The largest detainees, at Guantanamo, are 71 years of age, while many more have passed the 50, and it is not entirely clear how the US government plans to care for detainees in old age.
The remaining 40 prisoners at the naval base at Guantánamo Bay suffer from the same physical illness for an older person. Some people need hip replacements, eye surgery, sleep apnea therapy, mental health disorders, and some may have cancer and dementia someday. Because the military commissions designed by the George W. Bush administration are disproportionately inclined to convictions, a federal appeals court recently overturned three years of lawsuits in the Cole case; it seems likely that many of them Men die at the expense of taxpayers in the United States.
Seniors at Guantanamo pose unique challenges for Admiral John Ring, the latest in a series of officers who have run the detainee on year-long missions. Defense lawyers say many of the detainees are suffering from the bad effects of brutal interrogation methods, now considered torture. The United States has committed itself to providing the same health care it provides to its own forces to the remaining detainees, as required by the Geneva Conventions. But the safe medical facilities built to treat the so-called "guests" ring do not deal with every type of surgery that patients usually need, and have not been built to last forever. Congress has banned the transfer of detainees to the United States, meaning that any treatment they receive must take place at a remote location on the Cuban side.
A difficult situation
"I am in a difficult situation," Ring said. "Article 3 of the Geneva Conventions stipulates that detainees should be given equal medical care, such as that provided to a soldier. But if a soldier is sick, I send him to the United States. So I find myself stuck. All that the detainee needs must be done here at Guantanamo. "
Currently, with most of the detainees being healthy enough to dispense assistance, the system often works. Specialists and equipment are transferred to the infamous detainee, as needed, including a special cell for the disabled to use, so that a 57-year-old survivor recovering from full-day spine surgery, rather than endure the back-and-forth hardship of the detention facility .
Officials were told to expect the military establishment to continue operating for another 25 years. Most of the long-term planning to turn Guantánamo into a "terrorist sanctuary" goes back to policy makers at the Pentagon; it is not clear where the planning actually came from.
"Many of them have diabetes. Will I do dialysis here? I do not know. Someone has to explain it to me. Are we going to do complex care for cancer patients here? "Ring repeatedly told reporters," I do not know - someone has to tell me that. "
"Guests are pre-diabetic," said Admiral Ring. Will we set up a cancer treatment center in the prison? I do not know. Someone has to tell me what we're going to do. "
Pentagon plan
"We are in the early stages of feeling this problem," says Ring. "The long-term goal is to continue to house detainees in a cohesive society so that they can help nurture each other as they get older. In the coming months, a team will be sent to study how the facilities of the US Federal Bureau of Prisons deal with end-of-life care for elderly prisoners. In the end, the chief medical officer, who preferred not to be named, expects that the emergency care unit for the detainees will be changed. Surgeons have already done both emergency and optional procedures required by the Disability Act.
This facility was built a kind of interim measures, which is not the final solution. The emergency care unit for detainees is designed with a seven-year time frame, so by 2025, Pentagon officials will have to consider a permanent solution.
But experts say there are still many unanswered questions about the level of care that will be available to detainees.
"I can not imagine the possibility of integrating a range of disciplines into one place," said Stephen Shinakis, a retired military psychiatrist who worked with Guantanamo detainees and now defends torture at the NGO, Neurological diseases are completely different from those of heart patients. At the highest levels, some very difficult decisions will have to be taken. "
Executive Order
A Pentagon memo in February 2018, shortly after President Trump announced that he would keep Guantanamo open, said the US Southern Command would provide detainees with the same level of care that the US armed forces provide to their soldiers "only when possible" and as much as possible. If appropriate care is not provided on the island, according to the memorandum, «a committee will be formed to provide guidance in medical procedures». The memo directs the chairman of the Joint Chiefs of Staff to develop an "executive order" that would, inter alia, "improve medical options, address urgent and chronic health issues, long-term medical treatment requirements, staffing requirements and structural changes in camps and medical facilities."
"This memo will help determine the practical extent of the medical capabilities that can be used at Guantanamo to provide the appropriate medical care required by the detainee," said the memo, signed by Undersecretary of Defense John Rudd.
Executive Order
An executive order on detainee health care was not issued in April and is not expected until June, according to Joint Chiefs of Staff spokesman Pat Rider, who explained that "these new directives are a first step toward addressing the health care policy guidelines for detainees."
Although the memo instructs the Office of the Assistant Secretary of Defense for Health to update Defense Department regulations governing the support of the medical program for detainee operations, it has not been amended since 2006.
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Detainees still in Guantánamo
The remaining prisoners at Guantánamo have the same physical illness as any elderly person. There are those who need hip replacements, eye surgery, sleep apnea treatment, and mental health disorders.
question marks
Through a hallway at Guantanamo Bay, guards watch through unidirectional glass sitting prisoners drinking tea, chatting, reading and eating. Some of the detainees began to use sticks to walk, but none of them showed signs of serious age-related illness, according to the director of the detainee, Admiral John Ring, and the chief medical officer.
The Chief Medical Officer expects that, for some detainees, the hip and knee joint will soon be needed. While few cases of early cognitive disability began to emerge.
But no one uses a wheelchair permanently, so far, and no one is suffering from cancer, according to prison officials. No dementia was diagnosed. Compared to the American population, there is a correlation with age, although there is an increase in blood pressure, diabetes, cholesterol, and mental health disorders in the detainees.
This allegation raises some question marks between current and former US Department of Defense officers who worked with detainees in detention. Major James Valentin, a government-appointed defense lawyer for two of the detainees held in Camp 7, who has the highest security at Guantánamo Bay, believes one of his clients is suffering from cancer. He said one of them, Mohammed Rahim, showed nodules that grow at least in five different members of the body. "This is usually indicative of some kind of cancerous growth when it grows in different parts of the body." Valentin confirmed that he was not a doctor and could not access Rahim's full medical records.
Other detainees suffer from various chronic conditions, and defense attorneys blame them for ill-treatment by US interrogators. In particular, the "wall" is placed around the detainee's neck and is standing in the direction of a wall. As well as the use of methods of stress, as the detainee is kept in a painful position for a long period of time.
Challenges of care
Some of the Guantanamo inmates are 70 years old. Archived
Compounding the challenges of caring for inmates at Guantánamo Bay, a long-standing policy that medical care providers are not allowed to ask detainees about the causes of any injury or illness, which may be the result of torture during interrogations.
This means that you can not get the correct clinical history any doctor needs, as he needs to know what happened. According to doctors, history is particularly important when mental health care is provided to elderly patients, as their ability to deal with things is reduced, so these experiences in their young years must be reviewed very clearly.
Depression increases with age, and there are mental health diagnoses that show more with age. Even if the detainees are in good health now, the Director of Detainee Admiral John Ring acknowledges that some detainees may not be mentally sound while their case is being brought to trial.
"While commission operations take a long time, I think isolated cases may not be able to participate in the investigations, but I think in general that most of the detainees will be able to communicate with the investigating bodies well," says Ring.