U.N. Investigators Protest to U.S. Over Health Care at Guantánamo Bay

Two months ago, seven United Nations human rights investigators sent the U.S. government a protest over health care for detainees at Guantánamo Bay that described troubling treatment of an Iraqi prisoner who is now disabled.

The United States never replied, and over the weekend the U.N. Human Rights Council released the 18-page report by the experts, whose sole power is to investigate and disclose their concerns on human rights issues related to counterterrorism, the disabled and the elderly. Known as special rapporteurs, they have no enforcement authority.

The report focused on the case of Abd Al-Hadi Al-Iraqi, a former commander of insurgents in wartime Afghanistan who is in his 60s. He has suffered a degenerative disease of the spine during his 16 years in U.S. custody and, despite six back and neck surgeries at Guantánamo Bay since 2017, his health is declining.

The report cites descriptions of his alleged mistreatment, many of which have been contained in court filings and transcripts — notably one that occurred in September 2021, after Mr. Hadi told the medical staff of a weakening in his lower extremities. It says that, soon after he refused a nurse’s proposal to conduct a rectal exam, the senior doctor at the prison conducted a test, “directing guards to hold him upright by his shoulders and then directing them to release him to see whether he could stand.” He “collapsed immediately as he did not have the strength to hold his own body upright,” the report says.

Neither the Pentagon nor the State Department responded to a request over the weekend to comment on that episode in particular and the overall report. It was given to a U.S. diplomat in Geneva on Jan. 11. Last month, the doctor now overseeing medical care at Mr. Hadi’s prison, called Camp 5, testified in another case that his mission was to provide “safe, legal and humane primary care to the best of our ability to the detainees.”

After the report was submitted, the expert who led the study, Fionnuala Ni Aolain, conducted a fact-finding trip to the detention operations and spoke with some long-held prisoners but was not given access to Mr. Hadi.

Mr. Hadi is among the sickest of the 31 detainees at Guantánamo Bay, and the investigators relied on medical records and testimony in court proceedings that have been largely focused on his ability to be brought before the court since his health crisis began in 2017. He pleaded guilty to war crimes last year in an agreement that would allow him to be transferred after sentencing to another country better equipped to treat him, potentially in a long-term health care facility. So far, no country has agreed to receive him.

The report said there were “systematic shortcomings in medical expertise, equipment, treatment and accommodations at the Guantánamo Bay detention facility and naval station,” which sends service members who have complex health conditions to the United States for treatment. Congress has forbidden the same for the prisoners.

The report comes as the Defense Department is being confronted with how to plan for long-term care of detainees who are not approved for release and have classic geriatric conditions as well as conditions blamed on their torture in C.I.A. custody.

In plea talks in the case over the attacks of Sept. 11, 2001, some of the defendants want the Biden administration to agree to set up a comprehensive, civilian-run program to care for prisoners as torture survivors who suffer a variety of conditions such as gastrointestinal damage, brain injuries and other traumas.

Lawyers for Mr. Hadi, who says his real name is Nashwan al-Tamir, have made clear that he became aware that he had spinal stenosis, a narrowing of his spine that can cause paralysis, before his capture in 2006.

When he arrived at the prison, he could walk unassisted. Mr. Hadi now relies on a wheelchair and a walker inside the prison, and a padded geriatric chair for support in court. Guards also keep a hospital bed inside the courtroom where he has slept when heavy painkillers caused him to nod off.

His lawyers declined to comment on their role in the report, which said the prisoner “expresses fear and desperation over his current health conditions.” It also said Mr. Hadi “is especially anxious that the medical personnel have dual loyalties (to the military and to him) and that lodging any complaints could impact his medical treatment.”

The report said the detention facility at Guantánamo has “unique political, social and cultural sensitivities,” and called it “of utmost importance” that the United States “ensure a human-rights-based and gender- and culturally sensitive approach to the provision of health care services to all detainees, including Mr. al-Tamir.”

The report was dated Jan. 11, 2023, the 21st anniversary of the opening of the detention facility for suspected enemy combatants in the war on terrorism. It was kept confidential for two months and, after no response, was released by the special procedures branch of the Human Rights Council in Geneva, headquarters of the rapporteurs, who are independent experts on human rights with mandates to report and advise on specific issues.