What we (don’t) discuss in my MPH program

Three of my professors have MENTIONED the Tuskegee Syphilis Study. By mentioned, I mean just that, they’ve either said the words ‘Tuskegee Syphilis Study’ or painted some oversimplified, less severe, version of what actually happened. That one professor said that the problems with this ‘incident’ were these doctors (no specification of their race) didn’t practice informed consent, and that the participants were “mainly low-income, uneducated minorities from rural Alabama.” 

UM…first of all the US Public Health Service was involved in this study, and other professional groups and services (AMA and NMA) continued to support the study (design flaws and all) well into the 1960s. The “mainly low-income, uneducated minorities from rural Alabama” were ALL BLACK MEN, all 600 of them. And NO there was no informed consent, there were just outright lies, as not only did they tell the men that they were being treated for what they called “bad blood” but physicians who joined the study were told specifically NOT to treat the men for their syphilis, which could have been treated with penicillin. ALSO, these researchers actually prevented the men from getting treatment on more than one occasion. Yes, there were black health professionals involved in the study, but this was by and large WHITE doctors who purposefully targeted BLACK men in order to study the progression of syphilis until these men DIED from it. And they were targeted BECAUSE of their race, BECAUSE such a clearly unethical study like that could only have been executed on black people, who, for all intents and purposes, were considered inhuman. It wasn’t just some accidental oversight in design like my professor would have made it sound.

What he also failed to mention was were the effects of untreated syphilis (which is particularly ridiculous for a professor who is also a medical doctor). According to the CDC:

In the late stages of syphilis, the disease may subsequently damage the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. Signs and symptoms of the late stage of syphilis include difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, and dementia. This damage may be serious enough to cause death.

AND because these men went about their lives thinking they were getting treatment, they didn’t think twice about passing on the infection. THUS, many of their wives contracted syphilis, got pregnant, and passed on congenital syphilis to their children. And there is really NOTHING written up on the long term effects that their families faced as a result of this “study.” Just in case you didn’t know how syphilis affects pregnant women:

The syphilis bacterium can infect the baby of a woman during her pregnancy. Depending on how long a pregnant woman has been infected, she may have a high risk of having a stillbirth (a baby born dead) or of giving birth to a baby who dies shortly after birth. An infected baby may be born without signs or symptoms of disease. However, if not treated immediately, the baby may develop serious problems within a few weeks. Untreated babies may become developmentally delayed, have seizures, or die.

The lack of critical discussions in these classes is totally unacceptable. And worse, there are so many students who have been in these classes that only mentioned the study, who don’t even know what the Tuskegee Syphilis Study is. AND THAT, is an egregious oversight in the education of future of public health officials. We’re getting a masters degree here! We discuss theories, theoretical situations, policies (almost only from the perspective of what the laws say and what their intended to do as opposed to what they ACTUALLY do), some psychology, and a little bit of behavior analysis. But the social indicators, the issues in multicultural health, the issues in LGBTQ health, are either completely passed over or talked about in some oversimplified, glossed-over, manner. Health disparities are only discussed in a statistical manner, but WHERE IS THE HISTORY? WHERE IS THE CONTEXT? We didn’t just happen to run upon this problem of having a population with one of the most disparate health statuses in the world. SHIT HAPPENED TO CONTRIBUTE TO THIS! And we act like it’s not an important discussion in the classroom of public health students to know how the US Public Health Service contributed to one of the most heinous studies (that we know of) in this country!

Anyway, the whole long digression, just to provide a link to yet ANOTHER example of a heinous study done about syphilis, this time in Guatemala. This happened a couple of months ago, but NOT ONE, NOT A SINGLE ONE, of my professors even bothered to throw out a mention of this in class.

This is not okay. Tulane School of Public Health & Tropical Medicine, we need to talk…

What we (don’t) discuss in my MPH program