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To avoid paralysis, a team of specialists from the mainland had to fly to Guantánamo on a moment’s notice and perform emergency surgery.

Four additional surgeries later—all performed at Guantánamo, but again by off-island specialists—Mr.

Systemic change is necessary; these are not problems that well-intentioned military medical professionals—of which no doubt there are many, working now in an untenable environment—can resolve absent structural, operational, and cultural reform.

Nor, in many respects, are they problems that can be fully resolved as long as the detention facility remains open. Unless and until that happens, the Center for Victims of Torture and Physicians for Human Rights call upon Congress, the Executive Branch, and the Judiciary to adopt a series of recommendations aimed at meaningfully improving the status quo.

From the inception more than 17 years ago of the Guantánamo Bay detention center located on the U. naval base in Guantánamo Bay, Cuba, senior detention facility personnel have consistently lauded the quality of medical care provided to detainees there.

For example, in 2005, Joint Task Force (JTF) Guantánamo’s then-commander said the care was “as good as or better than anything we would offer our own soldiers, sailors, airmen or Marines.” In 2011, a Navy nurse and then deputy command surgeon for JTF Guantánamo made a similar claim: “The standard of care here is the best possible standard of care (the detainees) could get.” In late 2017, Guantánamo’s senior medical officer again echoed those sentiments: “Detainees receive timely, compassionate, quality healthcare…[which is]…comparable to that afforded our active duty service members on island.” There have been many more such assertions in the intervening years and since.

The case that perhaps best illustrates the state of medical care at Guantánamo is that of Abd al-Hadi al-Iraqi (aka Nashwan al-Tamir), who was captured in 2006, rendered to a CIA black site, then transferred to Guantánamo the following year. al-Tamir collapsed incontinent in his cell from a degenerative spinal condition—one about which he had told Guantánamo’s medical personnel more than 10 years earlier, they had independently diagnosed at Guantánamo in 2010, and that outside medical experts concluded had obviously required urgent surgical intervention years earlier.

al-Tamir’s prosecution in the military commissions, which has required him to attend court on a gurney, take pain medication during legal proceedings, and sleep in the courtroom when the predictable effects of that medication set in. al-Tamir’s fragile state, Guantánamo’s senior medical officer repeatedly recommended that Mr.

al-Tamir not be forcibly extracted from his cell to attend court proceedings (or otherwise). al-Tamir’s case that he did not need to issue an order to the same effect because Guantánamo’s non-medical staff would respect the recommendation. At the next hearing, prosecutors conceded that, in fact, Guantánamo’s non-medical commanders “are not bound by the [senior medical officer’s] opinions nor will they defer to them in every instance.” [7] The medical care situation at Guantánamo is not sustainable and should be expected to worsen rapidly over time as the impacts of both torture and indefinite detention exacerbate medical complications otherwise associated with aging.

The materials include litigation filings in military commission cases and federal court habeas corpus proceedings, filings before the Guantánamo Periodic Review Boards, press reports, and other publicly available sources.

The report also draws on 15 years of both organizations’ experience examining the CIA’s former rendition, detention, and interrogation program, the establishment and spread of torture and cruel, inhuman, and degrading treatment in the military in the aftermath of the September 11, 2001 attacks, and the role of U. health professionals in detainee torture and abuse.

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This report concludes with a series of recommendations that would at least mitigate medical care deficiencies and reduce the likelihood of unmanageable medical crises until Guantánamo—as it should be—is finally closed.

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  1. Germaine: I'm not saying you're not responsible, just perhaps, under the influence. Pilz-E: The doctors give these candies of special fun medication, hi!