Liberian Marine Malaria Results

In an article that has the facts right, but the headline exactly wrong: Malaria Outbreak Blamed On Troops.

Looks like my original rant was correct, this was a leadership failure, notwithstanding the blame-the-victim headline.

October 20, 2003

WASHINGTON – The large outbreak of malaria among Marines who spent time ashore in the West African nation of Liberia in the summer was apparently caused by a nearly wholesale failure of the troops to follow protective measures, and in particular not taking a once a week malaria preventing drug.
Blood samples taken from the 26th Marine Expeditionary Unit right after malaria was diagnosed in several troops in early September showed that only 5 percent had been regularly taking the recommended drug, mefloquine. Only 12 percent wore uniforms properly treated with the insecticide permethrin. Only 27 percent reported using the time-released insect repellant issued to them. And none slept under insecticide-treated mosquito nets.

The findings were presented last week in closed briefings to the House and Senate Armed Services committees. (emphasis mine)

I said it then, and Ill say it now, this was a leadership failure. If the command gets it, the troops get it. But, when force protection, in this case malaria, isn’t pushed, hard, from the top down, it will not get done.

In a classic statement that blames the individual but not the system:

“It is difficult to get these young Marines, who are willing to charge a machine gun nest, to be worried about a mosquito,” said … a Navy physician involved in the investigation. “It is much more difficult than we believe it should be.”
Later, the investigators specifically said they don’t think observed / forced compliance is the answer ‘more education’ is.

As several commenters to the recent posts have pointed out, it’s not all that hard to get compliance on this issue: observe your people taking their meds. No excuses, no wimpouts, just take it. Education is great; 100% compliance with the goal of having a force that’s combat capable is better.

Read the source article for the astonishing stats (a 44% attack rate for a 2 week deployment ashore), then be very glad that all have recovered.

Malaria isn’t a mystery illness, and it’s mostly preventable, if you just try. They (the commanders) knew going in that Liberia is 1,000 times more malarious than the Persian Gulf or Afghanistan, and they did essentially nothing to prevent this parasitic ambush. This force was basically combat ineffective by the time they were withdrawn to the ships, it’s a good thing we didn’t need to fight there.

Now, back to my original answer: a career or two need to come to a screeching halt over this, the ultimate career officer motivator.

Many thanks to Tony for the link!

General reading:
Malaria, from the CDC
Virtual Naval Hospital, NavMed Malaria Prevention


  1. I couldn’t have said it better or in fewer words.

    here, here!!

  2. Looks like ya nailed it, doc. If more than ten percent of troops are doing it, it is definitely a trend. considering that 95% were failing to take their meds, its more than a trend; it’s a tradition.

  3. John Schedler says:

    Doc, it’s me again. I stand corrected and shamed. That my Marines, especially SNCO’s (which I was once, long ago) would fail so utterly is beyond me. The Sqd Ldrs & Plt Sgts — with the Corpsmen — are supposed to bird dog this sort of thing. The officers rightly depend on them for this.

    It is, of course, very paternalistic. You make the Marines do this because it is good for them — & the Corps — and you just let them whine. These are still just kids who need their Dads (read Sgts) still. I take it all back & stand corrected.

    The Plt Sgts & Company GySgt should be facing office hours at the very least.

    Why weren’t the Corpsmen tell the Bn Surgeon of the problem so he could speak to the Bn CO?

    This is beyond comprehension.

  4. All, thanks for writing. I’m surprised this hasn’t gotten more attention, but I’ll bet it’s all the rage in NavMed circles, and hopefully with the Marine Commanders.

    I appreciate you folks reading, and the comments!

  5. This surprises me, because everytime I’ve gone to Thailand they’ve (the chain of command) have been Nazi’s about us taking our meds.

    I took one once on an empty stomach (forget which pill it was) and must have been turning green because several people asked me if I was ok. Eventually I mentioned I’d taken my meds that morning and someone put 2 and 2 together. A couple candy bars later I was fine.


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