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Researcher ‘Floored’ by Discovery of Intentional Infections in Guatemala

October 4, 2010 at 12:00 AM EDT
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Ray Suarez speaks with Wellesley College professor Susan Reverby about her discovery of how U.S. scientists did secret syphilis experiments on Guatemalans decades ago.

JUDY WOODRUFF: Now: another story about medicine, this of a shocking experiment and a tainted legacy. Ray Suarez gets the details.

RAY SUAREZ: The medical experiments were conducted in Guatemala more than six decades ago, but didn’t come to public light until this past weekend.

Between 1946 and 1948, researchers with the U.S. Public Health Service deliberately infected nearly 700 Guatemalans with syphilis, in most cases without their knowledge, in an effort to determine whether penicillin could prevent the disease.

The U.S. government apologized for the experiments on Friday.Wellesley College Professor Susan Reverby uncovered the documents while she was researching a book about another shameful chapter, the Tuskegee experiments.

She joins us now with more on her findings.Professor Reverby, what were American doctors doing in Central America in 1946, and what were they doing to their subjects?

SUSAN REVERBY, professor, Wellesley College:They were trying to figure out whether penicillin could be used to treat people before their syphilis infection took hold and had been already measured.

So, if you think about it, it’s a little bit like the morning-after pill, which you take when you think you have had unprotected sex and don’t want to get pregnant.They were trying to figure out whether penicillin would work for syphilis.But they needed a pool of infection.

And rather — so, they went to Guatemala because prostitution was in Guatemala, and it was also legal to take a prostitute into a prison for sexual services for prisoners.

RAY SUAREZ: So, they were using prisoners as basically their stock of observed subjects?

SUSAN REVERBY: Right.They started off doing prisoners.And when not enough infection was created with the prostitutes, they moved onto actually giving the men syphilis itself.And because they needed a larger pool of subjects, they moved onto an army barracks, and then to the national insane asylum.

RAY SUAREZ: With the cooperation of the Guatemalan government of the time?

SUSAN REVERBY: Well, the cooperation of a man named Juan Funes, who was the director of the sexually transmitted diseases in the Guatemala public health department.So, how far up it went — but, obviously, Americans can’t just walk into a prison or even an army barracks in Guatemala even in 1946.So, clearly, the heads of all of those institutions had to give permission.

RAY SUAREZ: As we mentioned earlier, you were doing more scholarly work about the Tuskegee program.How did that lead you to Guatemala?

SUSAN REVERBY: I was in the archives at the University of Pittsburgh looking at the papers of Thomas Parran, who had been the surgeon general when the Tuskegee study was first going on.

And I found while I was there the papers of John Cutler, who had worked in Tuskegee in the ’60s.And I opened the box expecting to find more on Tuskegee, and there was nothing on Tuskegee in the box, but, in fact, all there was in the box was this material on the Guatemala study.

And it said very clearly, inoculation, syphilis, and I was completely floored by what was there.I just had no expectation and no way of knowing what would be there, because it had never been published.

RAY SUAREZ: So, Dr. Cutler was the link between these two programs. But there’s a difference with Tuskegee, isn’t there?

SUSAN REVERBY: That’s right, absolutely. And that was part of what interested me. I have spent two decades writing about Tuskegee. I have written two books on it.

And the differences are very clear.In Tuskegee, the men already had latent syphilis.Even though there’s a myth that they were infected by the government, they were not.In Guatemala, they absolutely infected all of these people.

In Tuskegee, the idea was to deny treatment as much as possible to the men.In the Guatemala study, almost all of these people were treated.What we’re now looking at is the medical records to determine whether everybody got enough.And it looks like maybe about a third of the people there didn’t really get cured once they had been infected by the United States government.

RAY SUAREZ: In the 1940s, were the rules governing experimentation in humans very different from what they are today?Did the people involved from the United States think they were doing something wrong?

SUSAN REVERBY: Well, first of all, there were really no rules.I mean, there were expectations and sort of a sense of what was right, but there were no regulations, the way we have them now and have had them since the mid-1970s.

And, second of all, this study was enough on the edge that what I found in the correspondence, which was, frankly, one of the more shocking things, was the language back and forth where it became really clear that they knew that this was improper.

And Cutler’s bosses were not sure.And there’s an amazing quote from Parran, the surgeon general, who says, look, we couldn’t do this in the United States.

RAY SUAREZ: So, beyond the difference between the two countries, was there also anything latent about the way they thought about Guatemalans compared to what they would have thought about Americans in a similar setting?

SUSAN REVERBY: Well, they actually understood that there was a racial difference in the disease.They thought that African-Americans and white people had a different kind of syphilis, and they certainly thought that was a similar problem in Guatemala.

But I think they really went to Guatemala because of the connection with Funes and because they could get easily to this access of these prisoners.And a lot of American research in this time period was also being done in prison populations.

RAY SUAREZ: Well, since the story broke, since you broke it, it’s been called shocking, improper, many other similar names.But did it turn up anything worth knowing, ultimately?

SUSAN REVERBY: No.I mean, what’s interesting is that Cutler never published anything.They really couldn’t create enough infection to really get any interesting results.And, by 1948, it became really clear that penicillin could cure syphilis really easily.And so there was less interest from Washington to really continue this kind of research.

And so they had them pack up and come home.I think the thing that’s interesting here, both with this and with Tuskegee, is, in the end, it teaches us more about the doing of medical research than it does about medical science, per se.

RAY SUAREZ: It turned out that it is much harder to give people syphilis than you might have thought it was, doesn’t it?

SUSAN REVERBY: Well, I knew it was.And that’s why it’s a sexually transmitted disease, so all those warnings about dirty toilet seats are myths.

It is a disease that has to be in moisture.It can’t be created in a cell line even now.It has to be transmitted through sexual contact, through an infectious mother to her child, only at birth or through breast milk.

RAY SUAREZ: But even sending prostitutes into the prisons of Guatemala wasn’t a reliable method of transition, was it?

SUSAN REVERBY: No, it wasn’t. That’s why I called my paper “Normal Exposure,” because they kept saying, look, it’s not working with normal exposure. So that’s when they moved to this system of trying to abrade these men and women’s hands and then their — on their cheeks, and, then with the men, actually on their genitalia, and to pour the inoculum on them.

And it required them to literally pull back the man’s — you know, front of his penis, to hold a cotton pledget with the inoculum in place for an hour-and-a-half to two hours.

So, as you can imagine, not everybody let them do this.Prisoners ran away.It wasn’t so easy to do.And the study just really didn’t work.

RAY SUAREZ: Professor Reverby, thanks for joining us.

SUSAN REVERBY: You’re welcome.Thank you for asking me.