All Too Quiet
Where were the doctors and nurses at Abu Ghraib and Bagram?
Where were the doctors and nurses at Abu Ghraib, Qaim, Bagram, and the other islands of the United States prison archipelago abroad when prisoners were being beaten, suspended, and degraded? Defense Department policies set the stage for the abuses, but the silence of prison clinicians allowed them to continue. Some medical staffers witnessed the brutality. Others saw the injuries that resulted from the abuse.
Most of what we know about the role of prison doctors and medical staffers comes from tens of thousands of pages of government documents released pursuant to a Freedom of Information Act suit brought by the American Civil Liberties Union. These papers include criminal investigations, FBI notes on debriefings of prisoners, interviews with witnesses, sworn recollections of conversations, e-mails from soldiers and intelligence personnel, autopsy reports, military base policies, and prisoners' medical records. Here are some of the incidents they reveal.
False claims of death by natural causes
Abed Hamed Mowhoush voluntarily surrendered to American military authorities in Qaim, Iraq, in November 2003. He died of torture 16 days later. According to testimony at the trial of the intelligence officers responsible for the abuse, Mowhoush was repeatedly beaten with fists, hose, sticks, and a rifle butt under the supervision of Army, Special Forces, and CIA personnel. Six of his ribs were broken. Then he was stuffed head first into a sleeping bag and wrapped in 20 feet of electrical wire. A soldier briefly crouched over Mowhoush's chest. A few minutes later, he was found to be dead. Dr. Ann Rossignol, an Air Force physician, joined the resuscitation. She was told that Mowhoush was being interrogated, lost control of his urine, and collapsed. The trial transcript shows that she did not ask for more details. A Pentagon press release stated: "Mowhoush said he didn't feel well and subsequently lost consciousness. The soldier questioning him found no pulse, then conducted CPR and called for medical authorities. According to the on-site surgeon [Rossignol], it appeared Mowhoush died of natural causes."
Somehow Dr. Rossignol missed seeing that Mowhoush's body was bruised on the arms, legs, head, neck, pelvis, and front and back of the torso. These injuries were apparent to the criminal investigators and the pathologists who conducted an autopsy. She kept silent as the inaccurate report circulated that he had died by natural causes. The military has not granted interviews in relation to Mowhoush's death. The official explanation is that the death was an unintentional homicide.
Medics have been privy to abuse and said nothing about the incidents they knew of. According to his statement in one of the Abu Ghraib investigations, medic Reuben Layton saw pictures of the abuses at the prison when they were posted as screensavers on military computers there. In late 2003, medic Neil Wallin was called to a cell after Abu Ghraib guards slammed a prisoner into a wall, lacerating his chin. He saw the prisoner with a sandbag over his head and blood running down his clothes from a 2-and-a-half-inch cut. He later told Army investigators that he saw "blood on the wall near a metal weld, which I believed to be the place where the detainee received his injury." Wallin sutured the wound with 13 stitches but did not report it because he said that he did "not know how [the prisoner] was injured if it was done by himself or another."
Silent medical records
Human-rights monitors from the International Red Cross who visited prisons described a number of prisoners at various Iraq prisons with injuries from beatings or burns that had not been recorded in medical records. At Camp Mercury in Iraq, a physician's assistant wrote that injuries to prisoners caused by guards, including fractures, were present at capture. Army investigators at Mosul prison in Iraq learned that a soldier had broken the jaw of prisoner Salah Salih Jassim. The Army investigators found that the examining physician did not record how Salih's jaw came to be fractured. Neither the examining medic nor the physician removed the prisoner's shirt to look for other bruises.
In summer 2004, an Abu Ghraib prisoner described being beaten, slammed against the wall, having his head dunked in water, and being sodomized with a baton until he bled from his rectum. An Army investigator told a physician of the allegation and requested a "medical examination specifically for trauma due to sodomy." The physician did not examine the prisoner's rectum but nonetheless reported no signs of anal tearing. The investigation was closed with a note by the investigating officer, "If there isn't medical evidence then this terrorist lied and you should find a way to charge him with perjury, filing a false statement and anything else available."
Lost medical records
A physician at an undisclosed Iraq prison told investigators that a prisoner had complained of being beaten. But the doctor said that he did not see bruising. The medical record could not be found. In 2005, Army investigators thought believable the complaint of a Tikrit inmate that he had been chilled with an air conditioner, beaten, kicked, and dragged. But they closed the investigation because no medical records could be found and the detaining soldiers could not be identified. Another Tikrit inmate described three days of beatings after which his urine became bloody. Again, Army investigators could not find a medical record. In another 2004 case in Iraq, a medic recorded, in a medical note, abrasions, bruises, a broken nose, and a fractured leg. The attending physician signed the note without examining or interviewing the battered prisoner. When the prisoner brought formal charges of abuse through the prison's complaint system, the lack of a doctor's note harmed his credibility. The prisoner decided to drop his complaint and signed a formal statement, "I swear under oath that I do not want to file a complaint against the American Forces so I can get released."
The misplacement of medical records also was used to discredit an American soldier. In January 2003, Spc. Sean Baker put on a Guantanamo prisoner's uniform to allow soldiers to practice extracting a prisoner from a cell. The extraction team did not know that Baker was an American. He recalls, "They grabbed my arms, my legs, twisted me up and … got up on my back from behind and put pressure down on me while I was face down." Guard Scott Sinclair "began to choke me and press my head against the floor." He twice "slammed my head against the floor and continued to choke me." Baker was hospitalized for brain trauma, given a medical discharge, and continues to suffer from regular seizures. The videotape of the training exercise was lost.
An Army Physical Evaluation Board concluded that Baker's injuries and disabilities were due to the beating and gave its report to Baker. Yet 18 months later, Pentagon spokesperson Maj. Laurie Arellano told reporters that Baker's medical discharge was not related to his duties in the military. When Baker released the Army Board's statement, Arellano conceded that the beatings were a factor in Baker's discharge, stating that she had new information.
Steven H. Miles is professor of medicine and bioethics at the University of Minnesota, Center for Bioethics, and author of the new bookOath Betrayed: Torture, Medical Complicity, and the War on Terror.
Photograph of prisoner at Abu Ghraib by Wathiq Khuzaie/Getty Images. Photograph from Abu Ghraib on the Slate home page by Ho/Agence-France Presse/Getty Images.