking after them.

Located on Bathurst Street, the spine of Toronto’s vibrant Jewish community, Baycrest cares for more than 1,000 Holocaust survivors, including several hundred in-patients.

Staff organised the first multidisciplinary medical conference on the survivors’ special needs and published the first manual on their care. “The main lesson is that there are ‘triggers’ — certain events, environmental aspects or particular times that may set off an emotional traumatic reaction,” Paula David, co-ordinator of the centre’s Holocaust resource project, said.

“The obvious one is the shower. If someone in uniform walks in and says, ‘It’s time to go the shower!’, that can be extremely upsetting,” she said. “We have had people afraid of baths. We have had people react to a uniform. We had a woman walking in hard heels down a corridor and she heard someone shouting ‘Heil Hitler!’ That woman wears soft shoes now.”

The manual, entitled Caring for Ageing Holocaust Survivors, explains survivors’ reactions to various “triggers” so that medical staff can identify the problem. Showers, it says, evoke the gas chambers, since inmates being sent to their death were told they were just going to take a shower.

Baths can remind some survivors of electroshock, freezing and scalding experiments that the Nazis performed on prisoners by plunging them into tubs of water. Strong smells of faeces or disinfectant can bring back memories of the overcrowded Jewish ghettoes set up by the Nazis or the harsh chemicals used in camps.

Loud voices, foreign languages, dogs and even Jewish holidays — when the Nazis found it easy to round up Jews — can all bring back bad memories.

Survivors who are institutionalised may hoard food, as they once did in camps, or simply fear that becoming ill means they will be executed.

A woman who had been the victim of a vivisection experiment by Josef Mengele was so suspicious of surgery that she refused a minor operation to insert a pacemaker. She paid with her life months later. Baycrest’s new building was designed to avoid evoking the Holocaust. It has plenty of natural light and art work. There are canteens on each floor, so that survivors do not have to queue. Even so, staff cannot avoid unforeseen “triggers”.

Mrs Szabo spent six months as a slave labourer at Auschwitz. She still has her camp number — A-9053 — tattooed on her arm. (When asked to recite it, she does so involuntarily in German.) Assigned to a gang of 50 women who had to dig drainage channels for anti-aircraft positions, she stayed in barracks three blocks from the crematorium and had to march past the bones of those massacred. “We saw the smoke from the crematorium, every day, every night, and there was the smell,” she says.

Her tiny frame shakes as she recalls the music that was playing the first day she went to the fields. Recently, she heard the same tune at the Baycrest daycare centre and it brought the memories flooding back. “I asked that they do not play it.”

Nurses say the song was Vera Lynn’s The White Cliffs of Dover.

Other Holocaust survivors claim to maintain a greater control over their terrifying memories — but it quickly cracks. “I never think about it. The only thing I think about it is that future generations should not go through it,” said Rubin Bortenstein, before suddenly breaking into tears.

Now 80, Mr Bortenstein was one of 10,000 Jews sent to Auschwitz from northern Poland in 1942. He spent two and a half years there before being liberated by American troops.

When he entered Auschwitz he weighed 11st. By the end of the war, he was just 5st and could not stand up straight.

Mr Bortenstein used to be haunted by nightmares, but believes he has mastered the past. “I can have a good time. It’s more than 60 years ago. What am I going to do? Dream about it? Think about it? The few years I have [left], I’d like to live them through.”

The Baycrest centre’s work casts a fresh light on the outcry over Prince Harry’s choice of a German Afrika Corps uniform at a fancy dress party.

Mrs Szabo, who saw the photograph on TV, can barely restrain her anger. She calls the Prince’s behaviour “shameful”. “I felt like he was part of them. If I see a swastika it all comes back to me. I do not sleep at night. I get nightmares. I feel again like I am back there.”

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