Caring for hunger strikers is a medical mission

Friday, July 20, 2007

Caring for hunger strikers is a medical mission

By Army Spc. Shanita Simmons JTF-GTMO Public Affairs Office

Hunger strikes have been a part of Joint Task Force-Guantanamo’s history since the fi rst detainees arrived in early 2002. Public interest has ebbed and fl owed with the numbers of participants, publicity efforts of external organizations and subsequent media coverage. Despite all that, a dedicated team of doctors, nurses and corpsmen have tended to the striking population, everyday, safely and humanely.

In his final days of an 18-month tour, Navy Capt. Ronald L. Sollock, outgoing commanding offi cer of the Naval Station Guantanamo Hospital and head the JTF Joint Medical Group (JMG), addressed the care his team of medical professionals provide to the striking population.

Sollock said that JMG medical providers exercise the skills, training and commitment necessary to render effective care to each detainee. He emphasized their use of clinically appropriate medical interventions to ensure safe and humane care of detainees that elect to hunger strike.

“We respect preserving the life of everyone that we are charged to take care of as a medical staff,” said Sollock.

To that end, the medical staff uses a DoD-approved Standard Operating Procedure that outlines medical indications directing when to intervene to preserve life and health. Those same indications are followed by the U.S. Department of Justice, Bureau of Prisons.

Sollock said that it is necessary to have procedures in writing that clearly defi ne the profi le of a hunger striker and provide indicators to help guide the treatment decision-making process. Having the SOP also provides a clinically appropriate rationale to those who question why one detainee is receiving involuntary feeding while another with similar symptoms is not.

A hunger striker is defi ned as a detainee who misses nine consecutive meals and demonstrates intent to hunger strike. A detainee is recommended for involuntary feeding only after his baseline body weight has decreased to 85 percent and a medical doctor conducts a thorough medical examination.

Some medical indicators that physicians consider in evaluating hunger strikers for involuntary feeding include the potential for organ damage and neurological problems. Sollock reiterated the fact that detainees are very closely monitored and are only recommended for involuntary feeding when they exhibit these and other medical indicators.

Before administering involuntary feeding, each hunger striker is approached many times and offered a regular meal. All detainees are offered three culturally appropriate meals per day that are nutritionally complete and individually tailored for dietary restrictions that include the following considerations: diabetes, vegetarian diets and beef free, low fat, low sodium and other diets.

When a detainee is declared a hunger striker, they are counseled by both medical and behavioral health professionals on what they are doing and the medical complications that can result from their actions. The involuntary feeding process is thoroughly explained and the detainees are counseled through a language-specific translator to ensure they understand the effects a hunger strike could have on their health.

“Involuntary feeding is not used to break the hunger strike,” said Sollock. “We are using sound medical indicators when necessary to preserve the life and health of detainees. We do not let the detainees get to the point of losing consciousness or becoming comatose to intervene. We will intervene to preserve their health and life before that time.”

According to the Manchester Document which lays out tactics and training objectives for al Qaeda recruits, hunger strikes may be used to attract media attention to their detention.

Sollock emphasized that regardless of motivation and increases or decreases in the number of detainees actively on hunger strike, JMG staff are dedicated to delivering clinically appropriate medical intervention that has at its core an absolute commitment to preventing unnecessary loss of life through the provision of safe and humane care.