The man who led an inquiry into the 1992 beating death of a Somali teenager at the hands of Canadian troops says he is frustrated that his commission's work was cut short before it could explore what role a controversial anti-malarial drug might have played in the violence.
Gilles Létourneau, a retired judge of the Federal Court of Appeal, says it may be too difficult now to examine whether mefloquine was a major factor in the so-called Somalia Affair because most of the soldiers who were deployed to the African country have left the military. But Mr. Létourneau told The Globe and Mail in a telephone interview on Wednesday it would be worthwhile to take a hard public look at the dangers posed by the drug, which is still being offered to Canadian Force members.
"Surely, run a survey of existing use of mefloquine within the Armed Forces and see whether the problems that were raised 20 years ago are still there," Mr. Létourneau said.
"We ran out of time," he said of the inquiry, which gathered evidence for two years before being cut off by the Liberal government of Jean Chrétien before the 1997 election. "There were so many issues to be covered, and this one we had to leave aside in the hope that eventually medical progress would either sort out or solve these problems. But it hasn't been followed up, from what I can gather."
Health Canada agreed in August – three years after the U.S. Food and Drug Administration came to the same conclusion – with an assessment that said mefloquine can cause permanent brain damage. Symptoms reported by some users include anxiety, paranoia, depression, hallucinations, psychotic behaviour and, in rare cases, thoughts of suicide.
Some Canadian veterans say the drug ruined their lives. They are asking the government to contact members of the Armed Forces or veterans who were required to take it in places like Somalia, Rwanda and Afghanistan to determine if they suffered long-term consequences. They want more research to develop better diagnosis and treatment of the effects. And they are calling for an inquiry to determine what role mefloquine might have played in Somalia.
"No doubt about it, it should have been explored" during the Somalia Inquiry, Mr. Létourneau said, "because many soldiers complained to us when we toured … about the mefloquine and the side-effects and the nightmares. They called them the meflomares. There were a high number of persons reporting to us that it affected their behaviour and it scared them."
Jonathan Vance, the Chief of Defence Staff, said this week that the mefloquine issue has his full attention in light of the Health Canada warning. He has assigned Brigadier-General Hugh MacKay, the Surgeon-General of the Canadian Armed Forces, to examine the its current use.
Defence Minister Harjit Sajjan, meanwhile, says troops now make their own informed choice about whether to take mefloquine or an alternative.
But that was not always the case.
In Somalia, approximately 900 Canadian Forces members were forced to take the drug even though it had yet to be approved in Canada. Master Corporal Clayton Matchee and Private Kyle Brown were charged in the beating death during the mission of Shidane Arone, a 16-year-old Somali. Mr. Brown was convicted of manslaughter and served a third of a five-year sentence. Mr. Matchee suffered brain damage when he tried to hang himself and was found unfit to stand trial.
The Defence Department obtained the mefloquine that was administered in Somalia as part of a safety-monitoring study.
But the federal auditor-general found in 1999 that, contrary to the requirements for taking part in that study, the military did not obtain the informed consent of the troops, nor did it systematically monitor the efficacy or the adverse reactions. The military responded to the auditor's criticisms by saying "cases of potentially lethal malaria were prevented and the health and safety of Canadian Forces personnel was not compromised."
Many of the soldiers on the Somalia mission recall having bad dreams, and some say they or their comrades experienced the additional symptoms that are now associated with mefloquine toxicity.
Members of the Canadian Armed Forces who were sent to Rwanda in 1994 were also required to take mefloquine. Among them was Greg Passey, a psychiatrist who was part of a five-person mental-health team.
Over a matter of weeks, "two of the members became sort of isolative, aggressive, somewhat paranoid," said Dr. Passey, who left the military and is an expert on post-traumatic stress syndrome. "At one point, we were having a team meeting to try to discuss what was going on … one of the members pulled out a knife beside me and he was playing with it in a fairly aggressive manner, so I was very uncomfortable with that."
At the start of the Somalia inquiry, Dr. Passey wrote to Mr. Létourneau offering to testify about his observations in Rwanda. In spite of a Forces-wide edict to co-operate with the commission, he said his military bosses were furious that he volunteered to give evidence.
Then, "literally the week before I was to testify, the Liberal government shut the inquiry down," Dr. Passey said, "so I was never able to address the mefloquine issue at all."
One of the worst problems with mefloquine toxicity is that its symptoms mimic those of PTSD, and that can make it difficult to diagnose, he said. So "there's a whole veteran population out there that may not have been identified properly as far as what's causing their condition."