The Saudi prisoner awaiting a death-penalty trial for the USS Cole bombing was tortured physically, mentally and sexually, an expert in treating torture victims testified Thursday at the war court.
Dr. Sondra Crosby offered the diagnosis in open court during carefully choreographed testimony that never once mentioned that Abd al-Rahim al-Nashiri, 49, got to Guantanamo after four years of CIA captivity, during which he was interrogated with waterboarding and threats to his mother and was threatened with a revving power drill.
“I believe that Mr. al-Nashiri has suffered torture — physical, psychological and sexual torture,” Crosby said.
At issue is a defense claim — al-Nashiri’s lawyers describe it as medical malpractice — that Guantanamo prison’s military doctors have not treated him for the trauma he suffered at the hands of the CIA. A military medical board diagnosed him with post-traumatic stress disorder last year. Now his defense lawyers want the judge to freeze Dec. 4 trial preparations until he is treated.
Case prosecutor Navy Lt. Bryan Davis tried repeatedly to block the testimony of Crosby, an internist who said she treats victims of torture daily in her Boston-based practice and has seen more than 500 victims or possible victims in her career.
But the judge, Army Col. James L. Pohl, accepted her expertise and allowed her to describe in some detail the basis for the diagnosis. Prosecutors then chose not to challenge her finding through cross-examination.
Crosby, a Boston University medical school professor and member of Physicians for Human Rights, spent about as much time establishing her credentials as describing what she discovered in secret records plus more than 30 hours of Guantanamo prison camp interviews and physical examinations of al-Nashiri across three prison visits.
Al-Nashiri — a Saudi accused of orchestrating the Oct. 12, 2000, al-Qaida suicide bombing that killed 17 U.S. sailors on a warship off the coast of Yemen — sat through it emotionless, eyelids nearly closed, in the white prison camp uniform of a cooperative captive.
Crosby chose her words carefully in court because, in order to make her diagnosis, she was allowed to review top secret records and discuss with al-Nashiri what happened to him. So while she was not allowed to say in open court what she saw in a medical exam of him or what he told her, she was allowed to refer to unclassified government records to support her diagnosis.
“He suffers from chronic pain. He suffers from anal-rectal complaints,” she said. He also has “difficulty defecating, hemorrhoids, pain in sitting for a long time,” which she said are typical of “survivors of sexual assault.”
Al-Nashiri has scars on his wrists, legs, ankles “consistent with the allegations and history that he gave me.” And he suffers from wide mood swings — from “irritability, anger, extreme emotional intensity to silence” — that are “red flags” of trauma and torture.
But, she said, military medical staff treating him had failed to ask the right questions, if any.
“There was no trauma history in the records I read,” said Crosby, who by judicial order was provided access to al-Nashiri’s medical history since his arrival at Guantanamo. “They treated the symptoms without treating the cause.”
As an example, she said, rather than understand the nature of al-Nashiri’s nighttime cell sleeplessness, doctors offered him medication. In addition, she described the prison camp churn of Navy medical staff on nine-month rotations as an obstacle to developing a trusting therapeutic relationship.
It is prison policy not to comment specifically on what goes on at Camp 7, the secret prison with its own medical clinic where al-Nashiri and other former CIA captives are clandestinely kept.
But a soldier who escorts media around the detention center offered an endorsement of the care for the 154 captives in an article published on a Pentagon website Thursday. “I feel our guard force and the medical personnel are doing an outstanding job providing safe, humane, legal care and custody to the detainees,” said Army Staff Sgt. Karen Kozub.
Testimony on the adequacy of the captive’s medical treatment was expected to continue Friday with an anonymous naval officer in charge of prison medical staff called as a witness. Lawyers were also expected to argue over a prosecution bid to get the judge to scale back his sweeping discovery order requiring the government to turn over details of al-Nashiri’s CIA detention — including names of medical staff who treated him there and nations where he was covertly kept.
In presenting her credentials, Crosby said she twice made presentations to a subcommittee on ethics of the Pentagon’s Defense Health Board. The board was considering the military’s forced-feeding policy of Guantanamo prisoners during a hunger strike by an undisclosed number of the 154 captives. The military now does not reveal any information regarding the number of captives considered to be hunger strikers or the number getting forced feedings.
Crosby said the forced-feeding policy provided a window into the restrictions that Navy medical staff work under at the prison, saying commanders, not medical professionals, determine the so-called involuntary enteral feed policy of systematically renourishing hunger strikers who resist in a restraint chair.
“Doctors are instructed to force-feed competent hunger strikers when it is against medical ethics and the rest of the Western world,” she said.
In a separate description of non-medical command control of health care, she said an officer initially insisted that she conduct a physical exam of al-Nashiri while he was in shackles. She refused, citing a court order by Pohl that al-Nashiri be unshackled.
The officer then insisted that four guards be in the room and observe the full physical exam. She refused: “That would be a violation of a privacy, and I would not be able to do an adequate examination.”
The officer, a “representative from camp leadership,” relented as a “favor.”
She examined al-Nashiri in privacy, with guards outside the room, as the judge had ordered.