Consequences of Covert and Unethical Operations

The spread of tuberculosis is on the rise in rural Alabama. Researchers blame the infamous Tuskegee Syphilis Study as a significant factor in public aversion to healthcare in the region. Let's explore how some unethical and covert projects have detrimental consequences on public perception of the medical community and result in poor healthcare practices.   

Tuskegee and Guatemala

Tuskegee Institute, circa 1916

The Center for Disease Control reports that in 1932 the Public Health Service, working jointly with the Tuskegee Institute, launched a study to record the progression of syphilis among black men. Taking place in Central Alabama, the undertaking was titled, "Tuskegee Study of Untreated Syphilis in the Negro Male." The project was later considered unethical and found to have neglected to facilitate proper informed consent for research subjects. Originally slated to last six months, it went on for 40 years while failing to treat hundreds of infected individuals. Medical care continued to be withheld in lieu of observation long after effective treatments were developed by the medical industry. 

Perhaps most heinously, research subjects were led to believe they were receiving free healthcare. In fact, terms of their participation included burial insurance.

The Public Health Service also used its resources to conduct a similar study in Guatemala. From 1946 to 1948 the U.S. organization funded a collaboration with the Pan American Sanitary Bureau and various Guatemalan government agencies. An estimated 1000 to 3000 Guatemalans were subsequently infected with venereal diseases. The abused included soldiers, orphans, mental patients, and prisoners.

From the "Why do they hate us so much?" file: In addition to infecting Guatemalan citizens, Uncle Sam also overthrew their elected government.

In 1954 the CIA sponsored a coup in Guatemala. Operation PBSUCCESS, as it would become known, ousted the nation's president, but not before rumors of CIA involvement were published in a white paper. To minimize consequences of the white paper, a now declassified CIA cable reveals assets were instructed to consider distracting public attention by such means as to "fabricate big human interest story, like flying saucers." The declassified cable inspired the 2003 New York Times article title, Word for Word/Coup Control; The C.I.A.'s Cover Has Been Blown? Just Make Up Something About U.F.O.'s.

Mistrust of Medical Professionals

Fast forward to 2016. About 115 miles west of Tuskegee you'll find Marion, Alabama, right in the heart of a county hit hard by a lack of trust for public healthcare. The consequences of rejecting medical care can be seen in a rise in the highly contagious and fatal tuberculosis disease, and the reasons for mistrust include dwindling public funds. The community doesn't even have a hospital, leaving some residents feeling isolated and abandoned.

The reasons for mistrust also include echoes of the Tuskegee Study. As The New York Times reported in 2016, "Many people in Marion, where about 63 percent of the residents are black, said they knew little about what had happened in Tuskegee, but they often said their wariness of medical professionals had been passed on through generations."

A Harper's Magazine article published in the June, 2017, edition documented the TB outbreak in Marion to be nearly 100 times the national average. For some context, that puts the community at a higher infection rate than such third world countries as India, Kenya and Haiti.

Several strategies have been implemented by medical staff to try to encourage TB screenings, including throwing festive parties and even offering financial incentives, but progress has been slow. Harper's reports that residents often feel distrustful and fear being targeted by outsiders.

Similar social dynamics can be observed in a relatively recent CIA fake vaccination drive. The Agency covertly used medical personnel to claim they were providing vaccinations to children in Pakistan, but were actually extracting DNA. The samples were wanted for testing during a reported hunt for Osama bin Laden. The lead doctor was imprisoned by Pakistani authorities for cooperating with American intelligence agents, and residents understandably became wary of vaccine programs and international healthcare workers. Scientific American reported in its article, How the CIA's Fake Vaccination Campaign Endangers Us All, that villagers along the Pakistan-Afghan border subsequently chased off a legitimate vaccination team, among other concerning events.

There are most assuredly men and women of high integrity who serve their countries and fellow human beings honorably throughout both the medical industry and intelligence community. However, past actions carry consequences, and trust must be built and maintained.