When a federal judge investigates Guantánamo hunger-strike policy Monday, she’ll be hearing from two doctors who spent 14 hours with Abu Wa’el Dhiab, a Syrian captive awaiting resettlement in Uruguay who estimates that prison guards have forced him from his cell 1,300 times in 12 years.
The doctors are a former U.S. Army psychiatrist, retired Brig. Gen. Stephen Xenakis, and a Boston-based internist who specializes in treating victims of torture, Sondra Crosby. Both have already filed with the court their criticisms of Dhiab’s care at the prison in southeast Cuba, and both have testified about Guantánamo prisoners before.
U.S. District Court Judge Gladys Kessler has called the hearing to consider a slice of the 43-year-old Syrian captive’s challenge to his continuing detention:
Whether to order the U.S. military to stop sending soldiers to shackle him inside his cell and then restrain all four limbs and head while a Navy nurse snakes a tube up his nose to pump a nutritional supplement into his stomach up to twice a day. Dhiab, cleared to leave the prison years ago, is an on-again, off-again hunger-striker.
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The heart of the issue, according to his attorneys, is that he suffers such crippling back pain that he can’t walk in shackles to the feedings. He wants to go in a wheelchair. Because he won’t walk, the attorneys say, the prison conducts a “forced-cell-extraction” — a tackle-and-shackle technique used by troops to subdue uncooperative captives.
A court filing by Xenakis, the psychiatrist who reports having consulted on 50 Guantánamo detainee cases, described Dhiab as a “remarkably emaciated” 6-foot-5-inch man who is not suicidal and sees hunger-striking as “the only peaceful means he has” to protest his confinement.
Kessler will hear testimony from both doctors in open court after a group of U.S. news media organizations opposed a Justice Department proposal to shut out the public.
It’s a hearing that has been months in the making, and required a court order to the Pentagon to let the doctors see Dhiab. They got 14 hours last month.
Oddly, the drama is playing out for a man who is not only cleared for release but has a destination. Secretary of Defense Chuck Hagel recently gave final approval for Dhiab and five others to go to Uruguay, which has agreed to resettle them after it holds its presidential election but before current President Jose Mujica leaves office.
Rather than forcible removal from his cell for the feedings, Xenakis wrote to the court on Sept. 15, Dhiab “requires appropriate and humane treatment that allows for him to cope with his pain and symptoms while awaiting transfer.”
He and Crosby also dismissed suggestions that, by attributing his ailments to “jinns,” Middle Eastern spirits, he suffers a psychiatric illness. Rather, they told the judge, it’s culturally appropriate.
A U.S. military photo accompanying Dhiab’s leaked 2008 prisoner profile shows a bearded man in an orange jumpsuit who got to Guantánamo in August 2002 for interrogation about what he knew about al-Qaida. Pakistani police picked him up in Lahore four months earlier.
The U.S. has never charged him with a crime and he was approved to leave the prison by the first year of Barack Obama’s presidency. But, as a former Syrian soldier and Syrian Airlines employee who fled to Afghanistan, he could not be repatriated.
When troops brought him to his court-ordered medical examination last month, Crosby reported, he was wearing an orange jumpsuit — the military prison’s color-code denoting a rule-breaker who was being punished.
The doctors described him as a malnourished father of four who, according to medical records, suffers chronic back pain and complains of numbness up and down his right side — a condition he says is exacerbated by the tackle-and-shackle technique.
For the public, Monday’s hearing could fill in a vacuum of information surrounding Guantánamo’s 20-month-long hunger strike that the prison has cloaked in an information blackout even as Navy medical staff defend their treatment of the protesters as humane.
Lawyers accuse the military of punitively employing single-cell lockdown and forced-cell extractions to break the hunger strike.
Earlier commanders called the hunger-strikers peaceful protesters who were allowed to live communally with other prisoners — so long as they compliantly went to tube feedings when a guard ordered them to stand and be shackled at a gateway. Now, a prison manual calls the protest “long-term, non-religious fasting.”
Crosby, a consultant for Physicians for Human Rights, told the court that the captive’s back pain merited further study through an MRI.
And while he was clearly malnourished when she examined him, she reported, he ate fruit and nuts and mango juice in her company. “Astonishingly,” she wrote, the prison guards forbade him to bring the leftovers back to his cell — behavior she described as bad medical practice that “only fuels the motivation to continue the hunger strike.”
Prison commanders, for their part, have characterized unauthorized food as “contraband” at odds with orderly military discipline meant to monitor detainee consumption to decide who gets a forced-feeding.
On Friday, Kessler ruled that the public can also see videos made by the prison of troops forcing the Syrian from his cell, and then giving him the feedings — once content that could reveal identities of prison staff is deleted or obscured.
Kessler said similarly she would close portions of Monday’s hearings that cover classified or protected prison information but would allow the doctors to discuss their unclassified findings in open court.
On Tuesday, a medical ethicist with experience using nasogastric tubes will also testify in open court. Kessler ruled that because Dr. Steven Miles didn’t require a security clearance to review Dhiab’s records, all his testimony can be public.
Miles is a doctor of internal medicine and professor of bioethics at the University of Minnesota Medical School who studied some of Dhiab’s medical charts.
In his court filing, Miles accused the Navy medical staff of managing tube feedings “in a way that is more hazardous, burdensome, and uncomfortable than such a procedure should be.”
Miles also was harshly critical of the military doctors’ use of olive oil to lubricate the tube before inserting it into a captive’s nose and snaking it down his throat. When reporters visit, Navy medics say they offer olive oil as a nasogastric lubricant for detainees who have a “cultural preference.”
But Miles told the court in June that good medicine requires water soluble lubricants for tube insertion to avoid pneumonia. Olive oil is nonwater soluble, he wrote.
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