Arkansas jail’s ivermectin experiments recall historical medical abuse of imprisoned minorities

In late August last year, four inmates at the Washington county detention center in north-west Arkansas contracted Covid-19. In the days that followed, the four men were relocated to a quarantine block in the prison.

In the block, the inmates were given a cocktail of drugs. They soon began to suffer a series of side effects including vision issues, diarrhea, bloody stools and stomach cramps.

It was only later that they discovered they had been prescribed, without their consent, significantly high doses of ivermectin, an anti-parasitic drug commonly used on livestock animals including cows and horses.

The story of what may have happened in a small slice of Arkansas nestled against the Ozark hills has shocked many in America and come to symbolize the political divides triggered by the pandemic. The scheme reflects a growing obsession with ivermectin as a Covid-19 treatment – especially among rightwing communities in the US.

But it also repeats America’s dreadful history of racism as the alleged experimentation forced on the Arkansas inmates recalls a grisly history of medical exploitation by American authorities towards communities and inmates of color.

The Centers for Disease Control and Prevention (CDC), as well as the Food and Drug Administration (FDA), have warned against using ivermectin for Covid-19. Despite that the treatment has gained wide popularity among many on the right, including anti-vaxxers.

Last month, the Arkansas chapter of the American Civil Liberties Union filed a lawsuit on behalf of the men against Washington county jail, the Washington county sheriff, Tim Helder, and jail physician Dr Robert Karas.

One of the plaintiffs was recorded as 6ft 1in and weighed 158 lbs (71.6kg) on 22 August 2021. At his size, the approved ivermectin dosage to treat worms is 0.2 mg/kg in a single dose, which given his size, is 14 mg. According to the lawsuit, he was given 48 mg over four days, 3.4 times the approved dosage.

Another plaintiff, who has a history of heart conditions and suffered three heart attacks in 2018, was recorded as 6ft 1in and weighed 191 lbs (86.6 kg) on 21 August 2021. The approved ivermectin dosage to combat worms for someone his size is 0.2 mg/kg in a single dose, or 17 mg. He was prescribed 36 mg of the drug on 22 August, followed by 24 mg daily from 23-25 August.

The total dosage, 108 mg, was nearly 6.3 times the approved dosage.

At the time, the plaintiffs were told that the treatments merely consisted of “vitamins”, “antibiotics” and “steroids”, according to the lawsuit.

The FDA has warned against using ivermectin to treat Covid-19. The agency’s listed side effects of ivermectin overdose include nausea, diarrhea, low blood pressure, allergic reactions such as itching and hives, seizures, coma and even death.

“No one – including incarcerated individuals – should be deceived and subject to medical experimentation,” said Gary Sullivan, legal director of the ACLU of Arkansas.

Despite the widespread outrage at the allegations, last week some local Arkansas officials praised Karas for a “job well done”, despite widespread outrage against his actions.

“Dr Robert Karas and Karas Correctional Health have effectively treated … cases [in the jail] which have resulted in zero fatalities from the virus,” said a resolution recently passed by a local court’s jail and enforcement committee.

The exploitation faced by the Arkansas inmates reflects America’s longstanding history of medically abusing vulnerable communities of color, including inmates.

From 1946 to 1948, the US Public Health Service (USPHS) and the Pan American Sanitary Bureau worked alongside multiple Guatemalan agencies on medical research funded by the American government. The research involved deliberately exposing Guatemalans, including soldiers, prisoners, prostitutes and mental patients with syphilis and other sexually transmitted diseases.

In two years, over 1,300 people were exposed to syphilis, gonorrhea or chancroid. In 2011, the Presidential Commission for the Study of Bioethical Issues revealed that only around 700 of those infected received some form of treatment while 83 others died.

According to details that only emerged 10 years ago, one of the researchers, John Charles Cutler, injected gonorrhea and syphilis bacteria into the eyes of patients, often in the form of pus. In one study, he infected prostitutes with gonorrhea by inserting a cotton swab carrying the bacteria into their vaginas with “considerable vigor”.

Cutler then ordered the prostitutes to have sex with the men he wanted to study, including prisoners and army members.

Other researchers scraped men’s penises with needles and then applied syphilitic material around the abrasions. At times, women were subjected to injections of infected pus into their spinal cords.

According to experts, the research came up with no useful medical information and was instead concealed for decades until a Wellesley College medical historian uncovered the medical records among Cutler’s papers.

Cutler then went on to become a primary researcher in the later half of the infamous Tuskegee syphilis experiment. Starting in 1932 and continuing for 40 years, American government officials in rural Alabama withheld treatment from unsuspecting Black men infected with syphilis so doctors could monitor the disease and dissect their bodies when they died.

The study was fueled by harmful pseudoscientific and racist beliefs, including ones that assumed that African Americans had under-developed brains and over-developed genitals. Researchers also believed that Black people were significantly prone to sexually transmitted disease and that all Black people could not be convinced to receive treatment for syphilis.

As a result, the experiments, which involved 600 Black men, became known as the Tuskegee Syphilis Study. The USPHS called the research a “study in nature” rather than an experiment, meant to merely monitor the progression of syphilis in a community that allegedly refused to seek treatment.

The men were mostly sharecroppers and many had never visited a doctor. Doctors from the USPHS told them that they were being treated for bad blood, a general term used at the time to refer to a variety of diseases.

In exchange for their participation, the men received free medical exams, free meals and burial insurance. Many of them died, went blind or insane.

Cutler later said in a 1993 documentary, “It was important that they were supposedly untreated and it would be undesirable to go ahead and use large amounts of penicillin to treat the disease, because you’d interfere with the study.”

Similarly, from the 1950s to 1970s, inmates in Philadelphia’s Holmesburg Prison, many of whom were Black, were subject to a series of medical experiments.

In conjunction with the University of Pennsylvania, doctors and prison officials experimented on hundreds of prisoners for nearly two decades. Prisoners were used to test products for facial creams, perfumes, detergents and anti-rash treatments.

Others were subject to experiments that involved far more hazardous substances, including radioactive isotopes, LSD, chemical warfare agents and dioxins, a highly toxic group of chemical compounds often used to bleach paper pulp and manufacture pesticides.

One inmate said he was paid $10 to be injected with a “rare disease from India,” and was paid an additional $5 when he developed an abscess.

In 2018, the dean of Penn Medicine issued an apology for the experiments, saying that the “work done … was terribly disrespectful of individuals – many of whom were imprisoned Black men – denying them the autonomy and informed consent which the medical community now considers to be foundational underpinnings for conducting ethical research.”

Fast forward to present day, since ACLU’s lawsuit against Dr Robert Karas and the Washington county jail, Karas has filed a motion to dismiss ACLU’s lawsuit against him.

Karas’s actions encapsulate not only the horrific history of the carceral system in the American south, but also the continued exploitation of vulnerable communities, including inmates of color.

As one inmate said receiving news about the ivermectin treatments, “I’m scared. If you were so willing to put something in my pills and give me a pill without my acknowledgement, you could do the same thing and be deceptive and put it in my juice, my food … I can’t trust any of the medical staff. I can’t trust any of the guards.”

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