Two Marines from the 22nd Marine Expeditionary Unit in Haiti have contracted malaria. Cases of malaria are usually non-stories. However, Seth Robson from Stars and Stripes is reporting that:
Marines in Carrefour said they’ve been told they could face nonjudicial punishment, for disobeying an order to take their daily anti-malaria pills, if they contract the disease.
Cargile said the decision to punish a servicemember in such circumstances would be up to individual unit commanders based on the circumstances of each case.
For the anti-malaria pill (doxycycline) to be effective, it must be taken daily. Missing a single pill leaves you vulnerable. I am assuming the commanders are considering contracting malaria as a signal that their orders to take the pill daily were not followed.
Personally, I imagine getting malaria is punishment enough.
Christopher R. Albon is a political science Ph.D. specializing in armed conflict, public health, human security, and health diplomacy.
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It is worth noting that doxycycline must be taken with food and often results in nausea and vomitting when not taken with food and even when taken with food. Sunlight must also be avoided. My experience with doxycycline, and I have had a lot of experience with it over the years (11 cases of Lyme disease exposure), is that it is a difficult drug to take and be consistent with.
Did the marines vomit the medicine back up? Did sun exposure interfere with the drug? Did they get enough drug prophyllacticly before they were exposed to malaria? Is the strain of malaria resistant to the drug?
Too many possible variables, any commanding officer that punishes a marine on that kind of circumstantial “evidence” would be unwise.
A person can still contract malaria while on doxycycline. (A friend who is in Uganda right now is on doxy and has malaria.) If a person does happen to get malaria while on doxy, it generally lessens the intensity of illness. It is often chosen as an antimalarial by people who will be staying in an at-risk area for longer periods of time because it’s cheaper.
If the marines are on doxy, then simply the fact that they contracted the disease is no firm indicator of whether or not they’ve been taking their medications daily. What, then, is the basis of the punishment?
Made the mistake once of taking my doxy on the way to breakfast. Almost didn’t make it through the chow line. Even with food it tore me up.
During Pacific Partnership ‘08 there were two soldiers who suffered esophogeal ulcers from their doxy – they were taking it just prior to lights out and it was sitting halfway down while they slept. Of course, being a medical ship, we had to look at endoscope photographs and everything during the evening hotwash.
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