“ETHICALLY IMPOSSIBLE” STD Research in Guatemala from 1946-1948 
arrival and briefed him on the construction efforts to date. 222 Dr. Spoto also 
introduced Dr. Cutler to many Guatemalan officials who would facilitate 
the work. 223 The two met with officials at Guatemala’s Direccion General de 
Sanidad Publica (Ministry of Public Health), as well as with the “chiefs” of 
the Ejercito Nacional de la Revolucion (National Army of the Revolution) 
(Guatemalan Army). 224 Dr. Cutler also met with the Minister in charge of the 
Penitentiary and reported that “[a] 11 of those concerned” at the Penitentiary 
were indeed “very anxious” for the research to begin. 225 Additional PHS staff 
soon joined Dr. Cutler in Guatemala, including Dr. Sacha Levitan, a Senior 
Surgeon who served as the Assistant Director of the Guatemala project, Dr. 
Elliot Harlow, an Assistant Surgeon, Joseph Portnoy, a serologist, and Alice 
Walker and Virginia Lee Harding, bacteriologists. 226 
To facilitate the work, PASB officials signed agreements for “cooperative working 
arrangements” 227 with the Ministers of Health, War, and “Gobernacion” [Inte- 
rior] under whose jurisdiction the Penitenciarfa Central (the Penitentiary) 
fell. 228 According to Dr. Cutler, these agreements gave the researchers authority 
to work with officials and institutions across the Guatemalan government, 
including “the medical and other authorities of the public health service rapid 
treatment center for venereal diseases, in the governmental hospitals, with 
medical installations and officers of the military, with institutions caring for 
the orphans and the insane, and with the penal system.” 229 Writing in 1955, Dr. 
Cutler explained that many different activities were contemplated, including: 
assessing the prevalence of STDs in the country; developing an improved 
system of STD control through personnel training; establishing prophylactic, 
diagnostic, and treatment facilities; investigating and refining diagnosis and 
treatment; and prophylactic experiments. 230 The researchers were to train local 
personnel to take over the new PASB VDRL-constructed research laboratory as 
a Guatemalan government facility in the future. 231 
Treatment Programs and Goodwill Efforts 
After Dr. Cutler met with leaders of the Guatemalan Army in August, they 
asked the researchers to set up a “treatment program” for the Hospital Militar 
(Military Hospital). 232 With the support of Dr. Spoto, in whom Dr. Mahoney 
vested great confidence, 233 and Dr. Funes, the former VDRL fellow, Dr. 
Cutler argued to Dr. Mahoney that treatment programs should start in order 
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