Lost in India: passengers on an Indian railway platform. Photo: Getty
Show Hide image

Why did a man wake up on an Indian train platform with no idea who he was?

When David Stuart MacLean woke up in India with amnesia he assumed he was an addict who had overdosed. In fact, the only chemical he’d been taking was the prescribed antimalarial drug Lariam.  

On 17 October 2002, David Stuart MacLean woke up on a train platform in India with no idea who he was. “There, there,” a man dressed like a police officer said. “I have seen this many times before. You foreigners come to my country and do your drugs . . . It will be all right, my friend.”

David followed the man to a safe house for troubled foreigners, run by a Chinese woman whose son had overdosed in Singapore. “You have no idea what you do to your mother when you put these drugs into your body,” she said, crying as she told her story. David cried, too.

Later, he was taken to a neuropsychiatry centre in Hyderabad where a doctor administered antipsychotic drugs to stop the hallucinations that were keeping him awake at night. He managed to remember his parents’ phone number. “I’m so sorry,” he wept down the line. “I’ve been a terrible person. An awful son.” An Indian friend rounded up every American he knew in the city and brought them to the hospital. They arrived with newspapers and cigarettes, which David began to chain-smoke, despite never having touched a cigarette in his life.

As far as he knew, he was a junkie who had got himself into trouble. “I assembled a working self out of the behaviour of others,” he recalls in his memoir The Answer to the Riddle Is Me. In reality, he was a bright American student on a Fulbright scholarship suffering from amnesia, insomnia and convulsions. The only drug he had been taking was the antimalarial Lariam.

Lariam was developed by the US army with the Swiss pharmaceutical company F Hoffman-La Roche in the 1970s. It was approved by the US Food and Drug Administration in 1989. When a randomised double-blind study was conducted in 2001 – a study that should have been completed years earlier – researchers found 67 per cent of patients suffered at least one adverse affect; 6 per cent required medical treatment. If this data had been available, the drug may not have been approved.

Between 2002 and 2004 the journalists Mark Benjamin and Dan Olmsted filed more than 40 reports on US soldiers who had returned from malarial countries such as Rwanda, Liberia and Afghanistan and killed themselves. Sometimes they killed their wives and children, too. The murder of 16 Afghan civilians by Staff Sergeant Robert Bales in 2012 has been linked to Lariam. For those with susceptible brain chemistry (or who have suffered brain injuries, as in the case of Bales), the drug can pool in the brain, inflicting irreversible damage.

When David returned to Ohio, he was confronted by photographs of a stranger bearing his name. He met a woman named Anne, who told him they had been in love. He couldn’t picture the two of them together and ended the relationship. Over time, most of David’s memories returned but he still lives with the threat of relapse, unable to prove that Lariam caused his condition.

The US military stopped the procedural use of Lariam in 2009. Roche has ceased marketing it in the US (though it is still available to British soldiers and on the NHS). An army epidemiologist told the US Senate that it was the Agent Orange of our generation. In 1994, a Roche safety report noted that Lariam could cause depression, which may involve suicidal ideation in a few cases. That it could lead to suicide was harder to prove. The cause was more likely “the progressive breakdown of traditional values”, the company wrote. It had nothing to do with its drug.

Philip Maughan is a freelance writer in Berlin and a former Assistant Editor at the New Statesman.

This article first appeared in the 11 June 2014 issue of the New Statesman, The last World Cup

Getty Images.
Show Hide image

Trade unions must change or face permanent decline

Union membership will fall below one in five employees by 2030 unless current trends are reversed. 

The future should be full of potential for trade unions. Four in five people in Great Britain think that trade unions are “essential” to protect workers’ interests. Public concerns about low pay have soared to record levels over recent years. And, after almost disappearing from view, there is now a resurgent debate about the quality and dignity of work in today’s Britain.

Yet, as things stand, none of these currents are likely to reverse long-term decline. Membership has fallen by almost half since the late 1970s and at the same time the number of people in work has risen by a quarter. Unions are heavily skewed towards the public sector, older workers and middle-to-high earners. Overall, membership is now just under 25 per cent of all employees, however in the private sector it falls to 14 per cent nationally and 10 per cent in London. Less than 1 in 10 of the lowest paid are members. Across large swathes of our economy unions are near invisible.

The reasons are complex and deep-rooted — sweeping industrial change, anti-union legislation, shifts in social attitudes and the rise of precarious work to name a few — but the upshot is plain to see. Looking at the past 15 years, membership has fallen from 30 per cent in 2000 to 25 per cent in 2015. As the TUC have said, we are now into a 2nd generation of “never members”, millions of young people are entering the jobs market without even a passing thought about joining a union. Above all, demographics are taking their toll: baby boomers are retiring; millennials aren’t signing up.

This is a structural problem for the union movement because if fewer young workers join then it’s a rock-solid bet that fewer of their peers will sign-up in later life — setting in train a further wave of decline in membership figures in the decades ahead. As older workers, who came of age in the 1970s when trade unions were at their most dominant, retire and are replaced with fewer newcomers, union membership will fall. The question is: by how much?

The chart below sets out our analysis of trends in membership over the 20 years for which detailed membership data is available (the thick lines) and a fifteen year projection period (the dotted lines). The filled-in dots show where membership is today and the white-filled dots show our projection for 2030. Those born in the 1950s were the last cohort to see similar membership rates to their predecessors.

 

Our projections (the white-filled dots) are based on the assumption that changes in membership in the coming years simply track the path that previous cohorts took at the same age. For example, the cohort born in the late 1980s saw a 50 per cent increase in union membership as they moved from their early to late twenties. We have assumed that the same percentage increase in membership will occur over the coming decade among those born in the late 1990s.

This may turn out to be a highly optimistic assumption. Further fragmentation in the nature of work or prolonged austerity, for example, could curtail the familiar big rise in membership rates as people pass through their twenties. Against this, it could be argued that a greater proportion of young people spending longer in education might simply be delaying the age at which union membership rises, resulting in sharper growth among those in their late twenties in the future. However, to date this simply hasn’t happened. Membership rates for those in their late twenties have fallen steadily: they stand at 19 per cent among today’s 26–30 year olds compared to 23 per cent a decade ago, and 29 per cent two decades ago.

All told our overall projection is that just under 20 per cent of employees will be in a union by 2030. Think of this as a rough indication of where the union movement will be in 15 years’ time if history repeats itself. To be clear, this doesn’t signify union membership suddenly going over a cliff; it just points to steady, continual decline. If accurate, it would mean that by 2030 the share of trade unionists would have fallen by a third since the turn of the century.

Let’s hope that this outlook brings home the urgency of acting to address this generational challenge. It should spark far-reaching debate about what the next chapter of pro-worker organisation should look like. Some of this thinking is starting to happen inside our own union movement. But it needs to come from outside of the union world too: there is likely to be a need for a more diverse set of institutions experimenting with new ways of supporting those in exposed parts of the workforce. There’s no shortage of examples from the US — a country whose union movement faces an even more acute challenge than ours — of how to innovate on behalf of workers.

It’s not written in the stars that these gloomy projections will come to pass. They are there to be acted on. But if the voices of union conservatism prevail — and the offer to millennials is more of the same — no-one should be at all surprised about where this ends up.

This post originally appeared on Gavin Kelly's blog