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Content Warning: This article discusses medical experimentation and physical and sexual abuse of children.
In October 2010, the U.S. government apologized to Guatemala for experiments conducted in the country during the 1940s. U.S. and Guatemalan doctors working with the Pan American Sanitary Bureau (PASB) intentionally infected at least 1,308 Guatemalan soldiers, prisoners, hospital patients, and registered sex workers with three sexually-transmitted infections (STIs)—syphilis, gonorrhea, and chancroid. They wanted to study whether various chemical prophylaxis solutions they had prepared prevented the spread of STIs. The researchers paid sex workers to transmit the diseases. When “normal exposure” did not work, they tried using syringes to infect people with STIs. The doctors then conducted blood draws and invasive medical inspections of Guatemalan schoolchildren, orphans, and hospital patients to determine the prevalence of STIs in the country and the accuracy of diagnostic tests. They did not receive informed consent, nor did they provide the majority of the Guatemalans they infected with available treatments, including penicillin—which the same U.S. doctors had discovered to be an effective cure for syphilis just a few years earlier.[1]
U.S. and Guatemalan doctors then tried to hide the experiments from the general public, even as they gossiped about them among themselves. The doctors faced an active group of moral reformers and anti-vivisectionists in the United States who carefully monitored human subject research.[2] In 1947, exactly when the U.S. researchers were in Guatemala, the New York Times published a “note on science” saying that experiments in which researchers infected people with STIs in order to study the disease would be “ethically impossible.”[3] In Latin America, U.S. experimentation on humans was similarly controversial.[4] In the 1930s, for example, Puerto Rican nationalists got hold of a letter written by Cornelius P. Rhoads, a Rockefeller Foundation doctor in Puerto Rico, in which he claimed that he deliberately gave cancer to Puerto Ricans. Rhoads later insisted he was joking, but the nationalists publicized the letter, leading to fierce denunciations of U.S. imperialism in Puerto Rico and throughout Latin America.[5]
The experiments in Guatemala were not discovered until 2005, when historian Susan Reverby was conducting research on the syphilis study in Tuskegee, Alabama. Reverby found records of the experiments in the personal papers of John C. Cutler, the U.S. Public Health Service officer who had directed the research in Guatemala while on contract with the PASB. In the Alabama syphilis study, doctors observed African American sharecroppers with syphilis for forty years (1932–1972) and actively sought to keep them from obtaining treatment. Many of the same USPHS researchers, including Cutler, worked in both Alabama and in Guatemala.[6] Cutler later donated his records on the Guatemala experiments to the University of Pittsburgh, where he had been a “much beloved” professor of international and reproductive health.[7] But he restricted access to his records to “serious researchers.”[8] He tried to hide the experiments in a public archive. In 2010, Reverby passed the documents on the experiments to her friend David Sencer, who had directed the Centers for Disease Control and Prevention during the public fallout over the Alabama syphilis study in the early 1970s. USPHS doctors had published frequently on the Alabama study, but knowledge about this research also remained largely contained within medical circles. Sencer passed the documents to the CDC. Soon, word of the experiments reached the highest levels of the U.S. government.
These blackened-out photographs accompanied John C. Cutler’s final report on the Guatemala STI experiments. His wife, Eliese Cutler, took photographs in the prison and national mental health institutions of the Guatemalans subjected to experimentation. Photos 9, Prison and Insane Asylum Photographs to Accompany Final Report, Records of Dr. John C. Cutler, National Archives and Records Administration.
In 2010, the U.S. government apologized to Guatemala about what had happened. The public revelation about the experiments spurred international outrage, and many people informally began to refer to the experiments as “Guatemala’s Tuskegee.” The exposure of the Guatemalan experiments proved what many had already deemed plausible in Alabama—even though U.S. doctors had not infected men in the Alabama study with STIs, unlike they had in Guatemala, rumors still circulated that the USPHS did give them syphilis.
In Guatemala, the revelation of the experiments triggered other memories. In 2011, Guatemalan activists at a conference at the University of Texas at Austin denounced the experiments as having been “a second U.S. intervention” in the Guatemalan Spring (1944–1954). Sometimes referred to as the Ten Years of Spring, the period marked a moment of democratic opening in a country with a long history of authoritarian rule. In 1952, President Jacobo Árbenz Guzmán implemented agrarian reform and expropriated unused land from the United Fruit Company, a U.S. corporation known in Guatemala as “el pulpo” (the octopus) for the stranglehold it held over the country’s economy and politics. After the United Fruit Company drummed up fear at the U.S. State Department about communist influence in the Árbenz administration, the CIA backed a coup against Árbenz with support from right-leaning members of the Guatemalan military. The coup unceremoniously ended the spring, ushering in thirty-six years of civil war and military rule in Guatemala.[9]
Still, likening the STI experiments to U.S. involvement in the 1954 coup is misleading, as it obscures the prominent role played by Guatemalan doctors—many of whom also held key positions in the revolutionary government, such as Dr. Luis Galich, the director of the Ministry of Health. During the Ten Years of Spring, Guatemalan doctors sought to establish a research infrastructure as part of their efforts to build a new country. Since the late nineteenth century, Guatemalan elites had imposed a segregated social structure divided between ladinos (non-Indigenous) and Indigenous Guatemalans, who comprised roughly half of the population. In the Guatemalan Spring, doctors aimed to assimilate Indigenous Guatemalans into ladino norms, seeking to “regenerate” Indigenous, marginalized Guatemalans, and women.[10] They drew upon eugenic discourse that had circulated in the country for over twenty years.[11] To the doctors, “regeneration” meant moral reform, education, and public health efforts intended to reverse what they believed had been the decline of Indigenous populations since the colonial period. They saw the Guatemalan Spring as an opportunity for a eugenic revolution.
As doctors pursued regeneration, they linked themselves closely with U.S. colonialist public health and medical institutions. To be sure, the Guatemalan doctors did not simply digest the knowledge and technological innovations put forward by U.S. institutions and researchers; in some instances, they challenged the research and tested its application to the Central American region. Nevertheless, as U.S. medical and public health institutions gained global prominence during World War II, it became increasingly difficult for doctors from small countries like Guatemala in the “American lake” to circumvent the influence of U.S. medicine and public health. This was particularly true in the case of the USPHS doctors who had recently gained acclaim due to their momentous discovery that penicillin cured syphilis. Doctors from around the world, not just Guatemala, sought access to penicillin and insider knowledge about this groundbreaking research.
The experiments in Guatemala reveal that the Guatemalan revolution was no spring for Indigenous and other marginalized Guatemalans. The aspirations of the revolution and individual doctors were key reasons that researchers gained access to Guatemalans’ genitals and blood for experimentation.
The experiments also show that to study U.S. interventions in the Latin American region, it’s vital to pay close attention to local contexts. In Guatemala, a U.S. imperialist project intersected with local norms of morality and social control, and the collusion of U.S. and Guatemalan doctors produced devastating results. The experiments also highlight the challenges of building a revolution in the context of global inequality in the realms of medicine, public health, and research.
The few oral histories that I have been able to conduct with survivors have made it clear that the experiments were never a secret in the neighborhoods and communities where people who had been subjected to experimentation lived. One survivor, Marta Lidia Orellana, who was in the national orphanage at the time of the doctors’ research, told her children about the physical and sexual abuse she endured as a child at the orphanage.[12] She likened her frequent gynecological inspections to medical rape. She tested positive for syphilis when she left the orphanage, and she believes that doctors gave her the disease while she was a child, recalling that they used syringes to inject her with unknown substances. Although the USPHS records do not mention infecting the children, we know that the doctors were keenly aware of how their research would be perceived by the public, and they may have kept some information, including their intentional exposure of children, out of the historical record.
The emotional trauma and physical costs of these experiments have been passed down to generations of Guatemalans. Some of the survivors of the experiments have lived their entire lives with complications from these diseases. Left untreated, all three diseases that the doctors transmitted can be life threatening. Gonorrhea can cause miscarriages, infertility, and chronic pain.[13] A pregnant woman can pass gonorrhea to her baby as it passes through the birth canal for delivery, which can cause a life-threatening blood infection or blindness in the newborn child. Chancroid can cause painful ulcers in the genital area or lymph nodes.[14] Syphilis is arguably the worst of the three. It can damage the heart, brain, and other organs. Since syphilis and gonorrhea can be passed down from a mother to a fetus during pregnancy, these experiments have harmed generations of Guatemalans. Three of Orellena’s children tested positive for syphilis.
Guatemalans who have tried to receive reparations from the U.S. government and private institutions connected to the research have had little success. Since the 2010 public revelation of the experiments, Guatemalans have filed lawsuits against the U.S. government, Johns Hopkins University, Bristol-Myers Squib Company, and the Rockefeller Foundation, but none of these have moved forward.[15] These unsuccessful lawsuits highlight the challenges that people in other countries face in winning reparations from foreign governments and corporations, especially when they have greater economic and political power.
For many in the United States, the experiments carried out in Guatemala remain ignored or forgotten. Even in Guatemala there is little public discussion about what occurred in the experiments, although most people are aware that they happened. During the COVID-19 pandemic, Guatemalans feared that foreign corporations would again try to render Guatemalans “guinea pigs” to test drugs and vaccines. Former Minister of Health and congresswoman, Lucrecia Hernández Mack, argued that the STI experiments in the 1940s have shaped Guatemalans’ perceptions about their vulnerability to foreign medical research.[16] The experiments conducted by U.S. and Guatemalan doctors highlight the continued challenges of making the legacy of U.S. empire visible to people in the United States. That these experiments and others like them occurred in “America’s backyard” is known and even normalized in the United States and Latin America, but the details remain obscured to the majority of those in the United States.
Lydia Crafts is writing a book entitled “Little Empire”: A History of Hidden Human Experimentation in Guatemala. She received her PhD in history from the University of Illinois, Urbana-Champaign.
[1] Presidential Commission for the Study of Bioethical Issues, “‘Ethically Impossible’: STD Research in Guatemala from 1946 to 1948,” Sept. 2011, https://tinyurl.com/h8jb26vv.
[2] Susan E. Lederer, Subjected to Science: Human Experimentation in America before the Second World War (1995), xv.
[3] Waldemar Kaempffert, “Notes on Science: Syphilis Preventative,” New York Times, April 27, 1947.
[4] On controversial U.S. experiments in Latin America, see Mariola Espinosa, Epidemic Invasions: Yellow Fever and the Limits of Cuban Independence, 1878–1930 (2009), 61; Laura Briggs, Reproducing Empire: Race, Sex, Science, and U.S. Imperialism in Puerto Rico (2002), 109–41; and Steven Palmer, “Toward Responsibility in International Health: Death Following Treatment in Rockefeller Hookworm Campaigns, 1914–1934,” Medical History, 54 (2010), 149–79.
[5] Daniel Immerwahr, How to Hide an Empire: A History of the Greater United States (2019), 137–53.
[6] On Reverby’s work on Guatemala and Alabama, see Susan M. Reverby, “‘Normal Exposure’ and Inoculation Syphilis: A PHS ‘Tuskegee’ Doctor in Guatemala, 1946–48,” Journal of Policy History, 23 (Jan. 2011), 6–28; and Susan M. Reverby, Examining Tuskegee: The Infamous Syphilis Study and Its Legacy (2009).
[7] Tony Norman, “This Good Doctor Had Evil in His Past,” Pittsburgh-Post Gazette, Oct. 8, 2010.
[8] Marianne Kasica, “John C. Cutler at the University of Pittsburgh,” http://files.archivists.org/conference/sandiego2012/107-kasica.pdf.
[9] For further reading on the revolution see Julie Gibbings and Heather Vrana, eds. Out of the Shadow: Revisiting the Revolution from Post-Peace Guatemala (2020); Piero Gleijeses, Shattered Hope: The Guatemalan Revolution and the United States, 1944–1954 (1991); Cindy Forster, The Time of Freedom: Campesino Workers in Guatemala’s October Revolution (2001); and Jim Handy, Revolution in the Countryside: Rural Conflict and Agrarian Reform in Guatemala, 1944–1954 (1994).
[10] Luis Galich, “Breve reseña el Hospital de Profilaxis Sexual y Enfermedades Venéreas de la Ciudad de Guatemala y Proyecto para un hospital especializado” (1947), 1–16.
[11] Miguel Ángel Asturias, “Sociología Guatemalteca: El problema social del indio” (Thesis, Universidad de San Carlos de Guatemala, Dec. 1923).
[12] Marta Lidia Orellana interview by Lydia Crafts, Dec. 11, 2015, audiotape and transcript (in Lydia Crafts’s possession).
[13] Centers for Disease Control and Prevention, “Gonorrhea–CDC Detailed Fact Sheet,” https://tinyurl.com/3r9nbddr.
[14] Illinois Department of Public Health, “Chancroid,” https://dph.illinois.gov/topics-services/diseases-and-conditions/stds/chancroid.html.
[15] Allison Dunn, “Federal Judge Dismisses Suit Against Johns Hopkins, Rockefeller Foundation Over ‘Nonconsensual Human Medical Experiments’ in Guatemala,” Law.com, April 22, 2022, https://www.law.com/2022/04/22/federal-judge-dismisses-suit-against-johns-hopkins-rockefeller-foundation-over-nonconsensual-human-medical-experiments-in-guatemala.
[16] Lucrecia Hernández Mack interview by Lydia Crafts, Jan. 14, 2022, video (in Lydia Crafts’s possession).
