We’re finally stopping giving our soldiers Lariam. Thank goodness for that.
By Hugo Rifkind
Spectator – 28 May 2016
I once went mad in Africa and it was no fun at all. I was snorkelling off the coast of Zanzibar and I dived a little too deep, and something in the middle of my head went click. And then I came up and fell on to a boat that took me back to the paradise sands, and when I got there I couldn’t walk straight and everything started to fall apart.
In fairness, that might not have been madness. That might have just been a problem with my inner ear. At the time, though, it was all bundled together. I’d been sub-Saharan for about nine months by this point, living cheap in the Cape and writing a novel. Three weeks earlier, we had packed up our belongings and caught a flight to Dar es Salaam, with a plan to drift back south over the next few months on buses filled with chickens. First, though, I’d popped into a chemist and bought us half a year’s supply of antimalarials over the counter.
Things got weird pretty quickly. First came the dreams. In my teens, I used to sometimes have dreams which made me feel psychic. I’d dream a thing and the next day I’d see it. Like déjà vu, pretty much, although far more explicit. Never really been able to explain it. They went away, anyway, after puberty, but once I started taking these pills they came storming back. There were sex dreams, too, but not good ones. Dark, tempestuous nightmares, where my body would convulse to the beat of the ceiling fan, and then my sheet sleeping bag would go in the wash.
There was also a lot of standing around, staring at walls and thinking about death. ‘What are you thinking about?’ my girlfriend would ask me, perplexed. ‘Oh, nothing,’ I’d say brightly, because the moment you intone ‘DEATH’ in a situation like that, the jolly holiday vibe rather slips away. Dimly, I knew something was up, and I also knew that the malaria pills weren’t helping. It was manageable though and, in the strangest of ways, almost fun. I’d suffered from anxiety in the past and retained a horror of it, but this was something else. This was Doors of Perception-type stuff. A journey into a different sort of me.
All that went up the spout after the snorkelling, anyway. Things started getting properly edgy. Not all the time. Just when I had nothing else on. The trouble with backpacking, though, is that you don’t really. And so maybe a fortnight after that, wrapped in a blanket in the back of a Land Rover, and trailing along after my travelling companions like a hopeless, lobotomised ghost, I started having what I suppose was a true, albeit relatively mild, psychotic episode. I had stopped taking the pills by then, and had a burgeoning terror of malaria bundled in with my terror of everything else. What I remember most clearly is the day we spent in the Ngorongoro crater. It was misty, like a horror film, and occasionally juvenile Masai would loom out of the haze with patterns painted on their faces in luminous white. That night we slept in an unfenced campsite, while actual lions coughed outside. I mean, seriously. It was awful.
There followed ten days in a small, bright Tanzanian budget hotel room, where I fell apart and put myself back together while my girlfriend phoned home and fretted and went to museums. And then we got back on the road, pretty much as planned, although I did a lot of staring out of windows. We’d be back in London, five months later, before I felt truly normal. It was a good thing I didn’t have a job.
Or a machine-gun. This week, as you might have seen, the Defence Select Committee instructed the Ministry of Defence to consider Lariam, the drug I was on, only as a ‘last-resort’ antimalarial for British troops. According to Julian Lewis, the Tory chair, its use has led to phrases such as ‘mad Monday’ or ‘crazy Tuesday’ becoming widespread for the day after a dose is taken. Its side-effects have been mistaken for post-traumatic stress disorder, which I can well understand, and some personnel continue to experience them years or even decades later.
The American military, which developed the thing in the first place, banned it in 2012. Essentially, for them, it was the antimalarial of choice throughout the bulk of the conflicts in Afghanistan and Iraq. Whenever I read about a soldier on trial for some purported atrocity, I think of Lariam and I think of my day in the back of that Land Rover and I wonder. Everybody I know who has taken the stuff shivers at the memory. Why the hell did it take them so long?