A Pentagon memo from February 2018—shortly after President Donald Trump announced that he would be keeping Gitmo open—says that U.S. Southern Command will provide the detainees with the same level of care as the U.S. armed forces only “when it is possible” and “to the extent practicable.” If the appropriate care can’t be provided on the island, according to the memo, “a panel will be formed to provide direction … on medical courses of action.”
The memo directs the chairman of the Joint Chiefs of Staff to develop an “execute order” that would, among things, “refine medical options, address urgent and chronic health issues, long-term medical treatment requirements, staffing requirements, and structural changes to camps and medical facilities.”
“This EXORD will assist in defining ‘the practicable extent’ of medical capabilities that could be brought to bear at GTMO in order to provide the appropriate medical care required by a detainee’s condition,” reads the memo, signed by Defense Undersecretary for Policy John Rood and obtained by Defense One.
But as of April, the order had not been issued—and is not expected until June, according to Colonel Pat Ryder, a spokesman for the Joint Staff. “This EXORD is a first step towards addressing detainee healthcare policy guidelines tasked by the Undersecretary of Defense,” Ryder said in a statement.
And although the memo directs the Office of the Assistant Secretary of Defense for Health Affairs to update the DOD regulations governing medical-program support for detainee operations, they have not been amended since 2006.
Just how old is old?
In one of Gitmo’s communal cellblocks, guards sit in a chilled, dim passageway called the “rotunda” and watch through one-way glass as inmates sip tea, gesture and talk, read and pop bites of food in their mouths. A handwritten reminder is pinned to the desk: “Fill out hunger strike meal inventory before and after meals go on/off block.”
Read: How Guantánamo Bay became the place the U.S. keeps detainees
Some detainees are starting to use canes and walkers, but none are showing signs of serious age-related illness yet, according to Ring and the senior medical officer. The chief medical officer expects the first hip and knee replacements to be needed soon. And, he said, “I am seeing a few cases that may look like early cognitive impairment.”
But no one is making permanent use of a wheelchair yet, and no one has cancer, they say. “I haven’t gotten anything that I would diagnose as dementia,” the SMO said. “Generally across the board versus an American population of age-matched controls, we have the same conditions, although they tend to be a little bit less [prevalent] here,” including high blood pressure, diabetes, high cholesterol, and mental-health illnesses.
That claim raises some eyebrows among current and former DOD officers who have worked with detainees at the camp. Major James Valentine, the government-appointed defense attorney for two of the detainees kept in Guantánamo Bay’s maximum-security “Camp 7,” believes that one of his clients has some kind of cancer. Mohamed Rahim has shown Valentine sequential CAT scans showing “nodules that are growing in at least five different body organs,” he said. “Typically that is an indication of some kind of precancerous growth when they’re growing all over different parts of your body.” Valentine emphasized that he is not a physician and does not have access to Rahim’s complete medical records.