Crosby, Sondra - Interview master file
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Transcript
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| Interviewer | Okay, good morning. | 0:05 |
| - | Good morning. | 0:06 |
| Interviewer | We are very grateful to you | 0:08 |
| for participating in the "Witness to Guantanamo Project." | 0:09 | |
| We invite you to speak of your experiences | 0:13 | |
| and involvement in Guantanamo Bay issues. | 0:15 | |
| We are hoping to provide you with an opportunity | 0:19 | |
| to just tell us your story in your own words, | 0:21 | |
| we are creating an archive of stories so that people | 0:25 | |
| in America and around the world | 0:27 | |
| will have a better opportunity of understanding | 0:30 | |
| what happened in Guantanamo. | 0:32 | |
| And, future generations must know what happened | 0:35 | |
| and by telling us your story, | 0:40 | |
| you're contributing to history. | 0:43 | |
| And we're very grateful for you being with us today, | 0:44 | |
| and if there's any time you wanna take a break, | 0:48 | |
| just let us know. | 0:50 | |
| And if you say something that you wish | 0:51 | |
| you hadn't and you want us to remove it, we can do that, | 0:53 | |
| just let us know that too. | 0:55 | |
| So I'd like to begin by having you tell us your name | 0:57 | |
| and place where you were born and the date of your birth, | 0:59 | |
| and also how old you are now | 1:06 | |
| and then where you're living now. | 1:07 | |
| Just that. | 1:08 | |
| - | All right, my name is Sondra Crosby, I'm a physician, | 1:10 |
| licensed in the Commonwealth of Massachusetts. | 1:14 | |
| I was born in near Seattle, Washington, | 1:16 | |
| grew up in Seattle and- | 1:20 | |
| Interviewer | What year? | 1:22 |
| - | And I was born July 9th, 1959. | 1:24 |
| I'm 56 years old. | 1:27 | |
| Interviewer | And can you tell us | 1:29 |
| a little about your education? | 1:30 | |
| - | I went to medical school | 1:32 |
| at the University of Washington in Seattle. | 1:34 | |
| I did my internal medicine resident training | 1:36 | |
| in Boston at Boston City Hospital. | 1:39 | |
| Interviewer | And what is your expertise at the moment? | 1:42 |
| - | So I am the director of the Immigrant | 1:46 |
| and Refugee Health Program at Boston Medical Center. | 1:49 | |
| And my work primarily focuses on trauma | 1:52 | |
| and care of torture survivors for the past 20 years. | 1:55 | |
| Interviewer | And before we get into Guantanamo | 1:59 |
| how did you get into that particular (indistinct)? | 2:01 | |
| - | That's a great question. | 2:04 |
| I really just evolved into it. | 2:06 | |
| I started as a young faculty member, volunteering | 2:09 | |
| for positions for human rights and got training | 2:14 | |
| doing forensic evaluations, which has just evolved | 2:16 | |
| into academic scholarship over the last 20 years. | 2:21 | |
| Interviewer | And your earliest work, where was that? | 2:23 |
| - | My earliest work was locally | 2:26 |
| in Boston doing forensic evaluations | 2:29 | |
| for people who were applying for political asylum | 2:32 | |
| and alleging torture as a basis for their asylum. | 2:35 | |
| And I have since traveled and done torture evaluations | 2:39 | |
| in Bahrain, Krygyzstan and Tajikistan, Kazakhstan | 2:43 | |
| many African countries and Turkey. | 2:49 | |
| Interviewer | I mean, overall, | 2:53 |
| how do you manage your own life? | 2:55 | |
| How do you cope with seeing that for 20 years? | 2:57 | |
| (indistinct) | 3:01 | |
| - | Yeah, it's, no, it's a great question. | 3:02 |
| And certainly this work takes a toll on people. | 3:05 | |
| And one of the big issues for all of us in this field | 3:07 | |
| is vicarious trauma or secondary trauma. | 3:12 | |
| And it's something that we've all experienced | 3:15 | |
| and have really learned to try to recognize the signs | 3:18 | |
| and symptoms in ourselves and our colleagues | 3:24 | |
| and help and try to support each other. | 3:26 | |
| But it's certainly a looming risk of this work. | 3:29 | |
| - | And if someone acknowledges or notices in you | 3:37 |
| what do they tell you and how do you respond? | 3:41 | |
| - | There've been times where I've said | 3:44 |
| I need to take a break | 3:47 | |
| from seeing torture survivors and doing these evaluations. | 3:49 | |
| So for the next three months | 3:52 | |
| I'm just gonna practice medicine and not do this, | 3:54 | |
| take a vacation and spend more time with my family, | 3:58 | |
| read a novel that has been sitting on the shelf | 4:01 | |
| for two years. | 4:04 | |
| So there are lots of ways for self-help exercise | 4:05 | |
| and also very important is just debriefing with colleagues | 4:10 | |
| and having support groups and having somebody to talk to. | 4:15 | |
| Interviewer | And if you see yourself, | 4:19 |
| I assume you've had nightmares, | 4:21 | |
| and have you had nightmares? | 4:24 | |
| - | I have had nightmares. | 4:25 |
| Interviewer | And is that assign to you | 4:26 |
| that maybe you should back off or is that so common | 4:28 | |
| that it's not? | 4:31 | |
| - | No, no, that definitely is a sign | 4:32 |
| and I pay attention to that. | 4:34 | |
| And that is something that is a topic | 4:36 | |
| of discussion in our support groups. | 4:40 | |
| And I've had colleagues call me up and say, | 4:42 | |
| "Look, I'm having nightmares about this." | 4:44 | |
| And in fact, right now I'm planning with a psychiatrist | 4:48 | |
| who also does this work kinda an intervention, | 4:52 | |
| kinda a workshop intervention for all of us. | 4:55 | |
| So it's an ongoing thing. | 4:59 | |
| Interviewer | A flashback is part of that too, | 5:02 |
| or not as much? | 5:04 | |
| - | No, no, it's mostly, I think in us | 5:05 |
| certainly intrusive thoughts of perhaps things | 5:11 | |
| we've heard are nightmares, occasionally anxiety, agitation. | 5:14 | |
| So kind of you start to recognize those things | 5:21 | |
| in yourself or your family saying | 5:23 | |
| you're just really off the age, you know what's going on. | 5:27 | |
| So it's just important to pay attention | 5:31 | |
| to feedback from people. | 5:34 | |
| Interviewer | And is this work rewarding for you? | 5:36 |
| - | It's absolutely gratifying and rewarding, yes. | 5:39 |
| Interviewer | Why is that? | 5:43 |
| - | It just gives me a very personal sense | 5:47 |
| of gratification to be helping people. | 5:50 | |
| And there's just nothing more joyful | 5:54 | |
| than helping somebody work through their trauma | 5:59 | |
| and come out the other end and be successful. | 6:01 | |
| Interviewer | How many people do you kinda work? | 6:04 |
| How do you know having... | 6:07 | |
| are there many people do you- | 6:10 | |
| - | I think there are across different disciplines, | 6:11 |
| mental health workers, internists, legal advocates, | 6:15 | |
| social workers, I think there are many. | 6:19 | |
| Not so many of us that work with Guantanamo detainees. | 6:23 | |
| Interviewer | And how did you end up | 6:29 |
| working in Guantanamo issues? | 6:29 | |
| - | Well, again, that just evolved. | 6:32 |
| It was not something I saw it. | 6:34 | |
| And, | 6:36 | |
| back in approximately 2005, | 6:39 | |
| a law firm in New York contacted my chairman in Health Law, | 6:42 | |
| Bioethics and Human Rights in the School of Public Health. | 6:47 | |
| Interviewer | His name? | 6:51 |
| - | George Annas, Professor George Annas | 6:52 |
| and asked if he would be willing to look | 6:54 | |
| at some medical records of their client | 6:59 | |
| who at that time was a hunger striker in Guantanamo. | 7:01 | |
| And professor Annas is really a legal expert | 7:03 | |
| on hunger strikes and has been writing about them for years. | 7:08 | |
| So he accepted look at the records | 7:11 | |
| but actually they gave them to me (laughing) | 7:15 | |
| which is how things work in academics. | 7:17 | |
| And they were horrifying. | 7:20 | |
| These were medical records of hunger strikers. | 7:23 | |
| And so we gave the lawyer's feedback | 7:26 | |
| about what we thought were violations | 7:29 | |
| that were being committed based on the medical records. | 7:34 | |
| And eventually about three years later, | 7:38 | |
| I actually made my first trip | 7:42 | |
| to Guantanamo to see a hunger striker. | 7:43 | |
| Interviewer | Could you give us a little background? | 7:46 |
| What made the medical records horrifying? | 7:47 | |
| - | Well, the promise of informed consent | 7:51 |
| for any medical treatment was completely violated. | 7:56 | |
| Medical treatment and force-feeding was being imposed | 8:02 | |
| on people without their consent, but it was also being done | 8:06 | |
| in a brutal way with restraints and forced cell extractions | 8:09 | |
| and painful placement of nasal gastric tubes. | 8:16 | |
| Interviewer | Did you know anything | 8:20 |
| about force-feeding before you were put into this? | 8:22 | |
| - | So my chairman Professor Annas certainly | 8:26 |
| was a legal scholar on force-feeding, but before this, no. | 8:28 | |
| I knew nothing about force-feeding | 8:32 | |
| but I learned very quickly. | 8:33 | |
| Interviewer | And was it horrifying to you | 8:36 |
| from the beginning even though you knew nothing? | 8:37 | |
| It just seemed horrible- | 8:40 | |
| - | It was, I mean, as a physician | 8:40 |
| and an ethicist, I mean, that's just one | 8:45 | |
| of the basic premises of medicine | 8:47 | |
| is informed consent. | 8:49 | |
| Interviewer | And did you know anything | 8:54 |
| about Guantanamo at all before Professor Annas came to you? | 8:55 | |
| - | I certainly I did, | 9:00 |
| but I had not seen medical records | 9:03 | |
| or had been involved in this kind of way before it started. | 9:07 | |
| Interviewer | What was your role | 9:11 |
| in reviewing the medical records? | 9:12 | |
| What do they want from you? | 9:13 | |
| - | What they wanted was an opinion | 9:15 |
| as to were there any violations being committed | 9:18 | |
| against our client in our opinion, | 9:22 | |
| or what was my opinion of the medical care? | 9:24 | |
| They were concerned clearly about the force-feeding. | 9:27 | |
| Interviewer | And when you went to Guantanamo | 9:31 |
| few years later, was it on the same issue or was it? | 9:33 | |
| - | Initially, so I've been to Guantanamo over a dozen times, | 9:37 |
| maybe 15 times. | 9:44 | |
| And my first visit was to see a hunger striker | 9:45 | |
| and to do a medical evaluation. | 9:51 | |
| And also to assess whether or not | 9:55 | |
| I thought the hunger striker had capacity | 9:59 | |
| to make medical decisions. | 10:03 | |
| Whether he was competent to make his own medical decisions. | 10:04 | |
| Interviewer | How long they've been on a hunger strike? | 10:08 |
| - | This first time and I saw had been on a hunger strike | 10:12 |
| at the time, probably for three or four years. | 10:20 | |
| However, by the time he has been transferred | 10:23 | |
| to Saudi Arabia recently. | 10:26 | |
| And so he was on a hunger strike for over eight years. | 10:28 | |
| Interviewer | And what was your sense | 10:32 |
| when you first came to Guantanamo and saw them? | 10:34 | |
| - | Guantanamo is a surreal sort of place (laughing). | 10:40 |
| We like to call it Alice in Wonderland, | 10:43 | |
| you just never know what you're gonna see. | 10:45 | |
| I was actually very impressed with their detainees inside | 10:50 | |
| and knowledge of how his rights had been violated | 10:58 | |
| at Guantanamo. | 11:02 | |
| And as it turns out, the pictures never | 11:03 | |
| completely black and white, | 11:08 | |
| he was not suicidal. | 11:10 | |
| He did not want to die. | 11:11 | |
| He was protesting the conditions at Guantanamo, | 11:13 | |
| his illegal detention | 11:17 | |
| and violation of the Geneva conventions | 11:19 | |
| and it all made sense. | 11:23 | |
| Interviewer | So, maybe I'll back up a little bit | 11:26 |
| since you said that Guantanamo is like Alice in Wonderland, | 11:30 | |
| what was it when you first stepped off a plane? | 11:32 | |
| What did it seem to you? | 11:34 | |
| Why was it so surreal to you when you went to a camp? | 11:36 | |
| I mean, just the whole first impression. | 11:40 | |
| - | The whole first impression was surreal. | 11:42 |
| The camp, | 11:46 | |
| the guards, | 11:53 | |
| the fact that the rules | 11:56 | |
| change on a daily basis, | 11:59 | |
| You just never really know what the rules are that day. | 12:01 | |
| And I think I really felt that sense | 12:04 | |
| of people working in Guantanamo | 12:09 | |
| were all convinced that these men | 12:14 | |
| who were being detained were the worst of the worst. | 12:17 | |
| They were really like Superman and could not like eat | 12:20 | |
| through steel bars and they were just poised to kill you | 12:24 | |
| at any second if you turned your back. | 12:28 | |
| And there was this paranoia | 12:30 | |
| and it just seemed just fantastical. | 12:33 | |
| Interviewer | Were you afraid? | 12:39 |
| - | I was afraid of the guards (laughing) not the detainees. | 12:40 |
| Interviewer | Were you not afraid of detainees, | 12:44 |
| you ever heard that they would eat you alive? | 12:45 | |
| (indistinct) | 12:48 | |
| - | I'm a physician, | 12:50 |
| I've been a physician for a long time. | 12:51 | |
| I've cared for prisoners. | 12:53 | |
| we have... | 12:55 | |
| you just get a sense of your personal safety with somebody. | 12:56 | |
| And I've certainly cared for people | 12:59 | |
| in my hospital that I felt for my personal safety. | 13:01 | |
| And I was glad there was a guard there and shackles. | 13:07 | |
| The man I met in Guantanamo, | 13:11 | |
| I think I was able to establish rapport | 13:14 | |
| and a relationship with, | 13:16 | |
| and they're just... | 13:18 | |
| there was no fear at all. | 13:23 | |
| And so there was just a huge disconnect as- | 13:25 | |
| Interviewer | And so when you first came on your way | 13:32 |
| to Guantanamo you didn't have that fear either. | 13:34 | |
| You didn't expect. | 13:37 | |
| - | I didn't know what to expect. | 13:38 |
| So certainly I was anxious | 13:40 | |
| on that very first time walking | 13:42 | |
| into the meeting room with the first detainee, | 13:44 | |
| I was anxious. | 13:48 | |
| I didn't know what to expect. | 13:49 | |
| Interviewer | And why were you afraid of the guards? | 13:51 |
| - | So, you have a detainee who's been on hunger strike, | 13:56 |
| weighs 90 pounds, using a walker | 14:02 | |
| because he's so weak. | 14:04 | |
| And you have 15 guards, | 14:06 | |
| these big Marines (laughing) around | 14:08 | |
| and they just looked much scarier than this poor detainees. | 14:12 | |
| And they were all convinced | 14:20 | |
| these men were gonna kill them at any second. | 14:23 | |
| Interviewer | And your job there was to write up a report. | 14:29 |
| - | So I've had different jobs there. | 14:33 |
| So initially, the lawyers for this first client, | 14:36 | |
| their client wanted a medical report. | 14:42 | |
| What was this health like? | 14:45 | |
| What was this mental health like? | 14:47 | |
| And were there any recommendations | 14:49 | |
| for managing hunger strikes? | 14:51 | |
| So I've also... | 14:54 | |
| and subsequently I've gone to see other detainees | 14:57 | |
| with slightly different objectives. | 15:00 | |
| Interviewer | Such as? | 15:05 |
| - | So currently I'm on the defense team | 15:05 |
| of one of the high value detainees. | 15:08 | |
| And, although initially I was asked | 15:10 | |
| to do a medical evaluation, | 15:13 | |
| I continue to see him | 15:15 | |
| and actually provide ongoing support and counseling to him. | 15:16 | |
| Interviewer | What does support counseling mean? | 15:21 |
| What does that mean? | 15:24 | |
| Supportive counseling. | 15:25 | |
| - | Supportive counseling, just counseling. | 15:27 |
| So he has somebody to talk to | 15:30 | |
| and I can help him manage | 15:32 | |
| some of his mental health symptoms. | 15:35 | |
| Interviewer | You are training as a psychiatrist too? | 15:39 |
| - | I'm an internist. | 15:43 |
| I do not have formal training in psychiatry | 15:45 | |
| but my medical practice in Boston is 80% torture survivors. | 15:47 | |
| And most of that mental health has done in my clinic | 15:53 | |
| perhaps with the help of a social worker. | 15:56 | |
| So I do a lot of supportive counseling | 15:58 | |
| and direct treatment of PTSD and depression | 16:01 | |
| in my own practice, which is pretty common. | 16:04 | |
| Most mental health is actually done in the states | 16:07 | |
| by internist family practice, adolescent medicine doctors. | 16:12 | |
| Interviewer | And would you say you saw similar symptoms? | 16:17 |
| You said they were slightly different than the work you did | 16:20 | |
| but are there same symptoms throughout | 16:22 | |
| or do you see they're different symptoms | 16:24 | |
| among the men that you work with? | 16:26 | |
| - | I think the men in Guantanamo | 16:29 |
| that I've seen are profoundly damaged. | 16:32 | |
| And I think it's really a level above what I... | 16:36 | |
| it's quite a bit above what I see in my own practice. | 16:39 | |
| And part of that is because the men in Guantanamo | 16:43 | |
| are still continually being traumatized and triggered. | 16:48 | |
| People I see in my practice are primarily, | 16:52 | |
| have escaped their trauma | 16:54 | |
| and are living in a safe and relatively safer environment. | 16:56 | |
| Interviewer | So do you have a different approach | 17:00 |
| in how to counsel these men | 17:03 | |
| if they're continually being damaged? | 17:05 | |
| - | It's difficult. | 17:08 |
| I mean, this is an ongoing problem at Guantanamo, | 17:09 | |
| is that these men are profoundly damaged | 17:14 | |
| to have a lot of mental health symptoms. | 17:18 | |
| There is not adequate ongoing support and treatment | 17:20 | |
| from Guantanamo. | 17:24 | |
| And although they do have psychiatrists | 17:26 | |
| and a behavioral health unit, | 17:28 | |
| the detainees don't trust the doctors there. | 17:30 | |
| And as you know, both mental health | 17:33 | |
| and physical health or physicians, psychiatrists, | 17:37 | |
| psychologists were involved in interrogations | 17:40 | |
| and in the torture program. | 17:43 | |
| And once that trust has been eroded in the profession, | 17:45 | |
| you just can't get it back. | 17:48 | |
| So even though the current doctors at Guantanamo | 17:50 | |
| were never involved in interrogations, | 17:53 | |
| that legacy still lives on. | 17:56 | |
| And many of the detainees do not trust the doctors. | 17:58 | |
| Interviewer | Do the detainees | 18:02 |
| become dependent on you because of that? | 18:03 | |
| - | That's a good question. | 18:09 |
| I think there's one man that I'm seeing | 18:10 | |
| that I see on a regular basis. | 18:13 | |
| Well, it's probably true. | 18:18 | |
| Interviewer | Why would it not be true | 18:20 |
| for the others, you didn't see him that often | 18:21 | |
| or some of them have some inner strength | 18:23 | |
| they don't need to be dependent on you or? | 18:26 | |
| - | Well, no, I can't live down at Guantanamo | 18:28 |
| and see people continuously. | 18:32 | |
| So it depends on what the objective, | 18:34 | |
| what the lawyers asked me to do. | 18:36 | |
| And oftentimes it's a medical evaluation | 18:38 | |
| and then making recommendations | 18:41 | |
| to the lawyers or to the Guantanamo doctors. | 18:44 | |
| And I have written up treatment plans | 18:47 | |
| for hunger strikers in particular | 18:50 | |
| and for the Guantanamo doctors, | 18:52 | |
| most of whom I've never dealt with hunger strikes before. | 18:55 | |
| Interviewer | Well, you're looking at both sides. | 19:01 |
| So if you had a treatment plan | 19:04 | |
| for Guantanamo doctors, who asks you to do that? | 19:05 | |
| Did the lawyers ask you? | 19:08 | |
| Did the doctors? | 19:08 | |
| - | Oh, the lawyers, | 19:10 |
| Well, it's really my ethical obligation. | 19:12 | |
| If I see something I think is wrong, | 19:15 | |
| I write up a treatment plan. | 19:17 | |
| I give it to the lawyers | 19:18 | |
| but I also give it to the Guantanamo medical staff. | 19:19 | |
| Interviewer | And do they follow those you know? | 19:24 |
| - | They've read them | 19:27 |
| and I would have to say probably they don't follow them | 19:29 | |
| but it's still in the record | 19:32 | |
| that these recommendations have been made. | 19:35 | |
| I've even actually gone as far as giving my recommendations | 19:38 | |
| to the Assistant Secretary of Defense for Health Affairs | 19:42 | |
| when I become frustrated. | 19:46 | |
| Interviewer | What kind of responses do you get | 19:48 |
| when you gave it to doctors or the assistant director? | 19:49 | |
| - | Well, I mean, I think it's mixed. | 19:53 |
| I think on one hand the doctors appreciate input and help | 19:58 | |
| because I think many of them at Guantanamo | 20:01 | |
| are inexperienced, | 20:04 | |
| obviously on the other hand | 20:06 | |
| the military doesn't want people interfering | 20:07 | |
| and telling them what to do. | 20:10 | |
| So- | 20:11 | |
| Interviewer | So the pushback doesn't bother you. | 20:12 |
| You used to continue to do it regardless. | 20:14 | |
| - | Right? | 20:16 |
| Interviewer | Why? | |
| - | 'Cause it's the right thing to do. | 20:18 |
| Interviewer | And what response did you get | 20:21 |
| from higher officials? | 20:23 | |
| Do they basically not even respond or? | 20:24 | |
| - | No, I would have to say the assistant secretary of defense | 20:28 |
| has been most gracious and thankful for help, | 20:31 | |
| although it's not clear that anything really happens | 20:37 | |
| in response to what I've done. | 20:41 | |
| Interviewer | And what about with the lawyers | 20:44 |
| do with these reports and recommendations you make? | 20:45 | |
| What- | 20:49 | |
| - | They use them as part of their habeas cases | 20:50 |
| in legal proceedings. | 20:52 | |
| Interviewer | And do you ever testify in those? | 20:55 |
| - | I do. | 20:57 |
| So I've testified in, well, I provided written testimony | 20:58 | |
| for multiple cases at Guantanamo | 21:04 | |
| and some of those would include things like my opinion | 21:08 | |
| about the inadequacy of medical care for a specific detainee | 21:14 | |
| to plan for hunger strikes, | 21:20 | |
| for how to manage a particular detainee on hunger strikes | 21:23 | |
| to mental health treatment | 21:27 | |
| that might be needed. | 21:32 | |
| I have also testified orally in the military commissions | 21:33 | |
| for the defense of Mr. al Nashiri, the man accused | 21:38 | |
| of allegedly masterminding the USS Cole bombing. | 21:43 | |
| And in that testimony, which is public, | 21:50 | |
| I testified that in my opinion | 21:53 | |
| he'd been tortured physically, psychologically and sexually | 21:56 | |
| and was suffering from severe consequences of that torture. | 22:01 | |
| I also testified in the case of Mr. Diab, | 22:06 | |
| who was the first man to successfully bring his case | 22:11 | |
| force-feeding to federal court. | 22:15 | |
| And we actually lost in that case, | 22:18 | |
| but it was still very important because all of the testimony | 22:21 | |
| was made public. | 22:25 | |
| And this is the first time that the public | 22:25 | |
| was given access to what is happening | 22:28 | |
| with the hunger strikes. | 22:31 | |
| And unfortunately though, | 22:33 | |
| we are still waiting for videotapes | 22:36 | |
| of the force-feeding to be released in that case. | 22:39 | |
| Interviewer | You say Lost. | 22:42 |
| What does that mean? | 22:43 | |
| - | That means that Judge Kessler | 22:44 |
| did not rule in favor of Mr. Diab, | 22:48 | |
| deliberate indifference to medical care | 22:55 | |
| and allowed the force-feeding to continue. | 22:57 | |
| And that force-feeding is a difficult subject | 23:01 | |
| and very complicated. | 23:05 | |
| And on one hand the government doesn't want people | 23:07 | |
| to commit suicide, but hunger strikers are not suicidal. | 23:10 | |
| They are peacefully protesting some cause | 23:16 | |
| that they're willing to die for if necessary. | 23:20 | |
| So unfortunately, as I said, Mr Diab lost that case, | 23:24 | |
| but I still think it it was positive | 23:29 | |
| in that so much information came out | 23:33 | |
| and Judge Kessler publicly acknowledged the poor quality | 23:35 | |
| of medical care that Mr. Diab was receiving. | 23:39 | |
| Interviewer | Could you tell us just for the record | 23:42 |
| what causes you've heard the detainees express | 23:45 | |
| when they said they were on hunger strike? | 23:49 | |
| You said their causes, the different reasons | 23:52 | |
| why they go on a hunger strike. | 23:54 | |
| What reasons have they told you? | 23:56 | |
| - | So the detainees that I've seen on hunger strike | 23:58 |
| are usually hunger striking because of their... | 24:02 | |
| they believe they've been illegally detained. | 24:10 | |
| They believe Geneva conventions have been violated. | 24:13 | |
| They feel that religion has been disrespected. | 24:16 | |
| Their conditions of confinement, | 24:19 | |
| I would say were the big causes of the Guantanamo detainees. | 24:23 | |
| Interviewer | If you saw someone who is, | 24:29 |
| let's say 90 pounds perhaps even low in weight | 24:33 | |
| and maybe is near death, | 24:37 | |
| would you recommend that they eat? | 24:40 | |
| Would you do that? | 24:41 | |
| Is that part of your job? | 24:43 | |
| - | So, no, that is not part of my job. | 24:44 |
| And I've seen hunger strikers | 24:48 | |
| who have been at very low weights | 24:50 | |
| and what my job is is to inform them | 24:52 | |
| of the consequences of the hunger strike | 24:57 | |
| and make sure they understand the medical risks | 25:00 | |
| of what they're doing to try to determine | 25:03 | |
| what they would want done | 25:06 | |
| in case they were to lose consciousness | 25:08 | |
| or would be unable to make decisions for themselves. | 25:10 | |
| And they need people, | 25:14 | |
| need to be allowed to make their own decisions | 25:17 | |
| about medical care and feeding is part of that. | 25:19 | |
| Interviewer | Are there long-term medical risks | 25:22 |
| that you informed them on, separate from the risk | 25:25 | |
| of dying if they don't need? | 25:29 | |
| Are there longer term medical risks? | 25:31 | |
| - | Yes, and I think we're gonna be seeing | 25:33 |
| some of that in the hunger strikers, | 25:38 | |
| you can do longterm damage to your GI tract, | 25:40 | |
| with longterm hunger striking. | 25:44 | |
| And I think one of the big questions in my mind | 25:46 | |
| is neurocognitive defects that can occur over time | 25:49 | |
| with prolonged malnutrition. | 25:53 | |
| And those have certainly been described, | 25:56 | |
| but not extensively. | 25:59 | |
| Interviewer | Would you inform a detainee | 26:02 |
| of that of either one of those | 26:04 | |
| if he continues on his hunger strike? | 26:07 | |
| - | Yes, absolutely. | 26:09 |
| Interviewer | One detainee told us that he lost his sense | 26:10 |
| of smell after being on a hunger strike for seven years. | 26:12 | |
| Is that something you've observed? | 26:16 | |
| - | Yeah, yeah, absolutely. | 26:18 |
| Interviewer | And they would be informed of that. | 26:22 |
| So that is part of what you do. | 26:23 | |
| - | So, I would go through organ by organ. | 26:25 |
| Like these are the things that can happen. | 26:29 | |
| These are the symptoms that you can have. | 26:31 | |
| And some of them can be very unpleasant | 26:33 | |
| with abdominal pain, vertigo, | 26:35 | |
| irreversible neurological damage, et cetera. | 26:40 | |
| Interviewer | Have you ever seen a detainee switch | 26:43 |
| and start eating again after they've met with you? | 26:46 | |
| - | In most cases of hunger strikes, | 26:51 |
| detainees do not wanna die. | 26:53 | |
| They want their cause to be heard. | 26:55 | |
| And so it's complicated. | 26:57 | |
| So there's many detainees, well, except enteral nutrition | 27:03 | |
| which is not the same as force-feeding. | 27:09 | |
| They will say, "I don't wanna die. | 27:11 | |
| You can put a tube in and feed me, but I'm not gonna eat." | 27:13 | |
| And they'll actually accept the tube. | 27:17 | |
| And so that's not force-feeding, | 27:20 | |
| that's actually voluntary artificially being fed | 27:22 | |
| and most of them will accept that. | 27:29 | |
| Interviewer | What about the tubes? | 27:33 |
| The tubes have gotten apparently so red thicker | 27:35 | |
| as the years have gone on. | 27:38 | |
| Have you heard that? | 27:39 | |
| Is that true? | 27:40 | |
| And does that matter? | 27:41 | |
| - | The tubes have- | 27:43 |
| Interviewer | They've become thicker and the tubes | 27:44 |
| used to be thinner when they first inserted them | 27:47 | |
| in the early days and they've gotten larger | 27:50 | |
| and larger and therefore more uncomfortable as they- | 27:53 | |
| - | Oh, I think that's individual. | 27:56 |
| And I actually, in my experience | 27:59 | |
| that's a little bit reversed. | 28:01 | |
| I think initially with the hunger strikes back in 2005 | 28:02 | |
| when they ordered those chairs to go down to Guantanamo, | 28:05 | |
| I think they really intended to break the hunger strikes. | 28:10 | |
| And I think they were using larger tubes then. | 28:13 | |
| And what I've seen more recently is more reasonably | 28:16 | |
| and appropriately sized tubes. | 28:20 | |
| Interviewer | Have you seen people | 28:24 |
| who had tried to commit suicide? | 28:26 | |
| Have you worked with any people like that? | 28:29 | |
| - | I have worked with people | 28:32 |
| who have previously had suicide attempts, yes. | 28:34 | |
| Interviewer | And how do you deal | 28:38 |
| with that kind of person? | 28:40 | |
| - | It's never easy. | 28:45 |
| And as I said, | 28:46 | |
| the burden of mental health symptoms in Guantanamo is great | 28:48 | |
| and people really are not getting adequate treatment | 28:51 | |
| for a variety of reasons. | 28:56 | |
| So, | 28:58 | |
| yeah, I mean, there just isn't any easy answers. | 29:03 | |
| Interviewer | Would you counsel someone | 29:07 |
| who tried to commit suicide and hopefully convince them | 29:08 | |
| that it's not, I don't know, | 29:12 | |
| do you have a position on that? | 29:13 | |
| Would you try to counsel them not to do it again? | 29:17 | |
| Or would you let them do it again or- | 29:20 | |
| - | To commit suicide? | 29:22 |
| So if they're depressed to the point of committing suicide, | 29:22 | |
| that's like an emergency and they would need to be | 29:26 | |
| in the psychiatric unit of the Guantanamo Hospital. | 29:29 | |
| Interviewer | Is that what you would recommend? | 29:35 |
| - | That's what I would recommend if that. | 29:36 |
| Interviewer | If they don't follow up for you, | 29:38 |
| what would you do | 29:40 | |
| or do they follow through when you recommend that? | 29:41 | |
| - | Yeah, so I've not been in a position | 29:44 |
| where somebody was acutely suicidal. | 29:46 | |
| It's mostly been, they've had suicide attempts in the past | 29:48 | |
| but at the time I see them, they are not actually suicidal. | 29:51 | |
| If someone were to tell me they wanted to commit suicide, | 29:56 | |
| I would absolutely have them moved. | 29:58 | |
| Interviewer | And the fact that they had suicidal attempts | 30:01 |
| in the past, what does that mean to you | 30:04 | |
| when you meet with them or you're afraid | 30:05 | |
| they'll do it again? | 30:06 | |
| - | Certainly they're at risk, | 30:09 |
| but I think that's just the kind of the gloom of Guantanamo, | 30:10 | |
| is the despair and hopelessness of people staying there. | 30:15 | |
| People have been there now 15 years without charges, | 30:20 | |
| without any hope of release. | 30:23 | |
| So, I mean, it's not surprising | 30:26 | |
| that rates of depression are very, very high. | 30:29 | |
| Interviewer | I'm not sure that... | 30:36 |
| so what does that mean then? | 30:37 | |
| So, essentially it's expected, | 30:39 | |
| it's almost like you expect | 30:41 | |
| that somebody might have continued | 30:43 | |
| to have suicidal tendencies | 30:44 | |
| because the life is so miserable there. | 30:46 | |
| - | It's not surprising. | 30:50 |
| Yeah, it would not be surprising. | 30:51 | |
| Interviewer | And there's not much you can do | 30:53 |
| about that I guess, unless you see an emergency situation | 30:54 | |
| where it might be apparently imminent. | 30:57 | |
| - | That's correct. | 31:00 |
| Interviewer | Are there other specific medical situations | 31:04 |
| you've dealt with besides suicides and force-feeding? | 31:07 | |
| I know you've mentioned mental health | 31:11 | |
| but that's very general. | 31:12 | |
| Others specific situations | 31:13 | |
| that maybe the audience might be interested in. | 31:15 | |
| - | Well, I think what else is important | 31:20 |
| is that Guantanamo is a remote site | 31:23 | |
| and although they have a detention hospital | 31:27 | |
| and an able hospital, | 31:30 | |
| they do not have sophisticated medical care | 31:31 | |
| for every situation | 31:35 | |
| despite what the department of defense has, | 31:37 | |
| the best medical care in the world. | 31:39 | |
| And we're seeing now an aging population | 31:41 | |
| who are developing chronical medical problems. | 31:45 | |
| And for instance, there's no MRI machine. | 31:47 | |
| And we have patients down in Guantanamo who need an MRI. | 31:51 | |
| We don't have the capacity | 31:57 | |
| to do sophisticated cardiac studies. | 31:59 | |
| And people in Guantanamo are now developing cardiac disease | 32:03 | |
| and need these studies. | 32:07 | |
| So standard of medical care is just not available | 32:08 | |
| at Guantanamo. | 32:13 | |
| And as people know, there is a congressional block | 32:15 | |
| from actually moving people stateside | 32:19 | |
| even for emergency medical care. | 32:22 | |
| So those are issues I've dealt with on a one by one basis | 32:24 | |
| where I've encountered a detainee | 32:29 | |
| whose medical needs cannot be met at Guantanamo. | 32:31 | |
| And so they're just allowed to continue | 32:34 | |
| to get progressively more ill. | 32:36 | |
| Interviewer | How many detainees | 32:40 |
| have you spoken to in Guantanamo or what were... | 32:41 | |
| just to get a sense on- | 32:47 | |
| - | So, | 32:48 |
| that's a good question. | 32:52 | |
| So, initially, | 32:53 | |
| but I've never actually counted. | 32:58 | |
| So before I even went to Guantanamo, | 32:59 | |
| I evaluated 11 men in Istanbul, Turkey | 33:02 | |
| who had been held in Abu Ghraib prison and Guantanamo. | 33:08 | |
| So these were all people who had been horribly tortured | 33:12 | |
| including sodomized with rifle butts and broomsticks | 33:15 | |
| who are now just disenfranchised, | 33:20 | |
| could not reintegrate in their communities | 33:23 | |
| and were suffering horrible mental health symptoms. | 33:25 | |
| And that was really the first published report | 33:28 | |
| of the medical consequences of torture. | 33:32 | |
| So that was 11 men. | 33:35 | |
| I've then seen three men who'd been, | 33:37 | |
| on a one by one basis, | 33:41 | |
| who'd been released from Guantanamo | 33:42 | |
| who were living in various parts of the world. | 33:44 | |
| And I think I've seen six men actually in Guantanamo. | 33:47 | |
| So a little less than 20, I guess. | 33:53 | |
| Interviewer | Would you say Guantanamo was a unique study | 33:58 |
| that from your work over 20 years, | 34:01 | |
| Guantanamo is somewhat unique from other people's work, | 34:04 | |
| not just from your own in terms of how one looks | 34:09 | |
| at the both medical? | 34:14 | |
| - | I think it is. | 34:17 |
| I think it's certainly unique in my 20 years of experience. | 34:18 | |
| And in talking to colleagues, I think there's just a... | 34:23 | |
| there's been so much trauma done to these men, | 34:29 | |
| many of which is public with the executive summary | 34:31 | |
| of the Senate Torture Report that was released in 2014 | 34:34 | |
| and perhaps the high level of trauma, the culture, | 34:40 | |
| the religion, just so many things mixed together | 34:45 | |
| I think make it very unique. | 34:48 | |
| And a lot of these men, | 34:51 | |
| I mean, they really believe in their cultures | 35:01 | |
| and just quite frankly, they're likable people. | 35:03 | |
| And, but their level of trauma is so high | 35:07 | |
| and it's really hard to know how to treat it. | 35:13 | |
| And especially in the context of ongoing trauma. | 35:15 | |
| Just being in Guantanamo is a trigger | 35:22 | |
| for mental health symptoms. | 35:25 | |
| And so it's hard to... | 35:27 | |
| the first tenet of treating trauma | 35:31 | |
| is to provide a safe environment. | 35:33 | |
| And none of these men are in a safe environment. | 35:35 | |
| They can be triggered by a sound, a rattle or a chain, | 35:38 | |
| somebody's clothing or wristwatch, a noise, a smell. | 35:44 | |
| And it's just, it's ongoing. | 35:48 | |
| And it brings them back to the torture | 35:50 | |
| that was occurring early on. | 35:53 | |
| Interviewer | Have you dealt with men | 35:56 |
| who've been put in isolation for more than 30 days | 35:58 | |
| for a long periods of time? | 36:01 | |
| - | Oh, absolutely. | 36:02 |
| Interviewer | And how does that play out with- | 36:03 |
| - | Oh, isolation, as we know is, I mean, | 36:06 |
| the special repertoire and torture | 36:10 | |
| is called isolation torture, which it is, | 36:13 | |
| and isolation is common in Guantanamo | 36:18 | |
| and certainly results in profound mental health symptoms, | 36:22 | |
| psychosis, anxiety, depression, hallucinations. | 36:27 | |
| Interviewer | Is that why you would call it torture | 36:34 |
| because of those effects? | 36:38 | |
| - | Yes, yeah. | 36:39 |
| Interviewer | And if someone from your own study, | 36:41 |
| if someone has been in isolation for more than 30 days, | 36:45 | |
| even more than 15 days, do you see a difference? | 36:48 | |
| Can they return if they leave Guantanamo? | 36:53 | |
| Can they help improve? | 36:59 | |
| I mean, after you've been in isolation | 37:02 | |
| for that length of time? | 37:04 | |
| - | I don't know that I'm an expert to answer that adequately. | 37:06 |
| I think reintegrating into society after Guantanamo | 37:12 | |
| is very, very difficult for people | 37:18 | |
| because of the trauma that they've suffered. | 37:20 | |
| Interviewer | No matter what kind of trauma- | 37:23 |
| - | No matter what kind of trauma. | 37:24 |
| Interviewer | why is that? | 37:25 |
| - | They are damaged with post-traumatic stress disorder, | 37:31 |
| with depression, | 37:37 | |
| they've had social isolation, | 37:39 | |
| they don't know how to integrate with people, | 37:41 | |
| they've lost their ability to work, | 37:46 | |
| just to even function. | 37:50 | |
| So in my experience, | 37:52 | |
| I would say that people released from Guantanamo | 37:56 | |
| need a rehabilitation program, | 37:59 | |
| a comprehensive rehabilitation program, | 38:03 | |
| and that would include not only mental health treatment | 38:06 | |
| and counseling, it would include family counseling. | 38:13 | |
| So family members can learn to work together. | 38:16 | |
| It would include job training and reintegration into society | 38:19 | |
| and whatever else is necessary to a specific situation. | 38:25 | |
| And I did see something like that in Saudi Arabia | 38:29 | |
| of all places, their terrorist rehabilitation program, | 38:32 | |
| they've had 123 people from Guantanamo | 38:38 | |
| go through it already | 38:41 | |
| and it's a holistic approach where they take these men | 38:43 | |
| and put them in this resort like area. | 38:48 | |
| I mean, it it's confined | 38:51 | |
| but it's a beautiful resort like area. | 38:52 | |
| And they provide religious counseling, religious education, | 38:55 | |
| mental health, medical care, job training. | 39:00 | |
| They're allowed to take university courses | 39:04 | |
| and they do family counseling. | 39:07 | |
| They have families come in and then help them in. | 39:09 | |
| So that kind of holistic approach I think | 39:12 | |
| is what is necessary to help these men recover. | 39:14 | |
| Interviewer | Can you describe | 39:17 |
| what family counseling entails? | 39:18 | |
| What does that mean? | 39:21 | |
| - | I'm not an expert on family counseling | 39:22 |
| but what that would mean | 39:24 | |
| is they bring the family members together | 39:25 | |
| and talk about the difficulties of reintegrating | 39:28 | |
| and how the family members can help one another | 39:32 | |
| and education, psychoeducation of the family members. | 39:36 | |
| This is what your father, your son has been through | 39:39 | |
| and this is what he's gonna need, | 39:42 | |
| and this is what you can expect. | 39:44 | |
| And this is how you can help him. | 39:45 | |
| Interviewer | Have you done any of that | 39:48 |
| or observed it because sometimes I find families | 39:49 | |
| don't really want to know what happened to their loved one. | 39:53 | |
| - | Well, you don't need to know what happened to them | 39:57 |
| in order to do this. | 39:59 | |
| So I agree, and I don't think it's necessary | 40:02 | |
| that family members know the details of what has happened | 40:05 | |
| but certainly they need to know | 40:10 | |
| that there are family members had a very rough time | 40:12 | |
| and it's gonna need help getting back into the family | 40:14 | |
| Interviewer | Has anyone or any country | 40:17 |
| or any organization or NGO or whatever, | 40:19 | |
| asked you to set out a plan or help a detainee | 40:21 | |
| when he leaves Guantanamo so that he can resettle | 40:25 | |
| and reintegrate into his new environment? | 40:29 | |
| - | That's politically very tricky. | 40:36 |
| And no, I've not had the opportunity to do that. | 40:39 | |
| Although I have visited detainees after release | 40:45 | |
| who are having a very difficult time and have helped them | 40:49 | |
| to get resources that they needed for their immediate needs. | 40:54 | |
| But that's like putting a band-aid on a big gaping wound. | 40:57 | |
| It doesn't really- | 41:01 | |
| Interviewer | Are these sources that are private resources | 41:02 |
| separate from the government? | 41:05 | |
| - | Absolutely. | 41:06 |
| So I've received... | 41:07 | |
| I've had resources from NGOs, | 41:09 | |
| from the United Nations Voluntary Torture Fund | 41:12 | |
| and other places. | 41:15 | |
| So, no, I've never had government provided funds | 41:18 | |
| for rehabilitation. | 41:23 | |
| Interviewer | Would you say that's more than norm | 41:27 |
| that when detainees are released to host countries | 41:30 | |
| or their countries | 41:33 | |
| they're pretty much left to their own devices? | 41:34 | |
| Is that what you've observed? | 41:36 | |
| - | That's been my experience and I certainly don't have | 41:38 |
| intimate knowledge of every single detainee | 41:41 | |
| that's been released from Guantanamo or other sites, | 41:43 | |
| but the ones that I have seen | 41:47 | |
| have been in pretty dire circumstances. | 41:48 | |
| Interviewer | And have you seen any detainees | 41:52 |
| return to the home like the one that's Saudi Arabia separate | 41:55 | |
| from that anyone else's returned to their homeland | 41:57 | |
| and do they get better treatment | 42:00 | |
| and medical care or family counseling or whatever? | 42:02 | |
| - | Yeah, it depends on the... | 42:05 |
| it really depends on the country. | 42:07 | |
| And so certainly I think it's helpful | 42:09 | |
| to be returned to your homeland | 42:15 | |
| where you have culture and roots and language and family. | 42:16 | |
| But for instance, | 42:21 | |
| I saw a man returned to an African country | 42:22 | |
| where his family lived and where he had roots, | 42:26 | |
| but there's just no medical care | 42:28 | |
| or psychologic counseling available. | 42:30 | |
| So he was still suffering | 42:32 | |
| just because the care wasn't available in that country, | 42:37 | |
| it was a poor country. | 42:39 | |
| Interviewer | Have you picked up on discrimination | 42:41 |
| against the person who returns | 42:44 | |
| whether to a host country or transformed country | 42:46 | |
| by the fact that they weren't going Guantanamo? | 42:48 | |
| - | I've certainly been told of stigma | 42:50 |
| and people not wanting to associate | 42:54 | |
| with somebody who's been in Guantanamo. | 42:56 | |
| And people worried about their safety because of that. | 42:59 | |
| I don't know if it's real or not | 43:03 | |
| but certainly that's a perception | 43:04 | |
| on the part of some detainees, ex-detainees. | 43:05 | |
| Interviewer | So if ever some enlightened president | 43:09 |
| came into office in the US and asked you | 43:13 | |
| for a recommendation as to what to do with the detainees | 43:16 | |
| when they're released, | 43:19 | |
| what would you recommend to them? | 43:21 | |
| - | I would recommend that the US needs to fund | 43:23 |
| a comprehensive rehabilitation program | 43:30 | |
| as outlined in the Convention Against Torture, Article 14 | 43:33 | |
| and that would include a holistic program | 43:38 | |
| sort of what the Saudis have put together | 43:42 | |
| which would be mental health, | 43:44 | |
| physical health, family counseling, | 43:47 | |
| reintegration into society, job training, | 43:50 | |
| and follow-up care. | 43:54 | |
| And I think that's actually what the US | 43:56 | |
| needs to be providing to people. | 43:59 | |
| Interviewer | Do you know what the US does provide people | 44:01 |
| when they're sent... | 44:03 | |
| when they're transferred to other countries? | 44:04 | |
| (Sondra laughing) | 44:06 | |
| - | I am not an expert on that. | 44:08 |
| I can tell you that my observations is | 44:11 | |
| that they really don't provide very much at all. | 44:14 | |
| And certainly I know that there are deals with countries | 44:16 | |
| to except detainees but I have not seen a lot of benefit | 44:21 | |
| that actually the detainee, ex-detainee gets. | 44:26 | |
| Interviewer | I just wanted to... | 44:33 |
| there's another term that's been used | 44:34 | |
| for some of the detainees have suffered | 44:36 | |
| and in fact, I don't know | 44:38 | |
| if you've worked with any of the... | 44:39 | |
| with Jose Padilla. | 44:41 | |
| Did you work with Jose Padilla at all? | 44:42 | |
| - | I did not. | 44:44 |
| Interviewer | Okay, well, some men | 44:44 |
| have been sensory deprived. | 44:46 | |
| Do you see that as a separate concern from isolation | 44:49 | |
| or from other mental health issues? | 44:55 | |
| And have you heard about that or just | 44:56 | |
| I'm not sure what, | 44:59 | |
| I know what sensory-deprived means to me | 45:01 | |
| but I'm just curious to how you see it | 45:02 | |
| and whether you've seen that in Guantanamo. | 45:04 | |
| - | Well, I've certainly seen it in people held in US custody. | 45:07 |
| And as people know, the interrogation program | 45:10 | |
| which we know is torture now, | 45:18 | |
| involved many, many different techniques | 45:21 | |
| that were all used simultaneously | 45:23 | |
| in order to maximize harm | 45:26 | |
| and to break down resistance of their detainees | 45:28 | |
| and sensory deprivation is part of a larger picture. | 45:33 | |
| And what I've seen is just disorientation | 45:36 | |
| by either keeping people blindfolded | 45:43 | |
| with earmuffs on, or keeping the lights on all the time | 45:47 | |
| where they don't know what time of day it is, | 45:50 | |
| keeping them in isolation. | 45:55 | |
| So that never occurs by itself, | 45:59 | |
| that occurs with nakedness, with poor stress positions, | 46:02 | |
| with threats and so it's all a big picture | 46:06 | |
| that was orchestrated to maximize harm to the detainees. | 46:11 | |
| Interviewer | I mean, how will the US | 46:17 |
| look at Guantanamo 20 years from now? | 46:20 | |
| - | I think it is horrifying already. | 46:23 |
| And I think it will be even more horrifying in 20 years. | 46:26 | |
| I mean, look how long it took for the US to apologize | 46:30 | |
| after the Japanese internment, | 46:33 | |
| it's whether Tuskegee Syphilis Experiments, | 46:35 | |
| I think this is just gonna be a horrifying stain | 46:42 | |
| on our history. | 46:46 | |
| Interviewer | When you said you worked | 46:51 |
| at the Department of Defense, | 46:52 | |
| what did you do for them? | 46:53 | |
| - | So as part of my work in the School of Public Health, | 46:56 |
| the Center for Bioethics, | 47:04 | |
| I have worked with Professor George Annas | 47:07 | |
| as consulting on medical ethics issues in detention centers. | 47:11 | |
| So simultaneously with working | 47:16 | |
| on specific detainee cases at Guantanamo, | 47:18 | |
| Professor Annas and I have met | 47:22 | |
| with the Assistant Secretary of Defense | 47:23 | |
| and other military bioethicists and leaders | 47:26 | |
| including the army surgeon general on medical ethics issues | 47:30 | |
| related to detainee care. | 47:35 | |
| Interviewer | So you met in Guantanamo or to other? | 47:38 |
| - | Well in general, but yes, | 47:40 |
| Guantanamo is always a kind of a lightning rod, | 47:42 | |
| but it really applies to all us military detention centers. | 47:45 | |
| Interviewer | So you would be working on both sides, | 47:50 |
| both with lawyers representing detainees | 47:53 | |
| and work for government. | 47:55 | |
| - | Yeah. | |
| Interviewer | And is that beneficial to both? | 47:58 |
| - | I think so, yeah. | 48:03 |
| I mean, I have a lot of respect | 48:05 | |
| for the Health Affairs and I think they genuinely | 48:07 | |
| want to do the right thing. | 48:14 | |
| The assistant secretary had put together a committee | 48:17 | |
| to write medical ethics, | 48:22 | |
| to kinda rewrite recommendations for medical ethics | 48:24 | |
| for the Department of Defense | 48:27 | |
| which is in the final stages now. | 48:30 | |
| But I think you have to work with both sides | 48:33 | |
| I think in order to make progress and change. | 48:37 | |
| Interviewer | Some attorneys have told me | 48:41 |
| they've tried to get access | 48:42 | |
| to their client's medical records | 48:43 | |
| and they haven't been able to. | 48:44 | |
| Have you heard that? | 48:46 | |
| - | That it has been a huge issue | 48:47 |
| and a very frustrating one. | 48:50 | |
| So obviously looking at medical records | 48:52 | |
| is a very important part of what I do | 48:56 | |
| and part of my evaluation of any patient in any setting. | 48:58 | |
| And in some cases, | 49:03 | |
| the attorneys have been able to get court orders | 49:05 | |
| to have medical records released to them. | 49:09 | |
| In which case I am able to see the records. | 49:11 | |
| And in other cases, the Guantanamo | 49:14 | |
| or whoever has the say that will refuse to release records | 49:20 | |
| even like citing HIPAA which is quite incredible. | 49:26 | |
| When detainees have given permission for their lawyers, | 49:30 | |
| they have access to the records. | 49:33 | |
| And a very frustrating case happened last year. | 49:35 | |
| And that was the case of a man who was on a hunger strike | 49:40 | |
| and weighed 74 pounds. | 49:44 | |
| And I felt was probably very close to death. | 49:47 | |
| And I wanted to see his medical records | 49:50 | |
| and Guantanamo refused to release them to his attorneys | 49:52 | |
| despite the fact the man wanted commanded his own records | 49:55 | |
| and wanted them released to his attorneys. | 49:59 | |
| Interviewer | What's the government's argument? | 50:01 |
| - | HIPAA. | 50:03 |
| Interviewer | That is the- | 50:04 |
| (Sondra laughing) | 50:05 | |
| - | So it's always been a struggle | 50:07 |
| or in many other cases, it's been a struggle | 50:12 | |
| and we may eventually get the records | 50:15 | |
| but in other cases we haven't. | 50:16 | |
| So- | 50:19 | |
| Interviewer | And when you meet with the DOD, | 50:20 |
| you to bring that issue up with them? | 50:22 | |
| - | Yeah, I don't know that I... | 50:28 |
| that's usually up to the lawyers, | 50:32 | |
| you don't actually interface with the DOD. | 50:36 | |
| Interviewer | Is Professor Annas also advocate? | 50:37 |
| Do you consider yourself an advocate? | 50:41 | |
| - | That's a good question. | 50:45 |
| I mean, I guess all physicians are advocates on some level. | 50:48 | |
| Interviewer | And is Professor Annas an advocate? | 50:53 |
| Would you say he does the work that you do | 50:57 | |
| or he stands behind you or what's? | 51:01 | |
| - | He's really a leading bioethicist in the country | 51:03 |
| and has focused a lot of his scholarly work | 51:08 | |
| on the ethics of military medicine | 51:12 | |
| Interviewer | And he supports you in your work? | 51:15 |
| - | He does, yes. | 51:17 |
| Interviewer | So you feel supported? | 51:18 |
| - | I do feel supported by a Professor Annas, yes (laughing). | 51:21 |
| I mean, what I do certainly it's controversial | 51:28 | |
| and I think there are people on both sides of the fence | 51:32 | |
| and I have been accused of supporting terrorists | 51:37 | |
| and I think it's politically hard. | 51:42 | |
| And for institutions I think also it's politically hard. | 51:45 | |
| Interviewer | Do you respond when people accuse you | 51:49 |
| of supporting terrorists | 51:51 | |
| or you just left them be who they are? | 51:52 | |
| - | Yeah (laughing). | 51:55 |
| Interviewer | Can you work with Abu Ghraib | 51:57 |
| and I don't really wanna go into, | 51:58 | |
| it's not really part of the mission here? | 51:59 | |
| When you worked at Abu Ghraib, | 52:01 | |
| did you find some distinction there with the men you studied | 52:02 | |
| as opposed to the men in Guantanamo or? | 52:09 | |
| - | So actually some of that group of 11 men I alluded to, | 52:12 |
| some of them actually had been in Guantanamo | 52:15 | |
| as well as Abu Ghraib. | 52:17 | |
| But what do you mean by distinction? | 52:18 | |
| Interviewer | Well, I mean, the world knows a lot more | 52:20 |
| about how the men were treated in Abu Ghraib | 52:23 | |
| because of the photographs and they do in Guantanamo. | 52:25 | |
| Would you say that's a different kinda trauma | 52:29 | |
| or really it's all pretty much the same kind. | 52:31 | |
| The trauma that results is not all that different from- | 52:35 | |
| - | I would say though the men I saw | 52:40 |
| in that project were heavily traumatized, | 52:43 | |
| they were held in months, one to two years. | 52:46 | |
| So this is not 15 years of indefinite detention. | 52:53 | |
| So I think that was a major distinction. | 52:56 | |
| The actual types of trauma, | 52:59 | |
| I think were not all that different, | 53:00 | |
| but the the length of time | 53:03 | |
| I think made a big a big difference. | 53:06 | |
| Interviewer | So like the time really makes a difference. | 53:07 |
| I just want to emphasize that. | 53:09 | |
| - | Yes, it does absolutely. | 53:10 |
| And especially with indefinite detention | 53:11 | |
| you just don't know the uncertainty. | 53:13 | |
| That's a whole new level of stress. | 53:18 | |
| Interviewer | I think we need to stop for a moment. | 53:21 |
| The lights flashing. | 53:23 | |
| Johnny | Here we're going. | 53:25 |
| Interviewer | Okay, I know you've said | 53:26 |
| a little bit about this in this interview, | 53:29 | |
| I wanna just go back to it. | 53:31 | |
| We've said when the men are released | 53:34 | |
| especially to third countries | 53:36 | |
| and even to the home countries | 53:38 | |
| the lives that are not necessarily improved | 53:40 | |
| and some of the people we've interviewed have told us | 53:42 | |
| that they still were living in Guantanamo | 53:44 | |
| even though they'd been released from Guantanamo. | 53:46 | |
| I know you said some of that | 53:51 | |
| but what should America be doing? | 53:52 | |
| What should the countries be doing | 53:55 | |
| and why are these men saying that? | 53:58 | |
| What's really the bigger picture here? | 54:01 | |
| - | I mean, the bigger picture is these men | 54:06 |
| have been traumatized for 15 years. | 54:09 | |
| They don't have social skills. | 54:14 | |
| They have profound mental health symptoms | 54:17 | |
| and they don't know how to relate | 54:20 | |
| to people outside of a prison setting. | 54:22 | |
| And when you take somebody like this | 54:24 | |
| and essentially drop them off into a country | 54:29 | |
| where maybe they don't speak the language, | 54:32 | |
| they don't have any roots, | 54:34 | |
| they don't know the culture, | 54:35 | |
| this is going to be retraumatizing them all over again. | 54:37 | |
| And they do not have the skills to succeed | 54:40 | |
| in that kind of environment. | 54:44 | |
| And I've seen that over and over again. | 54:46 | |
| We've seen it with the men in Uruguay | 54:50 | |
| who actually have a pretty good situation in Uruguay. | 54:51 | |
| They have access to medical care | 54:54 | |
| but still they don't have their families with them. | 54:56 | |
| They don't know Spanish, | 54:58 | |
| they don't know the culture, | 55:00 | |
| and it's been very difficult for them. | 55:02 | |
| I had a young man who was dropped off in Chad, | 55:04 | |
| never been to Chad, | 55:08 | |
| didn't speak French and was so horribly traumatized. | 55:10 | |
| He ended up just fleeing across Africa | 55:15 | |
| and was in quite dire straits. | 55:19 | |
| So again, I've seen this over and over again | 55:21 | |
| and we need to be providing the rehabilitation | 55:25 | |
| and care that these men need | 55:30 | |
| once they're released from Guantanamo. | 55:32 | |
| Interviewer | Why? | 55:35 |
| Have you ever spoken to the DOD | 55:36 | |
| or to anybody as to why the families of these men | 55:38 | |
| are not given the option to transfer to the countries | 55:43 | |
| where these men all said maybe they have their family, | 55:46 | |
| that one man told us that he wishes he could meet | 55:49 | |
| and see his mother but he can't afford | 55:51 | |
| to fly his a mother from that country to this country | 55:53 | |
| and yet that would make huge difference for him in terms of- | 55:57 | |
| - | Absolutely family reunification is critical | 56:00 |
| and I've not spoken personally | 56:04 | |
| to the DOD about this. | 56:05 | |
| I don't know how they make those kinds of decisions, | 56:08 | |
| but it's so critically important | 56:12 | |
| for their wellbeing and for their recovery. | 56:15 | |
| Interviewer | And what about finding, quote wives, | 56:19 |
| is that important? | 56:22 | |
| Have you (laughing) to these men | 56:23 | |
| when they come out of Guantanamo? | 56:25 | |
| We've seen men say that to us. | 56:28 | |
| I just wanted to- | 56:30 | |
| - | To say what? | 56:31 |
| Interviewer | That they want a wife. | 56:32 |
| That now they need a wife | 56:33 | |
| once they've been released from Guantanamo. | 56:35 | |
| - | They've been in prison for 15 years. | 56:37 |
| Like I think (laughing). | 56:39 | |
| I mean, yeah, they want a wife. | 56:41 | |
| Interviewer | So on some level there's... | 56:46 |
| you can get counseling for them | 56:47 | |
| but there's bigger issues that need to be missed. | 56:49 | |
| - | Yes, yes. | 56:52 |
| Interviewer | You continue, | 56:57 |
| do you see yourself continuing this work? | 56:58 | |
| - | That's a good question. | 57:02 |
| I think on some level, yes. | 57:03 | |
| I am continuing to be involved with cases at Guantanamo | 57:07 | |
| and with helping to assist men after their release. | 57:11 | |
| Interviewer | Do you see yourself continuing | 57:17 |
| because it's necessary you won't burn out on it. | 57:18 | |
| - | Well, right now it's necessary. | 57:23 |
| And hopefully I won't burn out | 57:24 | |
| and hopefully I know where to get the resources | 57:28 | |
| if I feel that I'm starting to. | 57:29 | |
| Interviewer | So have you put other work you've done aside | 57:32 |
| and focusing on Guantanamo for the years? | 57:35 | |
| Do you see yourself doing that? | 57:37 | |
| - | Well, I have a medical practice in Boston and- | 57:39 |
| Interviewer | That continues. | 57:45 |
| - | That continues and so what I've done | 57:46 |
| is just set aside a specified amount of time each year | 57:48 | |
| to work on some of the Guantanamo cases. | 57:53 | |
| Interviewer | So I think when I was done, | 57:56 |
| Sondra, I guess two more questions. | 57:58 | |
| One is, is there something overall | 58:01 | |
| that you wanna just give the audience | 58:03 | |
| in terms of understanding or have we done that | 58:07 | |
| and then is there something I didn't ask you | 58:08 | |
| that maybe you'd like to share with us? | 58:10 | |
| - | I don't think so. | 58:14 |
| Interviewer | Okay, so if there's nothing | 58:15 |
| that you thought of before you came here | 58:17 | |
| that you wanted to say that we haven't covered? | 58:19 | |
| - | No, I think my biggest point was the fact | 58:21 |
| that we need to rehabilitate people | 58:28 | |
| after they're released from Guantanamo. | 58:30 | |
| And now it looks like the president is committed | 58:32 | |
| to releasing larger numbers of people | 58:35 | |
| and decreasing the population at Guantanamo. | 58:38 | |
| And I think it's really important to pay attention | 58:40 | |
| to how we are releasing them under what conditions | 58:43 | |
| and to think about rehabilitation care. | 58:47 | |
| Interviewer | Actually made me think of a question | 58:51 |
| I hadn't thought of, and that is, | 58:52 | |
| why couldn't... | 58:54 | |
| if they were somewhat more enlightened, | 58:55 | |
| why couldn't they start rehabilitating the men | 58:58 | |
| while they were in Guantanamo? | 59:00 | |
| Is that possible? | 59:02 | |
| Is that- | 59:03 | |
| - | In my experience in traveling to Guantanamo, | 59:05 |
| it just doesn't seem realistic. | 59:09 | |
| As we said earlier, it's very difficult | 59:13 | |
| for the clinicians to develop relationships | 59:16 | |
| with the detainees, therapeutic relationships. | 59:19 | |
| Trust is a huge issue and it's a hostile environment | 59:22 | |
| with many triggers of prior torture, so- | 59:28 | |
| Interviewer | So until they're released, | 59:31 |
| have you heard stories of men being told | 59:34 | |
| that they're gonna be released and then they're not? | 59:35 | |
| - | Well, I think there've been huge delays in transfers, | 59:39 |
| and there have been... | 59:47 | |
| I think it's public knowledge | 59:50 | |
| that men have been cleared for release, | 59:51 | |
| but then they don't actually get transferred | 59:54 | |
| for years later, | 59:56 | |
| which is also horribly stressful for people | 59:57 | |
| and just compounds the suffering | 1:00:01 | |
| and the distress that they're already experiencing. | 1:00:03 | |
| Interviewer | Well, so if there's nothing, | 1:00:08 |
| if that's it, we can end it and give you 20 seconds | 1:00:11 | |
| of room tone. | 1:00:15 | |
| Is there anything else.. | 1:00:17 | |
| Do you want to say anything else? | 1:00:18 | |
| - | I think I've said everything. | 1:00:19 |
| Interviewer | Okay, great, okay. | 1:00:20 |
| And Johnny, you wanna (indistinct)? | 1:00:20 | |
| Johnny | Yeah, we got a room tone. | 1:00:22 |
| Interviewer | Okay. | 1:00:37 |
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