Regime of Lies: 500 pages withheld in FOIA on death of Guantanamo detainee

While some detainees continue to be released, and the population of the prison camp known as Guantanamo continues to slowly shrink, 14 years after it began accepting "war on terror" prisoners the secretive regime continues to operate.

Guantanamo's slogan is "safe, humane, legal, transparent." But Guantanamo is really none of those things.

Last summer I received a response to a three-year old FOIA request from the Naval Criminal Investigative Service (NCIS) on its investigation into the death of Abdul Rahman Al Amri in May 2007. According to his autopsy report, quietly released in 2012, Al Amri was found dead in his cell, hanging from a noose presumably cut from his bedsheets, and with his hands tied behind his back.

I want to briefly discuss the Al Amri case as an exemplar of the lies and cover-up that emanate from Guantanamo, and secondarily, as an example of the complicity of the press, who while they churn out commemorative pieces for dates like this latest anniversary, have shown (with a few exceptions) no appetite to really get to the truth of what was and is still is going on in that remote island prison. Current censorship policy includes, among other things, the classification of things detainees have said, and what attorneys have heard from them.

As I noted in a February 2012 story at the webiste Truthout on Al Amri's death, and that of another detainee, Mohammad Ahmed Abdullah Saleh Al Hanashi in June 2009, "Authorities consulted... agreed, as one source put it, that having hands tied behind one's back in a hanging 'does not necessarily indicate homicide but certainly requires additional investigation.'"

But the Department of Defense never released publicly the fact Al Amri - who DoD sometimes refers to in documents as Al Umari - was found with his hands bound, and while I broke the story that he was indeed discovered that way, no other member of or agency or institution in the news media saw fit to follow up on the story, or even report it. In the meantime, I filed a FOIA for the investigative reports on his death completed by NCIS, and for the Army's 15-6 statutory report on the death filed at Guantanamo's ruling headquarters, Southern Command (SOUTHCOM).

I had also asked for the toxicology report (PDF) on Al Amri's death, because according to his autopsy report (PDF), he had inexplicably been tested for the presence of the anti-malaria drug mefloquine after his death. This was very strange. While there is no malaria problem in Cuba, all incoming detainees were administered a full treatment dose of mefloquine (also known as Lariam) upon entry into the prison, for supposed prophylactic purposed, i.e., as a public health measure.

But even if the public health rationale were true - and Jason Leopold and I published a series of articles demonstrating that the use of the controversial drug mefloquine had likely nefarious purposes, or as one military doctor put it, constituted "pharmacologic waterboarding" - Al Amri had been in Guantanamo for five years, and there was no reason to assume mefloquine had been in his blood stream for years.

One can only presume that someone thought he had possibly been administered mefloquine sometime in the near period prior to his death, and then asked the Armed Forces Institute of Pathology to see if it was present at the time of death. The possibility of such use of a drug whose only use was prophylaxis or treatment of malaria, and was already under tough criticism within DoD over its use on U.S. military personnel, raises serious questions regarding the purpose of administering that drug. Was mefloquine's common side-effects of inducing dizziness, nausea and paranoia or hallucinations in some people being used to chemically torture detainees?

Even more perplexing... why would Al Amri tie his hands behind his back before killing himself? Did he in fact do so, or was he actually murdered in his cell by guards, or others? I had hoped the FOIA material on the investigations would answer some of these questions.

But when the materials arrived from the NCIS FOIA office last July, they were heavily censored. Even more, hundreds of pages were withheld in their entirety as supposedly consisting of "documents proprietary to another Command." I was told, "Those documents have been referred for a classification review and releasability determination and return to this office."

All told, approximately 500 pages from the investigation have been withheld, awaiting "classification review." From what was released, much is redacted.

[Update (April 14, 2017): NCIS has released the 500 or so pages after the "classification review" by another Command. There are some startling new revelations in this release. I will be reporting on them very soon, so please continue to check or follow this blog.]

NCIS would not tell me what other "Command" they were referring to: that was classified, too (although I highly suspect the other Command is JTF GTMO itself). Meanwhile, six months later, I'm still waiting for clearance of this huge section of the FOIA, which was originally filed in 2012.

As for the SOUTHCOM AR 15-6 investigation, that is still under classificatory review as well, and months away from release... if I'm lucky.

Such delay in the matter of a FOIA on a detainee's death is not always so protracted. Yemeni detainee Adnan Latif was found dead in his cell in the Behavioral Health Unit at Guantanamo in September 2012. His AR 15-6 report was released in a reasonable period after a FOIA request was filed (and was the basis of news reports in 2013, again, by both Jason Leopold and myself).

Is this because Al Amri died under even incredibly more suspicious circumstances than Latif? According to one document I obtained that made it past the censors, someone after Al Amri's death tried to dispose of some of the evidence, as part of the sheet material that supposedly bound his hands was discovered by one NCIS agent tossed in "medical waste" (see accompanying photo). That doesn't sound like how a death scene is secured.

Readers may (or may not) be glad to know that I am still pursuing my investigation into Al Amri's death (and that of Mohammad Al Hanashi), and will have more to report on them in the near future. I feel this is a moral obligation, as the rest of the press has decided this is not a story worth reporting. But I think given the efforts to stymie the truth from getting out, the Pentagon knows better than that. The story will be reported, and I hope we will not have to wait for the 15th anniversary of the opening of the Guantanamo torture camp to know the truth about the death of one of its victims.

CIA Investigation Minimizes Use of Drugs on Rendition & Black Site Detainees

The CIA has released documents regarding a 2008 Inspector General (IG) investigation into the use of "mind-altering" drugs to enhance or facilitate interrogations undertaken as part of their rendition, "black site" detention, and interrogation-torture (RDI) program. Not surprisingly, a brief investigation found, according to a January 29, 2009 newly declassified letter sent from the CIA IG to Senator Dianne Feinstein, then-chair of the Senate Select Committee on Intelligence (SSCI), that CIA had not used any drugs on detainees for the purpose of interrogations.

The documents were released to Jason Leopold at VICE News, who posted a comprehensive article examining them earlier today. Leopold and I have previously written on the subject of drugging prisoners, and examined an earlier Department of Defense IG report on the subject a few years ago, as well as the use of mefloquine at Guantanamo, about which more below.

The CIA Inspector General, John L. Helgerson, referred Feinstein to a statement by the Director of CIA's Office of Medical Services (OMS), to the effect that "no 'mind-altering' drugs were administered to facilitate interrogations and debriefings because no medications of any kind were used for that purpose."

But as we shall see, there were many claims by prisoners of drugging during CIA renditions, and later by affiliated "liaison" government officials. Other prisoners claimed they were drugged during the time they were held by CIA itself at their black site prisons. None of those charges were addressed by Helgerson in his investigation, unless they were part of a 5-page section of the new CIA document release that was totally whited out by the CIA FOIA officials.

No CIA detainees were evidently ever interviewed as part of the IG investigation.

Helgerson said that he queried IG investigators working on another investigation of abuse claims by 16 high-value detainees then held at Guantanamo. The alleged abuse concerned treatment by CIA before the detainees were transferred to Guantanamo in 2006. Helgerson said the investigators had no knowledge of "the use of 'mind-altering' drugs as a part of the interrogation regimen." Nothing is known about this IG investigation on detainee complaints.

Helgerson, who is now retired, did refer in his letter to Feinstein to the May 2004 CIA IG report that examined "isolated allegations of mistreatment or abuse of detainees, though he never specifically states that there were no claims of drugging in that "comprehensive review."

Helgerson said that the CIA IG had investigated "a variety of specific unrelated detainee abuse allegations" since the 2004 report.

MKULTRA, KUBARK, and Phoenix

The issue of CIA drugging of prisoners has historical resonance since CIA engaged in a decades-long program of experimentation on the use of "truth serums" and other drugs, including LSD, for use in interrogations. Known under various acronyms, including Bluebird, MKDELTA and MKSEARCH, the program was best known in popular accounts as MKULTRA. The CIA's KUBARK interrogation manual from the early 1960s drew specifically upon MKULTRA research when it advocated use of "narcosis" or the use of drugs for interrogations.

The latest version of the KUBARK manual (PDF), released to me last year after a Mandatory Declassification Request, showed a much heavier emphasis on the use of foreign "liaison" agencies for detention of CIA prisoners than had been previously revealed.

The CIA's 1983 Human Resource Exploitation Training Manual also describes such liaison relationships in some depth, in addition to a discussion of using drugs during interrogation. According to National Security Archive, "The manual was used in numerous Latin American countries as an instructional tool by CIA and Green Beret trainers between 1983 and 1987 and became the subject of executive session Senate Intelligence Committee hearings in 1988 because of human rights abuses committed by CIA-trained Honduran military units."

This aspect of the CIA's program both before and after 9/11 has probably had the least amount of emphasis in the press, for partly understandable reasons, as the actions of police or intelligence agencies in foreign countries is least penetrable or open to examination by government or human rights agency, not to mention journalists.

An important exception to this was Douglas Valentine's extensive evaluation of the CIA's Phoenix Program during the Vietnam War. In his book on the subject, he described Phoenix as both a counter-terror assassination program and a interrogation-torture program which heavily relied on the use of South Vietnamese liaison personnel. Valentine detailed the use of drugs by both CIA Phoenix personnel and South Vietnamese police to both disorient prisoners and to obtain false confessions.

In a newly revealed section of the 1963 KUBARK manual, the CIA discussed use of foreign services for interrogation. It is worth referencing here as it is expresses issues still relevant to CIA rendition activities, and interactions with foreign intelligence services to whom CIA sends "ghost" or black site prisoners.

The legislation which founded KUBARK [CIA] specifically denied it any law-enforcement or police powers. Yet detention in a controlled environment and perhaps for a period is frequently essential to a successful counterintelligence interrogation of a recalcitrant source. Because the necessary powers are vested in the competent liaison service or services, not in KUBARK, it is frequently necessary to conduct such interrogations with or through liaison. This necessity, obviously, should be determined as early as possible. The legality of detaining and questioning a person, and of the methods employed is determined by the laws of the country in which the act occurs.

The issue of drugging detainees takes on even more relevance when one considers that the SSCI's report on CIA torture included revelations that James Mitchell worked for the CIA's Office of Technical Services (OTS) when he was referred to help lead the interrogation of Abu Zubaydah, and later to construct the EIT program itself. At least one other OTS official was said to have worked on the EIT protocols along with Mitchell, a fact totally ignored by mainstream press accounts.

OTS is notable in CIA history for being the department in charge of the CIA's MKULTRA program for some years.

Narcotic drugs, "sedatives," and antidepressants administered to detainees

Despite the claims no drugs were used for interrogation purposes, like a September 2009 Department of Defense Inspector General report (PDF) on the same issue, released via FOIA in July 2012, CIA admitted other drugs were used on detainees for various health-related purposes.

A full list of such drugs, by name or family of drug, was redacted in the current CIA FOIA release. Hence, the most crucial information that we could obtain from the IG investigation was censored.

But a memo from the Director, OMS to Helgerson (dated May 29, 2008) indicated that drugs given to detainees in the CIA's RDI program included both narcotic and non-narcotic analgesics for "pain relief."

In addition, CIA's OMS administered oral, topical and injectable antibiotics; topical agents for skin conditions; antacids, laxatives and antidiarrheals; as well as non-prescription medications for sleep. The letter drily noted that medications "to assist with sleep on request" were not administered during interrogations. (The CIA's torture program is known for its heavy reliance upon sleep deprivation.)

The CIA's medical services director also indicated that antidepressant medications were given to "several detainees." In addition, "sedatives" were also give in "two instances" to detainees "with their knowledge and consent" for "agitation or anxiety."

CIA documents maintain that what drugs were administered to detainees were done with the informed consent of the prisoners. This contrasts with DoD's admission that drugs were forcibly administered to some detainees for purposes of "chemical restraint."

The only drug actually named by CIA officials in the FOIA release was Ambien, and that was said to have been administered to CIA officers for use in travel to and from CIA black sites.

The Director, OMS, also told Helgerson that he knew of no other use of drugs for purposes of interrogation "in any other program or site." Helgerson himself later told Feinstein and other U.S. senators who had asked for the information, that he was told there no "information that any CIA officer or contractor... has procured and/or administered such drugs to detainees since September 2001."

Helgerson never mentioned the possibility that such drugs were administered by foreign nationals or liaison officials in other countries where CIA had sent detainees via rendition. In fact, there has been a great deal of evidence of such drugging.

"Drugged repeatedly"

The CIA documents focus on claims of drugging by US agents of Adel al-Nusairi, as described in an influential April 2008 Washington Post article by Joby Warrick. Yet, the Post story was the latest in a number of articles accusing the CIA and DoD of drugging detainees. Another such article in 2007 at NBC News included charges that the CIA's interrogation program included use of "psychotropic drugs."

The CIA was dismissive of Warrick's claims, noting in one memo, most likely from CTC to CIA IG, that al-Nusairi was never a CIA prisoner, "nor did we render him," and therefore they knew little about him or his treatment.

But certainly a search of open source documentation would have found many other instances of charges of drugging by CIA prisoners.

For one thing, as documented in the recent release by the SSCI of their study on the CIA's interrogation program, high-value detainee Abd al Rahim al Nashiri made repeated charges that we was drugged while in CIA custody. "Over a period of years," the report states, "al-Nashiri accused the CIA staff of drugging or poisoning his food, and complained of bodily pain and insomnia."

In February 2007, a Washington Post article by Dafna Linzer and Julie Tate related the story of Marwan Jabour, "an accused al-Qaeda paymaster," who claimed he was drugged in June 2006 on his very last day in CIA custody.

Jabour "was stripped naked, seated in a chair and videotaped by agency officers. Afterward, he was shackled and blindfolded, headphones were put over his ears, and he was given an injection that made him groggy," Linzer and Tate wrote.

A number of detainees accused the CIA of forcibly administering suppositories, presumably containing some drug. In December 2009, the European Court of Human Rights found that CIA had in fact "forcibly administered" a suppository during the CIA rendition of Khalid el-Masri.

A 2007 ICRC report, based on interviews with high-value prisoners held at one time by the CIA, stated, "A body cavity check (rectal examination) would be carried out and some detainees alleged that a suppository (the type and the effect of such suppositories was unknown by the detainees), was also administered at that moment." (p. 6) One of these detainees was accused 9/11 plotter, Khalid Sheik Mohammed.

The ICRC report was released in 2010 by the New York Review of Books, over a year after the CIA IG investigation, but certainly Helgerson had access to the report if he so wanted.

In fact, Helgerson and CIA appear to have done very little in the way of investigating the charges. Like DoD, which also did a poor job of investigating the drugging, interviewing only three detainees, CIA construed the charge to investigate drugging as narrowly as possible. Hence charges of being drugged by foreign governments after CIA had rendered prisoners to countries like Egypt and Morocco were ignored by Helgerson, even though CIA and other allied government agents were present at these interrogation sites, if not directing the interrogations themselves.

Charges of drugging by detainees rendered by CIA to "liaison" services have been detailed in open source documents. Egyptian-born Australian citizen Mamdouh Habib accused Egyptian jailers of drugging him after CIA rendered him to that country.

As a 2005 article on Habib in the Los Angeles Times reported: "'They outsource torture,' said Stephen Hopper, Habib's Australian lawyer. 'You get your friends and allies to do your dirty work for you.'"

British resident Binyam Mohamed, rendered by CIA to Morocco, and later to Guantanamo, said he was "drugged repeatedly" by Moroccan authorities, subsequent to CIA rendition.

In addition, there is the related issue of withholding of drugs as part of an overall manipulation of medical care. The SSCI report refers to this in the case of high-value detainee Abu Zubaydah. While it quotes CIA director Hayden as denying drugs were withheld from detainees, the report quotes a CIA cable from the time of Zubaydah's interrogation that mentions "the removal of formal obvious medical care to further isolate" AZ, which could refer also to withholding of medical drugs. (p. 491)

Another example of deleterious withholding of drugs concerns high-value detainee Ramzi bin al-Shibh. According to CIA documents quoted in the SSCI report, al-Shibh been in "'social isolation" for as long as two and half years and the isolation was having a 'clear and escalating effect on his psychological functioning." By April 2005, his psychological deterioration was considered "alarming." A CIA psychologist is quoted as saying, "significant alterations to RBS'[s] detention environment must occur soon to prevent further and more serious psychological disturbance."

The SSCI report notes that al-Shibh was placed on antipsychotic medication once he was transferred to Guantanamo on September 5, 2006. Evidently, al-Shibh was not placed on such medication prior to that, despite his desperate psychiatric condition.

While the CIA's Director of Medical Services told the Agency Inspector General that there were psychiatric problems and that antidepressants and "sedatives" were administered, nothing in the extant documents mentions antipsychotic medications. Conversely, the DoD IG report on drugging detainees mentions use of the antipsychotic drug haldol, and not just for antipsychotic use, but as a chemical restraint.

Blood Thinners and Antimalarials

The CIA IG investigation is disingenous in the way it approaches the question of drugs and their effects on prisoners, or the way in which drugs were used in the torture program.

The executive summary of the SSCI report released last December tells the story of Abu Ja'far al-Iraqi. According to CIA records, al-Iraqi "was subjected to nudity, dietary manipulation, insult slaps, abdominal slaps, attention grasps, facial holds, walling, stress positions, and water dousing with 44 degree Fahrenheit water for 18 minutes. He was shackled in the standing position for 54 hours as part of sleep deprivation, and experienced swelling in his lower legs requiring blood thinner and spiral ace bandages.... After the swelling subsided, he was provided with more blood thinner and was returned to the standing position" (p. 149, bold emphasis added).

Typical blood thinners that could have been used likely included heparin or warfarin, both drugs that can produce significant side effects, including headache, confusion, nausea, weakness, and fatigue, all conditions that would adversely affect a prisoner undergoing interrogation, not to mention torture.

The Helgerson investigation is also mum on the use of either scopolamine or mefloquine, both drugs that were administered to detainees rendered to Guantanamo. This presumably also included CIA prisoners transferred to Guantanamo from black sites. The use of scopolamine and mefloquine were standard operating procedures for prisoners entering Guantanamo. Nothing in the new documents speaks to whether such drugs were used on CIA prisoners at the DoD facility.

Former Guantanamo guard Joe Hickman has stated in his widely discussed new book, Murder at Camp Delta, that the CIA ran a secret "special access program" at Guantanamo that included a black site at the Cuba-based facility. It is Hickman's contention that the three detainees who died at Guantanamo in June 2006, which DoD officials called a case of concurrent suicide, were in fact victims of interrogations or experiments at the camp's CIA black site, known variously as "Camp No" and "Strawberry Fields."

Notably, one of the deceased detainees had needle marks on his arms. The suicides were also tested for the presence of the antimalarial drug chloroquine, and one of the deceased was tested for the presence of mefloquine. This was quite odd as, one, there is no malaria in Cuba, and two, the SOP that called for administration of mefloquine would have only been relevant to newly arrived prisoners. The three dead detainees had been at Guantanamo for approximately four years at that point.

What mefloquine, scopolamine, chloroquine, and blood thinners have in common are disagreeable, even potentially severe side effects, including psychiatric side effects, even as none of these drugs (with the possible exception of scopolamine) are considered psychotropic or "mind-altering" drugs. Their use by CIA or any government agency holding detainees or prisoners should be very carefully examined for their potential for abuse, as the drugs may not be considered primarily psychoactive, and yet affect mood, perception, consciousness or behavior.

It is worth recalling that the MKULTRA experiments on drugs were not solely about drugs like cannabis, mescaline or LSD. MKULTRA experiments included examination of antimalarials, and also drugs like curare and cancer medications. Indeed, according to an SOP for Physician Assistants at Guantanamo, the Detainee Hospital formulary stocked a number of older chemotherapy drugs. It also stocked heparin and the curare-based drug tubocurarine choloride.

In addition, the detainee hospital also had supplies of a very old malaria drug, quinacrine, as well as the fertility drug Clomid. Why detainees would need a drug that affected hormone levels of estrogen or testosterone is unknown. However, while the hospital stocked these drugs, the SOP indicated that physician assistants were prohibited from prescribing them.

Drugs in interrogations okay if no "lasting or permanent alteration or damage"

Leopold's article does a good job at detailing the history of the CIA's investigation, and the strange preoccupation of CIA officials in proving that they had never referred the drug issue to the Office of Legal Counsel for approval for use in the interrogation program. And yet, as Leopold points out, John Yoo, the primary author of the first three torture memos made a special point of giving legal cover to the use of drugs in interrogation.

It it worth noting that the use of drugs in interrogation also became a part of the Army Field Manual, which was revised in September 2006. While previously the military could not use drugs that that could cause a "chemically induced psychosis," the current Army Field Manual prohibits only the use of "drugs that may induce lasting or permanent mental alteration or damage."

In other words, any drugs can be used for interrogation that do not cause permanent damage or alteration in a prisoner, a very loose criterion that would allow for the use of many pernicious and harmful, not to say psychoactive or "mind-altering," medications. Today, per executive order by President Obama, the Army Field Manual is the official government guideline for interrogation for both the military and the CIA.

Crossposted from Firedoglake

New Book: Antimalaria Drugs Part of Secret Program to Torture Detainees at Guantanamo

It isn't often that a book that sets out a case that drugs were used to disorient and disable Guantanamo detainees for interrogation makes the front pages, or gets the news coverage one new book did. What's even more remarkable is that the revelations in that book are just the tip of the iceberg, as new evidence shows the drug use was even greater and more varied than previously reported.

Earlier this year, Simon and Shuster published to great acclaim former Guantanamo guard Joe Hickman's book, Murder at Camp Delta: A Staff Sergeant's Pursuit of the Truth About Guantanamo Bay. The book described Hickman's investigation of the 2006 purported suicides by three Guantanamo inmates, deaths the Guantanamo commander, Rear Adm. Harry B. Harris Jr., called at the time, "asymmetrical warfare waged against us."

But rather than a planned terrorist event of exquisitely-timed suicidal protest -- an implausible tale in the high-security Guantanamo setting to begin with -- Hickman, whose story was first told in an award-winning Harper's magazine article in 2010, discovered the deaths were likely linked to a secret, most likely CIA, black site on the Guantanamo base. As a tower guard, the night of the "suicides" he had witnessed three detainees secretly taken out of camp earlier that evening and driven in the direction of the black site.

Later, he was witness when the warden at the Guantanamo prison facility, Army Colonel Michael Bumgarner, told prison personnel that despite the fact it was known in the camp that the prisoners had died with rags stuffed down their throats, they were to say nothing to the press when the story was released the detainees supposedly had hanged themselves. A year after the Harper's article, Almerindo Ojeda, a researcher at University of California, Davis, made a strong case that the three detainees had been killed by a torture technique known as "dryboarding."

Hickman knew the official story did not hold together, and while he tried to put the nightmare of Guantanamo out of his mind, when a year later another detainee died of supposed suicide, Hickman knew he could not let the story rest. He began a private investigation into what occurred, later linking up with researchers led by attorney Mark Denbeaux at Seton Hall University Law School's Center for Policy and Research. Together, they released a number of reports deconstructing and refuting the official story.

The most recent Seton Hall report, published last year, included claims Hickman would make in Murder at Camp Delta, including charges that the Naval Criminal Investigative Service (NCIS) had suppressed evidence from their report, removed witness statements, failed to interview other crucial witnesses, and in general had produced, at best, a shoddy work. At worst, it was circumstantial evidence of a major government cover-up.

But one of the strangest links in the tale of government crimes concerned the use of a drug meant to prevent or help cure malaria. As Hickman was looking over a deceased detainee's medical record, he discovered that the detainee had been give a large dose of mefloquine upon admission to Guantanamo. (Mefloquine is often known by its former brand name, Lariam.) He later found that mefloquine had been administered to all the Guantanamo detainees on medical intake. But what was mefloquine?

Why mefloquine?

Mefloquine administration was standard operating procedure upon admission. The official story, first reported to Jason Leopold and me and published at Truthout, was that Cuban officials told Guantanamo camp officials that they were worried that detainees would bring malaria to the otherwise malaria-free Cuban isle. Perhaps never in the annals of U.S. history were Department of Defense officials so sensitive to Cuban fears and needs.

According to Navy nurse, and then chief surgeon for Guantanamo's Task Force 160, Capt. Albert Shimkus, at the behest of the Cubans he gathered experts, and a determination was made that mefloquine would be the primary drug used to control possible malaria. But when queried more closely on the issue, including the fact Cuba had no malaria, Shimkus admitted he and others had been told there were "certain issues we were advised not to talk about.”

But to date, Shimkus's story, which supposedly included consultation with the Centers for Disease Control (CDC), the Navy Environmental Health Center (NEHC) and the Armed Forces Medical Intelligence Center at Fort Detrick, Maryland, has not panned out, as FOIA requests for documents from the above agencies have all received a response of "no responsive documents."

Even more, as another article I wrote in 2011 with Leopold explained, foreign workers brought in to build Camp Delta itself were drawn heavily from malarial-endemic parts of the globe, including India and the Philippines, but DoD showed no interest in ensuring these workers did not carry malaria.

What DoD did was administer 1250mg of mefloquine in divided doses in the first 12 hours. Hickman is correct that this is five times the usual prophylactic weekly dose of the drug. But it is not, as Hickman portrays it in the book, a "massive overdose" of the drug. It is the amount administered when you are seeking to eliminate a certain stage of the malaria parasite from the bloodstream. It is a "treatment dose."

But that does not change the fact, which Hickman discovered, that there was no reason to administer such a large dose, and that large doses of the drug -- even the lower 250 mg level prophylactic dose -- carried intolerable neurological and psychological side effects.

Indeed, by 2013, DoD had requested that all service personnel, including special forces, forego use of the drug because of rare but documented neurological toxicity. That same year, the prestigious Institute on Medicine as a Profession called for an investigation on the use of mefloquine at Guantanamo.

An Army doctor-researcher, Remington Nevin, later confirmed in a 2012 published report in the medical journal Tropical Medicine and International Health that DoD's "presumptive treatment" of possible mefloquine in the detainees was both unprecedented and "inappropriate." He added that his "analysis suggests the troubling possibility that the use of mefloquine at Guantanamo may have been motivated in part by knowledge of the drug’s adverse effects...."

Hickman would conclude that the mefloquine was used at the highest known dosage precisely because of its propensity to cause side effects, including dizziness, nightmares, nausea, and suicidal feelings.

"... [T]he entire purpose of Gitmo," Hickman wrote, "was to practice new interrogation techniques on detainees, regardless of any information they may or may not have possessed. From this research, it became clear that not only was mefloquine administered as part of this program, the deaths of the three detainees likely occurred under the shadowy operations of something called a special access program (SAP)— and it had to be kept secret at all costs."

Presence of Mefloquine Examined in Autopsies

But there was more to the drug story than even Hickman knew. According to autopsy records for one of the three 2006 "suicides," Yemeni prisoner Ali Abdullah Ahmed, and the May 2007 death that had galvanized Hickman's investigation, the purported suicide of Abdul Rahman Al Amri, both had autopsy reports that specifically called for toxicology results on the presence of possible mefloquine in their bodies. See here and here.

But this made no sense. Why would Armed Forces epidemiology workers look for mefloquine in some of the deceased detainees and not others? Why would they look for mefloquine at all, as it was supposedly only administered as a malaria precaution upon entrance to the facility? Both Ahmed and Al Amri had been at Guantanamo four years or more when they died. Neither of their medical records such as we have extant point to the presumed presence or fear of infection by malaria.

The evidence points to use of the drug for other than malaria prophylaxis or treatment, in other words, exactly for the use that Hickman and Nevin and the Seton Hall researchers feared. The drug was being used to torture people.

Other drugs used: Chloroquine

But there was even more.

Al Amri, like the three 2006 detainees, was discovered with his hands bound. But unlike the 2006 victims, Al Amri had his hands tied behind his back.

As for Yasir al Zahrani, Mari Al-Utaybi, and Ahmed, the three 2006 "suicides," all had been tested for the presence of yet another antimalaria drug, chloroquine. (Of the three, only Ahmed was tested for presence of mefloquine.)

Chloroquine has long been used in the prophylaxis and cures of certain forms of malaria. Over the years mosquitos in various parts of the world have become immune to chloroquine. Nevertheless, it remains a drug in common usage, though it has its own problematic side effect profile. While not as neurotoxic as mefloquine, chloroquine can cause a large range of side effects, including dizziness, blurred vision and "extrapyramidal disorders (eg, dystonia, dyskinesia, tongue protrusion, torticollis)."

Chronic or long-term use of the drug can cause even worse side effects, including muscle weakness. There are a host of other "rare" side effects.

While other drugs involved in the toxicology tests on the three detainees, including for the presence of "cannabinoids" and cocaine, could be chalked up to the use of a standard protocol, there's no reason to assume that chloroquine, a drug used almost exclusively for malaria, should have been on the standard drug testing test panel. Indeed, the fact that mefloquine was included for testing on one of the three detainees demonstrates that the drug test could be manipulated selectively.

Was chloroquine also used as a drug of disorientation and abuse on detainees? We don't know for sure. In his book, Hickman pointed to a 1977 Senate investigation that disclosed past CIA research on the class of drugs from which mefloquine was derived. (Hickman wrongly attributes the entire investigation to use of that class of drugs, but it was a much larger investigation than that.)

Hickman's nod in that direction got me looking a few years ago, and I discovered that not only had the CIA investigated that class of drugs, but they used at least one of these drugs, a cousin of mefloquine called Cinchonine, as an "incapacitating drug" in its MKULTRA program. The revelations were part of the famous 1975 Church investigations in the U.S. Senate.

Not only were there indications that the antimalaria drugs mefloquine and chloroquine were used to chemically degrade the physical and mental condition of prisoners, but now there was a CIA precedent!

Other drugs used: Scopolamine

If the malaria drugs were used to incapacitate and disable, I asked myself, were there any other drugs used for the same purpose? We knew from a DoD Inspector General report that antidepressant and antipsychotic drugs were administered to detainees before interrogations (though DoD maintains not supposedly to affect the interrogation), even forcibly to restrain prisoners. But was there anything else like the antimalaria drugs?

Yes, there was. I discovered that the Standard Operating Protocol for nurses dated October 2003 refers to the presence of a scopolamine patch behind the ear on incoming detainees, themselves flown via extraordinary rendition to Guantanamo. (We now know some of those renditions were funneled via DoD's European command out of Germany.)

Scopolamine has a long history as a supposed "truth drug." While it is sometimes prescribed to prevent air sickness -- and that's the official reason DoD used the drug on detainees -- it is also known to cause a number of disorienting side effects. In fact, as far back as 1956, the military advised using meclizine instead of scopolamine to deal with motion sickness in pilots because of the latter's "distressing side effects."

The side effects, according to a CIA document that detailed use of the drug for possible interrogation, include "hallucinations, disturbed perception, somnolence, and physiological phenomena such as headache, rapid heart, and blurred vision."

Scopolamine has long-lasting effects. We can see now that prisoners arrived in Guantanamo frightened and disoriented. They had often been hooded. All were retrained. Many must have been suffering side effects from the scopolamine. Upon arrival they were given mefloquine, another long-lasting drug with possible horrific side effects. And these are only the drugs we know about. None of these drugs were either first-rank drugs, and in the case of mefloquine and chloroquine, there was no known reason to presumptively give the drug upon arrival. And even if there were, there was even less reason to administer the drug again years after a prisoner's initial medical intake at the island prison.

We owe a huge debt of gratitude to Joe Hickman for digging out much of this information, and having the courage to publish it and talk publicly about it. But as Hickman writes at the end of his book, "I wrote this account to provoke further research and informed debate, so that hopefully we may do a better job with our detention program."

I think that detention program is an abomination. It was and likely remains an experimental program in interrogation and torture. It should be closed down, and a full independent investigation with subpoena powers undertaken to finally bring the criminals who implemented the torture to justice.

While Hickman's book has gotten great coverage in the press, no one has really picked up the author's challenge to further the research the book began. This review is offered as a challenge itself to extend the investigative reporting on Guantanamo and the U.S. torture detention program in general.

The recent publication of the Senate Intelligence Committee's report on the CIA torture program was a limited hangout, and questions about the origin of the program, or how exactly it was approved and implemented still remain unknown. The Senate will not release the vast bulk of their own study for public consumption. Indeed, they will not even explain inconsistencies in their own account, such as the presence of SSCI staff members at the CIA's Dark Prison black site in Afghanistan in late 2003.

The truth is that only a public outcry will bring significant attention to move the torture story beyond the partial boundaries set by human rights organization attorneys, vote-sensitive politicians, and career-fearing journalists. Hickman has shown that the examination of drugs in the U.S. torture program can be mainstream. Who will pick up the baton now?

Cross-posted at FDL/The Dissenter

US Government Classifies Term "America's Battle Lab' in War on Terror" in Pentagon Report

The Department of Defense, after consultation with the CIA, the Joint Chiefs of Staff and the Defense Intelligence Agency, has released via Mandatory Declassification Request an early Pentagon study of intelligence operations at Guantanamo (along with accompanying slide presentation). It is very heavily redacted, with whole pages blanked out.

But even more, DoD and its "consultants" have seen fit to classify material that was already made public during a much-reported Senate investigation, including the controversial assertion that interrogations at Guantanamo constituted an experimental "battle lab" for treatment of and interrogations on prisoners captured in the administration's newly-minted "global war on terror."

When the Senate Armed Services Committee (SASC) published their report, "Inquiry in the Treatment of Detainees in U.S. Custody," in November 2008, Section III was titled, "Guantanamo Bay as a "Battle Lab" for New Interrogation Techniques." The quote was taken from a 2002 report commissioned by the Joint Chiefs of Staff on intelligence operations at Guantanamo's new prison for "war on terror" prisoners.

The SASC report referred to the JSC study as the "Custer report," named after Colonel John P. Custer, then-assistant commandant of the U.S. Army Intelligence Center and School at Ft. Huachuca, who led the review team for the Joint Chiefs. The report stated, "In his report, COL Custer referred to GTMO as 'America's "Battle Lab"' in the global war on terror, observing that 'our nation faces an entirely new threat framework,' which must be met by an investment of both human capital and infrastructure."

Despite the fact the portions of the Custer Report quoted above were not classified in the SASC report, there are no comparable quotations or remarks in the Custer Report or the slides released via MDR request. Because there are so many redactions in the report itself, it is impossible to know which agency did the classification, or what FOIA "exception" was used to justify this specific instance of censorship.

The Senate report also documented use of similar characteristic language from two Guantanamo commanders, Major General Mark Dunleavy and Major General Geoffrey Miller.

The Senate committee would conclude that psychologists at the military's SERE schools, and possibly special forces, along with their commanding officers and some legal officials, had colluded in creating a new and untested form of interrogation that amounted to abuse and torture of prisoners. While they did not say so, this program ran concurrently with the CIA's notorious "enhanced interrogation" program, and many of the techniques used overlapped between CIA and DoD, including use of isolation, sleep deprivation, stress positions, physical abuse, and sensory deprivation and overload.

The redactions in the Custer report are currently under appeal with the Office of the Secretary of Defense, who told me in an October 23, 2014 letter it is "coordinating this appeal with the Central Intelligence Agency, Defense Intelligence Agency, and Joint Staff."

"Negative connotations"

The "Battle Lab" term was viewed with alarm by military investigators from the Criminal Investigative Task Force(CITF), which DoD had assembled from investigators from the Army, Navy, Marines and Air Force. The SASC quoted CITF chief, Colonel Britt Mallow, who provided written testimony to the Senate committee:

MG Dunlavey and later MG Miller referred to GTMO as a "Battle Lab" meaning that interrogations and other procedures there were to some degree experimental, and their lessons would benefit DOD in other places. While this was logical in terms of learning lessons, I personally objected to the implied philosophy that interrogators should experiment with untested methods, particularly those in which they were not trained.

Mallow's deputy, Mark Fallon, concurred, telling the SASC "CITF did not concur with the Battle Lab concept because the task force 'did not advocate the application of unproven techniques on individuals who were awaiting trials.... there were many risks associated with this concept... and the perception that detainees were used for some 'experimentation' of new unproven techniques had negative connotations."

Told that the FOIA release of the Custer report had censored use of the term "battle lab," Fallon told this author he was "very disappointed" at the extent of the redactions in the FOIA version of the report.

"I was privy to the initial report when it was first published," Fallon wrote in a March 6 email, "and in fact, one of the factors that contributed to the need for such a review were the complaints the CITF had made to the chain of command about the activities and actions associated with detainee operations and interrogations onboard Guantanamo Bay, Cuba.

"Just as the Senate Select Committee on Intelligence (SSCI) found when they were staffing the release of the Torture Report, redactions are often to avoid embarrassment and not based on legitimate national security purpose.... In fact, the 2008 SASC hearings and report contained specific information about Col Custer’s report about interrogations at Guantanamo...

"Having spent more than 30 years working national security issues, including investigating unauthorized disclosure of classified information and espionage related matters; there are two resounding themes that spanned across those decades. One was the over classification of information that is not based on legitimate national security interests and the other is the lack of accountability for the over classification of material.

"In the aftermath of the 9/11 attacks, we did some things that are contrary to our values and we can neither hide from them nor redact them from the record. Our Nation has always grown stronger when we have confronted our failings and learned from them. It’s time to illuminate the darkness on this dark chapter and to once again be the beacon for human rights and American values."

Intelligence Contingency Funds

The Custer report as released is not without some interesting value. For one thing, it describes the recommendation for the founding of a "Terrorism University" at Guantanamo, meant to "provide a common orientation curriculum for personnel assigned to the GTMO operation." Personnel who have contact with detainees would be trained prior to their deployment. "Interrogators and debriefers who have worked at [redacted] detention center should be sent to "TU" as advisors/instructors," the document states.

Even more interesting is the reports discussion of use of "Intelligence Contingency Funds." Much of the section on this issue is, as is most of the document, censored. However, the intelligence officials who undertook the August 2002 review at Guantanamo were clearly unhappy about the facilities at the Cuba-based naval prison, citing them "too small for current and projected [nearly a line redacted] intelligence operations."

Military intelligence officials recommended that the Joint Chiefs work with the House and Senate intelligence committees "for an emergency intelligence appropriation to fund construction..." of updated facilities.

It is not generally known that the Congressional intelligence committees, ostensibly formed to provide oversight on the actions of the CIA and other intelligence committees (while SASC is supposed to be responsible for military intelligence oversight), act dually to provide appropriations for intelligence operations. Indeed, I have never seen it reported on.

But on its web servers, the CIA has a history online, L. Britt Snider's "The Agency and the Hill," which discusses the development of this aspect of the intelligence committees. (See especially its Chapter 6, "Program and Budget."

The import of this information cannot be clearer. Whatever its oversight functions and actions, the House and Senate intelligence committees clearly were involved in funding "America's 'Battle lab'" of torture.

Intel Agencies' Curiosity about "the limits of the human spirit"

In January 2015, the Seton Hall University School of Law, Center for Policy and Research, put out a report, "Guantanamo: America's Battle Lab," which amplified the points made above. The report (PDF) documented how an experimental program of torture had been implemented via a secret, unacknowledged Special Access Program (SAP), with no congressional oversight. (Strangely, the report failed to mention how the Custer report also used the "battle lab" language.)

The Seton Hall investigators summarized their findings:

The Center for Policy and Research has discovered the disturbing truth behind the purpose of GTMO. Instead of being used primarily as a detention facility, GTMO was designed and operated by Intel predominately as America’s Battle Lab—a facility where U.S. intelligence personnel could coordinate worldwide interrogation efforts and have unfettered control over persons in U.S. custody....

America’s most notorious detention facility was covertly transformed into a secret interrogation base designed to foster intelligence’s curiosity on the effects of torture and the limits of the human spirit....

... GTMO truly served as the think tank and center for experimentation in exploring interrogation techniques and training other military officials in facilities across the globe. In this sense, America’s Battle Lab served as the heart of worldwide interrogation testing and training.

"Murder at Camp Delta"

The discovery of the Gitmo SAP (or SAPs) was narrated in the first person, in the form of an odyssey though the maze of Guantanamo prison blocks and secret black sites taken by former Guantanamo prison guard Joseph Hickman, as described in his new book, Murder at Camp Delta: A Staff Sergeant's Pursuit of the Truth About Guantanamo Bay. Hickman was also a senior researcher on the Seton Hall study.

In June 2006, Hickman was eyewitness to lies told by high military officials about what happened when three young men were supposedly discovered dead by suicide. While at first he found the idea that command authorities or the Naval Criminal Investigative Service could be covering up a crime too difficult to believe, when a fourth detainee allegedly was found hanged in his cell nearly a year later, he realized that the evidence of his eyes and of his heart could be ignored no longer. The remainder of his extraordinary book details Hickman's own investigation into the deaths of the three 2006 "suicides."

Hickman cites many of the details found in the Seton Hall study, but unlike the documentary approach of the latter, the former guard's story puts you right in the middle of the investigation.

According to Hickman: "... by the time I'd gathered and sifted though all the relevant documents, I realized that all of us who arrived there, even Admiral Harris, had entered an intelligence operation in which no normal military rules or codes applied.

"Instead of order and discipline, the authorities behind it aimed to create 'controlled chaos.' The people we were guarding weren't just suspected jihadists or enemy combatants, but men who'd been given drugs by our medical personnel intended to make them believe they were insane when they arrived."

Mefloquine and beyond

Hickman, like his collaborators at Seton Hall, concentrate on the bizarre use of the antimalaria drug mefloquine at high treatment doses on all incoming detainees, as an example of the way drugs were used to disorient and disable incoming detainees. But evidence from this author shows that not only melfoquine, but the antimalaria drug chloroquine was used on at least some of the detainees at points well past their entry into Guantanamo.

Similarly, some detainees, including one who died in 2006 and another in 2007, were possibly given mefloquine at other points in their incarceration for reasons that could only be to disable and harm them.

There is much left to explore and discover about the US torture programs of the CIA and the Defense Department, and the mysterious Special Access Programs, unaccountable to no one, that have undertaken a lawless program of torture and mayhem and murder that no one can guarantee isn't over yet. Indeed, a recent UN meeting of the Committee on Torture castigated the U.S. for the continued use of isolation, sleep deprivation and sensory deprivation, as allowed in Appendix M of the Army Field Manual.

There are two things lacking in moving forward on this issue: political will, and the lassitude of the press. Of these, political will must come first, as the torture issue is tied to two political parties, one of which has members who are strong proponents of torture, and the other which has a leader in the Oval Office who refuses to prosecute former government officials for war crimes, and lectures others not to dwell on these past crimes because they are in the past. (This did not stop Obama's DoJ for prosecuting Rasmea Odeh for crimes purportedly committed 40 years ago, or holding former American Indian Movement leader Leonard Peltier in prison for trumped up charges for 38 years.)

But political will also rests ultimately in the hands of the people themselves, and unless citizens of the United States start to take these issues with the seriousness they deserve, then the torturers will continue to go free. They are free now - from Guantanamo to Chicago, Illinois -- and they are getting ever more aggressive. Failure of will to prosecute and punish the torturers will result in the total loss of democratic rights and the descent into the kind of hell usually reserved for U.S. torture-client states, like Egypt.

Crossposted at FDL/The Dissenter

IMAP/OSF Report Calls for Investigation of Drug Given to All Guantanamo Detainees

Breaking a three-year silence by the medical and human rights community, a panel of doctors, attorneys, human rights professionals, university professors and ethics experts have called for an investigation into the use of mefloquine on detainees at Guantanamo Naval Prison. The prison camp had instituted in very early 2002 an unprecedented policy of administering full-treatment doses of mefloquine to all incoming detainees at Guantanamo.

Mefloquine is an anti-malaria drug that has been very controversial over the years. It has been linked to severe neurological and psychiatric side effects, including depression, suicide, hallucinations, seizures, neurotoxicity as well as adverse and sometimes long-lasting central nervous system problems. The drug was also sold for years under the brand name Lariam in the United States, but Swiss manufacturer Hoffmann–La Roche ceased marketing it in here in August 2009.

The rationale for the Department of Defense policy on mefloquine at Guantanamo -- ostensibly to counter a supposed threat of malaria brought in by the newly arriving detainees -- underwent a withering analysis in a series of articles I wrote with Jason Leopold (see here, here, and here). At the same time, there was a strongly critical  2010 report by Seton Hall University School of Law’s Center for Policy and Research. This was followed by an article by Dr. Remington Nevin in the October 2012 edition of the medical journal, Tropical Medicine and International Health, entitled "Mass administration of the antimalarial drug meflouqine to Guantanamo detainees: a critical analysis" (PDF).

Nevin, a former Army doctor, concluded "there was no plausible public health indication for the use of mefloquine at Guantanamo," and suggested "the troubling possibility that the use of mefloquine at Guantanamo may have been motivated in part by knowledge of the drug’s adverse effects...."

The call to investigate mefloquine was made in the context of the report's strong recommendation that President Obama "order a comprehensive investigation of U.S. practices in connection with the detention of suspected terrorists... [including] inquiry into the circumstances, roles, and conduct of health professionals in designing, participating in, and enabling torture or cruel, inhuman, or degrading treatment of detainees in interrogation and confinement settings and why there were few if any known reports by health professionals."

The report, Ethics Abandoned: Medical Professionalism and Detainee Abuse in the “War on Terror, was released last week by its sponsors, the Institute on Medicine as a Profession (IMAP) and the Open Society Foundations (OSF) [link to PDF of full report]. IMAP is a major player in the medical ethics field and is funded by a number of foundations, including the Open Society Institute, the Josiah Macy Jr. Foundation, Kaiser Foundation Health Plan, Inc., the Selz Foundation, and the The Pew Charitable Trusts. IMAP also plays a central role in funding Columbia University's Center on Medicine as a Profession at Columbia University's College of Physicians and Surgeons.

The bulk of the report described how the CIA and the Department of Defense, with the connivance of the Department of Justice and health professional organizations like the American Psychological Association, changed the rules and procedures surrounding the use of health care professionals in interrogations and national security detention centers such that doctors and psychologists were enlisted in the design, participation and enabling of torture and cruel, inhumane and degrading treatment of prisoners.

In an article on November 5 at The Dissenter, Kevin Gosztola looked at the ways doctors and other health professionals participated in unethical forced-feedings of hunger strikers. In a previous look at the report, I noted its call for a new executive order banning certain interrogation techniques currently used in the Army's field manual on interrogation, which has been falsely sold to the public as "nonabusive."

The Role of Captain Shimkus

While labeling as "highly questionable" and "unexplained" the use of mefloquine at Guantanamo, the IMAP/OSF report did not investigate its use at length because, strangely enough, its task force panel included the former commanding officer at the Guantanamo Naval Hospital and chief surgeon (until summer 2003), Captain Albert Shimkus. Shimkus was the Guantanamo official who signed off on the mefloquine protocol to begin with.

IMAP/OSF report writers realized the dilemma they were in. Here's what they wrote about it:

Questions have arisen about the unexplained administration of an antimalaria drug with neuropsychiatric side effects to detainees at Guantánamo, including whether there were intelligence or security reasons rather than medical reasons for doing so. As the conduct of a member of the task Force has been questioned on this subject, the task Force does not address the matter here, but urges that the circumstances of the use of mefloquine, including the reasons for choosing it, be addressed as part of the full investigation of medical practices we recommend. [p. 48]

Asked to comment on Shimkus's inclusion on the IMAP/OSF panel, and on the report's recommendation on mefloquine, Dr. Nevin replied via email:

"While the recommendations of the Task Force to investigate the highly questionable use of mefloquine among Guantanamo detainees is welcome and long overdue, the Task Force has missed an opportunity to further explore this issue independently owing to the remarkable fact that one of the Task Force’s own members, CAPT (Retired) Albert Shimkus, former commander of the Guantanamo detainee hospital, was critically involved in the formulation and administration of detainee mefloquine policy.

For years CAPT Shimkus has consistently defended the practice by denying any misuse of the drug, including in a report published this year by the Constitution Project. Given the seriousness of allegations of misuse of mefloquine and the reluctance of CAPT Shimkus to acknowledge his role in having facilitated its questionable use, the Task Force should have recused CAPT Shimkus of involvement in their work so that the remaining panel members may have independently investigated this practice themselves, free of overt conflicts of interest. The loss of this opportunity will only further delay obtaining answers to the question of why mefloquine was used, and lessens the value of this report relative to its full potential."

Dr. Nevin's citation of The Constitution Project (TCP) report on detainee abuse is worth expanding upon, because Captain Shimkus was interviewed at length by TCP report investigators. Here's how the mefloquine issue was handled in their report, issued earlier this year:

Among Shimkus’ continuing critics are some who have suggested he aided interrogators by approving and initiating a regime of prescribing anti-malaria medication for all the detainees, at dosages far higher than those normally used for prevention rather than treatment of malaria. The drug, mefloquine, had side effects that could include paranoia, hallucinations, and depression, theoretically making recipients more vulnerable to interrogation. But Shimkus denied that this was the purpose of the anti-malarial medication, and the allegations that it was prescribed to assist in interrogation are speculative. Shimkus said he agreed with the medical decisions of others, including senior military medical officers, to conduct the medication program, and had consulted with officials at the Centers for Disease Control. He said that no one involved in the interrogation regime had any role in the decision or discussed the matter with him.

According to press reports from February 2002, malaria was far more prevalent in Afghanistan than in Cuba, where it was largely eradicated, and Cuban doctors had raised the issue of malaria prevention in meetings with Shimkus. In 2011, a Pentagon spokesperson told Stars and Stripes that the high doses of medication were appropriate because “[t]he potential of reintroducing the disease to an area that had previously been malaria-free represented a true public health concern. Allowing the disease to spread would have been a public health disaster.” [p. 32, link to PDF of full report]

"...certain issues we were advised not to talk about"

Shimkus appears to have gone out of his way to involve himself with investigations into detainee abuse, but his claims in the TCP report that he didn't notice abuse of Guantanamo detainees because he wasn't imagining any abuse would be taking place is just plain lame. (Shimkus was also a prominent positively portrayed figure in Karen Greenberg's book, The Least Worst Place: Guantanamo's First 100 Days.) His involvement in the mefloquine decision, including his explanations to this author about his motivations and actions, are, as the IMAP/OSF report indicate, matters for a full investigation.

For instance, rather than Shimkus's claim that no one discussed the mefloquine matter with him, he told me in an interview in 2010 that he was told by unspecified others not to discuss certain aspects of the mefloquine decision.

“There were certain issues we were advised not to talk about,” Shimkus told me, explaining the reason the policy was never publicly disclosed (see link).

Shimkus claims that he was worried about a possible "public health disaster." Yet he told me, in a separate interview from that noted just above, that he did not bother to discuss the malaria matter with KBR contract personnel or management when such workers were brought to Guantanamo in later 2002 to work on building Camp Delta, even though those workers mostly came from India and the Philippines, and areas where malaria can be endemic. So far as I was able to investigate, not one of those hundreds of workers could be documented to have taken mefloquine at Guantanamo.

No one knows the reason why mefloquine was mass administered at Guantanamo. Was it just poorly thought out medical policy? Was it covert testing on the side effects of mefloquine, a drug that was under fire at that same time at the Department of Defense (see link)? Was it an attempt to disorient or chemically weaken the detainees upon arrival?

The last question is not so strange when you realize that for years the CIA stockpiled another anti-malaria drug, cinchonine, to use as a chemical "incapacitating agent."

Many I speak to are not hopeful about the chances for a needed investigation. But I think that it would be premature to call over the struggle to fully unmask the torture that took place and get some form of accountability. More likely is that it would be part of, or even help spark a larger social struggle against the national security state and forms of injustice and inequality that plague this society.

Crossposted from The Dissenter/FDL

Are Politics Why IMAP Won't Publish Until 2013 Their Report on Doctors and Torture?

In 2010, the Institute on Medicine as a Profession (IMAP), along with the Soros-financed Open Society Institute (OSI) convened a Task Force on Preserving Medical Professionalism in National Security Detention Centers. On June 1, 2012, I received an email notification that the TF report "is now complete." But much to my surprise, the report was not due for release, however, until "early 2013."

Entitled "Doing Harm: Physician Participation in Interrogation and Torture, it is the result of two years of analysis by the Task Force, which was comprised of human rights, legal and medical experts," the email said. "They analyzed the role that health professionals played in the torture and interrogation of detainees at Abu Ghraib and Guantanamo. This topic has never been investigated in such depth and contains original research, analysis and policy recommendations."

IMAP has published a brief excerpt from the introduction to the report at their website. Here it is in toto:

“Everyone concerned with the integrity of medical professionalism and respect for human rights considers the participation of physicians in the interrogation and torture of military prisoners to be an egregious and alarming violation of the precepts of medical ethics and international conventions. Medical oaths and international declarations unambiguously prohibit and condemn such behavior. Nevertheless, in the aftermath of 9/11, these violations occurred at the detention camps in Abu Ghraib and Guantanamo. How did physicians and other health professionals come to participate in these activities? Why were accepted principles and codes ignored? What we can we learn from these events to prevent future occurrences? These are the central questions this report addresses—and although their significance is self-evident, they are by no means simple to answer.”

The Task Force Includes a Guantanamo Official

Initially, the task force membership was not public, but at the insistence of Jason Leopold and myself, IMAP published the list of members on their website. It's a formidable listing of experts in medical abuse and torture and medical ethics. It includes anti-torture candidate for presidency of the American Psychological Assocation, Steven Reisner; physicians Vincent Iacopino and Brig. Gen. (ret.) Stephen Xenakis, who wrote a PLoS research article last year concluding that military medical personnel at Guantanamo "neglected and/or concealed medical evidence of intentional harm" of detainees; Physicians for Human Rights Chairman of the Board Robert Lawrence; former American Psychiatric Association president Steven Sharfstein; ethicist George Annas; Deborah Popowski from Harvard's International Human Rights Clinic, and a number of others.

Interestingly, the IMAP TF included a former Guantanamo medical official, Captain (ret.) Albert Shimkus, Jr., who had been Chief Surgeon for JTF-160 at Guantanamo until mid-2003, and commanding officer at the Naval Base Hospital during the same period. Shimkus was not a doctor, but a nurse practitioner. Currently he teaches National Security Affairs at the U.S. Navy War College.

Of much importance to me, and presumably my readers, he was the official who signed off on the medical SOP that dosed every detainee entering Guantanamo with treatment-level doses of the anti-malaria drug mefloquine (also known as Lariam).

The unprecedented use of the drug, whose controversial history of side effects was already a subject of debate and research within the Department of Defense and CDC, was criticized by some public health experts. It was also the subject of an investigation by the Seton Hall Law Center for Policy and Research, published the same time as Jason Leopold and I issued the first of our Guantanamo mefloquine reports. The bulk of the public health field, however, stayed quiet on the subject; none came out in support of the measure, however.

More recently, government documents show that anti-malaria drugs were once used by the CIA as chemical "incapacitants." It remains an open question whether mefloquine was used in such a fashion on the Guantanamo prisoners, but the fact that two suicides at the facility were tested specially for the presence of meflqoquine at autopsy years after the administration of mefloquine raises questions about use of the drug on these detainees, and in general on all the prisoners.

The TF members I spoke to were nonplussed by the presence of Shimkus on the panel. None of the TF members had reacted strongly to the mefloquine revelations, although two members, Iacopino and Dr. Scott Allen, did say "the questionable use of mefloquine for malaria prevention at Guantanamo underscores the need for transparency of detention policies and procedures” at the prison facility. At the time they gave this quote to Leopold and myself, we were unaware that they were on the IMAP TF panel with Shimkus, and they did not reveal that to us.

Another TF panel member told me that by April 2011, the TF had only met twice. Shimkus was present at both meetings, and seemed "regretful and decent."

Captain Shimkus has always been responsive to my queries to him about the Guantanamo-mefloquine story, although responsive doesn't mean fully open. He explained there were things that were classified and he was unable to talk about, or was told specifically not to talk about. In addition, he never seemed "regretful" about anything he did or policies undertaken from a medical standpoint at Guantanamo. He disagreed with the conclusions of Drs. Iacopino and Xenakis about medical neglect and/or cover-up at Guantanamo, and he maintained, in more than one interview, that he consulted on the mefloquine SOP and it was undertaken for public health reasons and was nothing more than that.

The Politics of Delay

According to IMAP's tax return covering 2009, IMAP spent over $70,000 on a project looking at "Medical Professionalism and Dual Loyalty," a task force of military/department of defense experts; legal and human rights experts, and medical experts; to develop institutional mechanisms for preventing involvement of health professionals in interrogation and detainee abuse." This certainly seems a noble undertaking.

By 2010, according to IMAP tax records, it would seem this project metamorphosed into the Task Force on Preserving Medical Professionalism in National Security Detention Centers, with expenses over $92,000. And now the TF has completed its work, but the report won't be published until 2013. On June 12 I wrote to IMAP Chief Operating Officer, Michael Pardy, and asked him why the big delay.

Pardy wrote back the next day, explaining, "The publication date is tentative. We are moving it along as quickly as possible."

I felt that was still too vague for reporting purposed, so I wrote back:

OK, but for the purposes of an article I'm writing, the announced tentative publication date is still early 2013, is that correct? I really don't understand if the report is "done," that the publication could take so long. Either you are much more poorly funded than I thought (and I don't believe that is the case), or it appears to me the publication is being held back until after the election for political purposes.

Also, I was wondering if you could say if the report intends to cover at all the issue of the Behavioral Science Consultation Teams [BSCT] run by the Department of Defense?

I have yet to get a reply. Other task force members I asked about the delay in publishing, or the BSCT issue either didn't know, or did not answer my query. One person did say that the medical-ethical controversies over use of doctors and the force-feeding of detainees would be addressed in the report.

There is nothing in the delay in publishing that is nefarious, necessarily. And who really cares, in the end, what IMAP publishes or not, as the details are meant for medical journals and the medical or public policy elite, and not read by the general public?

But the question of medical ethics in the context of the US military's "war on terror" and DoD and CIA history in relation to torture and interrogation, including use of doctors and psychologists in the interrogation of detainees, in the monitoring of torture, and the construction of individualized torture protocols, is of high relevance and interest to the public at large.

I suspect, as I mentioned in the email to Pardy, the delay is due to the elections, with the intent to bury the problematic torture issue since it embarrasses the administration before its more liberal or human rights supporters. The embarrassment stems from President Obama's policy of non-accountability for the Bush-era torture program. His administration does not support the "looking back" at these issues that would bring about prosecutions, more investigations, or other forms of accountability. And the administration's supporters and backers pretty closely toe the party line on such things.

But it is sickening to think that human beings suffer in isolation and under indefinite detention, endure brutal ERF beatings, not to mention ongoing interrogations under the Army Field Manual's Appendix M protocols, in part because it would be politically inopportune to highlight their abuse before November 2012. In essence, the issue of detainee abuse is subordinated to the exigencies of American electoral politics.

Appendix M, by the way, includes, besides isolation, use of sleep deprivation and forms of sensory deprivation, which the manual advocates using in combination with the techniques that induce "debility" in prisoners (for instance, dietary manipulation), as well as use of techniques that produce emotional abuse ("Ego Down") and fear-generating treatment or manipulation of phobias, all with the intention of breaking-down the detainee... for what? Guantanamo is a "strategic interrogation center," according to government sources, and the interrogations there are not about operationally imminent intelligence, e.g. the so-called ticking bomb.

The answer is: for production of intelligence agents for use by the government, as well as the production of more false confessions, and cooperation with show trials, just as, for instance, Stalin used such torture when similar forms of prisoner abuse and interrogation was used by the NKVD once upon a time. It is possible as well that certain forms of experiments are conducted on these prisoners under the auspices of field trials of various instruments, procedures, or detention policies.

IMAP should heed its supposed call for change in the area of medical ethics and quickly publish their findings for the public. At the very least, an Executive Summary of the report could be published online. There is no excuse not to do this.

A Guantanamo Connection? Documents Show CIA Stockpiled Antimalaria Drugs as "Incapacitating Agents"

Listen to my interview with Peter B. Collins discussing this story

A Truthout analysis of historical records concerning government research and nonmedical use of antimalarial medications has revealed that such drugs were the objects of experimental research under the CIA's MKULTRA program. Even more, one of these drugs, cinchonine, was illegally stockpiled by the CIA as an "incapacitating agent."

Antimalarial drugs were studied as part of the CIA's mind control program MKULTRA. Cinchonine, an antimalarial drug derived from chichona bark, was one of the drugs used by the operational components of MKULTRA, code-named MKNAOMI and MKDELTA. The CIA worked with researchers for the Army's Special Operations Division, a secret component of the US Army Chemical Corps based at Fort Detrick, to develop delivery systems for the drugs.

Revelations concerning CIA interest in use of antimalarial drugs would be of historical interest, as it has never been written about before. But such interest gains contemporary significance in the light of actions taken by the Department of Defense (DoD) in the "war on terror," and the fact that a key DoD expert on antimalarial drugs was a psychiatrist involved in training personnel for Guantanamo interrogations.

In January 2002, the DoD deliberately decided that all incoming detainees at Guantanamo would be given a full treatment dose of the controversial antimalarial drug mefloquine, also known as Lariam. The purpose was supposedly to control for a possible malaria outbreak, in deference to concerns from Cuban officials.

But specialists in malaria prevention have said they have never heard of such presumptive treatment for malaria by mefloquine in this type of situation. Furthermore, a summary of antimalarial measures at Guantanamo given to Army and Center for Disease Control (CDC) medical officials at a February 19, 2002, meeting of the Armed Forces Epidemiological Board failed to describe the mefloquine procedure approved a month earlier.

Was mefloquine used at Guantanamo to help produce a state of "learned helplessness" in detainees? Were experiments conducted on adverse side effects of mefloquine on the prisoners held there?
Some years ago, this might have been considered a crazy scenario to even consider. While there is no smoking gun that can prove mefloquine was used for nefarious purposes, a strong case can be made that use of the drug at Guantanamo was not related to malaria control.

Antimalaria Drugs and MKULTRA

The revelation concerning cinchonine came from hearings the Senate's Church Committee held in September 1975 on CIA "Unauthorized Storage of Toxic Agents." The agency's illegal stockpile of chemicals and drugs, which included the antimalarial drug cinchonine, was supposed to have been destroyed by order of President Nixon in December 1969.

At the time of the president's order, the US had also signed an international agreement that such chemical and biological weapons would be destroyed, so the revelation of the CIA's stockpiling of such substances was highly embarrassing to the US government at the time.

At the behest of Congressional investigators, the CIA provided an inventory of all "lethal" and "incapacitating agents" they had kept contrary to presidential order. On this list, the CIA indicated it held two grams of cinchonine, stored as an incapacitating agent, that is, a substance meant to temporarily disable an individual. Temporary incapacitant or not, the CIA inventory listing for cinchonine states, "Overdose leads to severe cardiac convulsions, nausea and vomiting."

In separate testimony from another Senate investigation, a CIA-linked researcher, Dr. Charles F. Geschickter, told Sen. Edward Kennedy in 1977 hearings that the CIA was interested in antimalarial drugs that "had some, shall I say, disturbing effects on the nervous system of the patients." Geschickter's CIA researchers became interested in these antimalarial drugs as part of the work they were doing in the CIA's MKULTRA program. Dr. Geschickter ran the Geschickter Fund for Medical Research, and the Kennedy hearings also revealed how the fund laundered money for MKULTRA projects.

According to MKULTRA documents released as part of a related Senate investigation in 1977, research into quinolines, the class of drugs that include cinchonine, quinine and the modern antimalarial drug mefloquine (Lariam), was part of MKULTRA subprojects 43 and 45.

The CIA prior to the Congressional investigations destroyed most records concerning MKULTRA and chemical, biological and bacteriological research. Moreover, according to Senate testimony by former CIA Director William Colby, many of the organizational directions concerning both research and operationalization of such weapons were never written down.

An Antimalarial "Incapacitant"

Cinchonine is a quinine-derived drug and similar in some ways to the artificial quinine derivative antimalarial drug mefloequine, also known as Lariam. Mefloquine, a product of Army research, has been the subject of numerous controversies over its side-effect profile, and as recently as 2009, the DoD significantly cut back on its use for the military.

The stockpiling of cinchonine as an "incapacitating" agent was directly contrary to Nixon's order that all such toxic and bacteriological stockpiles held by the DoD and the CIA be destroyed. Other incapacitating agents held by the CIA for years after the disposal order included the powerful hallucinogen BZ; the anticholinergic drug Cogentin; digitoxin; and Phencyclidine HCL, commonly known as "Angel Dust"; among other drugs.

The CIA's stockpile of dangerous substances also included numerous "lethal agents," including shellfish toxin; cobra venom; fish toxin; and numerous substances only known by their code names ("E-4640," "F-270" etc.). It is not known if any of the lethal or incapacitating agents were ever used, or if so, by whom or where. (The one exception the CIA admitted to was the use of an arsenic suicide pill provided to Francis Gary Powers, a U-2 pilot shot down over the Soviet Union in 1960. Powers did not use the pill.)

According to Senate testimony, the stockpile was discovered after a review of secret programs ordered by Colby. Originally, the various drugs and weaponized biological substances were kept at the Army's Fort Detrick compound and were apparently moved later to a CIA storage facility.

The neurological side-effects of mefloquine are similar to the side effects of cinchonine. Cinchonism (or quinism) includes such side-effects as blurred vision, tinnitus, skin rashes, vertigo, nausea, headaches and other even life-threatening serious health problems. Mefloquine has been cited for neurological, but also psychological side-effects, including depression, anxiety, panic attacks, confusion, hallucinations, bizarre dreams and suicidal and homicidal behavior. The effects can be long or short-term.

But even the "short-term" effects can be debilitating, as one military doctor, Captain Monica Parise, told a group of other physicians at a government meeting in May 2003. Parise told the meeting of the Armed Forces Epidemiological Board (AFEB) that "there are a host of other more acute less severe neuropsychiatric issues that occur short-term [with mefloquine], such as insomnia, strange dreams, fatigue, lack of energy, inability to concentrate and some people have reported that those effects have lasted a very long time."

Parise noted that it takes "three, four, or five months to really wash the drug out of your system," and that she'd "heard that there might be some data in DoD ... that might shed light" on how the drug had "ruined people's lives." As we shall see, a psychiatrist present at this same meeting was also involved in training other psychiatrists to assist Guantanamo interrogators.

Administering Mefloquine to All the Guantanamo Detainees

In December 2010, Truthout and Seton Hall School of Law's Center for Policy and Research revealed that it was medical standard operating procedure (SOP) to give all arriving detainees full treatment doses of the antimalarial drug mefloquine upon arrival at the US prison camp. The military's own newspaper, Stars and Stripes, followed up with their own story a few weeks later.

[Update, 6/9/2012: Both the Truthout and Seton Hall investigations also noted the CIA's MKULTRA research into the quinoline family of drugs. The Seton Hall report described how "potential use of these drugs in an interrogation setting was a stated purpose for the [CIA] study."]

A treatment dose of mefloquine is five times the amount taken weekly by those who use the drug for prophylactic purposes. Larger doses are associated with a higher percentage of side effects.

The Truthout investigation showed that at the time the SOP was put in place, internal discussions within the DoD and an Interagency Malaria Working Group were expressing strong doubts about the serious neuropsychiatric side effects of the drug. Despite this, the surgeon general of the JTF-160 Task Force at Guantanamo signed off on the unprecedented mefloquine protocol.

The chief surgeon, who also served as commander of the Navy Hospital at the base, was Capt. Albert Shimkus. Shimkus told Truthout in late 2010 that he had first sought consult regarding the use of malaria drugs from an assortment of agencies, including officials from the CDC, the Navy Environmental Health Center (NEHC) and the Armed Forces Medical Intelligence Center at Fort Detrick, Maryland. All three agencies have told Truthout they were not involved in this decision or had no documents related to such consultation.

Shimkus told Truthout in a phone interview last October that the US State Department "would have been involved" in discussions about malaria concerns at Guantanamo, though he maintained no State Department officials were directly involved in the "clinical decision making."

In June 2004, the CDC announced, "'presumptive treatment' without the benefit of laboratory confirmation should be reserved for extreme circumstances (strong clinical suspicion, severe disease, impossibility of obtaining prompt laboratory confirmation)." Hence, "presumptive treatment" - the mass administration of a drug without knowing whether or not it is actually necessary - is reserved for situations when there is no possibility of laboratory confirmation of malaria, but that was not the case at Guantanamo.

Yet, even a year later, the mefloquine SOP was renewed at Guantanamo.

DoD spokeswoman Maj. Tanya Bradsher told Truthout, "A decision was made to presumptively treat each arriving Guantanamo detainee for malaria to prevent the possibility of having mosquito-borne [sic] spread from an infected individual to uninfected individuals in the Guantanamo population, the guard force, the population at the Naval base, or the broader Cuban population."

According to Bradsher, "The mefloquine dosage was entirely for public health purposes to prevent the introduction of malaria to the Guantanamo area and not for any other purpose." Nevertheless, when hundreds of contract workers from malaria-endemic countries such as India and the Philippines were brought by Halliburton subsidiary Kellogg Brown and Root (KBR) to build the new Guantanamo Delta Block in 2002, there was no DoD scrutiny of any exposure by these workers to malaria.

According to Bradsher, KBR alone was responsible for its own workers, belying a concern over possible reintroduction of malaria to Cuba, which, according to Captain Shimkus, had produced State Department concerns when it came to the arriving detainees.

In his October 2011 interview, Shimkus also said he sent "pretty detailed reports" regarding the mefloquine decision to JTF-160's Commanding Officer, Marine Corps Brig. Gen. Michael R. Lehnert. He had nothing further to say about a statement made to Truthout a year earlier in which he stated that he had been told not to talk about the mefloquine decision.

When Shimkus was asked if he was aware of any detainees who had suffered psychiatric problems because of drugs administered to them, he said, "Maybe. That's confidential," adding a moment later, "No for that."

He also rejected the opinions of two medical researchers who wrote in PLoS Medicine in April 2011 that "medical doctors and mental health personnel assigned to the DoD neglected and/or concealed medical evidence of intentional harm" to detainees. "They have an opinion and it should be out there," Shimkus said.

Army Mefloquine "Specialist" Trained Psychiatrists for Interrogations

A top psychiatrist working for the Office of the Assistant Secretary of Defense for Health Affairs (OASD-HA), Col. Elspeth Cameron Ritchie, traveled to Guantanamo in October 2002, purportedly to investigate a spurt of suicide attempts among the detainees. Within weeks, according to the AFEB minutes cited earlier, she attended an "experts" meeting on "Malaria Chemoprophylaxis" at the CDC in January 2003 that considered problems with the "neuropsychiatric adverse drug reactions" of mefloquine. Indeed, according to the AFEB speaker, Captain Parise, they specifically included a psychiatrist - presumably Ritchie - in their discussions.

Did Colonel Ritchie bring knowledge of the effects of mass mefloquine administration at Guantanamo to this meeting? We don't know and Colonel Ritchie, now retired from the military and chief clinical officer for the District of Columbia's Department of Mental Health, would not return a request for comment. A public spokesperson for OASD-HA told Truthout it had no connection with any decision to use mefloquine at Guantanamo.

It would be strange, if not highly unlikely that, given the widespread interest in mefloquine adverse reactions at the DoD and contemporaneous statements that the DoD was conducting research on this, that the effects of the Guantanamo mefloquine SOP were never examined.

Ritchie's involvement in mefloquine issues can also be ascertained by the fact that, in 2004, Ritchie, by then "Psychiatry Consultant" to Army Surgeon General Kevin Kiley, gave a presentation to the DoD's Deployment Health Clinical Center on the "Neuropsychiatric Side-Effects of Mefloquine."

Of convergent interest is the fact that, according to Dr. Ritchie, she taught psychiatrists slotted for assignment to the military's Behavioral Science Consultation Teams (BSCTs) working at Guantanamo and possibly elsewhere. She is, at this point, the only known person potentially linking military activities surrounding both mefloquine and interrogations or torture.

According to an Army surgeon general description of BSCT training during the period Colonel Ritchie was involved, such training included instruction in methods of inducing "learned helplessness."

"Learned helplessness" is a condition of near-total psychological breakdown produced by inability to escape an extreme set of stressors. Its study is associated with the work of psychologist Martin Seligman, who did research on the subject as far back as the 1960s. In the 1990s, all the Survival, Evasion, Resistance and Escape schools except the Navy school discontinued the use of the waterboard in their training program precisely because it tended to produce "learned helplessness" in its students, the opposite of the kind of effect they were seeking.

A Guantanamo Autopsy Tests for Mefloquine

The months-long period of time it takes for mefloquine to leave the system may have been involved with a decision to test a detainee at Guantanamo who had committed suicide for the presence of mefloquine in his bloodstream. But the detainee, whose autopsy report included toxicology results that show he was tested specially for mefloquine, had been at Guantanamo for five years at the time of his death.

Abdul Rahman Al Amri entered Guantanamo in February 2002 and would have been given a treatment dose of mefloquine at that time. We do not know why he would have been tested for its presence over five years later. All but one of the other detainees for whom we have autopsy reports due to purported suicides were not tested for mefloquine, showing such testing was not standard procedure.

Al Amri was also found dead with his hands bound behind his back, and his death as well as that of 2009 suicide Mohamed Salih Al Hanashi are under investigation by the UN Special Rapporteur for Extrajudicial Executions, primarily because of Truthout's coverage of these events.

A Plausible Hypothesis

The discovery that the CIA researched antimalarial drugs as part of its mind control program and, moreover, operationalized at least one of these drugs as an "incapacitating agent" means that the hypothesis that mefloquine was used for similar purposes at Guantanamo is not inconsistent with a known pattern of governmental behavior.

There are many reasons to question the supposed use of mefloquine at Guantanamo for purely public health purposes. Consider the following:

-- The mass use of treatment levels of mefloquine at Guantanamo was unprecedented.

-- The drug was limited to only one group of potential malaria carriers.

-- Use of mefloquine for presumptive treatment continued for years past the point when the DoD was already manifestly aware of the drug's dangers.

-- The mefloquine SOP was hidden from medical authorities at the Armed Forces Epidemiological Board.

-- Finally, there is the fact no government agency will admit to advising use of the drug, even when a Guantanamo medical officer states they were involved.

As a result of all the above, it appears highly possible that the motive for the drug's use was to psychologically disorient and physically debilitate all or some portion of incoming prisoners.

Copyright Truthout.org - Reprinted with permission (Original URL)