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Preview: Comments on: Liberia Marine Malaria: Inexcusable

Comments on: Liberia Marine Malaria: Inexcusable

Ramblings of an Emergency Physician in Texas

Last Build Date: Sat, 02 Dec 2017 13:18:31 +0000


By: GruntDoc

Sun, 30 Oct 2005 22:25:57 +0000

Gates gives £28m to malaria team My favorite Billionaire: Microsoft billionaire Bill Gates is donating £28 million to a UK university as part of a £145m ($258.3m) gift to malaria research worldwide. The Bill and Melinda Gates Foundation is supporting three international projects ove...

By: GruntDoc

Fri, 23 Sep 2005 22:57:01 +0000

Vacation / Best Of My gift to you is that I'm taking a vacation, so all those wasted hours refreshing to see if I've posted yet can be used to a more productive purpose, but only for a week. I'll be back early next...

By: Roger Bigod

Mon, 15 Sep 2003 05:43:38 +0000

Resistant strains occurred in Nam. theyy were unusual but IIRC all in P. falciparum, the most dangerous species and unfortunately a common one in West Africa. I hope things go well with your brother.

By: Chris H.

Sat, 13 Sep 2003 19:38:26 +0000

Everyone sure does have their thoughts about whether or not the Marines were compliant about taking their regime to prevent Malaria, about who's heads should roll over they-did-they-didn't scenario. Let me help you think about the other side of the coin. My brother is one the 31 removed from the 26th MEU and flown to Bethesda. Imagine the horror of being told that he was being airlifted for a "mystery illness" while the rumors all pointed to Malaria. There are about a million and one strains of Malaria these days. Has is it ever crossed anyone's mind that possibly, just possibly that the strains out there are not probably IN the anti malaria regime AND that this disease is HIGHLY is beginning to be resistant to medications traditionally given for this illness? Some of these guys are fighting for their lives as we speak...I think it's more appropriate for us to be passing thoughts and prayers to THEM. There will be plenty of time later to point fingers.

By: Roger Bigod

Sat, 13 Sep 2003 01:10:01 +0000

There was a problem with malaria prophylaxis in Nam. The pill was called the "CP pill", for chloraquin and primaquin. The doses were on the high side, because the pill was to be taken once a week. The urban legend among the troops was that it caused diarrhea and disturbed sleep with vivid dreams and nightmares. There was no way to check out tha accuracy of this, but it led to a lot of noncompliance. Another great urban legend, possibly true is that a junior officer was doing through the chow line on a Monday, CP day, and noticed and noticed a bowl of orange tabs. He asked and was told that he should have taken them every week and that the CO was very serious about enforcement. Being a gung ho type, and having been in country about 3 months, he downed 12. This produced acute renal failure and he spent some time in the dialysis unit in Saigon. This isn't a great margin between a therapeutic dose and a life-threatening one. On balance, the program was good prophylaxis, but I suspect compliance would have been better with a lower dose. Most of the malaria in Nam was P. vivax, which effectively is never lethal because it doesn't cause cerebral malaria. IIRC, in West Africa the common organism is falciparum, which is nasty (cerebral malaria, "blackwater fever" = massive hemolysis with altered hemoglobin in urine). That makes the case for command discipline much stronger.

By: Jim H.

Fri, 12 Sep 2003 22:44:40 +0000

As a retired Senior NCO who did several tours in Somalia and other, lesser known places in Africa, I agree that the blame here, if warranted, belongs to the NCOs. I can remember browbeating, cajoling and threatening the troops to take the pills and use the mossie nets. Threats were generally the most effective. In a deployment such as this, Sgt. Majors/Chief Master Sgts/Master Gunnery Sgts (sorry I didn?t identify Naval senior NCOs; can't remember seeing any of them on the beach!) The problem is almost always where the troops billet. Usually un-air-conditioned, little moving air and hot, gawd, does it get hot in Africa. Mosquitoes cannot land if there is a breeze 3 mph or greater; which is why we lie, cheat and steal to get some fans for the billeting areas. All said, it?s always been an article of faith that G.I.s will find a way around the rules they don?t like.

By: GruntDoc

Wed, 10 Sep 2003 08:48:48 +0000

An excellent point, and one which I didn't address: who's responsible? Of course, the Senior Officer is ultimately responsible, but as you point out the senior enlisted leaders (who really run the services) must have been out to lunch as well. Something bad happened here, and I wonder what lead to such an abject failure on many levels.

By: John Schedler

Wed, 10 Sep 2003 06:44:54 +0000

Well, truly, & righteously said. Just where the heck were the NCO's? Making sure the troops tale their Rx is their job. If the Plt Cdr or the Skipper is cavalier about this, the Plt Sgt or Co GySgt should be bending their ears.

By: Mike Spenis

Tue, 09 Sep 2003 18:51:54 +0000

I agree 100%. You nailed it exactly.

By: David

Tue, 09 Sep 2003 12:59:55 +0000

Damn straight. I just hope that all of the troops recover... if there are any deaths as a result of this failure - well, a "career ending" won't even be enough. Dammit. More later.