Alana Cutland was in Madagascar as part of a research trip.
The British 19-year-old had a thirst for travel, and was there to study a rare species of crab as part of an internship.
On Thursday July 25 she caught a light plane back to the lodge where she was staying after carrying out some research in the remote area of Anjajavy.
But 10 minutes into the flight, Alana undid her seatbelt and unlocked the right door of the plane and tried to get out.
The pilot of the tiny plane, Mahefa Tahina Rantoanina and Alana's friend and fellow passenger Ruth clung to her as she dangled 1000 metres over the Madagascan countryside.
Mahefa had a hold of her leg, while still steering the now rocking plane - Ruth was shouting at her trying to get her to come back in to the safety of the cabin.
But after five minutes of sheer panic and struggle, she slipped from their grasp.
She fell out of the plane over the Savannah, a remote animal invested part of the island which means Alana's body will likely never be found.
Madagascar is a country where malaria is a risk, and Alana had been taking anti-malaria tablets as a precaution.
During the course of the trip, she experienced five "paranoia attacks" and it's now emerged that she may have had a mental health episode in the plane that day as a side effect of the malaria medication she'd been taking, reports The Sun.
Canadian soldiers are suing their government over anti-malaria medication. Post continues after video.
Mahefa had noted that the teenager "looked a little sick" when she boarded the plane, and told him she had a headache.
She remained completely silent as she reached for the door and jumped out to her death.
There are certain types of malaria medication that have been found to cause hallucinations and vivid dreams, which is also a side effect of the disease itself.
Speaking to Mamamia, Dr Brad McKay said, "Medication used to prevent malaria is usually taken once-a-day, but some people prefer the convenience of taking a tablet once-a-week.
"One of these weekly tablets is associated with significant psychiatric side effects including anxiety, depression, hallucinations, and psychosis. This drug is still prescribed around the world, including Australia."
"For people who have a history of "mood disorders like depression, anxiety or psychosis," Dr McKay said it is not advisable they take the 'once-a-week' tablets. "Other medication can also interact with anti-malaria drugs, so it's important to discuss this with your doctor," he explained.
"Your body, brain, and environment are constantly changing, so there’s no guarantee you’ll have the same side effects every time you take anti-malarial medication," Dr McKay added. "If you’ve ever experienced psychiatric side effects from taking antimalarial medication, it’s usually a good idea to never take that drug again."
With that said, Dr McKay highlights the seriousness of malaria, explaining: "Malaria is a serious infection transmitted by mosquito bites, so it’s important to take precautions when you’re traveling to areas affected by malaria. This includes using insect repellent, wearing light-coloured trousers and long sleeve shirts, sleeping underneath mosquito protective netting, and also taking anti-malarial medication."
Right now there are Canadian soldiers suing their government over anti-malarial tablets they took while stationed in Somalia that they say caused them debilitating mental health side-effects.
They've cited depression, night terrors, aggressive behaviour and suicide as side effects, and claim they were misdiagnosed as having Post Traumatic Stress Disorder, reports CTV news.
Alana's uncle Lester Riley confirmed to the Daily Mail, the Cambridge University student had never suffered from mental illness, but the family knew something was unwell days before her death.
"She had taken ill after being there for a few days and when she spoke to her mother on the phone two days before the accident she was mumbling and sounded pretty incoherent,"he said.
