Obsolete

The Pentagon faced a groundswell of protest about its treatment of detainees at Guantánamo yesterday after it emerged that a hunger strike had been broken by force-feeding inmates and putting them in restraints.

Five months after inmates at Guantánamo began the strike to protest against their indefinite detention at the US naval base only four remain on hunger strike. Three of those are being force-fed with tubes through the nose, a Pentagon spokesman said.

He denied charges that the Pentagon was trying to break the hunger strike by punishing the protesters. "They are not trying to reduce the hunger strike, but they are going to feed people to protect life," he said. The feeding was administered by medical professionals in "a humane and compassionate manner" using the same process as in civilian prisons.

New details have emerged of how the growing number of prisoners on hunger strike at Guantánamo Bay are being tied down and force-fed through tubes pushed down their nasal passages into their stomachs to keep them alive.

They routinely experience bleeding and nausea, according to a sworn statement by the camp's chief doctor, seen by The Observer.

'Experience teaches us' that such symptoms must be expected 'whenever nasogastric tubes are used,' says the affidavit of Captain John S Edmondson, commander of Guantánamo's hospital. The procedure - now standard practice at Guantánamo - 'requires that a foreign body be inserted into the body and, ideally, remain in it.' But staff always use a lubricant, and 'a nasogastric tube is never inserted and moved up and down. It is inserted down into the stomach slowly and directly, and it would be impossible to insert the wrong end of the tube.' Medical personnel do not insert nasogastric tubes in a manner 'intentionally designed to inflict pain.'

It is painful, Edmonson admits. Although 'non-narcotic pain relievers such as ibuprofen are usually sufficient, sometimes stronger drugs,' including opiates such as morphine, have had to be administered.

Thick, 4.8mm diameter tubes tried previously to allow quicker feeding, so permitting guards to keep prisoners in their cells for more hours each day, have been abandoned, the affidavit says. The new 3mm tubes are 'soft and flexible'.

Although some prisoners have had to be tied down while being force-fed, 'only one patient' has had to be immobilised with a six-point restraint, and 'only one' passed out. 'In less than 10 cases have trained medical personnel had to use four-point restraint in order to achieve insertion.' Edmondson claims the actual feeding is voluntary. During Ramadan, tube-feeding takes place before dawn.

Article 5 of the 1975 World Medical Association Tokyo Declaration, which US doctors are legally bound to observe through their membership of the American Medical Association, states that doctors must not undertake force-feeding under any circumstances. Dr David Nicholl, a consultant neurologist at Queen Elizabeth's hospital in Birmingham, is co-ordinating opposition to the Guantánamo doctors' actions from the international medical community. 'If I were to do what Edmondson describes in his statement, I would be referred to the General Medical Council and charged with assault,' he said.