More on Liberia Marine Malaria

From the European Start & Stripes: Marines’ bout with malaria still puzzling

NAVAL STATION ROTA, Spain ? The first sick Marines arrived aboard the ship from Liberia with their skin riddled with mosquito bites. They became so ill that doctors planned to fly them hundreds of miles away to Germany for more care.

That night, 15 more Marines arrived on the USS Iwo Jima. Some had high fevers and high blood pressure. Many were throwing up and had severe diarrhea. By the next day, 31 Marines were seriously ill and nobody knew why.

One-third of the people sent to the West African country came down with malaria, according to the Pentagon. Eighty of the 200 Navy, Marine Corps and Department of Defense personnel developed a strain of malaria that kills 25 percent of its victims.

Something I didn’t hammer enough in my earier post on this subject was that antimalarial medications aren’t the only thing that needs to be done to keep the troops healthy. One of the commenters to that post pointed out that the mosquitoes cannot land to infect in even the slightest breezes, making fans a necessity, not a luxury.

Also, DEET, sleeves down, that sort of thing also need to be done. If your people are covered in bites, you’re not getting the job done.


Comments

  1. John Schedler says:

    OK let’s look at the other side of things. I was, long ago, one of those NCO’s [A Co., 1/26] trying to keep the troops taking their meds, etc. Fans, bug juice (we didn’t have DEET impregnanted clothes), are all very nice. But there are other things going on. Like, say, the mission.

    The fact is, if you stand still for any length of time, especially at night, you will get bit. A lot. I suspect the Marines moved through a swarm or swarms of mosquitoes that were all infected. I.e., the resevoir was nearby.

    Now, if the NCO’s slacked off on malaria prophylaxis, then they should be held accountable – absolutely. It’s just that even with impeccable attention to the drill, there are a lot of ways this could happpen.

  2. Aggressive attention to malaria prophylaxis is the only way to avoid malaria in these kinds of situations. DEET, mossie nets, fans, etc. are palliative at best.

    Damn it, making sure the troops take the damn pills morning and night or once a day with the newer ones isn?t that hard.

    A third!?!?! 80 of 200 troops got malaria!?! IF this isn?t the results of a new strain of malaria that is resistant to anti-malaria drugs then this is actionable incompetence that should not be overlooked. That sounds like the percentages experienced in a USMC deployment in Panama in 1903 not 2003!

    By way of comparison, during the first 60 days in Somalia (12/12/92 ? 02/13/93 we had 210 USAF guys who initially lived in a unventilated hangar. We had three cases of malaria; all from guys in the part of the hangar that received no breezes. The were a small EOD detachment (I think) that didn’t “belong” to anyone initially and the “senior NCO” was a new E-4. They had the pills and had taken them off and on, but not regularly.

    We began moving them into temper tents in December but it wasn?t until late January we had enough tents to house everyone.

    After we got them into the tents we had less than 5 cases the rest of the USAF presence there, March 1994.

    Three things were instrumental in reducing the cases of malaria.

    1. Everyone took his or her pills. There were only 210 fergawdsake how hard was it to enforce discipline on a number that small?
    2. Climatically controlled living environment of the temper tents prevented mossie from getting into the tents
    3. The ocean breezes

    The USMC (and the USA) needs to bite the bullet and get more temper tents for these kinds of deployments.

  3. Jim, I agree.

  4. And NO standing water. Period.

  5. John Schedler says:

    OK I agree w/ GruntDoc & Jim. To a point. They are quite right for any troops in bivouac or in barracks. Like, say, a USAF detachment.

    That just ain’t what happens in the grunts. At night grunts are on patrol, on watch, or sleeping in fighting holes. Tents and fans are just luxuries to be dreamed of. I can envision more than one patrol moving slowly at night through mosquito swarms that they just cannot evade. And moving at 3+ mph is just out of the question.

    That said, in my company in RVN I do not believe we had an infection rate nearly this high. In 19 months, I think it was 10% – no more. The Liberia detachment suffered 40% of one company on a short depolyment — meaning it would have been 100% if they had been there much longer. This is scary.

  6. I agree, by the way, that the mission has to get done, and it cannot get done from the inside of a tent. No argument.

    That’s why permethrin, deet, sleeves when not in the tent are so vital, in addition to the meds.

    The whole point of force protection is to have a force left to execute the mission. When everyone has malaria, the mission doesn’t get accomplished.

  7. Jim Hogue says:

    John,

    The marines in Liberia lived in crappy GPs near the embassy and close to the beach the entire time they were there. That they are still using GPs tents is the incompetence I referred to. This is the 2ist Century!!

    I agree with you when we talk about troops moving in an ?Iraqi Freedom? fashion or long-range combat patrols.

    But in these kinds of deployments ? and I?ve planned and been on more than I want to remember ? the USMC is so damn bloody minded (or worse, cheap!) that they still put their troops in GPs. They live in unventilated tents and use their cut down oil drum toilet crappers and jury rig showers from the other halves of the drums they cut down.

    All during the Gulf War I was at an Air Base in Bahrain. We had 2,000 USAF and 2,500 various Marines (aviation, POL, munitions maintainers etc) living next to us. In the GPs, crappers, etc. They never moved forward and spent the same war we did launching and recovering aircraft. The USAF had temper tents, showers and toilets. Our rates (USAF) of dysentery, gastric bugs and other assorted conditions associated with primitive living condition were virtually nil. The Marines? levels were shameful and probably hadn?t improved much over Vietnam era numbers. Maybe GruntDoc has more to say on the sanitary merits of GPs.

    We had a Senior NCO Council made up of USAF, USMC and (believe it or not) one USCG Guardsman. (As I mentioned before, USN Senior NCOs have always been conspicuously absent in deployments of these kinds ? excepting Corpsmen and Seabees) reoccurring subject during our meetings was the lousy living condition among the Marines and what could we do to improve them.

    The situation was the same again in Somalia in 1992 – 1994. I lived next to the Marines and worked very closely with them ? I was a combat counterintelligence collector and the Marines were my security escort when my translator and me made our forays into Mogadishu. Once again, USMC = GPs USAF = Temper tents. At least in Mogadishu both our groups were small enough to share our shower tents.

    Anyway john to make a long story short (TOO LATE) the US military has the options of making life more bearable on the deployments. That the USMC refuses to do so is ? in this day and age – inexcusable

  8. John Schedler says:

    Jim & GruntDoc:

    Thanks for the update. I can say that much of the problem w/ equipment procurement comes from DoD & Congress. Things like this get requested & then lined out all the time.

    That said, then the problem goes back to Command. If Command left their troops in billets like you say in Somalia, then I am one po’d (former) Marine.

  9. This kind of thread really brings out the comments. Thanks to all!

  10. http://www.military.com/NewsContent?file=FL_marines_102003

    Looks as though your initial thoughts were right Gruntdoc.