“Good doctors are useless without good discipline. More than half the battle against disease is fought not by doctors, but by regimental officers.”
British Field Marshal William Slim’s words serve as guidance for the medical team with Operation ONWARD LIBERTY, who are battling the same disease, malaria, in the tropical climate of Liberia. Slim initiated measures that held his officers directly responsible for the malaria rates among their troops. His changes caused the cases of malaria among his troops to decrease dramatically during the Burma campaign in World War II.
U.S. Air Force Capt. William Scott Jr., chief medical officer with OOL, and his medical team at Edward Beyan Kesselly Barracks have followed Slim’s lead. Scott ensures good discipline by holding every single mentor directly responsible for complete accountability. The medical team in Liberia has a much more modern set of tools than Slim did, and they have created a text messaging system in which other mentors have to let Scott, or another one of his medical team, know that they have taken the medicine every single day.
Scott also stresses the big four prevention methods: taking malaria medication, sleeping under bed nets, wearing permethrin-treated uniforms and insect repellent in the field. He also added the incentive of a quarterly beach party to celebrate the fact the team has been malaria free, and under Scott’s innovative style of leadership there has not been a single case of malaria among the mentors.
“Because I harp on the prevention methods so often, I sometimes get called captain malaria,” joked Scott. “It’s a serious threat we are facing, so I’m okay with whatever I’m called as long as it reminds everyone to take their medication. The type of malaria, Plasmodium falciparum, in Liberia is one of the most difficult to detect and deadliest. By the time a person starts feeling the effects, they are already in the danger zone.”
Malaria is the second leading cause of illness among the mentors. Thirteen members came down with the disease during 2010, with one case being fatal. Around the world, malaria is the most significant parasitic disease that infects humans.
“Malaria is a huge threat to our mission here,” said Marine Master Sgt. Craig Wilson, senior enlisted advisor with OOL. “Fortunately for us, we have some outstanding Air Force medical personnel here. The text message system they have implemented keeps everyone constantly connected, and if I ever forget to message Staff Sgt. Megan Corbett [medic], she always follows up with me by the end of the day to ensure I’ve taken my medication.”
Malaria infection rates among members of the Armed Forces of Liberia are staggering. There were more than 1,300 cases last year, according to Scott. Fortunately for Liberian adults, they have developed low level immunity to the disease that prevents it from being as deadly a threat. U.S. service members lack the constant exposure to malaria, and instead have a history of contracting Malaria in Liberia, including approximately 80 cases in 2003.
“We have successfully changed the mindset that malaria is evitable here,” said Scott. “Our documentation system is working, and because of that we have been able to celebrate the fact we are remaining healthy.”
The beach party started as a challenge by Scott to encourage the mentors to take their medication and remain vigilant about the other measures and evolved into a team building exercise. The mentors gathered together at the beach listened to Liberian music, ate local foods, including a roast pig, a barracuda and a large serving of homemade fried rice, and a good time.
“The party was an enjoyable event, and a great idea,” said Cpl. Jacob Gateman, the logistics mentor with OOL. “There are not a lot of places where we can all go out together, so to relax at the beach together was an awesome opportunity. I know I do not want to be the individual who gets malaria and ruins the chance for another party.”
Marine Col. Robert Senini, the officer-in-charge of OOL, said the party was a great reward for mentors who are doing all the right things.
“It’s really all about Doc Scott,” said Senini. “They have had issues in the past, and you aren’t going to be able to kill all the mosquitoes, so it really is the preventive measures that the Doc stresses that are working to prevent malaria.”
Senini recognizes that the entire medical team is doing a fantastic job here, and all the members of OOL are looking forward to another malaria-free three months and another beach party.
Operation ONWARD LIBERTY is a Department of State-funded, U.S. Africa Command-led program designed to provide uniformed advisors and mentors to the Armed Forces of Liberia. U.S. service members handing off training to the AFL and assuming a support and advisor role is a key goal of the program.