Lydia Crafts is Assistant Professor of History at Manhattan University and a 2024-2025 Consortium NEH Fellow.
My book project, Wounded Sovereignty: Hidden Human Experimentation and Revolution in Guatemala, examines the history of how U.S. and Guatemalan doctors came to conduct non-therapeutic experiments on sexually transmitted infections (STIs) on women, Indigenous, and marginalized Guatemalans during the 1940s. In these experiments, U.S. and Guatemalan doctors working with the Pan American Sanitary Bureau (PASB) intentionally infected at least 1,308 Guatemalans with three STIs—syphilis, gonorrhea, and chancroid. The researchers did not obtain consent to infect people with these diseases. They also did not provide Guatemalans with available treatments. Later, the doctors conducted widespread blood tests and invasive medical inspections on hospital patients, schoolchildren, and orphans to determine whether race or location affected the accuracy of results.
U.S. and Guatemalan doctors then hid these experiments, even as they continued to gossip about them among themselves. They knew that their research violated ethical norms and laws both in the United States and in Guatemala. The public only learned about these experiments in 2010. Historian Susan Reverby uncovered information about them in John Cutler’s records, the U.S. Public Health Service (USPHS) officer who directed the experiments for the PASB. Reverby had been conducting research for her book on the study in Tuskegee, Alabama (1932-1972). In 2010, Secretary of State Hillary Clinton apologized to Guatemala; President Barack Obama called Guatemalan President Alvaro Colom to express his regrets.
The public revelation that these experiments had occurred spurred international outrage. The media immediately drew connections between Alabama and Guatemala. Informally, some began to refer to the experiments as “Guatemala’s Tuskegee.” Part of the reason that people connected the two research programs was because Reverby made the discovery about the experiments in the personal archives of Cutler, who had already gained notoriety as the quintessential “Tuskegee doctor” for his defense of the study in a 1993 NOVA documentary. The research in Guatemala also was directed by the same USPHS Venereal Disease Research Laboratory and included many of the same doctors. Yet I argue in Wounded Sovereignty that the experiments were not simply the wrongdoing of one doctor. They constituted a systematic human rights violation. To date, the Cutler records and historical scholarship has revealed the perspective of the U.S. doctors who conducted these experiments. Drawing from oral histories and archival materials that I gathered in Guatemala and the United States, my book examines the experiments from the position of Guatemalan history and its entanglement with the United States.
My book emphasizes the structural violence that made these experiments possible. U.S. imperialism and increased military and economic involvement in the Central American region in the beginning of the twentieth century led to the establishment of medical and public health institutions and networks that supported U.S. expansion in the region. Before the STI experiments, the United Fruit Company, the Rockefeller Foundation, and doctors from Johns Hopkins, Harvard, and other U.S. universities had construed Guatemala as a medical laboratory to research tropical diseases that threatened U.S. soldiers, diplomatic, and business professionals. They built a culture of research that normalized subjecting people to non-consensual and harmful medical experimentation, but they often did so in conversation with Guatemalan doctors. Historian Greg Grandin has called Central American countries “workshops of empire.” They were sites where U.S. policymakers, military officials, doctors, and scientists could work out problems of foreign policy or tropical disease which supported the expansion of U.S. military and economic power. Yet the ability to exercise this power was contingent upon the local context. My book highlights that Guatemala served as an important node due to the aspirations of the medical and political elite, the weakness of the state, and the majority Indigenous population who Guatemalan political and medical elites marketed as medical subjects for foreign researchers.
As my book examines the impact that U.S. imperialism has had on the medical culture that developed in Guatemala, I argue that the experiments also need to be understood within the history of nation-state building within the country. Beginning in the late nineteenth century, Guatemalan doctors and elites had long aspired to construct a modern and homogeneous nation. Yet the country was ruled by authoritarian leaders who did not provide support for the professionalization of medicine. Doctors and political elites also remained wary of the majority Indigenous population who they construed as a threat to their modernizing and state-building goals. In 1944, Guatemala was one of many Latin American countries that was swept by a wave of democratic reform movements. Yet an examination of medical and public health records during this period reveals exactly who was left out as the country struggled to transition to a liberal democracy. As doctors and political leaders advocated for a more inclusive political structure, they used racial and gendered formations to cast women, Indigenous, and marginalized Guatemalans as disease vectors, public health threats, and medical subjects. Wounded Sovereignty highlights the “Ten Years of Spring” as a eugenic revolution during which doctors became the vanguards in implementing a “regeneration” of Indigenous, women, and marginalized Guatemalans. The history of public health, medicine, and experimentation reveal that the revolution was no spring for women, Indigenous, or marginalized Guatemalans who were the targets of their reform efforts.
Still, as U.S. and Guatemalan doctors forged a diplomatic alliance through their medical research, they had to contend with Guatemalans who claimed bodily sovereignty and asserted their own ethics that challenged the doctors’ authority. Guatemala is a medically pluralistic country where U.S. and Guatemalan doctors competed with healers who drew from Indigenous, African, folk, traditional and other practices. Drawing from popular medicine, Guatemalans rejected their identification as public health threats and medical subjects. They also challenged the hegemony of the Guatemalan Spring and U.S. imperial medical practices.
In addition to examining why these experiments occurred, my book also examines the imprint of these experiments on Guatemalans in the present day. Guatemalans who were left untreated by the doctors, and their children suffered health problems for the majority of their lives. Yet Guatemalans have gained no reparations for what happened, nor have they been able to find justice through lawsuits. My book explores why these experiments continue to remain invisible to the majority of people in the United States and Latin America.
Contributions to Literature
Wounded Sovereignty will be the first full-length book written about these experiments. Although there have been several important articles that have focused on these experiments, my book will be a comprehensive examination of what happened. Drawing from oral histories and archival materials that I gathered in Latin America and the United States, my book adds to the literature by examining them from the position of Guatemalan history.
My book also makes contributions to the history of Latin American medicine, science, and technology. In recent years, historians have highlighted the important contributions that Latin American health professionals have made to international health organizations, medicine, and research. I draw inspiration form this literature, but I also highlight that less has been said about how international health and development programs in Latin America have intersected with racial and gendered norms formed within individual nation-states. Guatemalan doctors sought to direct international health programs to further their nation-state building goals that were premised upon the exclusion of Indigenous people and those who challenged gendered norms. They augmented their own authority by claiming to have racialized and gendered knowledge about people within their country, and by differentiating themselves from Indigenous people.
My book also revises historical literature on Latin America’s Cold War by highlighting that the Guatemalan Spring was a eugenic revolution. Although eugenics as a project had been largely discredited by Nazism following World War II, Latin American countries continued to use the term in the 1940s. Historian Nancy Stepan argued that Latin eugenics was softer as opposed to U.S. and northwestern European eugenics which was interventionist in its efforts to limit the reproduction of those deemed “unfit.” Increasingly, Latin American historians of medicine have challenged this divide. My book builds upon this literature by showing that the experiments emerged from doctors’ willingness to limit the reproduction of undesirable populations to further their nation-state building goals.
A focus on the Guatemalan side of this history is important to challenge what is often a U.S.-centric bioethics narrative. My work draws on research by scholars such as Joanna Radin and Emma Kowal who have stressed that what we understand as ethical is shaped by varied cultural, political, and institutional contexts. Sociologist Laura Stark and others have criticized the emphasis on Tuskegee, Alabama as the prime example of unethical research. She highlights U.S. bioethics as a settler colonial narrative that ignores the place that medicine has had in the colonization of Indigenous people. A U.S. centric narrative about these experiments obscures the history of U.S. and Latin American settler colonialism and the manner in which this research also emerged from Guatemalan state-led efforts to build a homogeneous nationality through the erasure of Indigenous people.
Archival Research in Member Institutions
My fellowship provided the funding so that I could complete my archival research. I visited Harvard University’s Countway Library, the National Library of Medicine (NLM), and Johns Hopkins University’s Chesney Archives. These archival sources were particularly helpful in tracing how U.S. institutions built a medical research network in Guatemala with the cooperation of local doctors and elites.
In July 2024, I began my research at the Countway Library. I examined the archival documents related to Harvard’s School of Tropical Medicine and the papers of medical doctors including Drs. Richard Strong and George Cheever Shattuck. Harvard’s School of Tropical Medicine developed close connections with the United Fruit Company (UFCO), which offered its banana plantations as key sites for tropical medical research. Strong became the director of medical research for the United Fruit Company. His archival records show that Strong formed a close relationship with the doctor at the UFCO plantation in Guatemala. As a result of these connections between Strong, the UFCO doctor, and Guatemalan doctors, the country became a key research node. Shattuck also was a professor at Harvard’s School of Tropical Medicine and he researched the relationship between indigeneity and syphilis. He came to believe that Indigenous people in Central America had developed racial immunity to the disease. PASB drew from Shattuck’s research in the STI experiments in the 1940s.
Following my visit to Harvard, I went to the NLM where I continued to research how U.S. institutions and doctors enabled this research to occur. I read the autobiography and notes of Surgeon General Hugh Cumming, who was also the director of the PASB. Through his writings, I was able to see the close connections that he formed with Guatemalan doctors and how these ties remained strong during the revolution, even as medical and political leaders sought to increase their independence from the United States. I also read the diary of Dr. Fred Soper, who became the director of the PASB during these experiments. His diary reveals that he had full knowledge of what happened in these experiments, which had not been understood before. Soper’s connection to the Rockefeller Foundation shows how U.S. international health organizations developed a culture of medical research that led to the normalization of the venereal disease experiments.
My last research visit in February 2025 was at the Chesney Archives at Johns Hopkins University. These archives had information on Guatemalan doctors and nurses who went to Hopkins to study at the School of Hygiene and Public Health. Several Guatemalan doctors studied syphilis with prominent researchers including Drs. Thomas Turner and Joseph Earle Moore. These archives enabled me to see the challenges of Guatemalan doctors who studied at U.S. universities and contended with paternalism and racism from U.S. doctors. Yet even as they absorbed knowledge from leading researchers at Hopkins, Guatemalan doctors tested this knowledge and rejected aspects of it that they believed was not applicable to their own national contexts.
In addition to these archival visits, the fellowship provided me with critical time to work on my manuscript. In July 2025, I submitted my completed manuscript to the University of Nebraska Press for review.