- American troops in Liberia refused to take malaria pills,
because they fear the side effects more than bullets. Brendan O'Neill on
the undermining of morale
-
- Whatever happened to America's military intervention
in Liberia? On 14 August, around 200 helicopter-borne marines flew into
the war-torn West African state as part of a 'quick-reaction force' to
be deployed if African peacekeepers got into trouble. Following the winding-down
of hostilities between rebel forces and forces loyal to the former president
Charles Taylor, American troops planned, in the words of President Bush,
to assist Nigerian peacekeepers in 'making sure humanitarian relief gets
to the people who are suffering'. According to reports, ecstatic Liberians
greeted the arrival of America's Cobra attack helicopters with cries of
'Thank you, America!'
-
- Yet within weeks many of the US marines had been evacuated
following a bizarre outbreak of illness. In early September, a handful
of marines returned to the USS Iwo Jima, off the coast of Liberia, their
skin riddled with mosquito bites. They were so ill that doctors made arrangements
to fly them to Germany for intensive medical care. A few hours later, a
further 15 marines were sent back to the ship, suffering from high fevers,
high blood pressure, severe diarrhoea and vomiting fits. By the following
day, 31 marines were seriously ill; according to Lieutenant Chris Scuderi,
a doctor on board the Iwo Jima who desperately tried to treat the stricken
marines, 'We had no clue what it was.'
-
- It was malaria. By early October, the Pentagon had confirmed
that a third of the US military personnel sent to Liberia had come down
with the disease. Eighty of the 290 Americans who went ashore in Liberia
contracted it; 69 of the 157 troops who went ashore became infected. None
of the marines has died, though 44 were made so ill by falciparum malaria
- the most feared form of the disease - that they had to be evacuated from
the seas off Africa to Europe or the United States. According to some accounts,
even the shocking one-in-three figure fails to capture the seriousness
of the outbreak. The Washington Post reports that 'nearly all of the marines
...reported at least mild symptoms typical of malaria'.
-
- How could such an outbreak occur, affecting so many of
an entire invading force? US military officials claim that the outbreak
was a consequence of complacency among troops, many of whom failed to follow
protective measures and take the anti-malarial drugs prescribed by their
commanders. According to Commander David McMillan, a navy physician, 'It
is difficult to get these young marines, who are willing to charge a machine-gun
nest, to be worried about a mosquito.' It must have been a profound sense
of complacency. Blood samples taken from the 26th Marine Expeditionary
Unit showed that only 5 per cent had been regularly taking the recommended
dosage of the anti-malarial drug mefloquine, and only 12 per cent wore
uniforms properly treated with the insecticide permethrin. That leaves
about 95 per cent who did not properly protect themselves; were they all
simply 'complacent'?
-
- If so, marine commanders must shoulder some of the responsibility.
Liberia and other West African countries have some of the most severe malaria
transmission rates in the world. It is estimated that an individual who
spends a month in Liberia and fails to take protective measures has a 50
per cent chance of contracting malaria. If there was complacency among
US marines about taking anti-malarial drugs, it is surely because they
were not fully and forcefully informed of the risks. Yet dig a little deeper,
and there seems to be more to the malaria-and-marines story than complacency.
In the age of Gulf War Syndrome, when many troops are increasingly suspicious
of the medical concoctions given to them by their commanders, rumour and
suspicion appear to have played a part in the diseased operation in Liberia.
-
- Mefloquine, the drug used by the US military to protect
against malaria, has in recent years been the subject of much speculation
and scaremongering among American troops. It comes in tablet form and has
to be taken once a week, starting a week before arriving in a malaria-risk
area and continuing for four weeks after departing from the area. The majority
of people who take mefloquine experience few, if any, side effects, though
the drug can sometimes induce nausea, dizziness and vivid dreams. A small
minority of those who take it have reported serious side effects, including
seizures, hallucinations and severe anxiety. According to the US Centers
for Disease Control (CDC), such side effects are 'very rare'. Both the
CDC and the World Health Organisation recommend mefloquine as the most
effective treatment for those travelling to malaria-risk areas.
-
- Despite this approval for mefloquine, US military circles
have been rife with rumours about the drug making soldiers do terrible
things, from killing innocent civilians to committing suicide. In Somalia
in 1993, Canadian troops beat to death a Somali teenager called Shidane
Arone - and claimed that the mefloquine made them do it. However, as the
Canadian journalist David Akin points out, 'The Canadian mission in Afghanistan
[in 2001/2002] was unmarred by any incidents like those of the Somalia
scandal - but the troops did take mefloquine, and some reported strong
nightmares.' In 2000, British paratroopers involved in 'shooting incidents'
in Sierra Leone similarly claimed that their actions were partly a consequence
of the side effects of mefloquine - though, again, there is little evidence
to substantiate these claims. At Fort Bragg in North Carolina in summer
2002, four American soldiers killed their wives in the space of five weeks,
and an army medical team was sent to investigate whether mefloquine played
a part in the attacks - a story that received widespread media coverage
in the US. Earlier this year, an epidemiological team at Fort Bragg concluded
that mefloquine was not a factor in the murders.
-
- Some might think that Canadian and British troops and
the murderous husbands in North Carolina were trying to excuse their outrageous
behaviour by pinning the blame on mefloquine, a drug that is known occasionally
to cause severe anxiety. Yet stories about mefloquine-addled Canadians
and Brits beating and shooting innocents have assumed the status of proven
fact among some soldiers around the world, as rumours about the anti-malarial
drug continue to spread. These stories must surely have had an effect on
the US marines who went to Liberia, who so spectacularly failed to stick
to the recommended dosage. According to the US Democrat senator Dianne
Feinstein, 'While news reports of preliminary interviews with sick soldiers
suggest that complacency was the primary factor behind their decision not
to take [mefloquine] ...reports from fellow service members may have played
some role in their decision not to take it.'
-
- This would help to explain why such a high proportion
of the US marines in Liberia, 95 per cent, failed to take their full and
proper course of mefloquine - a take-up rate so low that it points to something
more than mere complacency. But how can rumours about a drug have such
an impact? Why did so many US marines fail regularly to take an anti-malarial
drug, even though they were heading into one of the world's most high-risk
malaria areas, and presumably had some knowledge of the potential deadliness
of the disease?
-
- The Liberian incident points to a high degree of mistrust
within modern military machines, particularly in relation to vaccines,
medicines and other drugs. Following a number of controversies and claims
of illness, today's troops are often suspicious of the protective medicine
given to them by their commanders. Whether in the American, British or
Canadian military, many troops appear to view themselves as isolated individuals
at risk from syndromes and sickness, rather than as a collective force
on a mission. This is best captured by the continuing controversy over
Gulf War Syndrome; as with mefloquine, it has been shown that the vaccines
given to soldiers during the first Gulf War of 1991 caused side effects,
though there is still little medical evidence of the existence of a unique
Gulf War Syndrome. Yet the spat between Gulf War veterans and their former
military commanders in both Britain and the USA seems to have exacerbated
serving troops' wariness of protective drugs and heightened mistrust between
ranks.
-
- The debacle that was America's intervention in Liberia
raises a worrying question for the US military: has this internal mistrust
now gone so far that some troops are more willing to take their chances
with a deadly disease than take the tablets given to them by their commanders?
-
- - Brendan O'Neill is assistant editor of spiked-online
-
- © 2003 The Spectator.co.uk
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