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

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The Prevent strategy needs a rethink, not a rebrand

A bad policy by any other name is still a bad policy.

Yesterday the Home Affairs Select Committee published its report on radicalization in the UK. While the focus of the coverage has been on its claim that social media companies like Facebook, Twitter and YouTube are “consciously failing” to combat the promotion of terrorism and extremism, it also reported on Prevent. The report rightly engages with criticism of Prevent, acknowledging how it has affected the Muslim community and calling for it to become more transparent:

“The concerns about Prevent amongst the communities most affected by it must be addressed. Otherwise it will continue to be viewed with suspicion by many, and by some as “toxic”… The government must be more transparent about what it is doing on the Prevent strategy, including by publicising its engagement activities, and providing updates on outcomes, through an easily accessible online portal.”

While this acknowledgement is good news, it is hard to see how real change will occur. As I have written previously, as Prevent has become more entrenched in British society, it has also become more secretive. For example, in August 2013, I lodged FOI requests to designated Prevent priority areas, asking for the most up-to-date Prevent funding information, including what projects received funding and details of any project engaging specifically with far-right extremism. I lodged almost identical requests between 2008 and 2009, all of which were successful. All but one of the 2013 requests were denied.

This denial is significant. Before the 2011 review, the Prevent strategy distributed money to help local authorities fight violent extremism and in doing so identified priority areas based solely on demographics. Any local authority with a Muslim population of at least five per cent was automatically given Prevent funding. The 2011 review pledged to end this. It further promised to expand Prevent to include far-right extremism and stop its use in community cohesion projects. Through these FOI requests I was trying to find out whether or not the 2011 pledges had been met. But with the blanket denial of information, I was left in the dark.

It is telling that the report’s concerns with Prevent are not new and have in fact been highlighted in several reports by the same Home Affairs Select Committee, as well as numerous reports by NGOs. But nothing has changed. In fact, the only change proposed by the report is to give Prevent a new name: Engage. But the problem was never the name. Prevent relies on the premise that terrorism and extremism are inherently connected with Islam, and until this is changed, it will continue to be at best counter-productive, and at worst, deeply discriminatory.

In his evidence to the committee, David Anderson, the independent ombudsman of terrorism legislation, has called for an independent review of the Prevent strategy. This would be a start. However, more is required. What is needed is a radical new approach to counter-terrorism and counter-extremism, one that targets all forms of extremism and that does not stigmatise or stereotype those affected.

Such an approach has been pioneered in the Danish town of Aarhus. Faced with increased numbers of youngsters leaving Aarhus for Syria, police officers made it clear that those who had travelled to Syria were welcome to come home, where they would receive help with going back to school, finding a place to live and whatever else was necessary for them to find their way back to Danish society.  Known as the ‘Aarhus model’, this approach focuses on inclusion, mentorship and non-criminalisation. It is the opposite of Prevent, which has from its very start framed British Muslims as a particularly deviant suspect community.

We need to change the narrative of counter-terrorism in the UK, but a narrative is not changed by a new title. Just as a rose by any other name would smell as sweet, a bad policy by any other name is still a bad policy. While the Home Affairs Select Committee concern about Prevent is welcomed, real action is needed. This will involve actually engaging with the Muslim community, listening to their concerns and not dismissing them as misunderstandings. It will require serious investigation of the damages caused by new Prevent statutory duty, something which the report does acknowledge as a concern.  Finally, real action on Prevent in particular, but extremism in general, will require developing a wide-ranging counter-extremism strategy that directly engages with far-right extremism. This has been notably absent from today’s report, even though far-right extremism is on the rise. After all, far-right extremists make up half of all counter-radicalization referrals in Yorkshire, and 30 per cent of the caseload in the east Midlands.

It will also require changing the way we think about those who are radicalized. The Aarhus model proves that such a change is possible. Radicalization is indeed a real problem, one imagines it will be even more so considering the country’s flagship counter-radicalization strategy remains problematic and ineffective. In the end, Prevent may be renamed a thousand times, but unless real effort is put in actually changing the strategy, it will remain toxic. 

Dr Maria Norris works at London School of Economics and Political Science. She tweets as @MariaWNorris.