APPNA and MPAC Meet with Pentagon - 2 Nov 2007

APPNA was represented by Dr Zahid Imran, a psychiatrist and a life member of APPNA. MPAC was represented by Dr. Nayyer Ali, a physician and MPAC Board Member, Safiya Ghori, Government Relations Director and Dr. Salam Al Maryati, the Executive Director.

The meeting was attended by Ms. Sandra Hodgkins, Deputy Assistant Secretary of detainees Affairs, and Dr. Jack Smith, the Medical Director of Detainees Services. Mr. John Casciotti, a Legal advisor to Dr. Smith, was also present. The meeting was also attended by the active medical staff of Guantanamo facility via two way video conference. Colonel Morgan represented South Command. Also participating in the meeting were mental health providers and the cultural affairs advisor from Guantanamo Bay via video teleconference.

MPAC and APPNA raised their concerns about the impact of the various investigation practices on the health of the detainees described in the recent UN Report and the reports of four suicide deaths in the detention facility. The UN Report posits that the effects of indefinite detention and the conditions of confinement such as "sensory deprivation, exposure to extreme temperatures, and the use interrogation techniques" have led to "serious mental illness, including 350 acts of self-harm in 2003 alone, as well as individual and mass suicide attempts and widespread hunger strikes."

During the meeting, the Pentagon officials stated the current US government stance that Guantanamo detainees are not POW's. It was also explained to the delegation that the military has established "The Combatant Status Review Tribunals (CSRT's), to look into the status of a detainee and decide if they meet the enemy combatant status. If they are classified as (NLEC), meaning they no longer meet the criteria of an enemy combatant, then arrangements are made for transferring them to their homeland. So far, 38 detainees have been placed classified as NLEC in such category. It was also pointed out by the officials, however, that 30 out of the previously released detainees from Guantanamo are suspected of returning to active participation in hostile action. Dr. Smith provided the statistics on the dental and other surgical procedures performed on the detainees. The US army has set up facilities for cardiologists, gastroenterologist and other medical specialist. There is a full time psychiatrist and five nurses.

It was clear that the current treating medical staff is following ethical guidelines similar to those associated with dealing with the prisoners in correctional or forensic facilities. It was explained that the treatment team members are not given access to the interrogators and are primarily in charge of the health of detainees.

It was also noted that there is a religious and cultural consultant retained by the department.

During the meeting, Dr. Smith gave a presentation about the policy and procedures of the use of forced medications and feeding of the prisoners.

Dr Smith described in detail the various policies regarding the involuntary treatment of detainees, forced feeding and other involuntary treatment. He told the delegation that such policies are molded on the model of the Forensic and correctional facilities policies regarding the inmates involved in such situations. It was pointed out by Sufia Ghori that the detainees have not been committed under a court order.

According to the Pentagon, there are currently 330 detainees still being held at Guantanamo, out of a total of 800. Additionally the Department of Defense recognized 41 suicide attempts among 29 detainees.

Comparatively, in January of 2005, the New York Times (include link to article) reported that out of 350 acts of self harm, there were 120 incidents of inmates trying to hang themselves, while 23 detainees took part in simultaneous mass-suicide attempts.

During the interview with the treating physicians at Guantanamo Bay, it was stated that a number of inmates have gone on hunger strike.

They stated that when the malnutrition becomes severe enough to constitute a threat to their health, they are force fed by the insertion and removal of a nasal feeding tube twice a day. In addition, the medical staff made it clear that if an inmate refused medication felt to be necessary for their life, it would be forcibly administered.

Dr. Nayyer Ali stated that "mental illness appears to be rather prevalent among detainees with 17% of the current inmates suffering from a psychiatric diagnosis and 5% suffering from depression." It was also stated in the meeting that 5% of the detainees are currently taking psychiatric medication and three of the inmates are diagnosed with schizophrenia. It was considered puzzling from the current psychiatric body of knowledge that not a single detainee has been diagnosed with PTSD.

The Guantanamo Medical team also stated that there has been no formal intelligence testing on the detainees, but that approximately 30% of the detainees are illiterate. Similarly the medical team explained that the medical personnel who engage in assisting in interrogations are separate from treating physicians.

Dr Zahid Imran questioned the ethical boundaries in which "Behavioral Science Consultants" are allowed access to information that is confidential under the doctor-patient relationship.

During the meeting, Safiya Ghori questioned the effect of interrogation techniques that amount to torture on the mental health of detainees. Both the Office of Detainee Affairs and the medical professionals at Guantanamo stated that no coercive practices are used during interrogations. To this effect, Dr Imran reminded the group that "torture only gives us an idea on someone's ability to tolerate pain, and doesn't really help in getting relevant information."

MPAC Executive Director, Salam Al-Marayati ended the meeting by emphasizing the importance of "the rehabilitation process and the need for an assessment of the ideology of terrorism, as well as ways to counter that ideology at the detention facility."

While the medical staff addressed concerns about the medical facilities at Guantanamo Bay, MPAC remains concerned about the deprivation of liberties and the lack of due process afforded to the detainees. MPAC strongly asserts that detention without charges or access to counsel is a departure from established principles of human rights and International law. Furthermore, the Guantanamo Bay detention facilities remain an iconic symbol worldwide of American policy in the War on Terror.

APPNA will like to explore the various areas in which APPNA along with other Human Rights Advocacy groups and community organizations can work with the Pentagon officials to improve the rehabilitation efforts undertaken by the Pentagon without compromising their commitment to human rights. APPNA recognizes the need to be a part of the debate on the ideology of Terrorism and how to combat it, and believes that this process "requires more engagement between organizations like MPAC, APPNA and the US government" as enunciated by Dr. Al Marayati at the conclusion of the meeting.

http://www.mpac.org/article.php?id=556