Iraq, Integrity, and Anti-malarials

This guest post comes to us today from Nik Rasheta.

In January 2003 I was deployed to the Middle East for Operation Iraqi Freedom. I was going to war.   One of the many steps of our deployment was having our whole unit get a series of vaccinations and medication.  

We were told that one of the medicines we needed to take was Mefloquine hydrochloride, which was produced by a Swiss company under the brand name of Lariam. This is an anti-malarial drug that helps prevent malaria for soldiers serving in areas of the world where malaria can be contracted. One pill must be taken per day for 30 days. The Army really emphasizes obedience; thus, a follow up-plan was initiated to assure obedience in taking this medication. We would be given the medicine in small quantities and then had to report back for second and third disbursements after having our names checked and updated by doctors and officers running the show.  

I remember taking the first pill and having the worse stomach ache all night. I decided that I needed to take the pills with a ton of food or liquid to avoid a stomach ache. My second dose was with a full stomach. I slept and had another stomach ache all night and just felt horrible. By the third night, I had made a decision to not take the medicine any more. Every night I would pretend to take the pill and then throw it away when no one was looking. My brother in law who was deployed with me (he was not my brother in law at the time) did the same. Every night we would pretend to take our pills and then trash them. We had decided that the probability of getting malaria was very low and that we would rather deal with the unlikely discomfort of malaria than the certain discomfort of getting immune to it for 30 days. The gamble paid off: we never got malaria.

This was a personal lesson on ethics for me as I was doing what I felt was right (at least for me) yet pretending to be doing something different. I would purposely lead my officers and doctors to believe I was taking the medicine because I felt I had no option in saying no. Perhaps I did and I was just young and impressionable back then, but I felt like I had no choice. It took personal courage for me to do this. I acknowledge that from another person’s perspective and in another reality, this could be viewed as dishonest and unethical. The doctor perhaps could argue that I had a faulty character and that I was not “honest in my dealings with my fellow man.”   I could have been looked at back then as being weak and lacking integrity.  

This week however, I attended a conference where I learned that the Army (the US Government) has had many issues with soldiers who have taken Mefloquine. The current FDA product guide states that it can cause mental health problems, including anxiety, hallucinations, depression, unusual behavior, and suicidal ideations, among others. The government has been studying soldiers who have had Traumatic Brain Injuries and, in 2009, said that “Mefloquine should not be given to soldiers with recent history of traumatic brain injury (TBI) or who have symptoms from a previous TBI.”   Turns out that if you have taken Mefloquine and also suffer a traumatic brain injury, you will have a high probability of developing mental disease. In 2009 the government suspended the use of Mefloquine and the FDA issued statements that it had not completed all three phases of testing required for human use. Furthermore, in the third phase, “Roughly 67% reported greater than or equal to one adverse event, with 6% of the users reporting severe events requiring medical attention.”

Now that 11 years have gone by and I have the opportunity to see the whole picture in regards to Mefloquine, I am lucky to know, without a doubt, that I was right. The reality of a weak character or unethical decision making is now a non reality and the decision to stand up against peer pressure and go against the flow in this regard has been deemed wise. This experience shows me that truth is abstract and that although in 2001, there could be a truth and two realities, today the truth of that dilemma has been answered. It was right to avoid taking Mefloquine even at the cost of being unethical or untruthful. The end justified the means. In my personal reality, I found that it was better that one man lie than a whole life be wasted in mental disease. HAHA. I share this with you all to give you strength to follow the truth that rings in your hearts even at the cost of being judged weak, or as lacking integrity. Truth can be just as abstract today as ever.