Random Analytica

Random thoughts, charts, infographics & analysis. Not in that order

Category: Mefloquine

29. Mefloquine Dispatches: Patricia Fernandez de Viana, 10th December 2021

On the final day of Hearing Block 1 for the Royal Commission into Defence and Veteran Suicide (DVSRC) held in Brisbane in December 2021, mother of James, Patricia Fernandez de Viana gave testimony which included a linkage to the use of anti-malarials. Via the AAP and The Guardian. Mother tells veteran suicide inquiry ADF failed to support family after son’s death. Excerpt:

Fernandez de Viana, a wound care specialist nurse, said she discovered the welter of medications her son was on when he died, including experimental treatments for malaria: “I was horrified, absolutely horrified.”

More to follow…

28. Mefloquine Dispatches: 3573 – Lambie, Senator Jacqui, 23rd April 2021

I was quite unwell when this came out and completely missed it. That said the questions are good but they don’t go far enough. They focus on the initial East Timor deployments (where mefloquine was used but Tafenoquine was the preferred option). Also, no mention of previous deployments where mefloquine was used for deployments from Rwanda to PNG. Certainly no mention of the 100-odd men who received mefloquine as part of the Sandline Affair deployment as the anti-malarial was not detailed on our medical records.

Via the Parlwork website. 3573 – Lambie, Senator Jacqui to the Minister representing the Minister for Defence. Her questions:

SENATOR LAMBIE asked the Minister representing the Minister for Defence, upon notice, on 23 April 2021:

1. How many Australian Defence Force (ADF) personnel who were prescribed mefloquine during Timor-Leste deployments were later deployed to do war service in the Middle East?

2. How many ADF personnel who were prescribed mefloquine during Timor-Leste deployments went on to serve in the Middle East:

in the Special Air Service;

as commandos; and

in Royal Australian Regiments.

3. What work has been done, and is being done, to track the effects of the mefloquine trials on soldiers’ response to trauma, is data on this being monitored.

4. How many soldiers who were prescribed mefloquine during deployment to Timor-Leste were later diagnosed with Post Traumatic Stress Disorder.

5. How many soldiers who were prescribed mefloquine during deployment to Timor-Leste later attempted suicide or committed suicide.

In response dated the 21st May 2021 via the Parlwork website. As above. The response:

1. The number of ADF personnel previously reported as using mefloquine was determined based on trial nominal roles and pharmacy dispensing records. Determining those personnel who were prescribed mefloquine during Timor-Leste deployments, and who subsequently deployed to the Middle East, would require an intensive process of matching health datasets with data in personnel service record systems, including physical records going back a number of decades. Significant resources and time would be required to consolidate and interpret this data. Defence health resources are fully engaged supporting the Defence response to the COVID-19 pandemic and are unable to be reallocated to producing the requested data.

2. The answer provided to Question 1 also applies to this question.

3. No work has been undertaken, or is being undertaken, to track the effects of the mefloquine trials on ADF personnel response to trauma. The Senate Inquiry in 2018 into ADF use of mefloquine and tafenoquine, recommended against such activities.

4. As at 1 May 2021, Defence is aware of 99 ADF members who were prescribed mefloquine in Timor-Leste, being later diagnosed with Post-Traumatic Stress Disorder. The rate of Post-Traumatic Stress Disorder amongst those prescribed mefloquine is similar to those who did not take mefloquine.

5. Of the ADF members who were prescribed mefloquine during their deployment to Timor-Leste, Defence is aware of seven members who have died by suicide.

27. Mefloquine Dispatches: McKinsey & Company, 19th October 2021

I completely missed this when it was very quietly released a month ago, so many thanks to Andrew Greene from the Australian Broadcasting Corporation for tweeting this out today.

Via the Defence and Veteran Suicide Royal Commission. Royal Commission into Defence and Veteran Suicide to open in Brisbane. Excerpt:

Last week the Federal Minister for Veterans’ Affairs and Defence Personnel announced the appointment of consultants McKinsey & Company to take action to improve the claims system for supporting veterans, administered by the Department of Veterans’ Affairs. The Minister is reported to have said that McKinsey & Co would be consulting with bereaved families of veterans who have died by suicide.

What?

The Royal Commission hasn’t even started and the current government is giving money to questionable consultants. The fact that staff from a consulting company would be discussing the deaths of loved ones with bereaved families is beyond my understanding. Then you have the complexities including mefloquine or tafenoquine.

In my view the McKinsey appointment doesn’t pass the pub test.

Submission to the Royal Commission into Defence and Veteran Suicide

My story starts in 1999 when I first self-reported about mental health concerns. To the best of my knowledge I am the only person to self-report from Operation Baritone (1997).

Two years prior, on the 22nd March 1997 the online company from 3 Brigade including a detachment from the 103rd Signal Squadron of which I was a part, commenced deployment operations for an airlift to Port Moresby as part of a Company Group deployment.

It was the first stage of a larger plan to ‘temporarily’ re-occupy Papua New Guinea during the Sandline Affair.

Things were moving very quickly. The medics and doctors were under intense pressure to get us out the door. A memory from pre-deployment was of the RMO making their notes on the back of the soldier in front of me, then the same for the next in line.

As part of our pre-deployment the company was given a number of medications including a mefloquine loading dose over three days to counteract malaria. After recent investigations I found that anti-malarials was not noted in my official medical records. I have since been able to prove that I was given mefloquine via my Red Cross blood donation history.

Long story short, the Sandline Affair works itself out without Australian intervention and Company Group is given a leave pass to get on the drink. So close though. Another Fiji, 1987.

For many years, I did not remember any detail from this period until a series of ‘flash-backs’ in 2018/19 become so bad that they hospitalised me. Ironically, it is on the 22nd anniversary of Operation Baritone I was finally admitted to a mental health facility.

Mefloquine sent me insane. I attempted suicide in 1997, 1998, 1999, 2000, and 2014. When I finally confirmed what the Army had done to me in early 2019 I was angry but also a little relieved. I could finally die with a little peace.

When enough memory had returned that I was able to prove the mefloquine exposure I tried to inform all the relevant authorities. Entities such as the Army HQ, the DVA were not interested in finding these men. The Australian Defence Force Malaria and Infectious Disease Institute and the Foreign Affairs, Defence and Trade References Committee were sympathetic but unhelpful.

In summary:

A company of soldiers were given mefloquine in 1997, a medication which was noted by the World Health Organisation as harmful in 1989. Mefloquine has also been linked to suicides and murder-suicides, most notably at Fort Bragg in 2002. It is rarely used these days. It is a medication that the Armed Forces of many countries wish they had never used.

Some from the Company Group may be dead from their mefloquine exposure. Some, like me, are permanently damaged. Many would not have experienced any symptoms and would wonder what all the fuss is about.

At the very least the men of my Company Group assigned to the opening phases of Operation Baritone deserve to be told they were exposed to mefloquine.

For your review and consideration.

26. Mefloquine Dispatches: LBMC, 28th April 1997

I wake up. I’ve managed to snatch a few minutes or hours of blessed sleep. I haven’t slept in a couple of days. I’ve got a whole body rash. In and out of ice-baths and I cannot stop scratching. If that’s not bad enough I can’t sleep as well. Don’t know why. I blame the itching but I’m pretty wired. My hands are covered in scratches. What happened there?

I’m bored. I look around for some alcohol swabs to put on my cut-up hands. There’s none near my bed but the little box is in its place, it’s just happens to be empty. At the next bed, the same story, no swabs. I don’t want to pinch the other bloke in the wards stuff but I’m desperate. I peek over. His are gone too? Curious I go out for a walk to find the duty medic. I know her. We lived together in the same Barracks when I was posted to the BASC unit the previous year.

“Hey T*, you got any alcohol swabs?”

“Sure” she says. She comes over and checks my hands. “Ouch, I saw these when you came in”. She smiles. “Must have been a bit of a scrap?”

I just smile. It’s all a bit fuzzy.

“Anyway, I shouldn’t tell you… but you know that that bloke in the ward with you?”

“Yeah” I reply. I’m interested now. I’ve always loved gossip.

I lay my hands flat on the counter while T* gently cleans the fine wounds. It stings a little.

“Ok, the reason why you don’t have any alcohol swabs is that bloke has been chewing them all. We had to take all the alcohol swabs out of the ward. Must have a big drinking problem, do you think?”

I shrug “Makes sense, I suppose”.

Not really but we all see lots of silly shit in the Army. Medics see it more than most.

24. Mefloquine Dispatches: Sausage rolls and the Red Cross, 1st July 1997

February 2019.

I had been doing memory recall exercises for some weeks at this point.

The process consumes me. I’m not really ready for this type of Rapid Exposure. As I sit with my psychologist we do the work and then he spends time ‘bringing me down’. When I do it on my own I go for hours. I’m a student who thinks he is a professor.

I’m merging into an old pattern which I am starting to recognise. It’s my roller-coaster. Every six to nine months. For more than two decades.

The memory work has been fruitful. I’ve remembered taking the mefloquine which was the SOP (Standard Operating Procedure) at the time. Is that enough to prove I was given mefloquine?

One of the boys gives me a doctor in the United States who I can talk to. I approach him with the evidence I have. He advises that it isn’t enough. I have no notation of mefloquine on my medical records. In fact he noted that I was cleared for doxycycline.

I’m devastated. It doesn’t matter what I can remember or what the SOP was at the time, without some sort of concrete evidence I know I’ll have a hard time proving my exposure.

I do more memory work. I should be resting. I look terrible. I feel awful. I’m not sleeping.

I get a memory.

Sausage rolls! I’m sitting in a clinical room across from a nurse who is taking notes. I’m at the Red Cross giving blood. The nurse gets excited about my blood because I had been given an anti-malarial without travelling (which is very unusual). I was there for hours too because I remember getting sausage rolls. In 1997 that was a big deal. Normal blood donations usually meant jatz biscuits with some cheese, not the luxury of sausage rolls!

At this stage I still cannot remember what I was given but despair has turned to elation.

Reality kicks in. What did I tell the nurses back in 1997? If I told them what medications I had taken did they note it? Do the notes still exist? How the hell do I access decades old records from the Red Cross?

I make a call to the Red Cross. They explained the process. I email the paperwork in March 2019.

A doctor from the Red Cross returns my call a week later. The news is confirmation of the worst. I was given mefloquine by the Army in March 1997.

I remember screaming into the sand in front of my kids when I heard the news. It was pure RAGE. We had taken the day off to enjoy a swim at a local creek. I had to collect myself before I thanked the doctor. I am so angry I gave my eldest son my phone. It takes me hours to calm down.

* Red Cross records from 1997

I finally calm down.

The evidence was compelling. Not only had I been given mefloquine in 1997 the Army had failed to note it.

Thank goodness for sausage rolls and the Red Cross!

23. Mefloquine Dispatches: Foreign Affairs, Defence and Trade References Committee, 28th February 2020

In correspondence to the Australian Senate in November 2019 I requested answers to the following questions:

  • I would like to know the status of the comprehensive health assessments announced by the minister on 15 March 2019;
  • I would like all the personnel involved in Operation BARITONE to receive a comprehensive health assessment and you would like to receive a response from the minister to this request;
  • I would like the committee to investigate the status of the Mefloquine help line;

The Committee replied on the 28th February 2020:

22. Mefloquine Dispatches: Mil Mi-24, 27th March 1997

If you or someone you know needs help, please phone Lifeline on 131 114, Kids Helpline on 1800 55 1800, Beyond Blue on 1300 224 636 or Open Arms on 1800 011 046.

21. Mefloquine Dispatches: Mindfulness, 5th December 2019

If you or someone you know needs help, please phone Lifeline on 131 114, Kids Helpline on 1800 55 1800, Beyond Blue on 1300 224 636 or Open Arms on 1800 011 046.

20. Mefloquine Dispatches: 1800 MEFLOQUINE, 10th May 2019

If you or someone you know needs help, please phone Lifeline on 131 114, Kids Helpline on 1800 55 1800, Beyond Blue on 1300 224 636 or Open Arms on 1800 011 046.