Hippocrates wept

In the last few weeks, a spate of reports has emerged about Shin Bet’s refusal to admit Palestinian patients from Gaza to enter Israel for treatment of their life threatening conditions. Dr. Danny Filk, chairman of Physicians for Human Rights, wrote on Ynet last week,

The 47-year-old Palestinian known as H. apparently suffers from a liver tumor and urgently needs to undergo a biopsy that would enable treatment. Meanwhile, C. is a Palestinian who requires urgent surgery, A. is a 20-year-old Palestinian woman who suffers from cancer and needs to urgently visit a hospital, 16-year-old girl T. suffers from a heart defect and urgently requires catheterization or surgery, 20-year-old L. has cancer and needs radiation and chemotherapy, and 27-year-old A. has a brain tumor and requires urgent treatment.

All these cases were examined by senior Israeli oncologists and cardiologists who ruled that treatment is urgently needed and postponing it endangers the lives of the patients. The State of Israel rejected the requests, arguing that the six are prevented from entering Israel for security reasons. However, after repeated inquires by the Physicians for Human Rights organization, the interference of Knesset members, and petitions by human right groups abroad, the six patients were granted a permit to leave the Strip.

You never know what desperate acts a dying person may carry out, so you can’t be too careful. That’s why a permit to leave the strip isn’t good enough. As Amira Hass writes, for example,

Mahmoud Abu Taha was diagnosed with cancer of the small intestine in August 2007. Treatment in Gaza was unsuccessful, and he lost a third of his body weight.

The Shin Bet is refusing to allow a 21-year-old Rafiah man who is sick with cancer and in need of immediate medical care to come to Israel, even though he obtained permission from the Israeli Defense Forces' Coordination and Liaison Administration.

The Shin Bet also arrested the patient's father, who accompanied him to the hospital.

Not content to deprive Gazans of treatment in Israel, the Palestinian Centre for Human Rights reports, the occupation authorities are now detaining doctors, as well.

…on Tuesday, 6 November 2007, IOF detained Dr. Nabih Abu Sha’ban (52), a neurosurgeon from Gaza City, at Erez checkpoint. Abu Sha’ban was accompanying his son, suffering from kidney problems, to Jordan for medical treatment. Abu Sha’ban was detained despite having permission from IOF to pass through. Medical reports indicate that Dr. Abu Sha’ban is suffering from several illnesses. He previously underwent heart surgery. In addition, he suffers from diabetes and high-blood pressure that require medication on a regular basis.

The Center’s lawyer visited Dr. Abu Sha’ban in El-Majdal prison on Monday, 12 November 2007. He informed the lawyer that he is being questioned about patients he treated in Gaza!

While Israel’s High Court of Justice waits for prosecutors ‘to look into the matter further’, writes Yuval Azoulay in today’s Ha’aretz,

Nail al-Kurdi, a 20-year-old Gaza resident, died over the weekend from cancer while awaiting approval to enter Israel for medical treatment.

Despite numerous requests by Physicians for Human Rights, the Shin Bet security service denied his entrance due to security reasons.

The rights group said Sunday that they have been submitting requests to allow his entrance into Israel since July, but each appeal was rejected. In light of the state's refusal, the group petitioned the High Court of Justice for the right to bring al-Kurdi in for treatment.

"The court decided to give the state time to examine its policy on the matter, despite the numerous medical opinions presented to them which warned that if al-Kurdi would not receive medical treatment immediately, he would die," a statement by the organization said.

But what of those fortunate enough not only to secure a permit, but actually to enter the Jewish state for treatment? Esti Aharonovitz, writing in Friday’s Ha’aretz, reports,

This week, [the deputy head of the orthopedic oncology department at Ichilov Hospital, Dr. Yehuda] Kollender recalled: "A little girl came to me with an advanced and neglected tumor, and when her father told me that the girl was getting radiation at Assuta, my hair stood on end. Every expert in oncology, actually every specialist in oncology or orthopedics, knows that the standard treatment all over the world for such a case is chemotherapy, followed by limb-preserving surgery, and then another round of chemotherapy…”

In January 2005, Farah [Harma], then 10 years old, was diagnosed with bone cancer. The tumor was discovered in her right knee after a biopsy at Rafidiya Hospital in Nablus. From there she was referred to Al-Watani Hospital in Nablus, and from there to Assuta Hospital in Tel Aviv for radiation treatment.

Prof. Natalio Walach, an oncologist who heads the chemotherapy unit at Assaf Harofeh Hospital and also served as director of radiotherapy at Assuta, sent Farah for radiation treatment without examining any medical information and without conducting any further examination to determine the exact type of the girl's cancer…during the brief meeting with the doctor, Farah and her escort were not asked a single question and did not receive any explanation about the method of treatment. There was no physical examination. This week, Walach said: "I don't remember the case that well."

[Michael] Sfard, the attorney for Yesh Din - Volunteers for Human Rights, says…"… It seems that at Assuta there's a separate medical channel for Palestinians, and they are given inferior care. And that's only the tip of the iceberg. Someone's making money from this. And we're talking about cancer-stricken children here."

"As far as is known," says Sfard, "the standard method of radiation treatment is with a linear accelerator. As a matter of fact, Assuta Hospital is the only medical institution that still administers radiation with a Cobalt 60, and it does not do so to Israelis. The only use made of this machine at Assuta is for the treatments the hospital gives Palestinians as part of the agreement with the PA."

…Assuta's medical director, Dr. Orna Ophir…admitted that the Cobalt 60 machine did not meet the accepted standard in Israel and that the use made of it at Assuta was solely to meet the needs of the Palestinian Authority.

Ophir further confirmed that ‘Assuta had found a way to make money from a service it couldn't sell to Israelis’, concluding, "Farah's parents had given up on her before they came to us. They have fourth-rate doctors, and they want me to give them first-rate treatment."

Azam Abu-Qabatya, from Yata near Hebron, also lost his daughter to Prof Walach’s special treatment.

…even though the referral from Al-Husseini Hospital proposed three further tests to diagnose the exact form of cancer, Walach did not perform any further examinations…As in the case of Farah Harma, he looked at her leg and drew with a marker to designate the area meant to receive radiation.

…Further examination found that the cancer had spread into the girl's abdominal cavity and lungs...Hayah Abu-Qabatya died at home in the village of Yata, on Thursday, October 13, 2005. She was just 12 years old.

[Hat tip to Mark Marshall and Dorothy Naor.]

Case closed

The examination of the complaints did not turn up any excesses in the interrogation, and in the wake of this, the official in charge of the OIC [Ombudsman of Interogees' Complaints] in the State Prosecutor's Office decided to close the examination file.

A few days ago, I posted a piece entitled ‘Pity the poor torturer’, which dealt in part with an interview with a retired Shin Beit torturer who went by the pseudonym, Sheriff. Friday’s Ha’aretz had a piece by Gideon Levy entitled ‘The twilight zone’ that detailed the experiences of one of nine Palestinians whose testimony is documented in a new report from the Public Committee Against Torture in Israel.

The report, “Ticking Bombs”: Testimonies of Torture Victims in Israel, begins with a poem, The Colonel and the Major by Avigdor Feldman. Here is a stanza, probably about that same Sheriff

The Colonel and the Major Johnny and Sheriff
The hand that strikes is sprinkled with brown age spots
An open palm, a slap
A sprung fist to the midriff.
A rolled hand punches the headTwo hands box the ears
Cymbals.

Luwaii Ashqar won’t walk again.

He is a young man whose world fell apart. He entered prison sound of body and mind and emerged a broken man. For four days and four nights nonstop, he says, he was interrogated and subjected to torture of the most brutal kind.

Was there a judgment by the High Court of Justice? There was. It banned precisely the types of torture he underwent: the "banana posture," the "shabah" (body stretching with hands tied to a chair), "invisible" blows and the "frog posture" (being forced to stand for hours on the toes in a crouching position) - all the way to a vicious kick to his chest that bent his body backward while he was tied to a chair with his arms and legs, and which was the probable cause of the partial paralysis of his legs.

After some ‘sports’ to warm him up for ‘military interrogation,

‘…they made me crouch on my toes, not letting me lean on the back of my foot. I was in that position for 40-50 minutes, maybe an hour - that was my estimate - until I felt my soles swelling and they turned blue and there was tremendous pain. After that, stand up, and they tied my hands and pressed as hard as they could on the metal handcuffs until the metal dug into my hand. Here are the signs, you can still see them. Because of the pressure, the key of the handcuffs didn't always work and they would bring huge metal scissors, like they use in construction, and tear off the handcuffs and then bring new ones, to go on. The color of my hands changed to blue, and when they opened [the handcuffs] my hands shook. The interrogator stood on the table and pulled me with a chain of handcuffs. When I fell, they pulled me by the hair…’

And so it goes on, for four days without food or sleep.

‘”You will drink only half a cup of saltwater.” That is what they gave me every time after they bent me and I vomited. Why with salt? I asked. Give me without salt. No, so nothing will happen in your stomach and intestines. I would drink it and vomit…He said to me: Stand on your feet. I felt that my legs were cold, like pins and needles in the legs. I said: I can't. He said: Now you are paralyzed. I said: I guess I am. He said: That is what we promised you and that is what you want…After that, they stopped the military interrogation.’

After another two months of interrogation without further torture, he was sentenced to 26 months’ prison for assisting a wanted person to hide and using a forged document.

Although the Supreme Court has outlawed torture, there is a loophole. Interrogators can claim extenuating circumstances if prosecuted for torture, where they claim they needed to use torture to get information about a ‘ticking bomb’. Clearly the message has not got through yet. Shin Bet’s investigation revealed

His interrogation was carried out according to the rules and directives, with constant review of the interrogation process.

The rehabilitation Luwaii needs is not available in the West Bank and Shin Bet will almost certainly obstruct the permission he needs to get treatment in Israel or overseas.

Pity the poor torturer

In Iraq, when Tony Lagouranis interrogated suspects, fear was his friend, his weapon. He saw it seep, dark and shameful, through the crotch of a man's pants as a dog closed in, barking. He smelled it in prisoners' sweat, a smoky odor, like a pot of lentils burning.

So writes Laura Blumenfeld in today’s Washington Post. But now,

The American interrogator was afraid. Of what and why, he couldn't say. He was riding the L train in Chicago, and his throat was closing.

"I tortured people," said Lagouranis, 37, who was a military intelligence specialist in Iraq from January 2004 until January 2005. "You have to twist your mind up so much to justify doing that."

Lagouranis's tools included stress positions, a staged execution and hypothermia so extreme the detainees' lips turned purple. He has written an account of his experiences in a book, "Fear Up Harsh," which has been read by the Pentagon and will be published this week. Stephen Lewis, an interrogator who was deployed with Lagouranis, confirmed the account, and Staff Sgt. Shawn Campbell, who was Lagouranis's team leader and direct supervisor, said Lagouranis's assertions were "as true as true can get. It's all verifiable." John Sifton, a senior researcher for Human Rights Watch, said the group investigated many of Lagouranis's claims about abuses and independently corroborated them.

"At every point, there was part of me resisting, part of me enjoying," Lagouranis said. "Using dogs on someone, there was a tingling throughout my body. If you saw the reaction in the prisoner, it's thrilling."

Not long ago in Iraq, he felt "absolute power," he said, over men kept in cages. Lagouranis had forced a grandfather to kneel all night in the cold…

"I couldn't make sense of the moral system" in Iraq, he said. "I couldn't figure out what was right and wrong. There were no rules. They literally said, 'Be creative.' "

Now Lagouranis's power had dissolved into a weakness so fearful it dampened his upper lip. Sometimes, on the train, he has to get up and pace. But he can't escape.

Being an interrogator, Lagouranis discovered, can be torture. At first, he was eager to try coercive techniques. In training at Fort Huachuca, Ariz., instructors stressed the Geneva Conventions, he recalled, while classmates privately admired Israeli and British methods. "The British were tough," Lagouranis said. "They seemed like real interrogators."

But interrogators for countries that pride themselves on adhering to the rule of law, such as Britain, the United States and Israel, operate in a moral war zone. They are on the front lines in fighting terrorism, crucial for intelligence-gathering. Yet they use methods that conflict with their societies' values.

But veteran torturers

whose wartime experiences stretch back decades, are more practiced at finding moral balance. They use denial, humor, indignation. Even so, these older men grapple with their own fears -- and with a clash of values.

James, 65, was one of Britain's most experienced interrogators in Northern Ireland. Starting in 1971, James said, he worked for the Special Branch of the Royal Ulster Constabulary (RUC), interrogating Irish nationalists Gerry Adams, Bobby Sands and others whom the British government suspected of being terrorists. Peter Taylor, a leading historian of the conflict in Northern Ireland, said he believes that "James's account is entirely credible."

"Yes, a bloke would get a cuff in the ear or he might brace against the wall. Yes, they had sleep deprivation," he said. "But we did not torture."

Once, IRA leader Brendan Hughes claimed that James had cocked a gun to his head. James does not deny it. "You fight fire with fire," he said,…"If it's going to save lives, you're entitled to use whatever means you can." How do you fight bad guys and stay good? "You don't. You can't."

According to an experienced Israeli torturer ‘who spoke on condition that he be identified by his code name, Sheriff’

"You have to play by different rules," the Israeli interrogator told an American visitor. "The terrorists want to use your own system to destroy you. What your president is doing is right."

He played good cop, and bad: "One day I was good. Next day I was bad. The prisoner said, 'Yesterday you were good. What happened today?' I told him we were short on manpower."

But when the pressure mounted for intelligence, Sheriff said, the best method was "a very little violence." Enough to scare people but not so much that they'd collapse. Agents tried it on themselves. "Not torture."

Sometimes a prisoner would accuse Sheriff of torture. He tried to shift the moral burden by blaming the prisoner: "I would tell him this: 'I'm sorry. We prefer it the nice way. You leave us no choice.' "

"I've got a clean conscience because I rarely use it."

Sheriff's concerns, however, aren't legal, they're mortal. He carries a Beretta. In cafes, he faces the door. He ran into a former subject -- "a bit scary" -- knocking on the window of his car.

For all his bravado, quips and denials, Sheriff is afraid to have his full name published.

"I would not like to die in pain."

Life’s tough for a retired torturer.