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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Even before Brexit, immigrants are shunning the UK

The 49,000 fall in net migration will come at a cost.

Article 50 may not have been triggered yet but immigrants are already shunning the UK. The number of newcomers fell by 23,000 to 596,000 in the year to last September, with a sharp drop in migrants from the EU8 states (such as Poland and the Czech Republic). Some current residents are trying their luck elsewhere: emigration rose by 26,000 to 323,000. Consequently, net migration has fallen by 49,000 to 273,000, far above the government's target of "tens of thousands" but the lowest level since June 2014.

The causes of the UK's reduced attractiveness are not hard to discern. The pound’s depreciation (which makes British wages less competitive), the spectre of Brexit and a rise in hate crimes and xenophobia are likely to be the main deterrents (though numbers from Romania and Bulgaria remain healthy). Ministers have publicly welcomed the figures but many privately acknowledge that they come at a price. The OBR recently forecast that lower migration would cost £6bn a year by 2020-21. As well as reflecting weaker growth, reduced immigration is likely to reinforce it. Migrants pay far more in tax than they claim in benefits, with a net contribution of £7bn a year. An OBR study found that with zero net migration, public sector debt would rise to 145 per cent of GDP by 2062-63, while with high net migration it would fall to 73 per cent.

Earlier this week, David Davis revealed the government's economic anxieties when he told a press conference in Estonia: "In the hospitality sector, hotels and restaurants, in the social care sector, working in agriculture, it will take time. It will be years and years before we get British citizens to do those jobs. Don’t expect just because we’re changing who makes the decision on the policy, the door will suddenly shut - it won’t."

But Theresa May, whose efforts to meet the net migration target as Home Secretary were obstructed by the Treasury, is determined to achieve a lasting reduction in immigration. George Osborne, her erstwhile adversary, recently remarked: "The government has chosen – and I respect this decision – not to make the economy the priority." But in her subsequent interview with the New Statesman, May argued: "It is possible to achieve an outcome which is both a good result for the economy and is a good result for people who want us to control immigration – to be able to set our own rules on the immigration of people coming from the European Union. It is perfectly possible to find an arrangement and a partnership with the EU which does that."

Much depends on how "good" is defined. The British economy is resilient enough to endure a small reduction in immigration but a dramatic fall would severely affect growth. Not since 1997 has "net migration" been in the "tens of thousands". As Davis acknowledged, the UK has since become dependent on high immigration. Both the government and voters may only miss migrants when they're gone.

George Eaton is political editor of the New Statesman.