Guantánamo detainees may start dying if the US does not act

Two significant statements released over the past two months have sounded the alarm on the state of medical care at the Guantánamo Bay detention centre. In March, the United Nations Human Rights Council released a letter from seven UN experts criticising the inadequate medical care provided to detainees, noting “systematic shortcomings in medical expertise, equipment, treatment and accommodations”.

Then, in April, in a break with traditional protocol, the International Committee of the Red Cross (ICRC) echoed the UN experts’ concerns and urged the United States to “find adequate and sustainable solutions … as a matter of priority”.

The ICRC very rarely comments publicly on conditions of detention. As an independent and neutral humanitarian organisation, it communicates concerns with governments privately.

Thus, the release of these two statements signals that Guantánamo’s medical care crisis has reached a point where it can no longer be ignored, and the worst possible outcomes – including detainees dying – may be on the horizon. It is long past time for a serious course correction.

For years, independent medical experts, former military personnel, and human rights groups (including my organisation, the Center for Victims of Torture) have documented and raised concerns about deficiencies in medical care at Guantánamo.

For example, detainees’ medical histories exclude information about their trauma and torture, or remain classified. Some former medical personnel have said they were instructed not to ask about detainees’ torture. Their failure to do so, and to document any trauma history, violates the US’s responsibility to provide adequate care under international norms.

Yet, the effects of the torture and cruel, inhuman, and degrading treatment that many detainees were subjected to, as well as a lack of adequate care thereafter, have compounded their conditions.

In January, Ammar al-Baluchi who suffers from traumatic brain injury and other impairments because of his torture, was diagnosed with a spinal tumour, which according to his lawyers could “eventually affect [his] motor or sensory nerves as it grows”.

Detainees also suffer from seizures, loss of vision, gastrointestinal problems, post-traumatic stress disorder and other long-term physical and psychological consequences of torture.

The UN and ICRC flagged “accelerated aging” of detainees as a major concern. As explained by the UN Independent Expert on the rights of older people, this is brought on by “poor socioeconomic and health backgrounds, along with the harmful effect of imprisonment on health and well-being”.

In particular, the UN called attention to the deteriorating condition of Abd al-Hadi al-Iraqi, a detainee in his 60s with a degenerative spinal disease who is now suffering from paralysis; the lack of adequate care is exacerbating his condition and harming his quality of life.

Medical care provision at Guantánamo is also affected by lack of staff and inadequate equipment, including broken imaging machines. In a disturbing example of Guantánamo’s limited capabilities, a medical officer said “the prospect of attempting” a complex surgery on one of the detainees at its hospital “scares the hell out of me”.

And unlike military personnel and civilians on the base, the detainees are prohibited by law from leaving and receiving medical care outside Guantánamo even in dire, life-threatening circumstances.

Even a previous Guantánamo commander became exasperated by the situation. In 2019, Rear Admiral John Ring told reporters: “Unless America’s policy changes, at some point we’ll be doing some sort of end-of-life care here … A lot of my guys are prediabetic … Am I going to need dialysis down here? I don’t know. Someone’s got to tell me that. Are we going to do complex cancer care down here? I don’t know.”

The recent UN and ICRC statements suggest that those questions still have not been answered, and that little, if anything, has changed.

Many of Guantánamo’s medical care problems can be fixed. One cannot: detainees continue to distrust government doctors due to the role of medical staff in torturing them (and/or other men).

And even if a provider succeeds in establishing rapport and trust, because medical personnel at Guantánamo rotate in and out so frequently, there will still be a lack of continuity in care.

In June 2022, organisations, including the International Commission of Jurists and Amnesty International, stated that none of the detainees “had access to an effective remedy or reparation for the atrocities they suffered”, and that under international law, “deprivation of effective medical treatment while still in detention constitutes a continuing act of torture”.

The Biden administration committed to closing Guantánamo and has made progress towards that goal. Ten detainees have been released from the facility and resettled to third countries or repatriated. The government is also in negotiations for a plea deal with the five defendants in the 9/11 case – which would finally bring an end to that interminable litigation – though senior administration officials are dragging their feet on key policy questions that need to be decided before negotiations can go any further.

Today, a finite group of 30 detainees remains: 16 who are cleared for release, 10 who have active cases in Guantánamo’s military court system, one who is serving a life sentence, and three “forever prisoners” who continue to be held without charge or trial.

To that end, the ICRC is calling on the US to “overcome the political and administrative deadlock” that is holding up the remaining transfers and the “fate of all other detainees”.

But for as long as any of the men remain, the government must develop and provide them with comprehensive, trauma-informed, and culturally competent treatment.

The UN and the ICRC have sounded the alarm. It is time to call a code red unless the US wants to deal with a humanitarian and human rights crisis that will further tarnish its global image.

The views expressed in this article are the author’s own and do not necessarily reflect Al Jazeera’s editorial stance.