Friday, June 19, 2009

Force-Feeding at Guantanamo

In the July 2009 issue of Harper’s Magazine, Luke Mitchell proclaims that the force-feeding of detainees in Guantanamo who go on hunger strike indicates that, in spite of changes promised by the Obama administration, the U.S still tortures. He writes that “we still use a series of punishments and interrogation techniques – touch and ‘no touch’ – that any normal person would acknowledge to be torture,” and that “when those men protest such treatment by refusing to eat, we strap them to chairs and force food down their throats.” Finally, “we know all of this because it is well documented, not just by reporters and activists but by the torturers themselves.[1]

Claims of abuse by detainees, attorneys, and activists are nothing new, and indeed have been standard operating procedure for detainees since the opening of Guantanamo. What is apparently novel in Mitchell’s analysis is the claim that the U.S. government, under the leadership of the Obama administration, condones the continued abuse of current detainees simply by playing semantics. Mitchell explains:


As we learned from the Office of Legal Counsel memos, it is possible to parse “torture” to a considerable degree. What is the allowable incline for a waterboard? How many calories will suffice to avoid starvation? Which insects are permitted to be used in driving a man insane? The correct answer, according to those who parse, is the difference between a war crime and a heroic act of patriotism.


The OLC memos have been discredited but not the thinking behind them. We are still parsing, still weighing, still considering the possibilities. Whereas once we understood torture to be forbidden – something to be hidden and denied – now we understand it to be “complex.” We are instrumental in our analysis, and that instrumentality is held to be a virtue. We don’t torture not because it is illegal or immoral or repugnant to democracy but because “it doesn’t work,” leaving the way clear to torture that does “work.”[2]

According to Mitchell, a line has been drawn between torture and otherwise permissive practices, where the dividing line is drawn between what does and does not work. What is deemed “instrumental,” however, is the result of “complex” analysis, with the upshot that certain practices that should be labeled as criminal are not: “[w]hat was once a crime becomes a sensible approach to law enforcement. And in becoming sensible it also becomes invisible.”[3] Mitchell cites “our evolving understanding of force-feeding” as an example “that most clearly demonstrates this process of inversion and invisibility…because it has been so completely mainstreamed.”[4]


Mitchell does not, however, present an alternative analysis to make more precise what should be considered torture. He seems to want us to take an intuitive approach. If it looks like torture, it is. But even Mitchell writes that “[f]orcing a man to drink a diet shake may seem like a minor affront, far removed from the rack or even from waterboarding.”[5] So Mitchell, like many critics of Guantanamo, is left to take detainees at their word that they have been unconscionably abused and tortured, giving short shrift to the notion that many detainees have been trained or otherwise coached by camp leaders to concoct fabricated claims of abuse while held by “infidel” authorities.


This is not an unfamiliar approach. British historian Andy Worthington, among the most vocal and prolific critics of Guantanamo and author of The Guantanamo Files, published in 2007, refers to a “document that the US administration has persistently used to justify its harsh treatment of prisoners: the so-called ‘Manchester Manual.’”[6] This manual “provided details of all aspects of terrorist training and operations, and included key passages dealing with conduct after arrest.”[7] Worthington continues:

If captured, prisoners were urged to remain silent or to tell false or confusing stories, and, if given the opportunity, they were also encouraged to ‘complain of mistreatment while in prison’ and ‘to insist on proving that torture was inflicted on them.’ In the ‘War on Terror,’ the manual’s use has been two-fold: first , it has convinced the [Bush] administration to behave like the witch hunters of the seventeenth century, treating every single claim of innocence as a lesson learned from the manual, and second, it has been used to refute all claims of torture.[8]

Worthington does not mention that the declassified files on detainees include declarations of innocence by the detainees without any judgment of whether or not such declarations are true. The merits of detainee assertions aside, however, it appears that Worthington, and now Mitchell, are happy to invert the process and simply take self-interested detainees at their word. They unquestionably treat many, if not most, claims of innocence and abuse as true, and seemingly dismiss out of hand any claim that detainees may be disingenuous or flat out lying. For example, Mitchell simply quotes detainee testimony from Red Cross interviews published in The New York Review of Books in which force-feeding is described as “traumatizing.”[9]


But there is reason to be skeptical of what detainees say given abundant evidence that detainees manipulate the perceptions of the public with the help of defense attorneys and the media while rankling commanders, soldiers, and medical personnel charged with supervising their detention and medical treatment while in Guantanamo. Lt. Col. Gordon Cucullu, author of Inside Gitmo: the True Story behind the Myths of Guantanamo Bay, recounts that one hospital corpsman he interviewed said that if hospital personnel did not comply with requests “they would say that they were going to tell their brothers that we de faced the Koran and start an incident. So we gave them what they wanted.” One such request was to feed them 1,000 calories per day, an amount sufficient “to keep them alive but looking wan.”[10] According to Paul Rester, director of the Joint Intelligence Group at Guantanamo, also interviewed by Cucullu:

The hunger striking population will pick up when they know the time for attorney visits is getting close…That way they’ll look really awful when the attorneys are here – and some media is around. Once the lawyers leave then they’ll start eating again.[11]


Cucullu’s book is the result of “numerous visits to the detention facility at Guantanamo” in which he “interviewed scores of military and civilians serving there, men and women of all specialties, ranging in rank from flag officer to private first class.”[12] His visits were “over the course of several years” and involved a regiment in which he “toured every camp and facility associated with detainee support, walked almost every square yard of the blocks, ate the same food that was served to detainees, observed interrogations, and walked through Camp IV the day after the May 2006 riots.”[13] Here is what Cucullu learned about the initial testing and ultimate application of the force-feeding technique:


All hunger strikers are clinically stable and receive excellent medical care. Initially they were fed by a nasogastric tube that is soft, flexible, and only four millimeters in diameter. That narrow tube has since been replaced by an even smaller-diameter tube of three millimeters. This is very small and comfortable. It is an apparatus commonly used in American hospitals. Of interesting note is that in the U.S. federal prison system – which has developed settled policies and procedures for addressing hunger strikes – a slightly larger tube is standard use. A lubricant with a mild painkiller in it is used to reduce any discomfort.[14]

Detainees are fed twice daily only if they refuse a standard meal that is always offered first. They will remain in the chair if considered a purge risk just long enough to digest the food. In order to test the system shortly after his arrival in spring 2006, Admiral Harris directed that medical personnel set him up with a tube feeding exactly as they do a hunger-striking detainee. He went through the entire process, including actually being given liquid nourishment, without discomfort.
[15]

Based on Cucullu’s findings, an intuitive assessment might suggest that U.S. personnel are clinically careful and humane in their application of the force-feeding technique. In fact, Cucullu writes that, when many detainees were on strike in the fall of 2005, detainees could even expect to get a “foot rub”:


The hospital was quickly becoming overworked, as were the escort teams required to move striking detainees to and fro for their twice daily feedings, weigh-in, and medical evaluation. “They get to where they knew it was wearing us down,” an Army major in the JDG said. “It had turned into a game with them and they were winning. They got to go to the air-conditioned hospital for a few hours, hang out with the brothers and talk all they wanted, get a feeding, and have their feet rubbed. Not a bad deal.”

What’s with the foot rub? “Hunger striking leads to poor circulation in the extremities. So the nurses and female corpsmen rub their feet.”
[16]

Nevertheless, Mr. Mitchell insists that force-feeding is abusive if only because the U.S government employs the technique to suppress legitimate resistance. In particular, Mr. Mitchell takes issue with the practice of strapping detainees to chairs, describing the practice as “a method of…preventing [detainees] from registering protest at the injustice of their condition.”[17] Noting that at least 30 men are currently on hunger strike, he writes:

Most of these prisoners are not facing imminent death. In fact, force-feeding is itself a risky “treatment” that can cause infections, gastrointestinal disorders, and other complications. The feedings begin very soon after prisoners begin a hunger strike, and continue daily – with military guards strapping them to restraint chairs, usually for several hours at a time – until the prisoners agree to end the strike. This hunger striker is not an emaciated Bobby Sands lying near death after many weeks of starvation. He is a strong man bound to a chair and covered in his own vomit.[18]

Indeed, most are not facing imminent death, and this fact has lead Mitchell to address elsewhere the claim that strapping down prisoners is necessary to protect medical personnel by pointing out a putative logical quandary:


If the prisoners are in danger of imminent death, one must assume that, by definition, they would lack the strength to present a threat to medical or military personnel. And yet if they are in fact strong enough to present a threat to medical or military personnel, then the claim of “imminent death” no longer carries legal or ethical relevance.[19]

But Cucullu explains that the issue is more than academic:

Detainees brought into the hospital were shackled to the beds with two-point restraints. Shackling detainees alleviated concerns about a detainee using on-hand equipment to injure medical staff or attempt an escape. Then the detainee would moan about the pain in a foot or hand and ask that the restraints be loosened. Often sympathetic medics would comply with the request.

On one such occasion, while being treated by a female nurse, a detainee with no provocation drew back and punched her so hard that her nose was broken and splashed across her face. Blood spattered profusely. She withdrew to get medical attention herself. Meanwhile the detainee loudly complained for his clothing and sheet to be changed. “The infidel whore’s blood has defiled me,” he shouted. “Change my clothes!”
[20]

Indeed, detainees in Guantanamo should not be mistaken for modern-day Ghandis engaging in non-violent protest. The fall 2005 hunger strikes put severe capacity strains on hospital staff.[21] In the wake of these strikes, according to Cucullu, “[i]ncidents of detainees striking or clawing nurses and corpsmen rose sharply, due in part to a failure to restrain the patients properly.”[22] Some detainees “were moved into the newly constructed mental health facility for feeding due to overcrowding at the hospital,” and “[a]ngry incidents rose to a peak and culminated with two detainee uprisings in the mental health area.”[23] According to a medic:

They tore out the IV bottles, swung the poles like clubs, ripped up the cots, and threw everything they could at us….Finally the guards came in with an ERF [emergency response force] team and quieted them down.[24]



Mitchell may dismiss such instances of violence as manifestations of detainee frustration with “unjust” detention. But there is reason to believe he is naïve to do so. For example, detainees have been quite successful in organizing resistance efforts not so graphically violent (to say nothing of verbal insults hurled at military personnel, such as “shitheads, niggers, fucking donkeys”) but nonetheless disruptive and indicative of deliberate planning. [25] While Mitchell writes sympathetically of detainees “covered in [their] own vomit,” Cucullu notes that “[s]ome of the hard-core detainees had gamed the system and began to vomit up the liquid – ‘purging,’ the medics called it. Others figured that if left alone for a few minutes they could suck on the NG tubes and siphon the liquid back out of their systems.”[26] It was then that Joint Detention Group commander Colonel Michael Bumgarner ordered special restraint chairs from the U.S.[27] Moreover, military and medical personnel have grown accustomed to resistance efforts that involve teams of detainees who coordinate to disrupt the aplomb of command personnel. According to an Army major:


It was highly organized….They would designate 10 guys to go on a hunger strike for a week. After it was over most would come back to eat. Some of the guys would say ‘I can hang in a few days more,’ and the leaders would tell them to ‘go for it.’ You could see them rotating teams in and out. Sometimes they’d eat for a few days, then go back. It was all designed to jerk us around.[28]


Mr. Mitchell has heard this sort of claim before and seems to think it strange. He writes: “[Pentagon spokesperson Cyntia] Smith went on to note that some strikers may be protesting because they feel pressured to do so by other prisoners. In such cases, force-feeding was a way to help them resist that pressure. This was a strange argument. Given that the prisoners are separated from one another and are under constant surveillance, such pressure could come only in the form of appeals to conscience.”[29] But it is not strange at all. Apparently, Mitchell is unaware of the subtle means of covert communication employed by detainees to organize resistance efforts and undermine the system of detention and interrogation.



There are multiple camps for holding detainees in Guantanamo, some of which are designed as maximum-security camps with no communal living and others (e.g. Camp IV) which are designed, according to Cucullu, for compliant detainees who are allowed “to wear white or beige clothing, live in 10-man communal facilities, and have a great deal of outside recreation time.”[30] According to Cucullu, almost 90 percent of the population wears white or beige clothing and lives communally.[31] Nonetheless, construction of new camps has been ongoing at Guantanamo, in part to reduce detainee movement among camps. Camp V was constructed based on lessons learned from U.S. prisons, but critics of Guantanamo have cited Camp V as an example of how detainees are held in isolation in Guantanamo.[32] Cucullu points out that while prisoners are indeed segregated, they are not isolated:


They see other detainees, and are permitted to converse across the hall and from cell to cell. “They talk to each other all the time,” [Sergeant First Class Allen] Rich noted, “and, of course, we don’t interfere with that.” It was reported that in Camp V, detainees also will yell into the toilet piping to communicate with their fellows.[33]


In addition, detainees have devised creative means of covert communications. Many detainees in a leadership role advise younger, less senior detainees to deliberately violate rules to be sent into different camps, or to the hospital wing, as a way to send messages to other detainees. According to SFC Rich:


I call a couple of them ‘Heavies’….They don’t ever get involved in assaults themselves but they have enough authority to tell other, younger ones what to do. Sometimes they’ll have one of these guys assault us to get moved to discipline block or to fake being sick to get over to the hospital. That’s how they communicate and pass messages back and forth.[34]


At a cost of $37 million, Camp VI is “designed as a communal facility in which maximum recreation time, co-mingling, and socialization among detainees was permitted.”[35] It “has eight separate pods surrounding common areas,” in which “[e]ach pod is two-story, with a high ceilinged, roughly circular interior, and contains 22 individual cells plus a common area.” Moreover, “[p]od interior space is very open and well lit, with both skylights and protected fluorescent lighting,” and “[c]ells have protected fluorescent lighting and are painted a light, neutral color.” Individual cells are “6 feet, 8 inches in width by 12 feet in depth, for an 81-square-foot capacity.” Both Camps V and VI meet or exceed the American Correctional Association standards of 80 square feet space per cell.[36] Camps V and VI have been constructed with full on-site dental and medical support facilities, interrogation rooms, and meeting rooms for attorneys and detainees, in an attempt to reduce detainee movement:

Why is this detainee movement reduction so important? In a large percentage of the cases, movement facilitated communications between camps and among detainees. Common areas like the detainee dispensary and the detainee hospital were favorite meeting places to exchange camp-to-camp information. The medical personnel were told not to refuse a detainee the right to go on sick call, so the local camp or block leader might designate one to complain of stomach cramps and diarrhea that day or to wake up with a headache. Once at the hospital, he could converse with fellow detainees, trade news and information, and pass along instructions. Many think that orders to engage in hunger strikes, to act hostile toward guards, or other instructions were commonly passed by this method.[37]

In his dismissal of Pentagon remarks that hunger strikers may feel pressure from camp leaders, Mitchell is apparently unaware of, or ignores, evidence of covert communication among detainees. Perhaps he is naïve, or too wedded to his cause. In either case, his apparent ignorance is reflected throughout his analysis, which rests primarily on the presumption that detainees are abused innocents telling the truth, and that government explanations of its conduct are little more than nefarious cover-ups.


Like detainees, military and medical personnel serving in Guantanamo have every incentive to describe their role in the best light possible. Perhaps it is impossible for us to go beyond “he said, she said” unless we visit the facilities ourselves or serve time in a support role to see for ourselves what goes on. However, let us at least acknowledge that Mitchell’s analysis, as it stands, takes for granted the veracity of statements and descriptions by detainees and their advocates. In so doing, he ignores a great deal of evidence that detainees wage asymmetrical warfare with a simple game of deception.

[1] Luke Mitchell, “We Still Torture: The new evidence from Guantanamo” (“Mitchell Critique”), Harper’s Magazine, July 2009, p. 50.
[2] Mitchell Critique, p. 51.
[3] Mitchell Critique, p. 51.
[4] Mitchell Critique, p. 51.
[5] Mitchell Critique, p. 53.
[6] Andy Worthington, The Guantanamo Files: The Stories of the 774 Detainees in America’s Illegal Prison (“The Guantanamo Files”) (London: Pluto Press, 2007), 94.
[7] The Guantanamo Files, p. 94.
[8] The Guantanamo Files, p. 94.
[9] Mitchell Critique, p. 53.
[10] Lt. Col. Gordon Cucullu, Inside Gitmo: The True Story behind the Myths of Guantanamo Bay (“Inside Gitmo”), (New York: HarperCollins, 2009), p. 185.
[11] Inside Gitmo, p. 185.
[12] Inside Gitmo, p. xxx.
[13] Inside Gitmo, p. xxx.
[14] Inside Gitmo, pp. 188-89.
[15] Inside Gitmo, p. 189.
[16] Inside Gitmo, p. 186.
[17] Mitchell Critique, p. 54.
[18] Mitchell Critique, p. 52.
[19] Luke Mitchell, “Six Questions for Cynthia Smith on the Legality of Force-Feeding at Guantanamo,” Harper’s Magazine, June 4, 2009, http://www.harpers.org/archive/2009/06/hbc-90005110.
[20] Inside Gitmo, pp. 158-59.
[21] Inside Gitmo, p. 185.
[22] Inside Gitmo, p. 186.
[23] Inside Gitmo, p. 186.
[24] Inside Gitmo, p. 186.
[25] Inside Gitmo, p. 96.
[26] Mitchell Critique, p. 52. Inside Gitmo, p. 187.
[27] Inside Gitmo, p. 187.
[28] Inside Gitmo, p. 186.
[29] Mitchell Critique, p. 54.
[30] Inside Gitmo, p. 94.
[31] Inside Gitmo, p. 95.
[32] Inside Gitmo, pp. 120, 125.
[33] Inside Gitmo, p. 125.
[34] Inside Gitmo, p. 125-26.
[35] Inside Gitmo, p. 129.
[36] Inside Gitmo, p. 129.
[37] Inside Gitmo, p. 133.