(This diary is concerned with current happenings in the US Military Detention Centre in Guantanamo Bay. It contains graphical description of treatment and it is strongly advised that this is not a diary for those who no longer feel able to bear the weight of events happening in our name)
The United States and Iran have an expression of public opinion that they share in common. It is one that still causes considerable distress to the majority of British.
In 1997, the people of Hartford, Connecticut, dedicated a monument to Bobby Sands and the other Irish Republican Army hunger strikers. The monument stands in a traffic circle known as "Bobby Sands Circle", at the bottom of Maple Avenue near Goodwin Park. The Iranian government named a street in Tehran after Bobby Sands. (It was formerly Winston Churchill Street.) It runs alongside the British embassy
I will presume that this part of the history of Northern Ireland involving the death through a hunger strike of the IRA detainee is known to most readers For those who aren't aware of it, a brief summary is given by the Cain Institute.
(In parenthesis. I need to say that I do not want to re-awaken the deep hurt of such recent events that is still keenly felt on both sides of the Atlantic. The deaths of Bobby Sands and his nine colleagues were some of the many, many tragic consequences of the troubles. I pay my respect to him and his dedication to his convictions now, although I cannot accept his support of violence in response to the wrong doings of an evil that he saw as being perpetrated by the British government. Yet I must accord him this respect, because there is an aspect of the treatment of these prisoners to which I have to refer and that stands in stark contrast to what is happening at Guantanamo Bay and which I need to address in this diary.)
I want to discuss the aspect of force feeding that is taking place now in your prisons. Before doing so, I want to step back in time. Step back quite a few years in terms of my own history and a bit, but not that much because of my age, further back in terms of the history of my country.
I first became aware of the question of force feeding through an excellent BBC docudrama many years ago about suffragettes, the women who employed civil disobedience in the UK from 1900 to 1920 in order to achieve the vote for themselves.
Many were imprisoned and used hunger strikes to further their cause. The authorities could not let these women, many of whom were connected to leading families in the country, die and becoming martyrs. They were forcibly fed.
The BBC did not hide what this meant in their dramatisation of the events. They showed the women being bound to chairs, their heads pulled back by their hair and the rough handed prison warders thrusting the large diameter rubber tubes down their throats and pouring the mixture in through a funnel.
I must ask you to sense the feeling of horror, the ugliness of the abuse, your mouth being forced open, the taste of that tube and the abomination of the act. I must ask it only so that you take what follows as seriously as you take all other acts now being done in our name. For surely we have become so immured to these atrocities that our newspapers can discuss them calmly and objectively. You cannot be objective about these horrors any more than you can calmly debate in Congress where and when torture might be acceptable.
Yet what follows is not classified as torture. It is "prisoner welfare"
Constance Lytton was force-fed in October 1909. An account of her experiences was included in her book Prison and Prisoners.
Two of the wardresses took hold of my arms, one held my head and one my feet. The doctor leant on my knees as he stooped over my chest to get at my mouth. I shut my mouth and clenched my teeth... The doctor seemed annoyed at my resistance and he broke into a temper as he pried my teeth with the steel implement. The pain was intense and at last I must have given way, for he got the gap between my teeth, when he proceeded to turn it until my jaws were fastened wide apart. Then he put down my throat a tube, which seemed to me much too wide and something like four feet in length. I choked the moment it touched my throat. Then the food was poured in quickly; it made me sick a few seconds after it was down. I was sick all over the doctor and wardresses. As the doctor left he gave me a slap on the cheek. Presently the wardresses left me. Before long I heard the sounds of the forced feeding in the next cell to mine. It was almost more than I could bear, it was Elsie Howley. When the ghastly process was over and all quiet. I tapped on the wall and called out at the top of my voice. 'No Surrender', and then came the answer in Elsie's voice, 'No Surrender'.
As I shall explain is happening now in Guantanamo Bay, nasal insertion was also employed:
Mary Leigh, a member of the WSPU was forced-fed in September, 1909.
On Saturday afternoon the wardress forced me onto the bed and two doctors came in. While I was held down a nasal tube was inserted. It is two yards long, with a funnel at the end; there is a glass junction in the middle to see if the liquid is passing. The end is put up the right and left nostril on alternative days. The sensation is most painful - the drums of the ears seem to be bursting and there is a horrible pain in the throat and the breast. The tube is pushed down 20 inches. I am on the bed pinned down by wardresses, one doctor holds the funnel end, and the other doctor forces the other end up the nostrils. The one holding the funnel end pours the liquid down - about a pint of milk... egg and milk is sometimes used.
Emmeline Pankhurst, who was now in her fifties, endured ten of these hunger-strikes. Kitty Marion endured 200 force-feedings in prison while on hunger strike. Emmeline Pankhurst's sister, Mary Clarke was taken ill at her home in Brighton and died soon after being released of a broken blood vessel, probably as a result of being forced fed in Holloway prison.
In Parliament Keir Hardy, one of the founders of the Labour Party, said
"In reply to a question of mine today, Mr. Masterman, speaking on behalf of the Home Secretary, admitted that some of the nine prisoners now in Winston Green Gaol, Birmingham, had been subjected to "hospital treatment", and admitted that this euphemism meant administering food by force. The process employed was the insertion of a tube down the throat into the stomach and pumping the food down. To do this, I am advised, a gag has to be used to keep the mouth open.
That there is difference of opinion concerning the horrible brutality of this proceeding? Women worn and weak by hunger, are seized upon, held down by brute force, gagged, a tube inserted down the throat, and food poured or pumped into the stomach. Let British men think over the spectacle."
In 1913 the British Government sought a better way to treat such prisoners. The Prisoner's Temporary Discharge of Ill Health Act came into force. Suffragettes were now allowed to go on hunger strike but as soon as they became ill they were released. Once the women had recovered, the police re-arrested them and returned them to prison where they completed their sentences. This successful means of dealing with hunger strikes became known as the Cat and Mouse Act.
Now step forward in time to the 1980's. Prisoners detained for terrorism in Northern Ireland were undertaking hunger strikes in support of demands that were unacceptable to British public opinion. In words so terribly familiar today, the Cat and Mouse Act could not be employed on the grounds that you could not allow alleged IRA gunmen loose on the streets. At the same time, the British government could not countenance creating martyrs by letting them die.
In the UK, the arguments came to a head in the 1970s when two Irish prisoners, the Price sisters, legally challenged the Home Office's right to force-feed in any case other than where refusal of food arose from a medical or psychiatric condition. It caused a furore and the prison policy of involuntary feeding that earlier IRA prisoners had experienced was overturned. In 1981, the wishes of hunger strikers were respected and doctors supervised death-fasts in Northern Ireland. As a result came the death of Bobby Sands. The policy was subsequently refined so, when prisoners became so weak that they could no longer communicate effectively, the prisoner's priest met with family members so that a final decision on intervention could be taken.
The hunger strikes came to an end, in part because of the realisation that each of the families of the strikers would ask for medical intervention whenever the strikers lapsed into unconsciousness. At the same time, on 6 October 1981, James Prior, then Secretary of State for Northern Ireland, announced a series of measures which went a long way to meeting many aspects of the prisoners' five demands.
I make no apologies for the length of this history, not least because its relevance to Guantanamo Bay will become clear.
I am grateful to the New York Times a few days ago for the following information:
United States military authorities have taken tougher measures to force-feed detainees engaged in hunger strikes at Guantánamo Bay, Cuba, after concluding that some were determined to commit suicide to protest their indefinite confinement, military officials have said.
In recent weeks, the officials said, guards have begun strapping recalcitrant detainees into "restraint chairs," sometimes for hours a day, to feed them through tubes and prevent them from deliberately vomiting afterward.
The report goes on to say:
Some officials said the new actions reflected concern at Guantánamo and the Pentagon that the protests were becoming difficult to control and that the death of one or more prisoners could intensify international criticism of the detention center.
Colonel Martin said force-feeding was carried out "in a humane and compassionate manner" and only when necessary to keep the prisoners alive. H e said in a statement that "a restraint system to aid detainee feeding" was being used but refused to answer questions about the restraint chairs.
The NYT quotes lawyers representing six of the prisoners:
"It is clear that the government has ended the hunger strike through the use of force and through the most brutal and inhumane types of treatment," said Thomas B. Wilner, a lawyer at Shearman & Sterling in Washington, who last week visited the six Kuwaiti detainees he represents. "It is a disgrace."
The extent of this is indicated in the article:
The Guantánamo prison, which is holding some 500 detainees, has been beset by periodic hunger strikes almost since it was established in January 2002 to hold foreign terror suspects. At least one detainee who went on a prolonged hunger strike was involuntarily fed through a nasal tube in 2002, military officials said.
Since last year, the protests have intensified, a sign of what defense lawyers say is the growing desperation of the detainees. In a study released yesterday, two of those lawyers said Pentagon documents indicated that the military had determined that only 45 percent of the detainees had committed some hostile act against the United States or its allies and that only 8 percent were fighters for Al Qaeda.
These words are chilling: "This is just a reality of long-term detention," a Pentagon official said. "It doesn't matter whether you're at Leavenworth or some other military prison. You are going to have to deal with this kind of thing."
We do not know the exact methods adopted to force feed these prisoners, not least because the Pentagon is reluctant to go into details or is conflicting in some of its statements:
Until yesterday, Guantánamo officials had acknowledged only having forcibly restrained detainees to feed them a handful of times. In those cases, the officials said, doctors had restrained detainees on hospital beds using Velcro straps.
Two military officials, who insisted on anonymity because they were not authorized to discuss the question, said that the use of restraint chairs started after it was found that some hunger strikers were deliberately vomiting in their cells after having been tube-fed and that their health was growing precarious.
In a telephone interview yesterday, the manufacturer of the so-called Emergency Restraint Chair, Tom Hogan, said his small Iowa company shipped five $1,150 chairs to Guantánamo on Dec. 5 and 20 additional chairs on Jan. 10, using a military postal address in Virginia. Mr. Hogan said the chairs were typically used in jails, prisons and psychiatric hospitals to deal with violent inmates or patients.
In the absence of better information our sources can only be those quoted in the NYT:
...a Kuwaiti detainee, Fawzi al-Odah, told [his lawyer] last week that around Dec. 20, guards began taking away items like shoes, towels and blankets from the hunger strikers.
Mr. Odah also said that lozenges that had been distributed to soothe the hunger strikers' throats had disappeared and that the liquid formula they were given was mixed with other ingredients to cause diarrhea, Mr. Wilner said.
On Jan. 9, Mr. Odah told his lawyers, an officer read him what he described as an order from the Guantánamo commander, Brig. Gen. Jay W. Hood of the Army, saying hunger strikers who refused to drink their liquid formula voluntarily would be strapped into metal chairs and tube-fed.
Mr. Odah said he heard "screams of pain" from a hunger striker in the next cell as a thick tube was inserted into his nose. At the other detainee's urging, Mr. Odah told his lawyers that he planned to end his hunger strike the next day.
This has echoes in the words of one of those IRA prisoners in Northern Ireland, before the British government was made to face its inhumanity in 1981. Sinn Féin's Gerry Kelly in an interview with the North Belfast Newsin 2004 said:
"They press their knuckles into your jaws and press in hard. The way they finally did force feed me was getting forceps and running them up and down my gums," he said.
"I opened my mouth, but I was able to resist after that," said the Sinn Féin man in the interview.
"Then they tried - there's a part of your nose, like a membrane and it's very tender - and they started on that. It's hard to describe the pain. It's like someone pushing a knitting needle into the side of your eye. As soon as I opened my mouth they put in this wooden bit with a hole in the middle for the tube. They rammed it between my teeth and then tied it with cord around my head.
"Then they got paraffin and forced it down the tube. The danger is that every time it happens you think you're going to die. The only things that move are your eyes.
"They get a funnel and put the stuff down."
The NYT quotes a government official:"There is a moral question," the assistant secretary of defense for health affairs, Dr. William Winkenwerder Jr., said in an interview. "Do you allow a person to commit suicide? Or do you take steps to protect their health and preserve their life?"
There is indeed a moral question and it is one that the international community has answered and it reaches very different conclusions from that apparently reached by the United States.
The World Medical Association, which includes support from the British Medical Association, has deemed the involuntary feeding of hunger strikers as coercive and provides an alternative route. Their statement, adopted by the 43rd World Medical Assembly Malta, November 1991 and editorially revised at the 44th World Medical Assembly Marbella, Spain, September 1992 can be read here. I give the preamble in full:
1. The doctor treating hunger strikers is faced with the following conflicting values:
a. There is a moral obligation on every human being to respect the sanctity of life. This is especially evident in the case of a doctor, who exercises his skills to save life and also acts in the best interests of his patients (Beneficence).
b. It is the duty of the doctor to respect the autonomy which the patient has over his person. A doctor requires informed consent from his patients before applying any of his skills to assist them, unless emergency circumstances have arisen in which case the doctor has to act in what is perceived to be the patient's best interests.
2. This conflict is apparent where a hunger striker who has issued clear instructions not to be resuscitated lapses into a coma and is about to die. Moral obligation urges the doctor to resuscitate the patient even though it is against the patient's wishes. On the other hand, duty urges the doctor to respect the autonomy of the patient.
in favour of intervention may undermine the autonomy which the patient has over himself.
b. Ruling in favour of non-intervention may result in a doctor having to face the tragedy of an avoidable death.
3. A doctor/patient relationship is said to be in existence whenever a doctor is duty bound, by virtue of his obligation to the patient, to apply his skills to any person, be it in the form of advice or treatment.
This relationship can exist in spite of the fact that the patient might not consent to certain forms of treatment or intervention.
Once the doctor agrees to attend to a hunger striker, that person becomes the doctor's patient. This has all the implication and responsibilities inherent in the doctor/patient relationship, including consent and confidentiality.
4. The ultimate decision on intervention or non-intervention should be left with the individual doctor without the intervention of third parties whose primary interest is not the patient's welfare. However, the doctor should clearly state to the patient whether or not he is able to accept the patient's decision to refuse treatment or, in case of coma, artificial feeding, thereby risking death. If the doctor cannot accept the patient's decision to refuse such aid, the patient would then be entitled to be attended by another physician.
Throughout this lengthy diary, I have asked the reader to be patient with the detail that has been provided. The excellent New York Times report came and went with little remark. The treatment of prisoners on hunger strike by forcible feeding continues.
Somehow, I have needed to show that "saving" prisoners from their hunger strike is a deceptive distortion of a cruel and unacceptable coercion that needs our urgent attention to bring to an immediate end.
If we dare not allow prisoners to seek death as a means of escaping their circumstance or because they want to make martyrs of themselves, and yet we cannot meet any of their demands for the promise of a fair trial and some relief from their seemingly endless imprisonment, why cannot we follow the procedures demanded by the World Medical Association? If this is not acceptable, why cannot we adopt the British measures in Northern Ireland which respected prisoners wishes up until the point that one is able then to involve Imams and families in the decision-making regarding medical intervention?
Our answer at the moment is to revert to a practice that was discredited as cruel and barbaric a hundred years ago.
I am asking Kossacks to please show the mercy to these people that seems absent in our lawmakers and bring this issue to the attention of Congress through your representatives. I shall be doing so in the United Kingdom. Perhaps our Canadian friends can also raise questions on this treatment of detainees with representatives of their own government to increase international pressure?
(Cross posted from ePluribus Media)