Monday, March 27, 2006

Biscuits, anyone?

By William Fisher

"Press Office", chirped the Defense Department voice on the phone.

"Yes, good morning. My name is Bill Fisher. I write for Truthout. I have a couple of questions about the Biscuit program. Would you be able to help me?"

"What are Biscuits?" said a confused voice.

"They are military shorthand for Behavioral Science Consultation Teams", said I.

"Let me connect you with the person who knows about that program," said the helpful voice.


Then came an answering machine. "This is Jane Doe (I am not using her real name because I might get her in trouble). Please leave your name and phone number and the nature of your question, and I'll call you back", said the disembodied voicemail message.

I did, adding that I wanted to file a story today. Then I waited. And waited. And waited some more.

Altogether I called three times, each time being referred either to a different person (who was away from his/her desk), or to another automated voice mailbox, where I left the same message.

The questions I never got to ask anyone at DOD were:

"I'd like to know whether BISCUIT units are working at Abu Ghraib and Bagram and other U.S.-controlled detention centers as well as at Guantanamo", and "Some folks who are in the medical and other health-provider fields have been critical of the BISCUITS at Guantanamo Bay, saying they have been using doctors and nurses and psychologists to help the interrogators get information out of the detainees, and advising about how best to keep people alive who are on hunger strike there."

Now, if my name happened to be Bob Woodward or Jane Mayer or Sy Hirsch or Walter Pincus or Jim Risen, I suppose I could have called a "high level official close to the Bush Administration", who might speak "on condition of anonymity".

But I wanted to discover whether a plain vanilla working stiff journalist - and taxpayer -- could actually get some information on a sensitive subject from a famously secretive government.

I guess I got my answer. The silence was deafening.

Now, just in case you've been living on Pluto for the past year or so, BISCUITS -- Behavioral Science Consultation Teams - consist of military psychiatrists, psychologists, behavioral scientists, and other healthcare professionals. Their role, it has been charged by former Guantanamo interrogators, is to advise them on ways of increasing psychological duress on detainees, sometimes using their medical records to find ways of exploiting their fears and phobias, to make them more cooperative and willing to provide information.

In one example, published in the New York Times, "interrogators were told that a detainee's medical files showed he had a severe phobia of the dark and suggested ways in which that could be manipulated to induce him to cooperate."

The DOD has said that there is very limited access to prisoners' medical records. But many members of the healthcare community remain skeptical.

An article in the New England Journal of Medicine said interviews with doctors who helped devise and supervise the interrogation regimen at Guantánamo showed that the BISCUIT program was explicitly designed to increase fear and distress among detainees as a means to obtaining intelligence.

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

After April 2003, when Defense Secretary Donald H. Rumsfeld tightened
rules on detainee treatment, one interrogator said detainees' medical records had to be obtained through BISCUIT team doctors, but that the doctors always obliged. The former interrogator said the BISCUIT team doctors usually observed interrogations from behind a one-way mirror, but sometimes were also in the room with the detainee and interrogator.

The biscuit teams were also central, the former interrogators told the New York Times, in devising strategies like "Operation Sandman," in which a detainee's sleep patterns were systematically interrupted several times a night.

Then there is the issue of the "autonomy" of a doctor's patients. That refers to a patient's fundamental right to decide which medical interventions he will permit. That well-established canon of medical ethics requires that a detainee who is on a hunger strike has the "autonomy" to remain on a hunger strike if that's what he wants. If one is a healthcare provider, the patient is a patient whether or not he's a prisoner. Which means that medical personnel are barred from forcing a prisoner to stay alive, or advising others about how to reach that objective.

So, to return to my unanswered questions to the DOD: Have the BISCUITs changed at all as a result of criticism from civilian medical and other healthcare authorities? And are they being used elsewhere?

As to the "elsewhere" question, what we know is that Maj. Gen. Geoffrey Miller, the former commander at Guantanamo, recommended the use of BSCT teams at Abu Ghraib when he was sent there to "GITMO-ize" it in August and September of 2003. According to the testimony of those who were at Abu Ghraib, psychologists were indeed involved in the interrogations and abuses of detainees.

Gen. Miller recently invoked his right against self-incrimination in a case of two soldiers accused of using dogs to intimidate detainees at Abu Ghraib. This invocation was the first sign by Miller that he might have information that would implicate him in the abuses in Iraq. Numerous reports indicate that Miller instituted the use of dogs to intimidate prisoners at Abu Ghraib after first using the technique at Guantanamo Bay. A military investigation recommended that Gen. Miller, who is soon to retire, be reprimanded, but a higher-ranking officer denied the request.

And a senior human rights attorney told me on condition of anonymity, "I would suspect since the BSCTs continue to be used as part of the intelligence apparatus at Gitmo" and because have been judged favorably by the military establishment "they are likely in place at the very least at strategic interrogation facilities in Iraq and in Afghanistan."

As to changes in the way the BISCUITs operate, the DOD finally issued revised guidelines last June, after various healthcare professional organizations and prominent medical authorities ignited a firestorm of criticism. Both the American
Psychological Association and the American Psychiatric Association have
made clear that it is unethical for members of their profession -- whether in the military or not -- to participate interrogations or to provide information to interrogators about ways to "break" a detainee.

Dr. William Winkenwerder Jr., assistant secretary of defense for health affairs, acknowledged that the new guidelines came about as the result of a review of procedures begun after allegations of medical personnel assisting in abusing prisoners surfaced. "What got the ball rolling was an awareness from all the information coming out of Abu Ghraib and the various allegations," he said.

Some of the most passionate of these allegations have come from Brigadier General Stephen N. Xenakis, M.D., who retired from the U.S. Army in 1998, after serving in many high-level positions, including Commanding General of the Southeast Regional Army Medical Command. He has reportedly played a major role in driving the DOD to re-examine its medical practices.

Last month he said: "Medical officers enjoy special privileges and status and are expected to abide by and stand up for their professional principles at all times and in all situations. This operation - the War on Terror - is no different... It is important to remember that the burden of leadership is to ensure that high moral and ethical practices are maintained in even the most demanding situations."

But, speaking about prisoner deaths while in U.S. custody, Gen. Xenakis charged, "To date, we have no indication that either the Army Medical Department or the Office of the Assistant Secretary of Defense for Health Affairs has conducted a thorough investigation of the medical care provided to detainees and the circumstances surrounding the known deaths."

The new guidelines, said Dr. William Winkenwerder Jr., assistant secretary of defense for health affairs, consolidates "principles and procedures for U.S. military medical personnel when working with detainees under control of U.S. armed forces."

The guidelines specify that military medical personnel must observe medical ethics, make medically appropriate decisions, and report inhumane treatment. Military healthcare professionals must "be guided by professional judgment and standards similar to those that would be applied to members of the U.S. armed forces, including duty to protect the physical and mental health of the detainee" and "will not participate in any activity that is not consistent with applicable law."

But in a briefing for reporters, Winkenwerder declined to say whether the guidelines would prohibit some of the activities described by former interrogators and others. He said the medical personnel "were not driving the interrogations" but were there as "consultants".

Winkenwerder added that "only a very, very small number of reports of observation of possible abuse" have been recorded. Pentagon officials have previously said that the practices at Guantánamo did not violate ethics guidelines.

The Pentagon invited representatives of a number of health-related professional associations, including the American Medical Association, to pay a one-day visit to Guantanamo Bay. But they were not allowed to interview any detainees.

One of those attending, Prof. Nancy Sherman, who teaches philosophy at Georgetown University and has written extensively about ethics in the military, said that the DOD had worked hard to present a positive, upbeat image of what occurred at Guantánamo. "I think what was being sought was some sort of confirmation that their practices were ethically sound" and that some of the news accounts were wrong, she said.

Professor Sherman added that the distinction between using psychiatrists and psychologists as consultants rather than as providers of medical care was a tenuous one that invited ethical problems.

Winkenwerder said the new procedures separate individuals who are providing care from health professionals who work in other capacities in detention operations. Medical personnel who are in a provider-patient relationship with detainees -- those who actually provide treatment -- "shall not and will not undertake detainee-related activities for purposes other than to provide health care," he said.

"Such healthcare personnel shall not actively solicit information from detainees for purposes other than healthcare purposes," he explained.

But medical professionals in other roles in detention operations should not provide actual care for detainees, the new guidelines say. Such individuals might include behavioral-science specialists, such as FBI profilers; forensic psychiatrists, who are often appointed by a court to evaluate the mental competency or sanity of an individual; prison psychologists, who evaluate the potential danger of somebody to society; or public-health experts, who evaluate potential for disease outbreaks.

Which still leaves us with nagging questions: Aren't forensic psychiatrists physicians? Aren't they, as well as behavioral science specialists and prison psychologists, governed by the ethical rules of their professions?

Medical doctors take an oath to "do no harm". While psychologists and behavioral science specialists may not have to take such an oath, they are nonetheless committed to doing good, not harm.

And what part of "do no harm" don't they understand? It doesn't require an oath to act ethically. And there is nothing ethical about advising interrogators about how to "break" detainees.



By William Fisher

This week the U.S. Supreme Court will hear what will almost certainly be one of the landmark cases of the past fifty years.

Their decision will determine whether the Supreme Court will continue to assert its authority to review and check the executive’s power to detain and try individuals caught up in the “war on terror.”

The case is called Hamdan versus Rumsfeld. The Hamdan is Salim Ahmed Hamdan, who has been a prisoner at Guantanamo Bay, Cuba, since 2002. The Rumsfeld is Defense Secretary Donald Rumsfeld, whose department has jurisdiction over all detainees held at U.S.-controlled military prisons.

Since the Court agreed to hear Hamdan’s case, the administration of President George W. Bush filed an extraordinary motion to dismiss it. The government argues that a law passed by Congress late last year was intended to deny the right of habeas corpus to all prisoners in U.S. custody -- including not only new cases, but those that were pending at the time Congress acted. The Bush administration contends that Congress intended to strip the high court of its jurisdiction to hear any challenge arising out of the detentions at Guantanamo Bay.

But according to Deborah Perlstein, an attorney with legal advocacy group Human Rights First, “Apart from the weakness of the Administration’s case on the merits, the statute passed by Congress last year makes clear its intent to apply only to cases arising after Hamdan’s.”

Perlstein told us, “It’s hard to see even this new Court accepting that kind of frontal assault on its own power.”

Two new Justices have been appointed to sit on the Supreme Court in the past few months. John Roberts has become chief justice, replacing William Renquist, who died. And Samuel J. Alito Jr. has joined the court, replacing Sandra Day O’Connor, who resigned after 24 years as an associate justice.

Even if the justices resolve the court-stripping issue, it will be left to decide two other weighty questions: Does the President have the authority to convene military commissions to try alleged terrorists and ignore the procedural protections that Congress and the Constitution have long afforded those facing U.S. military trials? And are the Geneva Conventions – the laws of war that the United States long ago ratified and made part of U.S. law – enforceable by individuals in federal court?

According to Perlstein, “Either one of these questions is generational in nature. Taken together, they give Hamdan the potential to be one of the most important cases the Supreme Court has heard on the issue of presidential power in the past half-century.”

To complicate matters further, Chief Justice Roberts has recused himself from the Hamdan case because he participated in ruling on it in a lower court before his recent appointment. That means eight justices will hear the arguments, thus eliminating the possibility of the 5-4 decision often made by this court in contentious cases.

But, says Perlstein, “More significant than the absence of Chief Justice Roberts, is the absence of Justice Rehnquist and O’Connor in this kind of case. Those justices had for the past nearly 30 years been at the leading edge of the Court’s assertion of its own power, above Congress and the Executive, as a co-equal branch of government. Whether the absence of their voices will have left a court more reluctant to weigh in on matters of individual rights in the face of government power remains to be seen.”

The Hamdan case has been bouncing around the U.S. justice system for several years, beginning in 2004, when the DOD Formally referred charges against the 34-year-old Yemeni national, one of six Guantánamo detainees who were designated by President Bush in July 2003 as subject to trial by military commission under the President’s Order of November 13, 2001. Hamdan was captured by Afghan forces and handed over to the U.S. military in Afghanistan in late 2001.

The government accuses Hamdan of serving as Osama Bin Laden’s bodyguard and personal driver, delivering weapons to al Qaeda members and purchasing vehicles for Bin Laden’s security detail. He is formally charged with conspiracy to attack civilians, attack civilian objects, murder, destruction of property, and terrorism.

Held at the U.S. Naval Base at Guantánamo Bay, Cuba, since early 2002, Mr. Hamdan is currently represented by Navy Lt. Cmdr. Charles Swift, who brought suit in 2004 seeking Hamdan’s release from solitary confinement and declaring the commissions unconstitutional.

Documents unsealed in early August reveal allegations that Hamdan was beaten, threatened, and kept in isolation for upwards of eight months. A military commission preliminary hearing began the week of August 23, 2004.

In September 2004, the petition was re-filed in the federal district court for the District of Columbia, and, in November 2004, that court found the military commission unlawful because the process violated the laws of war and military law, and stayed the commission.

In July 2005 the Court of Appeals for the District of Columbia reversed the district court and upheld the commission as lawful. Hamdan’s lawyers appealed the ruling, and in November 2005 the Supreme Court agreed to hear the case.

In January 2006, the government filed a motion for the Supreme Court to dismiss the case on the ground that the Detainee Treatment Act of 2005 (the Graham/Levin amendment) divested Hamdan of the right to seek habeas corpus in a federal court.

That law entered congress as an amendment to a massive war-spending bill. It was introduced as a compromise by Sen. Lindsey Graham, a conservative Republican from South Carolina and a former military judge, and Sen. Carl Levin, a liberal Democrat from Michigan.

HRF’s Perlstein told IPS the Graham-Levin compromise was “a mistake”. She says that she understands Senator Graham’s motivation – “to try to address the uncertain legal status of those held in a U.S. detention system that includes thousands of people worldwide.”

However, she adds, “The great irony of Congress’ action here was to guarantee that the question of the legal status of those stuck in limbo already for years would remain unresolved, and would continue to be litigated for some time to come. Apart from the Amendment’s legal infirmities – trying to strip the federal courts of the power to enforce the Constitution against an executive branch strikingly uninterested in law – as a matter of security policy, it effectively made matters worse.”

Brian J. Foley, a professor at Florida Coastal School of Law, told us he was uncertain about whether the Graham-Levin measure “clearly supports an argument that it is prospective only. Legislative history may say otherwise, but courts might not consider legislative history if they think the text is clear. It will be up to the courts”

However, he adds, “Congress did make clear that it doesn't want to give these prisoners a way to 'complain' about conditions of confinement, including torture. Congress made clear that it doesn't want to give them a way to 'complain' that they are not being given a hearing, or that getting a decision in a hearing is taking too long. Congress was foolish to pass this law, because these enormous presidential powers can so easily be turned against US citizens. What if a US citizen is rounded up and never given a hearing to test whether he's an enemy combatant -- or even a US citizen? Well, he can't access the courts, thanks to this statute. The only hope is that the Constitution's right to habeas corpus transcends this statute. That will ultimately be a major issue in the Supreme Court, and we can only hope that the justices don't simply side with the Administration.”

The High Court’s decision will not be public until July. Meanwhile, American citizens ought to be pondering whether it wants to become a monarchy, ruled by a president. They also ought to give some serious thought to the kind of message indefinite detention of prisoners without a real trials sends to the rest of the world.


By William Fisher

Last week’s announcement that Iraq will now have to pay for its own reconstruction has left some observers wondering whether the yet-to-be-formed government there will be up to the task.

Iraq's deputy finance minister, Kamal Field al-Basri, said it was "reasonable" for the United States to sharply cut back its reconstruction efforts after spending about $21 billion. "We should be very much dependent on ourselves," al-Basri said in an interview the American newspaper, USA Today.

That will prove to be a very tall order. In 2003, the World Bank estimated the total rebuilding cost would be $60 billion. Current estimates put the bill at $70-100 billion.

The new estimate comes at a time when little progress has been made in increasing Iraq’s oil production – which represents more than 90 per cent of the country’s income. Slowed to a near halt by insurgent attacks, Iraq now spends about $6 billion annually to import oil.

Iraq must increase oil exports from their current level of about 1.6 million barrels a day to 2 million barrels a day, said Daniel Speckhard, director of the U.S. Iraq Reconstruction Management Office. The deputy finance minister said Iraq needs foreign investment to lift exports to three million barrels a day. That would equal the oil exports achieved by Iraq in the 1980s. Oil production today is far below prewar levels.

According to the Pentagon's prewar planning, oil production was supposed to provide the funds for Iraqi reconstruction. Vice President Richard Cheney and other senior Bush Administration officials emphasized this point repeatedly in their pre-war effort to justify the U.S. invasion.

Also facing the country is a massive rebuilding of infrastructure. Lack of security has also stymied efforts to rebuild electrical, sewer and water systems. A report last month by the special U.S. inspector general overseeing reconstruction said so much money was being spent on security that most sewer, irrigation, and drainage projects had been canceled.

Production by Iraq's national electrical grid remains at 4,000 megawatts, 400 megawatts below pre-war levels, with the average Iraqi receiving less than 12 hours of power a day. The shortfall has been attributed mainly to sabotage by insurgents.

Approximately 16%-22% of each reconstruction dollar spent by the U.S. has gone to protect projects and contractors.

Speaking on condition of anonymity because he is involved in the current Iraqi political process, a leading Middle East expert told us, “Because the U.S. did understand Iraqi culture, it did not anticipate the insurgency. Because it did not anticipate the insurgency, it could not have planned for the huge sums that would have to be spent on security.”

Critics of the Bush Administration see the end of American reconstruction funding as vindicating this position. Typical is Prof. Beau Grosscup, professor of international relations at California State University at Chico. He told us, “Having destroyed Iraq, the U.S. can't and now refuses to put it back together again. This decision reflects the disastrous reality of the U.S. occupation for the Iraqi people as it is obvious there won't be peace until the U.S. leaves. Meanwhile, the make-over of the Iraqi economy has been completed.”

But the Pentagon defends the reconstruction project as the best that could be achieved under very difficult and dangerous security conditions.

With the billions of dollars appropriated by the U.S. for Iraqi reconstruction almost all spent, other nations and multinational institutions will be asked to shoulder the burden for funding the large number of unfinished projects.

Speckhard said the U.S. aid program sought to "kick-start the economy" and "lay a foundation" that Iraq could build on. He added, "That kick-starting process has occurred.”

However, the extent of U.S. commitment to reconstruction has always been somewhat murky. "The U.S. never intended to completely rebuild Iraq," Brig. Gen. William McCoy, the Army Corps of Engineers commander overseeing the work, told reporters at a recent news conference. In an interview, McCoy reportedly told The Washington Post newspaper, "This was just supposed to be a jump-start."

But McCoy’s assertion seems to be at odds with previous administration statements. For example, in a speech on Aug. 8, 2003, President George W. Bush said, "In a lot of places, the infrastructure is as good as it was at prewar levels, which is satisfactory, but it's not the ultimate aim. The ultimate aim is for the infrastructure to be the best in the region."

While President Bush gave the impression that Iraq was slated for a complete makeover, Defense Secretary Donald Rumsfeld appeared less certain. He told the Senate Appropriations Committee in March 2003, “I don't believe that the United States has the responsibility for reconstruction…(reconstruction) funds can come from…frozen assets, oil revenues and a variety of other things, including the Oil for Food, which has a very substantial number of billions of dollars in it.”

On the other hand, that view seems to contradict a report submitted the same year by the prime consulting contractor hired by the Pentagon to lay out the future of Iraq’s economy. The company, BearingPoint Inc. of McLean, Virginia, said, “The reconstruction of Iraq has begun. Not the reconstruction of vital public services such as water, electricity or public security, but rather the radical reconstruction of its entire economy.”

Clearly, this has not happened. And the Administration’s recent decision not to ask Congress for additional funding for reconstruction suggests it is not likely to happen any time soon.

With many of Iraq’s key ministries in disarray and some dogged by persistent corruption, and with no permanent government in place, observers say it is doubtful that the country’s government will have either the resources or the expertise to manage the large-scale reconstruction projects that remain unfinished

Relatively little of the $30 billion allocated for reconstruction since the invasion
remains to be spent, and spending authority is scheduled to run out in June 2007.

According to a recent report by the U.S. special inspector general for Iraq (IG), reconstruction officials cannot say how many planned projects they will complete, and there is no clear source for hundreds of millions of dollars a year needed to operate the projects that have been finished.

The IG’s report described some progress but also cited a number of projects that have failed. For example, expensive electrical substations were built but not connected to the country's electrical grid.

Much of the reconstruction funding has been diverted to other projects. At least $2.5 billion earmarked for infrastructure and schools was diverted to building up a security force. Funds originally intended to repair the electricity grid and sewage and sanitation system were used to train special bomb squad units and a hostage rescue force. The U.S. has also shifted funds to build 10 new prisons to keep pace with the insurgency, and safe houses and armored cars for Iraqi judges.

Hundreds of millions of dollars from the reconstruction fund was also used to hold elections and for four changes of government, and to establish a criminal justice system, including $128 million to examine several mass graves of Saddam Hussein’s alleged victims.

In addition to the diversion of funds to other types of projects, the reconstruction efforts have been plagued by substantial corruption and overcharging by contractors.

The cost of security has eaten up as much as 25% of each project, according to the IG. A U.S. congressional report last October forecast that many reconstruction projects were unlikely to get off the ground because of security costs. Iraqi authorities estimate that 10 billion dollars are needed for the health sector alone, to build or rehabilitate and provide equipment for hospitals and clinics.

The bottom line here is that while Iraqi politicians squabble over the composition of their future government, Iraq’s infrastructure remains in shambles. If these leaders – and wannabe leaders – really care about their country more than they do about their party or their egos, real reconstruction provides a huge incentive for them to get on with the job.