Slow Death at Guantánamo: Why Torture and Open-Ended Arbitrary Detention Are Such Bad Ideas


An undated photo of a prisoner at Guantánamo being escorted by guards (Photo: Chris Hondros / Getty Images).

Please support my work as a reader-funded journalist! I’m currently trying to raise $2500 (£2000) to support my writing and campaigning on Guantánamo and related issues over the next three months of the Trump administration. If you can help, please click on the button below to donate via PayPal.


I wrote the following article for the “Close Guantánamo” website, which I established in January 2012, on the 10th anniversary of the opening of Guantánamo, with the US attorney Tom Wilner. Please join us — just an email address is required to be counted amongst those opposed to the ongoing existence of Guantánamo, and to receive updates of our activities by email.

Let’s be clear about two things before we start: torture and indefinite imprisonment without charge or trial are never acceptable under any circumstances. Torture is prohibited under the UN Convention Against Torture, introduced in 1985 and ratified by Ronald Reagan, and Article 2.2 of the Convention states, unequivocally, “No exceptional circumstances whatsoever, whether a state of war or a threat of war, internal political instability or any other public emergency, may be invoked as a justification of torture.” 

In addition, indefinite imprisonment without charge or trial is unacceptable because there are only two ways in which it is acceptable for countries that claim to respect the rule of law to deprive someone of their liberty: either by trying them for a crime in federal court, or holding them as a prisoner of war until the end of hostiliites, with the protections of the Geneva Conventions. 

After 9/11, however, the US created a network of torture prisons around the world, and invented a third category of prisoner — illegal or unlawful enemy combatants — who had no rights whatsoever. 

As well as it being legally unacceptable to torture people or to hold them indefinitely without charge or trial, the use of both of these tactics also raises other complications, as is apparent at Guantánamo, where, as Carol Rosenberg has just reported for the New York Times, the tortured men who can’t be released, and those indefinitely detained, who the US government, under Donald Trump, doesn’t want to release, are aging, and will need a level of care that, to date, the US government has shown no willingness to provide.

In “Guantánamo Bay as Nursing Home: Military Envisions Hospice Care as Terrorism Suspects Age,” Carol Rosenberg, reporting from Guantánamo as she has done relentlessly since the prison opened, began by stating, “Nobody has a dementia diagnosis yet, but the first hip and knee replacements are on the horizon. So are wheelchair ramps, sleep apnea breathing masks, grab bars on cell walls and, perhaps, dialysis. Hospice care is on the agenda.” 

As she added, last year those in charge at the prison were told to “draw up plans to keep the detention center going for another 25 years, through 2043.”

“At that point,” Rosenberg added, “the oldest prisoner, if he lives that long, would be 96.” As she also explained, “Another of the 40 people still held here — the Palestinian known as Abu Zubaydah, who was confined to a box the size of a coffin while held at a secret CIA site and waterboarded 83 times to break him — would be 72. Like him, a number of the detainees are already living with what their lawyers say are the physical and psychological aftereffects of torture, making their health especially precarious as they head toward old age.”

In a frank discussion with Rosenberg and other reporters, Rear Adm. John C. Ring, the prison commander, said, “Unless America’s policy changes, at some point we’ll be doing some sort of end of life care here.” He added, “A lot of my guys are pre-diabetic. Am I going to need dialysis down here? I don’t know. Someone’s got to tell me that. Are we going to do complex cancer care down here? I don’t know. Someone’s got to tell me that.”

These are clearly pressing questions. As Rosenberg explained, “The prison is envisioning communal nursing home-style and hospice care confinement” for the 40 men still held. As military commanders put it, prisoners already “suffer typical middle-age conditions: high blood pressure and cholesterol, joint pain, diabetes and, lately, sleep apnea.” However, the appropriate response is not a straightforward matter. As Rosenberg described it, “the military is grappling with an array of questions about how much medical care the prisoners should receive, how it should be delivered and how much Congress will provide to pay for it.”

When military personnel fall ill, and have “medical needs that the small base hospital cannot provide, like an MRI,” they are flown to the nearest major military hospital, in Jacksonville, Florida, 822 miles away. Unhelpful laws passed since 9/11, however, prevent the military from taking Guantánamo prisoners to the US for any reason.

As a result, prisoners with non-routine medical needs have had to have expensive visits to Guantánamo arranged. As Rosenberg explained, “Cardiologists have for more than a decade come to consult on some prisoners’ cases. Other specialists have made regular visits to do colonoscopies and examine orthopedic injuries. A prosthetist comes for those with long-healed battlefield amputations.”

For now, Rosenberg was told, “no prisoner has cancer and anybody using a wheelchair can get himself in and out of it,” but the future is uncertain. Adm. Ring said the military “had no geriatric or palliative care physicians,” and so he was “sending a team to see how the federal Bureau of Prisons handles sick and dying convicts.”

The prison, Rosenberg explained, “has a revolving medical staff of 140 doctors, nurses, medics and mental health care providers,” who care for the prisoners but “also provide some services to the 1,500 troops assigned to the prison.”

However, there does not appear to be much political willingness to address the issues raised by the prisoners aging. Rosenberg noted that the Pentagon “is seeking $88.5 million to build a small prison with communal hospice care capacity” for the so-called “high-value detainees” — 15 men previously held in CIA black sites, including those allegedly responsible for the 9/11 attacks. To date, however, Congress has “declined to fund it, citing more urgent Defense Department infrastructure needs.”

Rosenberg added that their defense lawyers and medical experts they work with “call them Guantánamo’s sickest,” adding that, although the military would like to attribute their ailments to aging, the reality is that some “are actually the aftermath of CIA torture.”

Marine Maj. James Valentine, who represents Hambali, 55, an Indonesian allegedly responsible for terrorist attacks in south east Asia, “is due for a knee replacement,” with Maj. Valentine explaining that the damage to his knee “directly resulted from his first year of CIA captivity, when he was always shackled at the ankles.” 

More severe is the case of Mustafa al-Hawsawi, 50, one of the alleged 9/11 co-conspirators, who, as Rosenberg described it, “has for years suffered such chronic rectal pain from being sodomized in the CIA prisons that he sits gingerly on a pillow in court, returns to his cell to recline at the first opportunity and fasts frequently to try to limit bowel movements,” according to his lawyer, Walter Ruiz, who added that he has “become dependent on a narcotic painkiller called Tramadol to make it through the day.”

Although Rosenberg stated that it “may strike some people as odd that the military is discussing complicated, expensive medical care” for prisoners, “especially those the Pentagon prosecutor wants sentenced to death,” Dr. Stephen N. Xenakis, a psychiatrist and retired Army brigadier general, who has consulted on Guantánamo cases since 2008, said that, although it might seem paradoxical, “we don’t let people just die in this country. It violates all of our ethics, our medical ethics.”

A particularly challenging case is that of Abd al Hadi al Iraqi, one of the last prisoners to be brought to Guantánamo, in 2008, who “underwent three spine surgeries in September 2017, the first on his lower back, another on his neck and a third to drain a post-operative hematoma.” In October, however, “a senior officer at Guantánamo’s community hospital declared in an email that the patient’s ‘cervical fusion has failed,’” and “offered three possible options: giving Mr. Hadi a neck brace and hoping for the best; bringing in a special screwdriver from a Navy hospital in Portsmouth, Va., to remove hardware inserted in the patient’s neck in an earlier operation, or transporting him to the Portsmouth hospital for complex surgery.” That last option, however, was “obviously not pursued nor explored further given the legal restrictions,” according to a prison spokesperson.

As Rosenberg further explained, “Court filings show Mr. Hadi has chronic pain and back spasms, for which he is prescribed a variety of painkillers and muscle relaxants. His surgeon has testified that Mr. Hadi may not improve. At a hearing on his case in March, guards brought him to court in a wheelchair; he used a walker to transfer to a cushioned rehabilitation chair.”

She added, “Mr. Hadi, now 58, has a February 2020 trial date. To ensure his attendance, the Pentagon fast-tracked bringing a wheelchair-accessible holding cell to the court compound where legal proceedings take place. It was already on order in anticipation of a population of aging detainees. It is triple the size of the court’s other five holding cells, large enough to hold a hospital bed and, according to a case prosecutor, will have a video monitor so Mr. Hadi can watch a feed of his trial from the bed. It will also have a phone to let him or a lawyer call the courtroom next door, if he has something to say.”

As Rosenberg also explained, “The military has already figured out what to do when a detainee dies because that has happened nine times since 2006.”

I can’t, however, end this article without noting that, on the day Rosenberg’s article was published, Adm. Ring “was abruptly fired for unknown reasons,” as the Guardian explained, adding that a “statement from US Southern Command said the change in leadership was ‘due to a loss of confidence in his ability to command.’” 

The Guardian added that officials “said the decision to relieve Ring of his command was not connected to the interviews he gave on detainees’ health issues, but was the result of a month-long investigation that had been submitted to the head of Southern Command, Adm. Craig Faller, in mid-April,” although whether or not that is true remains to be seen. The timing certainly seems suspicious.

* * * * *

Andy Worthington is a freelance investigative journalist, activist, author, photographer, film-maker and singer-songwriter (the lead singer and main songwriter for the London-based band The Four Fathers, whose music is available via Bandcamp). He is the co-founder of the Close Guantánamo campaign (and see the latest photo campaign here) and the successful We Stand With Shaker campaign of 2014-15, and the author of The Guantánamo Files: The Stories of the 774 Detainees in America’s Illegal Prison (click on the following for Amazon in the US and the UK) and of two other books: Stonehenge: Celebration and Subversion and The Battle of the Beanfield. He is also the co-director (with Polly Nash) of the documentary film, “Outside the Law: Stories from Guantánamo” (available on DVD here — or here for the US), and for his photo project ‘The State of London’ he publishes a photo a day from six years of bike rides around the 120 postcodes of the capital.

In 2017, Andy became very involved in housing issues. He is the narrator of a new documentary film, ‘Concrete Soldiers UK’, about the destruction of council estates, and the inspiring resistance of residents, he wrote a song ‘Grenfell’, in the aftermath of the entirely preventable fire in June 2017 that killed over 70 people, and he also set up ‘No Social Cleansing in Lewisham’ as a focal point for resistance to estate destruction and the loss of community space in his home borough in south east London. For two months, from August to October 2018, he was part of the occupation of the Old Tidemill Wildlife Garden in Deptford, to prevent its destruction — and that of 16 structurally sound council flats next door — by Lewisham Council and Peabody. Although the garden was violently evicted by bailiffs on October 29, 2018, and the trees were cut down on February 27, 2019, the resistance continues.

To receive new articles in your inbox, please subscribe to Andy’s RSS feed — and he can also be found on Facebook (and here), Twitter, Flickr and YouTube. Also see the six-part definitive Guantánamo prisoner list, The Complete Guantánamo Files, the definitive Guantánamo habeas list, the full military commissions list, and the chronological list of all Andy’s articles.

Please also consider joining the Close Guantánamo campaign, and, if you appreciate Andy’s work, feel free to make a donation.

20 Responses

  1. Andy Worthington says...

    When I posted this on Facebook, I wrote:

    Here’s my latest article, following up on an article about Guantanamo’s aging prisoners by Carol Rosenberg for the New York Times. As I explain, the problems of having to deal with men who are getting old and ill and may well die at Guantanamo is a direct result of the Bush administration’s indefensible decision to establish a torture program after 9/11 (which, as well as being illegal, and morally reprehensible, is also incompatible with any judicial process), and also to hold prisoners at Guantanamo indefinitely without charge or trial, which is also unacceptable — but which is, sadly, a policy whole-heartedly endorsed by Donald Trump.

  2. arcticredriver says...

    You probably saw this already, Admiral Ring, commandant, has been fired. The DoD didn’t say why but the speculation is that his superiors are angry over how candid he was about the captive’s health issues, as they age.

  3. Andy Worthington says...

    Thanks, arcticredriver. Yes, I mentioned it at the end of the article, but it was difficult to speculate. The military said his sacking related to an ongoing investigation, but it does seem to me that perhaps that wasn’t true, and that he had been sacked because he had been too candid in his assessment of the actual situation regarding old and ill prisoners, and the lack of resources being made available to him to cater properly to their requirements.

  4. Valerie Lucznikowska says...

    Whether or not Ring was fired for the official reasons is moot as no one can trust official versions of just about anything here. (I am now in Guantanamo for the third time.) Mitigating circumstances of the torture program should first, take the death penalty off the table in favour of life without parole – that’s what they are going to get anyhow, and second, give them the best medical care possible as reparations for their torture. But the government has fought hard against that. Once a culture has been built it is hard to break it – everyone is accustomed to it. Only the iguanas have a better deal.

  5. Andy Worthington says...

    Great to hear from you, Valerie. I think it’s absolutely correct to say that “once a culture has been built it is hard to break it,” but especially so under Donald Trump, who is in charge of Guantanamo, but presumably takes no interest in its day to day running. A responsible president would understand that the only way to defend Guantanamo’s long-running lawlessness would be by providing proper treatment of the prisoners, but I imagine that these sorts of notions don’t occur to Trump.

  6. Andy Worthington says...

    Pam Arnold wrote:

    Obama didn’t help at all, in fact his drone wars have increased terrorism … thats his legacy

  7. Andy Worthington says...

    Yes, he was mostly a great disappointment, Pam – the drone president. However, he did set up review processes that led – eventually – to nearly 200 men being released before he left office, whereas, under Trump, it is as though the men still held are frozen in time.

  8. Andy Worthington says...

    Barbara Quintiliano wrote:

    Proving that all super villains aren’t in the movie theaters. Millions of dollars being spent to provide old age care for men never convicted of a crime.

    We are treating the Gitmo detainees as though they’re super villains. We’ve fetishized them and decided that they cannot at any cost be brought to the US to stand trial (those with credible charges against them), because some horrible evil will befall us. As for those without credible charges, we can’t admit that we made a mistake in detaining them and simply release them. Instead, we’re prepared to spend (more) millions of dollars to build facilities for old age related medical conditions and keep them in Gitmo until their death.

  9. Andy Worthington says...

    Valerie Lucznikowska wrote:

    I am in GTMO right now and agree with you. But it was a political ploy by Congress to bar them from the mainland. It can be reversed, but not likely. They’re never getting out and we should treat them humanely. They are human, and deeply affected mentally and physically by their torture. Guantanamo will be known in the future as a huge black mark on the US…and even people who are here and involved with the system say that. To further the farce, the Judge announced this morning he will be leaving in June to take up his post over all US Embassy security … he said he would when he came last year. So many years for a new judge to cope with – what will happen now? Who knows – ask the CIA.

  10. Andy Worthington says...

    Thanks for your comments, Barbara and Valerie.

  11. Andy Worthington says...

    Pam Arnold wrote, in response to 7, above:

    thats good to hear Andy, thanks, this is a horrifying indictment of what America is, truly a fascist society

  12. Andy Worthington says...

    Betty Molchany wrote, in response to 7, above:

    Andy, I didn’t know that. There were some good things he did immediately before he left office. But this must’ve been quite some time before he left to result in having 200 released.

  13. Andy Worthington says...

    Anna Elliott wrote, in response to 7, above:

    Andy Wow, really..

  14. Andy Worthington says...

    I’m glad to be able to provide some clarification, Pam, Betty and Anna.
    So there were really three phases to the prisoner releases under Obama:
    1) 66 were released from February 2009 to September 2010 – some as a result of them having their habeas corpus petitions granted; others because they were approved for release by the high-level inter-agency Guantanamo Review Task Force that Obama set up after first taking office.
    2) Then, for nearly three years only five men were released, because Congress raised obstacles, and Obama chose not to fight back. This phase only came to an end in 2013 when the prisoners, in despair, embarked on a prison-wide hunger strke, and Obama receved a torrent of criticism from around the world, prompting him to take action.
    3) The rest were released from August 2013 until just before he left office in January 2017. It wasn’t always easy, as third countries had to be found that would take in prisoners who couldn’t be safely repatriated – and that total included many dozens of Yemenis whose repatriation was considered unacceptable across the whole of the US establshment. By the end of his presidency, all 156 men approved for release in 2009 by the Guantanamo Review Task Force had been released, and, in his last few years, 36 others, previously regarded as “too dangerous to release,” were released after a second review process – a parole-type affair called the Periodic Review Boards – approved their release too.

  15. Andy Worthington says...

    David Knopfler wrote:

    The invention of a new third category was highly irregular and I think did more than raise eye brows at the time. This is still the antithesis of every civilised norm that separates us from barbarism.

  16. Andy Worthington says...

    Yes, exactly, David. Good to hear from you.

  17. Andy Worthington says...

    Malcolm Bush wrote:

    Whilst sitting here reading this I cannot help but think about how it also jams up the works of justice. We have seen all the various failings from far back in the past to the present day. All the torture and wrong doing comprehensively have done a great deal to hide the truth.

  18. Andy Worthington says...

    Malcolm Bush wrote:

    New categories of terrorist coming about as Trump and the gang declare more and categories of people terrorists. Just about everyone in Iran will soon be a terrorist according to Trump and the gang. This is different to before; it’s more ambitious, more instant and we can almost see the money.

  19. Andy Worthington says...

    Thanks for your comments, Malcolm. Good to hear from you.

  20. Eurasia Review: Horribly Repressive: The Truth About Donald Trump's Guantánamo – OpEd | FBI Reform says...

    […] As Davies described it, “The subject of detainee care has been an issue of increasing debate in recent years, with the facility now reportedly considering end of life care services for the remaining detainees, according to the New York Times,” in an article in April that I wrote about here. […]

Leave a Reply

Back to the top

Back to home page

Andy Worthington

Investigative journalist, author, campaigner, commentator and public speaker. Recognized as an authority on Guantánamo and the “war on terror.” Co-founder, Close Guantánamo and We Stand With Shaker. Also, photo-journalist (The State of London), and singer and songwriter (The Four Fathers).
Email Andy Worthington

CD: Love and War

The Four Fathers on Bandcamp

The Guantánamo Files book cover

The Guantánamo Files

The Battle of the Beanfield book cover

The Battle of the Beanfield

Stonehenge: Celebration & Subversion book cover

Stonehenge: Celebration & Subversion

Outside The Law DVD cover

Outside the Law: Stories from Guantánamo


Posts & Comments

World Wide Web Consortium



Powered by WordPress

Designed by Josh King-Farlow

Please support Andy Worthington, independent journalist:


In Touch

Follow me on Facebook

Become a fan on Facebook

Subscribe to me on YouTubeSubscribe to me on YouTube

The State of London

The State of London. 16 photos of London

Andy's Flickr photos



Tag Cloud

Abu Zubaydah Al-Qaeda Andy Worthington British prisoners Center for Constitutional Rights CIA torture prisons Close Guantanamo Donald Trump Four Fathers Guantanamo Housing crisis Hunger strikes London Military Commission NHS NHS privatisation Periodic Review Boards Photos President Obama Reprieve Shaker Aamer The Four Fathers Torture UK austerity UK protest US courts Video We Stand With Shaker WikiLeaks Yemenis in Guantanamo