The Guatemala Syphilis Experiments

Join Kelli as she goes over another case where the US government experimented on humans - but this time, they purposefully infected Guatemalans with syphilis, taking what happened with the men of Tuskegee a whole step further.

So today we'll do some historical context to figure out why Guatemala - what happened in history that led to such a level of interventionism that the US government would conduct medical experiments on the Guatemalan people? 

Once that's squared away, we'll briefly go over syphilis so we have a complete understanding on what the infected Guatemalans faced. Then, we'll talk about the event itself - and how we only just learned about it.

I really hope I run out of examples of the US doing this.  

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Transcript

Welcome to A Popular History of Unpopular Things, a mostly scripted podcast that makes history more fun and accessible. My kind of history is the unpopular stuff - disease, death, and destruction. I like learning about all things bloody, gross, mysterious, and weird.

Ooooookay. I’ve got yet another example of unethical medical experiments on people. Similarly to the Tuskeegee Syphilis Experiments, the Guatemala Syphilis Experiment is a story about using humans as guinea pigs to test their theories on sexually transmitted infections. But unlike with Tuskeegee, where the patients already had syphilis and just weren’t told or treated… in this case, the American government purposefully infected Guatemalans with syphilis.

From 1946-1948, the US government conducted medical experiments in Guatemala. Over 5,000 Guatemalans were part of this study, and a quarter of them were purposefully infected with bacteria, like the one that causes syphilis which, if left untreated, can kill.

So in today’s episode, we need to talk about that. First, the historical context - my favorite part of doing history. Historical context helps us understand the why - why was the US conducting experiments on people, why were they doing it in Guatemala, why syphilis, and why 1946-1948? There needs to be a reason for the time and place, so we’ll dive into the history to get a good sense of what was going on there.

After we’ve sorted through that, we’ll have a brief lesson on syphilis and what it can do to the body. I’ve covered it in at least two episodes, most obviously in the Tuskegee Syphilis Experiment episode, but just in case you didn’t catch that one or need a refresher, we’ll talk diseases for a bit.

And then, once we know why this story takes place in Guatemala, and what syphilis can do to the body, we’ll take a look at the event in question.

I really hope I run out of episodes like these. It’s disconcerting that there are so many episodes I can write on the US experimenting on people, with or without informed consent. We’ve done the Minnesota Starvation Experiment, Tuskegee, I just did the Holmesburg Prison Experiments, and now we’re heading south to Central America. And I know there are more stories. I just wish there weren’t.

And a quick shout out to my newest Cannibal patron, Sarah B! Sarah, thank you so much for being a Cannibal and a supporter. It’s because of amazing, beautiful people like you that I can continue to do this show, sharing gross and unpopular stories to help more people fall in love with history. So thank you.

Now let’s get started.
Historical Context
So first, before we talk about what we did in Guatemala, we need to answer why Guatemala. And the answer involves dictatorships, the Guatemalan Revolution, and US intervention in Latin America. But first, we actually need to talk about bananas. 🍌

Yes. The fruit.

The United Fruit Company was founded in 1899 to grow and market bananas, a fruit that had been growing in popularity throughout the 19th century, that’s the 1800s. And did you know that bananas are berries? So there’s a fun fact for you. You know what’s not a berry? The strawberry. *Brain explosion* 

Now bananas need a humid, tropical climate to grow. But more than that, they need a consistently warm temperature. So typically, bananas are grown in the tropical regions of the world - Central and South America, Africa, and Southeast Asia. And yes, with modern technology, bananas can now also be grown in the US, but in limited production. I’ll also mention real quick that perhaps our most humid state, Florida, got snow this year… so not a warm, humid, consistent temperature.

Anyways.

Bananas were growing in popularity, and to capitalize on this, the United Fruit Company set up plantations in Latin America. Guatemala was ripe for banana plantations *make a face* - it had the perfect growing conditions, but more than that, it was economically underdeveloped.

Most Latin American countries gained their independence in the early- to mid-19th century after centuries of colonization at the hands of Europeans, mainly the Spanish and Portuguese. They certainly weren’t the first to fight for their freedom in the Age of Revolutions; the American Revolution came first, then the French, then the Haitian, so there were certainly examples to help guide those in Latin America who no longer wanted to be controlled by volatile European monarchs and their politics. 

Creoles led many of the revolutions - those of European descent, but born in the New World. Men like Simón Bolívar, José de San Martín, and Miguel Hidalgo argued that they should be in control of their respective countries and regions - they wanted political power and autonomy, much like their northern neighbors in the United States. And with that power, they hoped to experience an economic boom, to be able to compete on the international market like the United States did after their revolution. But it didn’t happen that way. Instead, there was widespread economic stagnation.

There have been a lot of theories as to why it worked for the post-revolutionary United States but not for most Latin American nations. One of the more notable theories was the Dependency Theory, developed by Raul Prebisch in the 50s. Prebisch was an Argentinian economist who served as the Director of the UN Economic Commission for Latin America. His argument went back to the days of European colonialism - centuries of mercantilism meant that Latin American countries never profited from trade. They would sell their raw materials to the Western world, who then sold them back to Latin Americans as manufactured goods at a higher price. This meant two things - one, Latin American economies would never profit, and two, their economic growth was dependent on foreign markets.

Dependency theory was actually a response to an earlier argument for why Latin American economies didn’t perform the same as other Western countries, called the modernization theory. Essentially, the argument was that all countries follow the same trajectory to modernity, and that the US was just further along on this journey than Latin America. But this theory is really outdated, as it assumes that all countries are on the same path to becoming like Western Europe, so they were judged based on how Western European nations progressed. Prebisch argued that the goal wasn’t to become a clone of Western Europe, it was to become self-sufficient, which looks different in different cultures. And that they couldn’t become self-sufficient because international markets made them dependent.

Prebisch’s dependency theory has its critics as well - it doesn’t really hold up to the complexities of the 21st-century economic world, and it overly simplifies the argument into external factors impacting Latin American growth, not internal ones. But at least it gives us a window into understanding how colonialism impacted the economies of Latin America, even post-Revolution. And this is also very true of Guatemala.

Guatemala’s economy in the late 19th and early 20th  centuries was built around agriculture. Their three largest exports were coffee, sugar, and bananas - all things grown in this stable, tropical climate. Guatemala’s economy depended on them. And the Americans, eager to get their hands on more bananas, helped fuel the market.

But here’s where things go south - the United Fruit Company didn’t just want to purchase bananas from Guatemala and sell them for profit - they wanted to control all aspects of the business. From the land on which the banana trees were planted, to the railroads used to bring them to ports, the United Fruit Company owned large swaths of Guatemala. And they had a vested interest in maintaining control over their lands. This is part of a broader pattern of US interventionism in Latin America. It wasn’t just businesses - the US government was also interested in maintaining control over places like Guatemala.

And this is where we get the term banana republics - *not the store* - a term given to countries whose economies depended on single-produce exports, and who were usually controlled by foreign-owned businesses, like the United Fruit Company. Although to be fair, Guatemala also exported coffee and sugar. Not just bananas. But the US definitely controlled the political and economic situation in Guatemala through the banana industry.

To make sure that American businesses maintained this control, the US supported governments that aligned with their interest. And in this case, those governments were either strong right-wing leaders, military juntas, or authoritarian dictatorships. I’ll say that again for the people in the comments already typing away furiously - the US supported dictatorships in Latin American countries like Guatemala so they could keep their business interests. This is a fact. We fought against dictatorships in WWII, but then supported them in Latin America during the Cold War.

There’s another factor here that’s important to the conversation - communism. The spread of communism in the post-WWII world was a massive concern. There was a rise in socialist and communist ideals and principles in Latin America because there was (and still is) massive inequality between the ruling elite and everyone else. This all stems back to the caste system put in place by Spanish and Portuguese colonial authorities, but that’s a story for another day. 

In addition to supporting their business interests, the US also wanted to contain the spread of communism - the Truman doctrine, right? And it wasn’t just a theoretical - remember that the communist revolution eventually toppled Cuba in 1959.

So to try and prevent the spread of communism, and to support their business interests in Guatemala, the US supported Guatemalan dictator Jorge Ubico, who ruled Guatemala from 1931 to 1944.

Here are some of his highlights. Lowlights? They’re not good. He allowed the United Fruit Company to own or lease millions of acres of Guatemalan land and gave them big tax exemptions. In fact, the United Fruit Company owned 42% of Guatemala’s land, and 77% of all Guatemalan exports went to the US. In return for all this power and control, the US provided financial and military support for the Ubico regime. With this support, Ubico built a police state, and rebellions were met with violence. Ubico, in his own words, once said, quote, “I am like Hitler. I execute first and ask questions later.” End quote.

I think that says enough. The US supported him, because he supported our business interests there. Or, as the Zinn Education Project notes, quote, 

[The US government] simply ignored it so long as U.S. investment in the country flourished.

End quote.

In 1944, two years before the Guatemala Syphilis Experiments began, his regime was toppled by the Guatemalan Revolution, as people were tired of his authoritarian regime. And though, for a while, there were open, democratic elections, there was still a lot of political instability and economic concerns - what would happen to the US’s control of Guatemalan lands under a new government that wasn’t as favorable to businesses like the United Fruit Company? Eventually, in 1954, a US-backed coup deposed the Guatemalan President and put another dictator in power. It caused four decades of Civil War in Guatemala, and some of the men who were militarily, financially, and politically supported by the US went on to massacre the indigenous Maya peoples, an event known as the Guatemalan Genocide. That’s also a story for another day.

And it was during this period of intense political instability, economic uncertainty, and intervention that the US government conducted syphilis experiments on thousands of Guatemalans from 1946 to 1948.

A Quick Lesson on Syphilis
So before we talk about the event in question, let’s briefly go over syphilis and why it’s so incredibly dangerous and immoral for the US to have purposefully infected people with it.

Syphilis is a bacterial infection, and most infections are sexually transmitted. And if you get syphilis, it can sometimes hang out in your body for years without you knowing about it. Not everyone who contracts syphilis is symptomatic. But regardless, if left untreated, it can do some serious damage to your heart, brain, liver, bones… it can kill you.

There are four stages of syphilis - primary, secondary, latent, and tertiary. 

In the primary stage, you’ll see small sores pop up around the site of infection, and they are called chancres (SHANG-kurs). They are normally painless, can appear alone or in multiples, and surface 3 or so weeks after initial contact. And as I said in my Tuskegee episode… because it’s painless, you may not know you have it. You might think to yourself - I’d know if I had a random new lump. And my PG answer to that question is that the bumps may appear in places you can’t see, so you may not even know you have them. After 3-6 weeks, the lumps heal, and they’re gone.

The secondary stage presents as a rash, normally. Sometimes it happens alongside the chancres from the primary stage, sometimes weeks after healing. It’s not normally itchy and may be faint, so you might not catch it. You’ll likely also experience the normal things your body does when it deals with an infection: muscle aches, fever, sore throat, fatigue, weight loss, and enlarged lymph nodes. For some, these symptoms will go away on their own. For the unlucky ones, they’ll come and go, on and off, for years.

If you haven’t been treated, then the infection can progress to latent syphilis. This is when the bacteria goes into hiding, where it can sit dormant for years. If you’re lucky, it will never “reawaken.” But about 30-40% of those in the latent stage will develop complications, which is the tertiary stage. Also known as late syphilis. And this is the stage that can cause serious harm or death.

The infection at this stage essentially ravages your insides. It can damage your brain, your nerves, your eyes, heart, blood vessels, liver, bones and joints. And this could happen right away, or years, even sometimes even decades after the initial infection. Any of these complications can lead to death.

Can syphilis be treated? Yes, of course. It’s a bacterial infection, and we live in an age of antibiotics, thanks to Alexander Fleming and his petri dish full of penicillium mold spores. If you catch it early, you can kill the bacteria causing the syphilis infection, and you’re good to go.

But hey, listen. I’m still an educator even though I left the classroom. So let me remind everyone there that you cannot cure a viral infection with antibiotics. Antibiotics only cure bacterial infections, not viruses. There might be anti-viral medicines you can take to cure or prevent viruses from wreaking havoc in your body, but most of the time, you just need to wait for your body to take out a virus on its own. And some viruses, like herpes, set up a nice cozy little home in your body and never leave. So… be safe out there.

So this bacterial infection, studied in black men in Tuskegee from 1932 to 1972, was purposefully given to Guatemalans in 1946. Let’s find out why.
Terra Haute, Indiana
In 1946, the National Institutes of Health, the NIH, funded a study to see what would happen if we put syphilis into human bodies. Why? Where did this idea come from?

The US government, in the years after WWI, was concerned with sexually transmitted infections, or STIs. In 1938, Surgeon General Thomas Parran went before Congress in support of funding for research into STIs, arguing for, quote, 

studies, investigations and demonstrations which are necessary to develop more effective measures of prevention, treatment, and control of venereal diseases... [so that] science will give us a much more effective method of treatment than we now have.

End quote.

That sounds good, but what would that entail? Infections were on the rise during and after WWII, so there was a need for better care and research into ways to prevent and cure STIs.

And even though this story ends up in Guatemala, initially, this research was to be conducted at the US penitentiary in Terra Haute [hoat], Indiana. Planning began in 1942, and the idea was to intentionally infect prisoners with gonorrhea, which would be, quote, 

“not only desirable but necessary in the study of many of the problems of war medicine which confront us.” 

End quote. 

The idea was to find volunteers to be infected with gonorrhea, and then they’d be trialed with different things to treat it, both before and after infection - sulfonamide compounds taken by mouth before, and chemicals applied locally to the genital tract after.

And in case you were wondering, they’d be exposed to gonorrhea by applying the bacteria directly to the end of the member. Just take a little Q-tip with bacteria on it and dab it right at the end. Yikes. 

But not everyone in the planning stage agreed with this - what are the morals and ethics of intentionally exposing humans to STIs? What about the legal implications? 

There were a lot of reasons for choosing prison inmates for this, like constant supervision and access to medical care. The proposal was approved, and it looked like Terra Haute would be the place because it had better medical facilities than other penitentiaries. And it fell to the Public Health Service to conduct it. The experiments happened between 1943 and 1944 and involved 241 prisoners. But shortly after it began, researchers faced challenges - they weren’t able to consistently infect the volunteers, which is a problem for an experiment where you need consistent variables. There were questions about abandoning the project, but the National Research Council (NRC) countered that, quote,

The opportunity for a study of experimental gonococcal infection in human volunteers and its relationship to the chemical prophylaxis of gonorrhea has never previously arisen on the present scale and with the termination of this experiment [it] is unlikely to arise again unless under the impetus of a future war.

End quote.

But despite this, the project ended in July 1944 after one of the lead researchers, Dr. Mahoney, decided to stop since they wouldn’t reliably induce an infection. He noted that, quote,

In spite of the use of different strains of Neisseria gonorrhea, modifications in methods of cultivating the organism and of inoculation, it was found impossible to infect with a degree of regularity which would be required in the testing of prophylactic agents.

End quote.

So that experiment was a failure. But there were still unanswered questions about which prophylaxes could prevent STIs. And towards the tail-end of the Terra Haute experiments, researchers were planning another set of human experiments - but this time in Guatemala.
The Guatemala Syphilis Experiments
So first, why Guatemala?

Dr. Mahoney, the same one who stopped working on the Terra Haute experiments, noted in the Journal of Venereal Disease Information in July 1947 that, quote,

It has been considered impractical to work out, under postwar conditions in the United States, the solution of certain phases concerned with the prevention and treatment of syphilis. These problems are largely concerned with the development of an effective prophylactic agent for both gonorrhea and syphilis and the prolonged observation of patients treated with penicillin for early syphilis. Because of the relatively fixed character of the population and because of the highly cooperative attitude of the officials, both civil and military, an experimental laboratory in Guatemala City has been established.

End quote.

Okay, got it. It’s because the US government had such a good relationship with Guatemala’s dictators and already owned a decent chunk of the land there. This was true of several authoritarian governments in Central America though, so why Guatemala specifically?

Well, according to the brief, the doctors involved, including Dr. Mahoney, worked with a Guatemalan physician named Dr. Juan Funes who had experience in a clinic where sex workers were required to get testing and medical inspections. So Funes was the link, and he recommended doing this test in his home country. Mahoney and others, including a Dr. John Cutler, saw the potential for carefully controlled studies.

Similarly to Terra Haute, the doctors planned to study STIs at the Penitenciaría Central where, quote, “exposure of volunteers to infected prostitutes would provide the testing opportunities.” The initial idea was to have prisoners… err… couple with infected prostitutes. They hoped that this “normal” exposure would yield better results than what they tried to do at Terra Haute - applying bacterial gonorrhea samples directly to the tip. But the prisoners had no idea that the sex workers were infected.

Once infected, the plan was to study different medications to see how effective they were in preventing symptoms from emerging, or in curing infections. The main two substances were the antibiotic penicillin and salvarsan, which was the first drug used to treat syphilis. But it was derived from arsenic, so it was pretty toxic and caused some bad side effects.

The project proposal was approved by Surgeon General Thomas Parran and they got funding to begin testing on volunteer inmates. But the scope ended up being much larger than that.

More than 5,500 prisoners, sex workers, soldiers, children, leprosy patients, and psychiatric patients were studied. About one-quarter of them, 1,308, were intentionally infected with either syphilis, gonorrhea, or chancroid. Chancroid is another STI that causes painful ulcers on and near infection sites. Very contagious, but curable with antibiotics. And all of those intentionally infected did not give informed consent; some didn’t know anything about it.

I’m going to hone in on that one more time. 1,308 people were intentionally infected. And their ages ranged from 10 to 72. TEN. Ten years old. And many of these subjects were indigenous Guatemalans, or those living in poverty.

Now exposure didn’t just happen in the “normal” way. I won’t get too specific here, but in some cases patients would be injected with the bacteria directly or they orally ingested it. But in most cases, it was, in one way or another, done through sexual contact.

But with some patients, like the psychiatric patients, they would directly inoculate through the urethra, rectum, or eyes. Yes - syphilis straight to the eyeballs. Here’s an example from the brief that, I will warn you in advance, is really shocking. Quote:

Berta was a female patient in the psychiatric hospital. Her age and the illness that brought her to the hospital are unknown. In February 1948, Berta was injected in her left arm with syphilis. A month later, she developed scabies. Several weeks later, Dr. Cutler noted that she had also developed red bumps where he had injected her arm, lesions on her arms and legs, and her skin was beginning to waste away from her body. 

Berta was not treated for syphilis until three months after her injection. Soon after, on August 23, Dr. Cutler wrote that Berta appeared as if she was going to die, but he did not specify why. That same day he put gonorrheal pus from another male subject into both of Berta’s eyes, as well as in her urethra and rectum. He also re-infected her with syphilis. Several days later, Berta’s eyes were filled with pus from the gonorrhea, and she was bleeding from her urethra. On August 27, Berta died.

End quote.

I don’t even really know what to say. There is no scientific, ethical, or moral justification for the horrors inflicted on women like Berta and the others who were subjected to these medical experiments. 

Those not intentionally infected, but still part of the study, underwent serology testing - the collection of blood and spinal fluids to detect infections. This part of the experiment lasted until 1953, longer than the purposeful infections that ended in 1948.

Did they give treatment to those infected? Some, yes. Dr. Cutler, as a measure of goodwill, set up a treatment program at the behest of the Guatemalan military. Around 820 subjects got treatment for their infections… but according to researchers, around 650 of them were part of the group who were purposefully exposed to it in the first place!

And since I’m angry about this now, let’s also just put out there that the whole point of this study was to find a place where they could get better rates of infection, since that was the whole problem with Terra Haute, right? Well that was still a problem in Guatemala. 

And I can’t get over the fact that the US government funded an experiment where infected sex workers were sent into prisons to infect prisoners. We paid for that. Let that sink in. 

The study ended in 1948. The results were never published. 83 people died during the course of these experiments, but it’s not clear how, or if it was from infection, so we can’t conclusively say one way or another if we killed 83 Guatemalans with our unethical, immoral scientific study. 

Dr. Mahoney was the main supervisor of the experiments. He later became the chairman of the World Health Organization in 1948, and then the Commissioner of the New York City Department of Health. He died in 1957.

Surgeon General Thomas Parran knew what was happening. He once said to Cutler, quote, “You know, we couldn't do such an experiment in this country [the United States].” End quote. So that tells us everything we need to know about that. After serving as Surgeon General, he went on to work as the dean of the School of Public Health at Pittsburgh. After his death, a building was named after him - Parran Hall - though it was renamed in 2018 after all of his involvement in unethical experiments came to light - it wasn’t just Guatemala, he was involved in the Tuskegee experiments as well.

Cutler, the main man in charge of what happened in Guatemala, who reported to Mahoney, was also later involved in Tuskegee. He went on to become the Assistant Surgeon General in 1958, worked at the University of Pittsburgh Graduate School of Public Health in 1967, and then served as the dean until 1969. 

In 2010, when news of what we did in Guatemala broke out, President Obama issued an apology to Guatemalan President Alvaro Colom. They did some commissions to find out the facts, which is where we get a lot of our information after the initial research and digging done by heroes like Susan Mokotoff Reverby of Wellesley College who brought all of this to light in 2005 while researching Tuskegee. And in 2008, Dr. Cutler’s role was publicized, and he posthumously lost much of his legacy.

The 2011 Commission report concluded that, quote, 

The Guatemala experiments involved unconscionable basic violations of ethics, even as judged against the researchers' own recognition of the requirements of the medical ethics of the day.

End quote.

But on the other side, the Guatemalans issued their own report, calling what happened a crime against humanity. And with descriptions like what happened to Berta, I can see why. They argued that “racism and discrimination were present throughout the experiments in an explicit and conscious way.”

An article by Michael Rodriguez and Robert Garcia, titled “First, Do No Harm: The US Sexually Transmitted Disease Experiments in Guatemala,” outlines it really well. Quote:

The wrongful actions by US officials can be characterized by several facts. First, US officials intentionally infected victims with bacteria that cause STDs without informed consent. Second, they have failed to provide victims with treatment or compensation. Finally, they covered up and did not publish or disclose the experiments, including the intentional infections and their failure to provide treatment.

End quote.

So what can we learn from this? Well, as the 2011 Presidential Commission for the Study of Bioethical Issues brief notes, quote,

The events in Guatemala serve as a cautionary tale of how the quest for scientific knowledge without regard to relevant ethical standards can blind researchers to the humanity of the people they enlist into research.

End quote.

We have a long and complicated history with Guatemala. From the damage done by the United Fruit Company, to supporting dictatorships and authoritarian regimes, to providing the guns and training used to perpetrate the Guatemalan Genocide, to conducting unethical studies on its vulnerable people… There’s a lot going on. And not all of that has been dealt with properly.

We have to remember that we are all human beings deserving of dignity - and to lose sight of that is to lose our humanity.

I’ll leave a link to the 2011 study in the description for those of you who want to check this out for yourself. Let me know in the comments what you think, what your theories are, or what else you know about it.
Outro
Thanks for joining me for this episode of A Popular History of Unpopular Things. My name is Kelli Beard, and I hope you’ve enjoyed the story of the Guatemala Syphilis Experiments. Thank you for supporting my podcast, and if you haven’t already checked out my other episodes, go have a listen!

You can also support me and the show on Patreon - just look up a popular history of unpopular things. Subscribe to APHOUT on YouTube and check out Nedric, the musician who created the song you’re hearing right now! Links for all that are in the description.

Be sure to follow my podcast, available wherever you listen, so you know when new episodes are dropped. And stay tuned to get a popular history of unpopular things.

—

2011 brief: Ethically Impossible
https://archive.org/details/ethicallyimpossi00unit