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Showing posts with label Canada in Somalia. Show all posts
Showing posts with label Canada in Somalia. Show all posts

Thursday, April 12, 2018

Bercuson: A Somalia Retrospective

By: David Bercuson

March 2018 was the 25th anniversary of the killing of Somali teenager Shidane Arone, which began the “Somalia Affair” that racked the Canadian military – primarily the army – for much of the next 10 years, and led to substantial changes in military education and leadership the Canadian Armed Forces (CAF).

By any standards, the government of Somalia was a mess in the early 1990s (it still largely is), and that disarray was compounded by widespread famine that left many thousands dead and starving. Television coverage was unsparing in showing starving children in refugee camps and the almost pitiful effort of international aid agencies to fight the scourge. The main problem was that Somalia had virtually no operating central government and different warlords in various parts of the country were using armed militants to impede and sometimes to completely block food aid arriving by sea.

Donations of food aid were sold on the black market instead of reaching the starving population and no military force existed that could take out the warlords and restore order there.

Led by the United States under newly elected president Bill Clinton, the Unified Task Force (UNITAF) was authorized as a United Nations Chapter 7 peace enforcement mission in December 1992 – with individual countries donating military forces to bring order to different key parts of Somalia such as ports and major transportation routes.

Canada chose to contribute a Canadian Airborne Regiment Battle Group (CARBG) to the mission, and was eventually assigned to the area of Belet Huen, a city in south central Somalia. In December 1992, CARBG, along with elements of the US 10th Mountain Division, established a base north of the city. When the Americans later withdrew, the Canadians ran the base, which quickly became a major supply depot to be used to send Canadian patrols through the area to challenge the local warlord and his troops.

The Airborne largely succeeded in its mission (a fact later forgotten by many) but Number 2 Commando (equivalent to a battalion) had become dominated by bullies way before it left for Somalia, and continuous morale and discipline issues plagued the Commando during the mission. Some members seemed to believe that the local population were the enemy, and acted like it – setting ambushes, killing at least one person for no reason, and torturing Arone to death after he crept into camp, presumably to steal helicopter parts.

Arone’s death was reported by the press, beginning a long chain of events, which quickly uncovered significant flaws, particularly an attempt to cover up the affair, and the many incidents of indiscipline that had occurred in Canada. Many Canadians concluded that the Airborne should never have been sent to Somalia and the government began a thorough examination of the entire mission to determine what went wrong. Evidence of despicable hazing procedures emerged in the Airborne and the government eventually concluded that the regiment could not be saved – it was disbanded in January 1995.

An official commission of inquiry – the Letourneau Commission – was later established, and its hearings were televised almost every day for months. Morale sagged across the armed forces and many Canadians concluded that the CAF had gotten out of hand. The Liberal government was faced with a real possibility that its military was dissolving before its eyes.

When Doug Young became Minister of National Defence in 1996, he closed down the Letourneau Commission and initiated a series of steps to initiate sweeping reforms of the CAF. University degrees became required for commissions, the education system was revamped, training for deployments was ramped up, a National Investigation Service was founded, and Canadian soldiers were drilled in the laws of war. Racism was rooted out. Efforts were made to integrate women into the military in a more meaningful way, and reform of the relationship between the reserves and the regular forces was initiated.

Young was defeated in the federal election of 1997 and replaced by Art Eggleton who drove the reform process forward by forming the Minister’s Monitoring Committee on Change, which monitored change in the military and DND for six years. The concept was revolutionary. In effect, the Chief of the Defence Staff and the Deputy Minister were directed to aid the Monitoring Committee in its allotted task – to ensure that all the recommendations for change that had been set out by the Somalia Committee, the Commission on Military Justice, the Commission on the Reserves, and other bodies, were implemented (except for those which the government itself had rejected, such as, instead of instituting an office of Inspector General, the government favoured an Ombudsman).

Between 1997 and 2003, the Monitoring Committee watched over the process of change and reform. It reported regularly to the Minister of National Defence, and issued quarterly reports. Chaired by former Speaker of the House, John Fraser, it made plain that it was not a committee of inquiry but a group of people who wanted to modernize the military and bring it back in line with Canadian values. If effect, for six years, the self-governing professionalism of the military was suspended while the government, through the Monitoring Committee, led the change process.

When the Monitoring Committee was disbanded in 2003, the Canadian Armed Forces was a different institution and reflected to a much greater extent the values and mores of Canadian society as a whole.

The events of March 1993 are not much talked about today, but the “Somalia Affair” produced a Canadian military that is in tune with the desires and aspirations of the Canadian people.

– David Bercuson, Research Director, Canadian Global Affairs Institute

Monday, December 5, 2016

Canadian Forces firm on anti-malaria drug ahead of Africa mission

By: Gloria Galloway, The Globe and Mail 

Val Reyes-Santiesteban is convinced she lost a military son to the neuropsychotic side effects of the anti-malarial drug mefloquine, and she fears some of the Canadian soldiers who are about to deploy to Africa could meet the same fate.

Members of the Canadian Airborne Regiment get into position as they arrive to assume responsibility for the airport at Bali Dogle, Somalia, on December 15, 1992. Senior medical officials in the Canadian Forces say there is not enough scientific evidence to remove mefloquine as an option for troops who go to countries where malaria is a threat. (Andrew Vaughan/Canadian Press)
Members of the Canadian Airborne Regiment get into position as they arrive to assume responsibility for the airport at Bali Dogle, Somalia, on December 15, 1992. Senior medical officials in the Canadian Forces say there is not enough scientific evidence to remove mefloquine as an option for troops who go to countries where malaria is a threat.
(Andrew Vaughan/Canadian Press)
“It makes me sick. They’ve got to stop them from taking this drug,” Ms. Reyes-Santiesteban, of Welland, Ont., told The Globe and Mail. “Everyone in the government should take this pill once a week for a month and let them see what happens.”

Her son, Corporal Scott Smith, died of a self-inflicted gunshot wound on Christmas Day of 1994 in Rwanda, where he had been sent after taking part in the 1992 Somalia peacekeeping mission. Military doctors prescribed mefloquine for him on both deployments.

The army says he was “killed in action” even though his death, at the age of 23, was clearly suicide.

But, more than two decades later, as the government determines where its next peacekeeping mission in Africa will be, senior medical officials in the Canadian Forces say there is not enough scientific evidence to remove mefloquine as an option for troops who go to countries where malaria is a threat. They remain dubious of claims it can cause permanent damage, despite a Health Canada warning and veterans who say the medication ruined their lives.

Military brass said the same after allowing more than 1,000 Canadian Forces members in Somalia to be part of a poorly monitored clinical trial. Two of the soldiers on that mission were charged in the beating death of a Somali teen, and many others complained of alarming dreams, hallucinations and depression.

Even after doctors on the front lines implicated mefloquine in the troops’ violent behaviour, officers in Canada reassured the commission of inquiry into the Somalia affair that the drug could not cause the psychotic side effects being reported.

The current Liberal government has rejected calls from an all-party committee of the House of Commons and Somalia veterans for more research on mefloquine. And a previous Liberal government shut down the Somalia commission just before the issue of mefloquine was to be addressed.

As a result of recent media coverage, the chief of defence staff asked the military’s surgeon-general to take another look at the scientific literature about the drug. It is now prescribed to just a small fraction of Canadian troops.

The use of mefloquine in Somalia was unorthodox and possibly illegal. The drug had not been approved in Canada in 1992, but National Defence obtained it from Health Canada as part of a clinical trial in which military personnel were supposed to receive the informed consent of the users and to monitor the efficacy and the adverse reactions. They did neither.

The military chose mefloquine over other options because, unlike most anti-malarial drugs, it is taken once a week instead of daily and the Forces determined it was the best option for the Somalia theatre.

Ms. Reyes-Santiesteban does not doubt the drug killed her son.

As he was on his way to Rwanda in the fall of 1994, Cpl. Smith told a reporter for what is now called Canadian Shipper magazine that the malaria medication gave him hallucinations. A few months later, he was dead.

In the hours before he shot himself, Cpl. Smith took part in a convoy in which he was laughing and joking with his colleagues. Then he called his mother, his father and his best friend to wish them a Merry Christmas.

“He was coming home, we were going to have a late Christmas in February,” Ms. Reyes-Santiesteban said. “Nothing seemed to add up.”

Ms. Reyes-Santiesteban wrote to the military and politicians to demand they examine the role mefloquine may have played in the tragedy but, she said, she was never taken seriously.

That was also the response when Barry Armstrong, one of the military doctors who took part in the Somalia mission, expressed concerns about the drug’s effects on the troops.

In a post-deployment analysis he wrote for a 1993 conference, Dr. Armstrong said the failure of the United Nations forces in Somalia was “rather exceptional,” and “I believe that a simple reason may exist. Canadian and American troops may have been impaired by the use of mefloquine.”

Of the three military people who presented papers about the Somalia mission at the conference, “two of us had minor neuropsychiatric problems which occurred regularly in the 24 to 48 hours after our weekly mefloquine doses. If there are two of us, these reactions aren’t so rare.”

Greg Passey, a military doctor who was deployed to Rwanda in 1994, had similar concerns, and wanted to make them known to the Somalia inquiry. Despite a forces-wide communication that said any member of the military who had pertinent information should step forward, Dr. Passey said his decision to testify drew anger from senior officers.

Dr. Passey said one of his colleagues told him “the surgeon-general [then Major-General Wendy Clay] was very upset with me.” He said he decided to testify at the commission anyway, but it was shut down the week before his scheduled appearance.

Dr. Clay said in a telephone interview that she has no recollection of the incident, given that it took place nearly 20 years ago, and it would not have been her place to stop someone from testifying.

She was deputy surgeon-general during the Somalia mission and “certainly, at the time, you weighed the risks and the benefits and there seemed to be no doubt that mefloquine was an appropriate drug to give at that time,” Dr. Clay said. “Whether I would say the same thing now, I don’t know.”

Additional background material for the Somali inquiry includes a 1994 memo from Dr. Clay to the chief of defence staff saying she did not mean to “deny the perceptions of those who served in Somalia,” but the weight of scientific evidence suggests “that the probability of there being adverse effects severe enough to have an impact on the behaviour of our troops, and to constitute a contributing factor to the tragic events that occurred, is very low indeed.”

Some of the troops who believe they suffer long-lasting effects from the drug have started a class-action suit against the government and Hoffman-LaRoche, the drug’s manufacturer.

“The management of the soldiers’ mefloquine use was not at all what would constitute an approved trial,” Dr. Armstrong said in an e-mail. “Considering the dangers of mefloquine, its unapproved status in 1992 and the promise of our Charter of Rights and Freedoms, to guarantee Canadians’ rights to life, liberty and security of the person, I consider the military orders about taking mefloquine to be wrong.”

Early studies of mefloquine conducted by Hoffman-LaRoche put the risk of even mild side effects at about one in 10,000. Those statistics were recently quoted to The Globe and Mail by Brigadier-General Hugh MacKay, the current military surgeon-general.

But Hervey Blois, a medic on the Somalia mission, estimates that 300 or 400 troops who took part in that deployment were affected in one way or another.

“It was an extreme topic of conversation,” Mr. Blois said. The soldiers would say: “Holy cow, was I ever loopy the other night,” he said. “I would have some really vivid and real dreams. I got into a state of paranoia later on.”

A medical report from HMCS Preserver, a navy support ship stationed off the coast of Somalia at the time, said mefloquine was a problem. “Ten patients experienced nightmares with one patient having feelings of unease and paranoia,” it said. “One patient heard voices and talked to himself. All were switched to Doxycycline with no subsequent problems.”

In March, 1993, Clayton Matchee and Kyle Brown were charged in the beating death 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.

When news of the crime hit the papers, an employee of the drug approvals branch of Health Canada walked into the office of Michele Brill-Edwards looking worried. Dr. Brill-Edwards was the senior physician at the department in the late 1980s, when Hoffman-LaRoche began the process of obtaining approval for mefloquine in Canada and, although she was no longer in that role, her former staff still came to her for advice.

“He said: ‘We allowed access under a clinical trial and all of this is going on and it clearly reflects possible mental derangement and we’re not getting any information back. We have no idea whether they are following the protocol that’s been set up and this is basically a big mess,’” Dr. Brill-Edwards said.

Several years later, Dr. Brill-Edwards decided to check the claim that just one in 10,000 people experience mefloquine’s side effects. She said she found those results were obtained from questionnaires handed to travellers on airplanes returning from Africa.

That is no way to collect data, she said, because those who had killed themselves or were in jail over a mefloquine-induced crime would not be counted, and people who had a psychotic episode abroad might be reluctant to divulge it on a card collected by a flight attendant. “If you think about it,” Dr. Brill-Edwards said, “it is the perfect way not to collect the experience of people who have had adverse effects of a mental nature.”

Health Canada, which still says “the benefits of mefloquine outweigh its risks when it is used as directed,” updated its warning labels in August. The department says mefloquine can cause adverse neuropsychiatric reactions that can persist after it is discontinued, and that permanent damage has been seen in some cases.

Nearly 1,000 British soldiers have required psychiatric treatment after taking the drug.

And the Pharmacovigilance Risk Assessment Committee of the European Medicines Agency says that, due to the long half-life of mefloquine, adverse reactions may occur or persist up to several months after discontinuation, or become permanent.

Val Reyes-Santiesteban, who found her son riding a bicycle down a hallway of her home in the middle of the night while he was on leave from his deployment to Somalia, does not need more proof of mefloquine’s long-term psychiatric damage.

“I blame it now. I blamed it then,” she said. The government and the defence department “don’t admit fault. It’s not their job to admit fault. But I knew right away.”

Friday, October 28, 2016

Canadian veterans say anti-malaria drug prescribed in Somalia ruined lives


By: GLORIA GALLOWAY, The Globe and Mail
Veterans who took part in the Somalia mission of the 1990s, which ended after the murder of a local teenager, blame the anti-malarial drug mefloquine for psychological damage that may have caused the tragedy and say Ottawa should reach out to others who have been affected.

A House of Commons committee heard from veterans on Thursday who say their lives have been permanently altered, and in some cases destroyed, by the pills they were required to take as part of a clinical trial involving members of the Canadian Forces who were deployed on the Somalia mission.

All of the men urged the government to create an outreach program that would educate both current and former military personnel, as well as civilian consumers, about the drug’s potential side effects.

Claude Lalancette was one of paratroopers with the Canadian Airborne Regiment who was sent to Somalia.

“This is where I can retrace the route of my mental-health issues,” Mr. Lalancette told the MPs on the committee. “We were young and so well-trained for this mission. But the intensity of our aggression and psychoses led to the closure of Canada’s elite – the Canadian Airborne Regiment.”

The regiment was disbanded in 1995 after what was known as the Somalia Affair. Master Corporal Clayton Matchee and Private Kyle Brown were charged in the beating death of Shidane Arone, a 16-year-old Somali.

“Clayton Matchee and Kyle Brown, they are victims,” said Mr. Lalancette, who blamed mefloquine for their actions. Mr. Brown was convicted of manslaughter in the teenager’s death and served a third of his five-year sentence. Mr. Matchee suffered brain damage when he tried to hang himself and was found unfit to stand trial.

Mefloquine is also sold under the brand name Lariam. A spokeswoman for the Department of National Defence has said it was given to 15,677 Canadian soldiers between 2001 and 2012.

Mr. Lalancette said his own symptoms include depression, irritability, hyper-vigilance, sleep disorders and aggression. “My temper goes from zero to 1,000 in an instant,” he told the committee.

He said he has given up driving because he cannot control his road rage. The drug, he added, has cost him his relationship with his children, his military job, pushed him into a life of poverty and prompted him to contemplate suicide.

All of the men talked about being diagnosed with post-traumatic stress disorder, which they say has similar symptoms of mefloquine toxicity.

But the treatments for PTSD do not work for those whose brains have been damaged by the drug, said John Dowe, who was also in Somalia and now works with the International Mefloquine Veterans’ Alliance.

“In the absence of national action to identify and alarm soldiers and consumers of the latest knowledge about mefloquine,” Mr. Dowe said, “we are left to remember psychosis, murder, violence and suicide.”

In 1999, the federal Auditor-General said the drug had been improperly prescribed during the Somalia mission. “National Defence did not keep essential records or follow required procedures required to fulfill its obligations as a participant in clinical study,” that report said.

Different drugs that have fewer side effects than mefloquine are now more commonly prescribed to soldiers. But Canadian troops are still given mefloquine far more often that it is prescribed for troops in the United States.

The British military allows it only as a last resort after a report earlier this year cited the risk of severe psychological side effects.

Dave Bona of Saskatchewan, a former member of the Canadian Airborne, said he took the drug during the Somalia mission and again in Rwanda a couple years later, and the psychological effects have been profound.

Mr. Bona told the committee that he has tried to track down the 28 men who deployed in his platoon to Somalia and has been able to account for 10 of them. “Two have committed suicide, six have attempted it and there’s only one soldier that is actually doing well,” Mr. Bona said, “and that’s the one guy that I know did not take the drug.”