Below follows my story, as told at the Mefloquine Rally held at Parliamant Hill in Ottowa, today on September 19th:
How much of a privilege it is to stand here this afternoon, among all of these passionate advocates, members of parliament, experts, and family members, who are all here to to speak on what has become a serious and neglected health and wellness issue among our Canadian soldiers and veterans for the past 25 years.
To be quite frank, I am also quite surprised to be standing here, as I have been merely an observer from the sidelines, following the story of mefloquine ever since my own encounter with it in 1998. You see, given the scope of stories of adverse reactions among civilians and soldiers worldwide, and here in Canada, I genuinely believed in my heart that surely the Canadian government would be dealing with the consequences of mefloquine openly and with great concern.
Unfortunately, I was wrong. It wasn’t until John Dowe of the International Mefloquine Veterans Alliance called me up about 3 years ago, that I finally began to understood an even more troubling component of the mefloquine tragedy. The government has been very reluctant to address this health issue and potential contributor to the mental health issues in the veteran community.
As an optometrist who has worked my entire professional career near military installments in Edmonton, and now in Comox, I cannot sit back and simply watch and wait for the answers and solutions. It has been a long wait, and I can’t imagine what it has been like for those like Marj Matchee. From my perspective, this is a medical issue that needs urgent attention. So today, I speak from the point of view as a civilian who has firsthand experience of the adverse effects of mefloquine, AND, as a very concerned Canadian Citizen.
I will share as briefly as possible, my own experience with mefloquine. In 1998, my husband and I were both asked by the Edmonton Travel Clinic to do a 4 week trial of meflqouine, prior to our 6 month world trip that included Northern Thailand. We were told mefloquine was the preferred anti-malarial drug for Northern Thailand, and this 4 week trial of the once weekly pill was a necessary step to determine what degree of side effects we might experience. We were told that one in four people experiences mild side effects from mefloquine, one in four experiences moderate side effects, one in four more serious side effects, and one in four, no side effects. I actually felt quite reassured that we were being screened for these more serious side effects prior to leaving Canada.
It was on pill #3 of melfoquine that I experienced my first recognizable side effects. The night before attending a wedding that my husband was master of ceremonies for, I crawled into bed early while he joined the groom and friends for drinks and a night out. I asked him to be responsible and not ruin the wedding day with terrible hangovers. Unfortunately, he arrived home very drunk at 4 am and I was extremely enraged, that he would do such a thing. Then I woke up. It was only midnight, and he was quietly slipping into bed completely sober. I was not lucid. My heart was pounding and it took 10 minutes for that rage and anger to settle down. After I calmed down, I fell back asleep.
The next morning, I experienced, and somewhat enjoyed, my second vivid dream. This dream was long and entertaining, as I slowly and methodically visited every religion in the world. My best guess is that a heavy consumption of travel books in the the weeks leading up to our world trip provided this interesting subject material for this dream. I had visited Budhism, Islam, Judaism, Hinduism, and at the very end of the dream, I saw Jesus., his face glowing, and I was overcome by an overwhelming joy that I had somehow been gifted with a special power to understand and appreciate every religion of the world deeply and profoundly. I woke up in this euphoric state and commenced to wake up my husband and tell him how I was very religiously enlightened in my dream. As I began describing this profound dream, I recognized the puzzled and concerned look on my husbands face, and then began to recognize my own distorted thoughts. I was delusional. As I continued to talk, I once again slowly “came to” and “calmed down”, like the night before. It was very reassuring afterwards, to realize and discuss and laugh with my husband that I was seemingly “tripped out”. We didn’t think too much more of it, as I felt pretty normal thereafter. I had never experienced such a delusion or hallucination before in my life, but this was very clearly what had happened, and was most likely related to meflquiine.
Just a couple more points about my experience. I was 28 years old at the time, had never taken any prescription drug before in my life, and was healthy and fit with no prior family history of mental health issues. I am pretty certain that neither my husband nor I bothered with the 4th mefloquine pill prior to returning to the Travel Clinic the next week.
Here is where the mefloquine story became very intriguing for me. Prior to entering Northern Thailand, and just as we commenced taking our mefloquine for this portion of our world trip, Australian backpackers were sharing their stories about mefloquine. All of the Australian travelers were using doxycyline instead of mefloquine, and were telling first hand stories of their own, or of friends or family, who had such a wide range and high frequency of side effects from mefloquine, including frank psychosis, that it became clearly evident to my husband and I that we preferred to limit the risk that mefloquine could put an abrupt end to our world trip. We found a local clinic and switched to doxycyline like the Aussies were taking, and I can say with certainty, that the daily dose of doxycline was a far more comfortable regimen than the weekly dose of mefloquine.
In summary about my own experince, I would just like to add that my story is not uncommon. In twenty years of interviewing other civilian travelers, I have collected many stories about adverse reactions to mefloquine, and there certainly were many folks who did not fair nearly as well as we did. But most commonly, travelers like myself who did experience the uncomfortable side effects of mefloquine while abroad, simply enjoyed the luxury of discontinuing mefloquine. And I can assure you, none of these people including myself, ever reported our experiences with mefloquine to Health Canada. And it has seemed for some time now, that among knowledgable travelers, you will find that it is just a “matter of fact” that you avoid mefloquine as the anti-malarial of choice.
I have no doubt in my mind that the frequency and seriousness of adverse effects of mefloquine needs a proper and thorough review by way of research and perhaps improved pharmacovigilance in Canada. I believe that the last 20 years of multiple drug label changes has still not provided adequate protection from life changing adverse effects for those unlucky travelers and soldiers who did experience either the acute or the more chronic and long lasting side effects of mefloquine.
In conclusion, I offer three additional points to those in government and those advocates who are strongly calling for the removal of mefloquine from the list of anti-malarial options, and who are calling for urgent outreach and research into the neurotoxic side effects of mefloquine, also known as quinism.
- I would just like to emphasize that although Mefloquine side effects are not exclusive to soldiers and veterans, the single most significant departure in the stories from civilians from those of soldiers, is that so very many civilian travelers simply enjoyed the luxury to quit taking mefloquine when the adverse effects became uncomfortable. . Additionally, many travelers only took mefloquine for short terms of a few weeks. But as we all know, starting in Somalia and right on through deployments up to Afghanistan, most soldiers especially in the early years of this drug, did not have the option to either discontinue or switch to an alterative anti-malarial. The recent testimony of Romeo Dallaire calling Ottawa to explain how disabled he felt by mefloquine, was met with the threat of charges for self-inflicted injury if he were to discontinue taking mefloquine. To put it simply, I could not imagine being in that predicament. And let’s also not forget, that many of these soldiers were also required to take mefloquine for months at a time, and on multiple deployments.
- The second point I would like to offer is to assure everyone here that Canadians do care. PTSD and mental health is well on the radar now and is not a taboo topic. But, what the public doesn’t know or understand still, is the story about mefloquine and how it may be contributing in part to this epidemic of mental health issues and suicides. That is in large part why Pieter Vorster and I created Mefloquine Awareness Canada, as we are determined to share the story about how mefloquine was introduced to our soldiers in Somalia, and then was quickly approved by Health Canada for general use in the Canadian population. Mefloquine Awareness Canada will continue to strive to educate Canadians about the neurotoxic side effects of mefloquine. If Canada wants to make some tangible progress in rehabilitating those veterans with mental health and PTSD issues, then it is incumbent on the Canadian government to officially address the issues of quinism.
- For me, the severity of side effects from mefloquine, the high frequency of neuropsychiatric side effects, and the long term consequences of mefloquine, is an outstanding medical issue that has too many unanswered questions. We need answers by way of current and independent research. Many questions about mefloquine were actually raised in both the abrupt ending and final report of the Somalia Commission, and the 1999 Auditor Generals report. But where is the Canadian commitment to a thorough evaluation and research into these questions? This is well into a third decade and these questions still linger unanswered with no visible attempts to research the concerns. From a scientific point of view, this makes no sense to me. To recognize mefloquine side effects, there needs to be acknowledgement, outreach and research, sponsored by our Canadian Government. And, I cannot help but think that a very logical starting point in examining mefloquine thoroughly and promptly, is to begin with where the Somalia Commission of Inquiry abruptly left off.
About Bev Skwernuik
A trained optometrist, I am driven by the urge to increase my knowledge and improve my ability to contribute to the betterment of others. Personally affected by the anti-malarial drug mefloquine, I am touched by the horrific effects it has had on the lives of many others. I am currently dedicating myself to bringing awareness of mefloquine and the dangers of using it to the Canadian public.