(Image: Jared Rodriguez /
Truthout
)


A Truthout analysis of
historical records concerning government research and nonmedical use of
antimalarial medications has revealed that such drugs were the objects of
experimental research under the CIA’s MKULTRA program. Even more, one of these
drugs, cinchonine, was illegally stockpiled by the CIA as an “incapacitating agent.” 


Antimalarial drugs were
studied as part of the CIA’s mind control program MKULTRA. Cinchonine, an
antimalarial drug derived from chichona bark, was one of the drugs used by the
operational components of MKULTRA, code-named
MKNAOMI
and MKDELTA. The CIA worked with researchers for the Army’s
Special Operations Division, a secret component of the US Army Chemical Corps
based at Fort Detrick, to develop delivery systems for the drugs.


Revelations concerning CIA
interest in use of antimalarial drugs would be of historical interest, as it
has never been written about before. But such interest gains contemporary
significance in the light of actions taken by the Department of Defense (DoD)
in the “war on terror,” and the fact that a key DoD expert on
antimalarial drugs was a psychiatrist involved in training personnel for
Guantanamo interrogations.


In January 2002, the DoD
deliberately decided that all incoming detainees at Guantanamo would be given a
full treatment dose of the controversial antimalarial drug mefloquine, also
known as Lariam. The purpose was supposedly to control for a possible malaria
outbreak, in deference to concerns from Cuban officials.


But specialists in malaria
prevention have said they have never heard of such presumptive treatment for
malaria by mefloquine in this type of situation. Furthermore, a summary of
antimalarial measures at Guantanamo given to Army and Center for Disease Control
(CDC) medical officials at a February 19, 2002, meeting of the Armed Forces Epidemiological Board failed to
describe the mefloquine procedure approved a month earlier.


Was mefloquine used at
Guantanamo to help produce a state of “learned helplessness” in
detainees? Were experiments conducted on adverse side effects of mefloquine on
the prisoners held there?


Some years ago, this might
have been considered a crazy scenario to even consider. While there is no
smoking gun that can prove mefloquine was used for nefarious purposes, a strong
case can be made that use of the drug at Guantanamo was not related to malaria
control.


Antimalaria Drugs and MKULTRA


The revelation concerning
cinchonine came from hearings the Senate’s Church Committee held in September
1975 on CIA “Unauthorized Storage of Toxic Agents.” The
agency’s illegal stockpile of chemicals and drugs, which included the
antimalarial drug cinchonine, was supposed to have been destroyed by order of
President Nixon in December 1969.


At the time of the president’s
order, the US had also signed an international agreement that such chemical and
biological weapons would be destroyed, so the revelation of the CIA’s
stockpiling of such substances was highly embarrassing to the US government at
the time.


At the behest of Congressional
investigators, the CIA provided an inventory of all “lethal” and
“incapacitating agents” they had kept contrary to presidential order.
On this list, the CIA indicated it held two grams of cinchonine, stored as an
incapacitating agent, that is, a substance meant to temporarily disable an
individual. Temporary incapacitant or not, the CIA inventory listing for cinchonine states, “Overdose leads to
severe cardiac convulsions, nausea and vomiting.”


In separate testimony from
another Senate investigation, a CIA-linked researcher, Dr. Charles F.
Geschickter, told Sen. Edward Kennedy in 1977
hearings
that the CIA was interested in antimalarial drugs that “had
some, shall I say, disturbing effects on the nervous system of the
patients.” Geschickter’s CIA researchers became interested in these
antimalarial drugs as part of the work they were doing in the CIA’s MKULTRA
program. Dr. Geschickter ran the Geschickter Fund for Medical Research, and the
Kennedy hearings also revealed how the fund laundered money for MKULTRA
projects.


According to MKULTRA
documents released
as part of a related Senate investigation in 1977,
research into quinolines, the class of drugs that include cinchonine, quinine
and the modern antimalarial drug mefloquine (Lariam), was part of MKULTRA
subprojects 43 and 45.


The CIA prior to the Congressional
investigations destroyed most records concerning MKULTRA and chemical,
biological and bacteriological research. Moreover, according to Senate
testimony by former CIA Director William Colby, many of the organizational
directions concerning both research and operationalization of such weapons were
never written down.


An Antimalarial
“Incapacitant”


Cinchonine is a
quinine-derived drug and similar in some ways to the artificial quinine
derivative antimalarial drug mefloequine, also known as Lariam. Mefloquine, a
product of Army research, has been the subject of numerous controversies over
its side-effect profile, and as recently as 2009, the DoD significantly cut
back on its use for the military.


The stockpiling of cinchonine
as an “incapacitating” agent was directly contrary to Nixon’s order
that all such toxic and bacteriological stockpiles held by the DoD and the CIA
be destroyed. Other incapacitating agents held by the CIA for years after the
disposal order included the powerful hallucinogen BZ; the anticholinergic drug
Cogentin; digitoxin; and Phencyclidine HCL, commonly known as “Angel
Dust”; among other drugs.


The CIA’s stockpile of
dangerous substances also included numerous “lethal agents,”
including shellfish toxin; cobra venom; fish toxin; and numerous substances
only known by their code names (“E-4640,” “F-270” etc.). It
is not known if any of the lethal or incapacitating agents were ever used, or
if so, by whom or where. (The one exception the CIA admitted to was the use of
an arsenic suicide pill provided to Francis Gary Powers, a U-2 pilot shot down
over the Soviet Union in 1960. Powers did not use the pill.)


According to Senate testimony,
the stockpile was discovered after a review of secret programs ordered by
Colby. Originally, the various drugs and weaponized biological substances were
kept at the Army’s Fort Detrick compound and were apparently moved later to a
CIA storage facility.


The neurological side-effects
of mefloquine are similar to the side effects of cinchonine. Cinchonism (or quinism)
includes such side-effects as blurred vision, tinnitus, skin rashes, vertigo,
nausea, headaches and other even life-threatening serious health problems.
Mefloquine has been cited for neurological, but also psychological
side-effects, including depression, anxiety, panic attacks, confusion,
hallucinations, bizarre dreams and suicidal and homicidal behavior. The effects
can be long or short-term.


But even the
“short-term” effects can be debilitating, as one military doctor,
Captain Monica Parise, told a group of other physicians at a government meeting
in May 2003. Parise told the meeting of the Armed Forces Epidemiological Board (AFEB)
that “there are a host of other more acute less severe neuropsychiatric
issues that occur short-term [with mefloquine], such as insomnia, strange
dreams, fatigue, lack of energy, inability to concentrate and some people have
reported that those effects have lasted a very long time.”


Parise noted that it takes
“three, four, or five months to really wash the drug out of your
system,” and that she’d “heard that there might be some data in DoD
… that might shed light” on how the drug had “ruined people’s lives.”
As we shall see, a psychiatrist present at this same meeting was also involved
in training other psychiatrists to assist Guantanamo interrogators.


Administering Mefloquine to
All the Guantanamo Detainees


In December 2010, Truthout and Seton Hall School of Law’s Center for Policy and Research 
revealed that it was medical standard operating procedure (SOP) to give all
arriving detainees full treatment doses of the antimalarial drug mefloquine
upon arrival at the US prison camp. The military’s own newspaper, Stars and Stripes, followed up with their own story a few
weeks later.


[Update, 6/9/2012: Both
the Truthout and Seton Hall investigations also noted the CIA’s MKULTRA
research into the quinoline family of drugs. The Seton Hall report described
how “potential use of these drugs in an interrogation setting was a stated
purpose for the [CIA] study.”]


A treatment dose of mefloquine
is five times the amount taken weekly by those who use the drug for
prophylactic purposes. Larger doses are associated with a higher percentage of
side effects.


The Truthout investigation
showed that at the time the SOP was put in place, internal discussions within
the DoD and an Interagency Malaria Working Group were expressing strong doubts
about the serious neuropsychiatric side effects of the drug. Despite this, the
surgeon general of the JTF-160 Task Force at Guantanamo signed off on the unprecedented
mefloquine protocol.


The chief surgeon, who also
served as commander of the Navy Hospital at the base, was Capt. Albert Shimkus.
Shimkus told Truthout in late 2010 that he had first sought consult regarding
the use of malaria drugs from an assortment of agencies, including officials
from the CDC, the Navy Environmental Health Center (NEHC) and the Armed Forces
Medical Intelligence Center at Fort Detrick, Maryland. All three agencies have
told Truthout they were not involved in this decision or had no documents
related to such consultation.


Shimkus told Truthout in a
phone interview last October that the US State Department “would have been
involved” in discussions about malaria concerns at Guantanamo, though he
maintained no State Department officials were directly involved in the
“clinical decision making.”


In June 2004, the CDC
announced, “‘presumptive treatment’ without the benefit of laboratory
confirmation should be reserved for extreme circumstances (strong clinical
suspicion, severe disease, impossibility of obtaining prompt laboratory
confirmation).” Hence, “presumptive treatment” – the mass
administration of a drug without knowing whether or not it is actually
necessary – is reserved for situations when there is no possibility of
laboratory confirmation of malaria, but that was not the case at Guantanamo.


Yet, even a year later, the
mefloquine SOP was renewed at Guantanamo.


DoD spokeswoman Maj. Tanya
Bradsher told Truthout, “A decision was made to presumptively treat each
arriving Guantanamo detainee for malaria to prevent the possibility of having
mosquito-borne [sic] spread from an infected individual to uninfected
individuals in the Guantanamo population, the guard force, the population at
the Naval base, or the broader Cuban population.”


According to Bradsher,
“The mefloquine dosage was entirely for public health purposes to prevent
the introduction of malaria to the Guantanamo area and not for any other
purpose.” Nevertheless, when hundreds of contract workers from malaria-endemic
countries such as India and the Philippines were brought by Halliburton
subsidiary Kellogg Brown and Root (KBR) to build the new Guantanamo Delta Block
in 2002, there was no DoD scrutiny of any exposure by these workers to malaria.


According to Bradsher, KBR
alone was responsible for its own workers, belying a concern over possible
reintroduction of malaria to Cuba, which, according to Captain Shimkus, had
produced State Department concerns when it came to the arriving detainees.


In his October 2011 interview,
Shimkus also said he sent “pretty detailed reports” regarding the
mefloquine decision to JTF-160’s Commanding Officer, Marine Corps Brig. Gen.
Michael R. Lehnert. He had nothing further to say about a statement made to
Truthout a year earlier in which he stated that he had been told not to talk
about the mefloquine decision.


When Shimkus was asked if he
was aware of any detainees who had suffered psychiatric problems because of
drugs administered to them, he said, “Maybe. That’s confidential,”
adding a moment later, “No for that.”


He also rejected the opinions
of two medical researchers who wrote in PLoS Medicine in April 2011 that “medical doctors and
mental health personnel assigned to the DoD neglected and/or concealed medical
evidence of intentional harm” to detainees. “They have an opinion and
it should be out there,” Shimkus said.


Army Mefloquine
“Specialist” Trained Psychiatrists for Interrogations


A top psychiatrist working for
the Office of the Assistant Secretary of Defense for Health Affairs (OASD-HA),
Col. Elspeth Cameron Ritchie, traveled to Guantanamo in October 2002,
purportedly to investigate a spurt of suicide attempts among the detainees.
Within weeks, according to the AFEB minutes cited earlier, she attended an
“experts” meeting on “Malaria Chemoprophylaxis” at the CDC
in January 2003 that considered problems with the “neuropsychiatric
adverse drug reactions” of mefloquine. Indeed, according to the AFEB
speaker, Captain Parise, they specifically included a psychiatrist – presumably
Ritchie – in their discussions.


Did Colonel Ritchie bring
knowledge of the effects of mass mefloquine administration at Guantanamo to
this meeting? We don’t know and Colonel Ritchie, now retired from the military
and chief clinical officer for the District of Columbia’s Department of Mental
Health, would not return a request for comment. A public spokesperson for
OASD-HA told Truthout it had no connection with any decision to use mefloquine
at Guantanamo.


It would be strange, if not
highly unlikely that, given the widespread interest in mefloquine adverse reactions
at the DoD and contemporaneous statements that the DoD was conducting research
on this, that the effects of the Guantanamo mefloquine SOP were never examined.


Ritchie’s involvement in
mefloquine issues can also be ascertained by the fact that, in 2004, Ritchie,
by then “Psychiatry Consultant” to Army Surgeon General Kevin Kiley,
gave a presentation to the DoD’s Deployment Health Clinical Center on the
“Neuropsychiatric Side-Effects of Mefloquine.”


Of convergent interest is the
fact that, according to Dr. Ritchie, she taught
psychiatrists slotted for assignment to the military’s Behavioral Science
Consultation Teams
(BSCTs) working at Guantanamo and possibly elsewhere.
She is, at this point, the only known person potentially linking military
activities surrounding both mefloquine and interrogations or torture.


According to an Army surgeon
general description of BSCT training during the period Colonel
Ritchie was involved, such training included instruction in methods of inducing
“learned helplessness.”


“Learned
helplessness” is a condition of near-total psychological breakdown
produced by inability to escape an extreme set of stressors. Its study is
associated with the work of psychologist Martin Seligman, who did research on
the subject as far back as the 1960s. In the 1990s, all the Survival, Evasion,
Resistance and Escape schools except the Navy school discontinued the use of
the waterboard in their training program precisely because it tended to produce
“learned helplessness” in its students, the opposite of the kind of
effect they were seeking.


A Guantanamo Autopsy Tests for
Mefloquine


The months-long period of time
it takes for mefloquine to leave the system may have been involved with a
decision to test a detainee at Guantanamo who had committed suicide for the
presence of mefloquine in his bloodstream. But the detainee, whose autopsy
report included toxicology results that show he was tested specially for
mefloquine, had been at Guantanamo for five years at the time of his death.


Abdul Rahman Al Amri entered
Guantanamo in February 2002 and would have been given a treatment dose of
mefloquine at that time. We do not know why he would have been tested for its
presence over five years later. All but one of the other detainees for whom we
have autopsy reports due to purported suicides were not tested for mefloquine,
showing such testing was not standard procedure.


Al Amri was also found dead
with his hands bound behind his back, and his death as well as that of 2009
suicide Mohamed Salih Al Hanashi are under investigation by the UN Special
Rapporteur for Extrajudicial Executions, primarily because of Truthout’s coverage of these events.


A Plausible Hypothesis


The discovery that the CIA
researched antimalarial drugs as part of its mind control program and,
moreover,  operationalized at least one of these drugs as an
“incapacitating agent” means that the hypothesis that mefloquine was
used for similar purposes at Guantanamo is not inconsistent with a known
pattern of governmental behavior.


There are many reasons to
question the supposed use of mefloquine at Guantanamo for purely public health
purposes. Consider the following:


  • The mass use of treatment levels of mefloquine at
    Guantanamo was unprecedented.
  • The drug was limited to only one group of
    potential malaria carriers.
  • Use of mefloquine for presumptive treatment
    continued for years past the point when the DoD was already manifestly
    aware of the drug’s dangers.
  • The mefloquine SOP was hidden from medical
    authorities at the Armed Forces Epidemiological Board.
  • Finally, there is the fact no government agency
    will admit to advising use of the drug, even when a Guantanamo medical
    officer states they were involved. 


As a result of all the above,
it appears highly possible that the motive for the drug’s use was to
psychologically disorient and physically debilitate all or some portion of
incoming prisoners.


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