The Mefloquine Debate
This article has been brewing in my mind for quite some time. Although I wanted to write it, I didn’t want to be an angry veteran while writing it (which at times can be hard to do). I have lost a lot of friends to Mefloquin toxicity, currently being coined Quinism by Dr. Remington Nevin a Vermont-based physician epidemiologist and expert consultant in the adverse effects of anti malarial drugs, who is also a veteran and victim of Quinism. I lost one friend as recently as Jan 2, 2018 just a couple of weeks ago, although not a close friend we marched together on Parliament Hill in Sept last year asking for the Somalia inquiry to be reopen in order to allow testimony on Mefloquin. Although she was not military she was a warrior and a fierce one at that. She and a few others were instrumental in taking the fight of the veterans into Canadian culture. But first let me go back to the beginning.
In late 1992 the Canadian Government sought (or was coerced depending on who you listen two) to approve for use in Somalia the anti malarial drug Mefloquin, the approval process included the need for a study on the drug, and that’s where the controversy truly begins. I was the pharmacist representative for the Airborne Regiment, which means I was responsible to order, stock and pack all medical supplies for the operation. This is where the first oddity begins, at no time did any order, record or accounting of the anti malarial drug Mefloquine ever enter into our records for procurement, distribution or administration to any individual or unit at our level. In fact it wasn’t until we returned to Canada and the Regimental Medical Officer had us place on everyone’s file a letter stating that we had been exposed to Mefloquin during the operation that Mefloquin found any notation on any of our medical documents.
Three months into the operation, we had at least one psychotic break, a murder and if I am correct 2 attempted suicides. Yet despite this and from what we have gathered so far (that we were the drug trial for approval of Mefloquin on the Canadian Market) Mefloquin was approved for use in early 1993 while we were still on operation and without supporting clinical trial evidence. The media circus that followed our ill fated mission painted us as Racist Neo Nazi Skin Heads, who had always been out of control and should have been shut down as a unit decades ago. And in fact there had been incidences in the Regiments past as there has been in all military regiments’ history, when you train men to kill, expect them to at times reflect poor morality. In Somalia, the Italians’ wiped out several hundred Somali’s at a time for trying to enter their compound. India’s army conducted summary executions on the spot for any transgressions against them, and our American Cousins had several incidences a month of illegal shootings. This is not to justify our actions, but to place into perspective, the one transgression against a Somalian that was the dismantling of the Canadian Airborne Regiment. Truth is unless there is a study on the effects of Mefloquin as stated in the Somalia inquiry we will never know. This is an excerpt from the Somailia Inquiry on the use of Mefloquin from page 3 paragraph 7;
If mefloquine did in fact cause or contribute to some of the misbehaviour that is the subject of this Inquiry, CF personnel who were influenced by the drug might be partly or totally excused for their behaviour. However, for reasons described more fully in Chapter 41, we are not able to reach a final conclusion on this issue. We can offer only general observations about the decision to prescribe mefloquine for personnel deployed to Somalia: 32
Although this is a small amount of what is in the chapter, I encourage you to read it all for yourself, Chapter 41 states;
We cannot say, however, whether DND took adequate precautions to ensure that persons susceptible to severe psychiatric disorders did not receive mefloquine, since even in 1992 it was known that mefloquine should not be prescribed to such individuals.
3. More recent medical information suggests that severe adverse effects from mefloquine used as a prophylactic are not as rare as first thought, but views on this point conflict, and further investigation may be necessary.
4. Mefloquine use could have been a factor in the abnormal behaviour of some troops in Somalia. However, one cannot begin to determine whether mefloquine contributed to the behaviour of the individuals in question without answers to the following questions:
A list of questions then continues that I did not include due to space, but you should read them yourself as this list of questions conclude with;
It is evident that further investigation is warranted before any firm conclusions about the role of mefloquine can be drawn. 33
The inquiry continues to outline the lack of cooperation at senior levels as the cause of further compounded adversity in reaching a conclusion with this observation from the inquiry not from the Airborne Regiment, but from the Department of National Defense, and those calling the shots here in Canada during the operation;
However, we must also record with regret that on many occasions the testimony of witnesses was characterized by inconsistency, improbability, implausibility, evasiveness, selective recollection, half- truths, and plain lies. Indeed, on some issues we encountered what can only be described as a wall of silence. When several witnesses behave in this manner, the wall of silence is evidently a strategy of calculated deception. Perhaps more troubling is the fact that many of the witnesses who displayed these shortcomings were officers, non-commissioned officers, and senior civil servants – individuals sworn to respect and promote the values of leadership, courage, integrity, and accountability.
So with all this uncertainty in the air, here is where the loss of this magnificent warrior I mentioned at the beginning comes in. Unless we know for certain the effects of Quinism the symptoms will continually be attributed to Post Traumatic Stress Disorder (PTSD) or mental illness. If you read my article last week, Coming Out Of The Cold, the degree of ineffective treatment surrounding PTSD (incidentally the study I quote is a study on Civilian PTSD not military) can be further compounded, by treating Quinism as mental illness and not poisoning. My friends roll was critical in having this drug investigated because she and others like her show the exact same signs and symptoms as us military people, but unlike us they have never been in a combat zone to be traumatized. They received the same symptoms of us from taking the same medication while on vacation in some swanky resort. Yet like us she will be called a suicide from mental illness as opposed to a victim of poisoning from an untested illegally licensed drug.