November
07, 2007
Mental Health
at Guantanamo Bay
For almost six years, several
hundred persons captured mostly in Afghanistan
have been held at the US detention facility at
Guantanamo Bay. This American jail has the unique
status of being totally under US control, but
remaining the sovereign territory of another country,
namely Cuba, from which the land is leased in
perpetuity. Bush placed the prisoners there so
he could deny them the benefit of the American
judicial system, a ruse that worked for several
years despite its patent absurdity.
Over the last two years, particularly as the courts
have forced formal review of the “enemy
combatant” status and both domestic and
global criticism of Gitmo have mounted, the government
has provided greater access to outsiders to Gitmo.
Although only the International Committee of the
Red Cross is allowed access to the detainees themselves,
numerous groups and journalists have been given
access to the facilities and staff of Gitmo. In
that framework, the Muslim Public Affairs Council
(MPAC), of which I am a board member and former
chairman, was given the opportunity to visit Gitmo
and to interview the medical staff on the issues
of mental health.
I, along with Executive Director Salam Al-Marayati,
DC office staffer Safiya Ghori, and APPNA psychiatrist
Dr. Zahid Imran, went to the Pentagon to discuss
these issues. We were allowed to ask questions
directly to the treating physicians and to the
head of the medical services at Gitmo for the
detainees.
According to the Pentagon, there are now about
330 detainees still being held at Gitmo, out of
a total of about 800. The health care facilities
are apparently quite comprehensive. In addition
to basic treatment facilities, an operating room
and cardiac catheterization lab is available.
The number of physicians and other medical personnel
assigned to the detainees is quite substantial,
and they are able to access care easily.
There have been four deaths at Gitmo which are
still subject to medical review but are considered
to have been suicides. In addition, there have
been 40 attempted suicides, 12 of the attempts
were apparently by a single individual.
A number of inmates have gone on hunger strike.
When their malnutrition becomes severe enough
to constitute a threat to their health, they are
force-fed by the insertion and removal of a nasogastric
feeding tube twice a day. In addition, the Gitmo
staff made clear that if an inmate refused medication
felt to be necessary for his life, it would be
forcibly administered.
Mental illness appears to be rather prevalent
among the detainees. 17% of the current inmates
have a psychiatric diagnosis. 5% are suffering
from depression. 5% of the inmates are currently
taking psychiatric medication, and three of the
inmates are diagnosed with schizophrenia.
There has been no formal intelligence testing
done on the inmates, but it is of note that about
30% of the inmates are illiterate. This would
suggest that a large fraction of the inmates are
not exactly criminal masterminds, although they
certainly could be highly motivated Jihadists.
The Gitmo medical personnel stated that their
doctor-patient relationship is ethically bound
to the same standards that apply to doctor-patient
relationships in US prisons. There are medical
personnel who are engaged in assisting interrogations,
but these personnel are separate from the treating
physicians.
The issue of torture was only touched on briefly.
The military personnel stated categorically that
no commonly mentioned coercive practices are currently
being used at Gitmo. This included solitary confinement,
stress positions, water boarding, sleep deprivation,
and other similar practices that many critics
consider tantamount to torture. It is not clear
if this policy was only adopted since the new
Secretary of Defense came to office. Despite these
denials, released inmates, and leaked reports
from the ICRC and from FBI agents that have been
to Gitmo all have suggested that these practices
occurred, at least at some point in the past if
not now.
While the US has provided a tremendous amount
of resources for the medical care of the Gitmo
detainees, it does not change the fact that Guantanamo
Bay remains a very potent negative symbol in the
current conflict. Its very existence, and the
Bush administration’s continued goal of
keeping the inmates outside the American legal
system or the Geneva Convention, cast a pall over
America’s moral standing. No matter how
well the detainees are treated, the best course
of action remains the closure of Guantanamo and
the transfer of the detainees into US legal custody
or prisoner of war status. Comments can reach
me at Nali@socal.rr.com.
