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Inside Guantanamo’s Force-Feeding Quagmire

Dozens of hunger strikers at Guantánamo Bay are being kept alive with a painful, ethically questionable, and politically sensitive medical procedure.

Nicholas Kamm/AFP/Getty,NICHOLAS KAMM

With the White House’s appointment of Clifford Sloan to head the Office of Guantánamo Closure, many hope that the end one of the darker chapters in American history is finally near.

David Remes, a human-rights lawyer representing 18 detainees at Guantánamo, says that hope is a false one. “President Obama is marvelous at giving the impression of movement even while he’s standing still,” he says of the decision to appoint Sloan. The memory of a phone call from one of his clients, the newest addition to the force-fed list, is still fresh in his mind.

“I was so afraid,” Abdalmalik Wahab a resident of Guantánamo since 2002 and one of the 104 prisoners there currently on a hunger strike, told Remes of the moment before he was force-fed for the first time last week. Down to 129 pounds from 195, Wahab—a native of Yemen who has never been to trial—was admitted to the hospital in Gitmo after losing consciousness. When he awoke, he told Remes, doctors gave him two options: drink a bottle of Ensure or be force-fed. Hoping to keep his story, and that of the other hunger strikers, in the national spotlight, he refused to eat.

He was quickly transported by wheelchair (he’s too weak to walk) to what’s known as the feeding block. Strapped into a restraint chair, nurses inserted a feeding tube into his right nostril, Wahab told Remes, neglecting to lubricate the tube or offer anesthesia, as directed in the standard operating procedure.

“They kept asking me to swallow the tube…but it was my first time. It was so difficult,” he told Remes on a rare phone call on June 14. “So much pain.” The removal of the tube turned out to be the worst part—so excruciating that Wahab became convinced they were “sucking out his stomach.” Now, being force-fed twice a day, he is alive—barely. “I’m a skeleton. You can count all of my ribs from 1 meter away,” he told Remes on the same phone call. “Sleeping is hard… because I’m sleeping on my bones.”

Wahab is one of 44 men currently being force-fed at Guantánamo Bay Detention Center. Internally, the procedure is known as “involuntary enteral feeding.” Outside, many consider it torture. “It’s brutal, inhumane, and merciless,” Remes tells me—echoing a sentiment shared by other attorneys representing the detainees.

The medical world has taken issue with the procedure as well. In an April 25 letter to Secretary of Defense Chuck Hagel, the American Medical Association denounced the practice of force-feeding, saying it “violates core ethical values of the medical profession.” Just last week, the New England Journal of Medicine published an article titled Guantanamo Bay: A Medical Ethics–free Zone? In it, the three authors call the situation a “legal black hole.” “Force-feeding a competent person is not the practice of medicine; it is aggravated assault,” they write. In an article published on the Lancet Wednesday, 150 physicians and doctors nationwide asked President Obama to answer the plea from 13 force-fed detainees who are asking for independent medical treatment (they say they are now afraid of the medical staff at Gitmo).

Inside Washington, opinions vary. Last month, a senior physician at Guantánamo dismissed claims that force-feeding is unethical. “This is kind of a tough mission and this is kind of an ugly place sometimes,” the physician, who remained anonymous, told Al Jazeera. The Defense Department has defended the practice, saying its purpose is “to support the preservation of life by appropriate clinical means, in a humane manner.” General John F. Kelly, the chief of the U.S. Southern Command, offered support for the practice after visiting Gitmo last week. “They’re all eating something,” he told reporters, calling the protest a “Hunger Strike Lite.”

Whether it is ethical to perform the procedure under these circumstances remains unclear. But a close examination of the actual practice itself reveals that the writhing, miserable reality of it is virtually undeniable. Here, a step-by-step guide to what force-feeding actually means.