Detainees' Medical Files Shared

Extraordinary secrecy surrounds the Guantanamo Bay detention center, which primarily houses prisoners captured in Afghanistan. Except for the six captives facing military tribunals, detainees -- some of whom have been there two years or more -- are not allowed to meet with lawyers or relatives. Red Cross monitors are the only outsiders many are permitted to see.

Red Cross officials would not comment on the issue of medical records. But last October, the head of the organization's Washington office, Christophe Girod, made a rare public complaint that the Guantanamo Bay facility was "an investigation center, not a detention center." Girod said he was frustrated by the indefinite confinement of prisoners at the facility.

Brig. Gen. Rick Baccus, who commanded the Guantanamo Bay facility from March 2002 to October 2002, said that after new detainees were processed and given a medical review, their records were routinely shared with military intelligence personnel. Military doctors and medics were available to advise interrogators about the new detainees' health, Baccus said, in an effort to determine whether the prisoners were strong enough to withstand questioning.

Baccus said he knew of no prohibition on interrogators reviewing the files over time, but he added that he was unsure how often that occurred or how the information might have been used. He said no one, including the Red Cross, raised concerns about use of the records during his time at the facility. If he had determined the practice violated rules or international codes, Baccus said, "I would have stopped the process."

Baccus was succeeded by Miller, who worked to improve intelligence gathering. U.S. authorities considered Miller's work such a success that in late August they dispatched him to Iraq with orders to improve interrogation efforts at Abu Ghraib.

An account pieced together from confidential documents and sources familiar with the matter shows that a Red Cross team discovered the sharing of the medical records in a visit to the Guantanamo Bay medical facility in mid-2003, during Miller's tenure there.

The Red Cross team's task, repeated at prisons throughout the world, was to assess how the complex's medical facility functioned. The medical team studied equipment and treatment options, speaking with detainees and U.S. military medical staff. Other Red Cross experts monitored other aspects of prison life.

The team's mission was not to treat detainees, but to ensure that they received adequate care. If a prisoner had persistent headaches, was he able to see a doctor? If he suffered from psychological problems -- 21 captives have tried to kill themselves at Guantanamo Bay -- was he receiving treatment?

U.S. military doctors told Red Cross medics that interrogators had access to prisoners' medical records, according to two people knowledgeable about the issue who demanded anonymity because details of the interrogations and Red Cross monitoring are kept secret. As one source said, the doctors "were very honest about that" and "some people expressed concern."

Daryl Matthews, a civilian psychiatrist who visited Guantanamo Bay in May 2003 at the invitation of the Pentagon as part of a medical review team, described the prisoners' records generated by military physicians as similar to those kept by civilian physicians. Matthews said they contain names, nationalities, and histories of physical and psychological problems, as well as notes about current complaints and prescriptions.

Matthews said an individual's records would routinely list psychologists' comments about conditions such as phobias, as well as family details, including the names and ages of a spouse or children.

Such information, he said, would give interrogators "tremendous power" over prisoners. Matthews said he was disturbed that his team, which issued a generally favorable report on the base's medical facility, was not told patient records were shared with interrogators.

Asked what use nonmedical personnel could make of the files, he replied: "Nothing good."

The practice made some military medical workers at Guantanamo Bay uncomfortable. "Not everyone was unified on this," said one person aware of the situation. "It creates a tension. You have people with many different opinions."

The Red Cross team considered the breach of patient confidentiality a grave problem and protested. "Doctors in the ICRC did not want to play this game," said the source. When U.S. authorities made clear that the policy would continue, the Red Cross responded with a decision that no medical team would return to Guantanamo Bay.

The Oct. 9 Defense Department memo recounts a meeting between Red Cross monitors and military officials. It quotes Vincent Cassard, a Red Cross team leader, as saying that "there is a link between the [military] interrogation team and the medical team. This is a breach of confidentiality between a physician and a patient. Only medical personnel are supposed to have access to these files."

The memo says Miller, the commander, disputed the claim and asked the Red Cross to recheck its facts. In response, Cassard complained that Miller "was not taking the discussion seriously."

After the dispute, the Red Cross continued to monitor other activities at the prison. But with the issue still unresolved, the organization has only recently agreed to send a medical specialist to the detention facility. The medical visit is the first since last summer, and officials intend to keep confidential any prisoner information they learn to prevent further personal details from being recorded in military files.

Red Cross officials, bound by confidentiality rules that call for findings to be delivered only to host governments, would not discuss when or where they lodged complaints about the issue of medical records. When the Red Cross has discovered problems at Guantanamo Bay in the past, it has reported them to the prison commander and, if necessary, to a Pentagon committee that oversees detainee policy.

Staff writer Scott Higham contributed to this report.