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Charles M. Blow: How Black people learned not to trust

(National Archives via AP) In this 1950s file photo released by the National Archives, men included in a syphilis study pose for a photo in Tuskegee, Ala. Historic failures in government response to disasters and emergencies, medical abuse, neglect and exploitation have jaded generations of black people into a distrust of public institutions. Some might call it the Tuskegee effect, referring to the U.S. government’s once-secret syphilis study of black men in Alabama that one study shows later reduced their life expectancy due to distrust of medical science.

It would appear that the people in American hit hardest by COVID-19 — Black people — are also the group most leery about the prospects of a vaccine.

As a Pew Research report published last week pointed out: “Black Americans are especially likely to say they know someone who has been hospitalized or died as a result of having the coronavirus: 71% say this, compared with smaller shares of Hispanic (61%), White (49%) and Asian-American (48 %) adults.”

But that same report contained the following: “Black Americans continue to stand out as less inclined to get vaccinated than other racial and ethnic groups: 42% would do so, compared with 63% of Hispanic and 61% of white adults.”

The unfortunate American fact is that Black people in this country have been well-trained, over centuries, to distrust both the government and the medical establishment on the issue of health care.

In the mid-1800s a man in Alabama named James Marion Sims gained national renown as a doctor after performing medical experiments on enslaved women, who by definition of their position in society could not provide informed consent.

He performed scores of experimental operations on one woman alone, an enslaved woman named Anarcha, before perfecting his technique.

Not only that, he operated on these women without anesthesia, in part because he didn’t believe that Black women experienced pain in the same way that white women did, a dangerous and false sensibility whose remnants linger to this day.

When he finally got his experiments to be successful, he began to use them on white women, but he would begin to use anesthesia for those women.

As medical writer Durrenda Ojanuga wrote in the Journal of Medical Ethics in 1993: “Many white women came to Sims for treatment of vesicovaginal fistula after the successful operation on Anarcha. However, none of them, due to the pain, were able to endure a single operation.”

Sims would go on to become known as the Father of Gynecology, even though, as one researcher put it:

“Sims failed utterly to recognize his patients as autonomous persons and his own personal drive for success cannot be minimized, especially as a balance to the enormous amount of praise accorded Sims for his work and for subsequent applications of the technique developed in Montgomery and elsewhere.”

After the Civil War and the freeing of the enslaved, the limited and fragile infrastructure for Black people in this country collapsed and an epidemic of disease flourished.

Many formerly enslaved people were estranged from the small gardens they used to grow things for home remedies. The larger plantation that had sick houses saw operations cease.

White doctors refused to see Black people and white hospitals refused to admit them. Furthermore, federal, state and local governments squabbled over whose responsibility it was to provide health care for the newly freed men and women, with no entity truly wanting to assume that responsibility.

Because of all of this, Jim Downs, a professor at Gettysburg College, estimates that at least one-quarter of all former slaves got sick or died between 1862 and 1870.

For nearly half of the 20th century, women — often Black — were forcibly sterilized, often without their knowledge. As The Intercept reported in September, “Between 1930 to 1970, 65% of the 7,600-plus sterilizations ordered by the state of North Carolina were carried out on Black women.”

As Ms. Magazine pointed out in 2011:

“Some women were sterilized during cesarean sections and never told; others were threatened with termination of welfare benefits or denial of medical care if they didn’t ‘consent’ to the procedure; others received unnecessary hysterectomies at teaching hospitals as practice for medical residents. In the South it was such a widespread practice that it had a euphemism: a ‘Mississippi appendectomy.’ "

Even famed Mississippi civil rights heroine Fannie Lou Hamer was a victim of forced sterilization. As PBS has pointed out, “Hamer’s own pregnancies had all failed, and she was sterilized without her knowledge or consent in 1961. She was given a hysterectomy while in the hospital for minor surgery.” Hamer would later say, “(In) the North Sunflower County Hospital, I would say about 6 out of the 10 Negro women that go to the hospital are sterilized with the tubes tied.”

Furthermore, as the Centers for Disease Control and Prevention explains: “In 1932, the Public Health Service, working with the Tuskegee Institute, began a study to record the natural history of syphilis in hopes of justifying treatment programs for blacks. It was called the ‘Tuskegee Study of Untreated Syphilis in the Negro Male.’ "

Hundreds of Black men were told they were being treated for syphilis, but they were not. They were being observed to see how the disease would progress. The men suffered under this experiment for 40 years.

I hope that America can overcome Black people’s trepidations about this vaccine, but it is impossible to say that that trepidation doesn’t have historical merit.

Charles Blow |The New York Times

Charles M. Blow is an Op-Ed columnist for The New York Times.

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