U.S. Is Found Lacking in Detainee Care Plans

By Josh White
Washington Post Staff Writer
Saturday, July 9, 2005

Defense Department officials failed to adequately plan for the medical care of detainees captured during the Iraq war, causing some medical personnel to reuse needles and other medical supplies and leaving them without guidance on how detainees should be treated, according to an Army surgeon general's report released yesterday.

The 215-page report, parts of which were redacted, was made public a day after Lt. Gen. Kevin C. Kiley, the Army's surgeon general, announced that his office's assessment had found only isolated cases of detainee abuse involving medical personnel. In his Thursday briefing, Kiley also praised the U.S. military's worldwide care of detainees.

But Kiley did not mention that his office's inquiry found serious flaws with the early stages of detainee health care in Iraq and Afghanistan. The report details dozens of alleged cases of abuse, lack of care or questionable collaboration between medical personnel and interrogators who were working to extract information.

Maj. Gen. Lester Martinez-Lopez, who led the assessment team, recommended that the Defense Department stop using physicians and psychiatrists to aid interrogators, criticizing the lack of a doctrine or policy defining the role of such Behavioral Science Consultation Teams.

The BSCT units, referred to as "biscuit teams" within the military, have stirred controversy because some critics in the medical profession think the teams violate ethical boundaries by using medical information to guide interrogation efforts. The report says that members of the teams had access to medical records at the U.S. detention facility in Guantanamo Bay, Cuba, until June 2004 and that "biscuit" team members at Abu Ghraib had knowledge of detainees' medical conditions until "recent months."

Martinez-Lopez recommended that only senior psychologists should serve on the teams to assist in conducting "safe, legal, ethical and effective interrogation and detainee operations."

Kiley, in a cover letter attached to the report, disagreed with excluding psychiatrists and physicians from roles on biscuit teams. The only other point in the report that Kiley disagreed with was a recommendation that "all detained individuals be treated to the same care standards as U.S. patients in the theater." He instead ordered more studies.

The report plainly states that although medical care in Iraq, Afghanistan and at Guantanamo Bay was generally good, there was a distinct lack of policy planning for detainee health care, causing "confusion among some medical personnel, both leaders and subordinates, regarding the required standard of care for detainees."

Some medical personnel reported that a lack of supplies in Baghdad and the Tallil Air Base in Iraq in 2003 caused them to reuse gloves, needles and syringes on detainees. "There was no policy on reuse for Iraqi patients, it was just done because of a shortage of supplies," according to one interview cited in the report. Another person reported that doctors were allowed to use only one pair of gloves per day so they would not run out. One mentioned facing a terrible choice.

"He received directives to use resources on U.S. soldiers first and only use what was left over for detainees," according to the report. "He felt that as medics, they were put in an unfair position because they weren't given enough to care for both U.S. soldiers and the detainees, and yet they were held accountable to the [International Committee of the Red Cross] for the care given to the detainees."

The report also details alleged abuses. A soldier reported treating two detainees who had burns on their buttocks from being transported on a Humvee's hot surfaces.

Others reported soldiers keeping psychotic detainees in hot metal containers as temperatures rose past 130 degrees, leaving them to sit on their urine and feces. Nurses in Balad, another military base in Iraq, reported that between August 2003 and February 2004, the staff purposely fed detainees meals-ready-to-eat that contained pork products, in violation of Muslim dietary rules. The "practice" was reported to the chain of command, according to the report, and was stopped.

At Guantanamo Bay, members of a biscuit team reported at least two cases of interrogator abuse. In one, an interrogator pulled on the thumbs of a detainee. In another, previously alleged by a detainee, "a female interrogator took off her [uniform] jacket, rubbed her breasts against the body of a detainee being interrogated, sat on his lap, and whispered in his ear." According to the report, the interrogation was stopped and the interrogator's actions were reported to superiors.

And between July 2003 and March 2004, a doctor was allegedly "pressured by OGA personnel into filling out death certificates on Iraqi detainees" though the doctor was not given the opportunity to examine the bodies. The causes of death given for two detainees were later found to be inaccurate. The term "OGA" is used to refer to the CIA.

© 2005 The Washington Post Company