Pentagon Board Report: Detainees Died Soon Upon Arrival at Guantanamo
The Navy liaison to the Armed Forces Epidemiological Board said in Feb. 2002 that detainees had died at Guantanamo from wounds they arrived with from the battlefield. So why wasn't that a bigger deal?
Of all the issues I’ve covered, the one highlighted in this essay has been among the most frustrating. In the incident under consideration, a Navy official, speaking at a high-level meeting of military health officials at the Armed Forces Epidemiological Board (AFEB) in February 2002, reported that in the first month or so of its operations an unspecified number of deaths had occurred at Guantanamo from detainees who arrived at the facility with serious battlefield wounds (see pg. 108 at link).
To date, every supposedly authoritative source on deaths at Guantanamo has reported that there were a total of nine deaths at the DoD-operated prison, and, moreover, we know all their names. Examples of this exercise in “history” include The New York Times, PBS, Al Jazeera, Human Rights First, Reprieve, and many others.
I first published on the AFEB revelation in December 2010. The report was met with near silence. It was picked up at a couple of UK news outlets, most notably by Andy Worthington, who had been cataloguing the news and biographies surrounding all the Guantanamo detainees. (Andy recently started his own Substack newsletter.) In the U.S., however, there was no interest, no response.
Luckily for me, as my original 2010 article disappeared after the site it was published at was shuttered, the article was archived at UC Davis’s Center for the Study of Human Rights in the Americas (thanks, Almerindo Ojeda!), and at Internet Archive. Unfortunately, the link to the AFEB document upon which my report was made is broken at both these archival sites, leaving a piece of history hanging by its fingernails. I’ve fixed that link for the essay you are reading today.
In 2020, in an article at Medium.com, I updated the story after I obtained via FOIA a piece of convergent evidence about the actions of Guantanamo’s Mortuary Affairs department in early 2002. This material is incorporated into the present article.
Eleven years after my first report, I was able to briefly present the story of the unreported deaths at a November 2021 University of Brighton symposium, “Guantanamo: 20 Years After.” A video of my presentation is available online. Unfortunately the presentation did not lead to greater interest in the story. Even so, I’m very grateful to Sara Birch at University of Brighton for the opportunity to publicly discuss the AFEB material before an international audience.
To this day I have not heard any former Guantanamo detainee, mainstream reporter, human rights organization, or Guantanamo historian (other than Andy Worthington) ever publicly reference this material. I suppose that some of these people, who certainly knew of my research, did not want to be associated with this story for reasons of their own. Maybe some of them were unconvinced, and had already relegated the story to the realm of untouchable “conspiracy” theories. Others, perhaps, had more nefarious reasons to keep silent.
Despite the fact that other deaths at Guantanamo made headlines over the years, the AFEB story on unreported deaths at Guantanamo withered on the vine. I, of course, am hoping that the present article may perhaps change that unfortunate outcome.
Certain facts about the story stood out for me. For one thing, there was the matter of the deaths themselves, and that they were never publicly reported. Then there is the fact that the U.S. was renditioning recently wounded prisoners from Afghanistan thousands of miles away, even as they required strenuous and complex medical treatment and ongoing care. Some of the surgeries detainees received at Guantanamo are detailed below. Sending seriously wounded prisoners to Guantanamo was bizarre and had no justifiable purpose.
It is not surprising that some of these prisoners died either en route or once at Guantanamo. In fact, the Pentagon expected some of these prisoners to die, and had made arrangements accordingly, as I discovered in the FOIA release mentioned above. It took me six years to get that particular FOIA documentation, and you can read the record of that FOIA effort here. Reading it is, I think, quite an instructive exercise for those of you interested in FOIA.
The following is based on both my 2010 and 2020 news articles. I will only add here that I was able to obtain at least one testimony from inside Guantanamo verifying that it was known that such early deaths had occurred. However, since I do not have other testimony from “inside the wire” about these deaths, I can’t corroborate the story from an eyewitness point of view. Lacking that, I don’t wish to expose my source who then would be hanging out there all on their own. This source, in any case, only had second-hand knowledge, i.e., what he or she had heard. Perhaps in the future more such testimonies will surface.
In 2010, while researching the U.S. military’s decision to presumptively treat all arriving detainees at Guantanamo with the controversial anti-malaria agent, mefloquine, I chanced upon a transcript from the February 2002 meeting of the Armed Forces Epidemiological Board (AFEB). The meeting, dated February 19, discussed the military’s decision to use primaquine and other anti-malaria measures to control for the spread of malaria from some arriving prisoners. Nothing was said about mefloquine.
But the AFEB meeting was extraordinary for another reason. The same officer who had reported on the anti-malaria measures, Captain Alan “Jeff” Yund, who was the Navy’s liaison officer to the AFEB, told those present that some detainees were dying after arriving at Guantanamo with wounds from the battlefield.
“Detainees have died”
Captain Yund was a preventive medicine doctor from the Bureau of Medicine and Surgery. He served as the Navy’s liaison officer to the AFEB. His February 19 report on “mortuary affairs” at Guantanamo was part of a larger discussion on health issues at the new prison facility.
During the meeting, Captain Yund identified himself as working directly with Admiral Steven Hart, who was the Director of Navy Medicine Research and Development, as well as with “a number of other admirals.”
Yund’s full quote is as follows, on pg. 108 of the AFE transcript (bold added):
Mortuary affairs is an important but hopefully small aspect of the activities of the [Guantanamo] hospital. A number of the detainees have died of the wounds that they arrived with. So there’s attention being paid to doing the things with the body that would be appropriate for their culture. [Bold added for emphasis]
By the time of Yund’s presentation, there were already 300 detainees held in the primitive cages the Defense Department called Camp X-Ray.
The AFEB meeting, which included 31 of the military’s top doctors and medical officials, took place approximately five weeks after the first detainees arrived at Guantanamo’s new, if rudimentary, detention facility, known as Camp X-Ray. Dr. Stephen Ostroff from the Centers for Disease Control, and who was also AFEB board president, chaired the meeting.
A Directive to Mortuary Affairs
A declassified document, which I obtained in late 2019 via the Freedom of Information Act, confirms that soon after Camp X-Ray at Guantanamo started to receive detainees, Department of Defense officials said they expected some of these prisoners to die. Camp authorities were also informed that burial at the U.S.-run naval base in Cuba was “authorized for detainees.”
According to a February 4, 2002 directive to Camp X-Ray from the Mortuary Affairs division at Guantanamo’s new JTF-160 medical department:
“As a consequence of disease, battle injury, and non-battle injury it is assumed that some loss of life may occur among detainees.”
This directive was released in response to a FOIA request I made in 2013, using the Muckrock News website.
The 2002 Mortuary Affairs directive also provided instructions about “processing” the bodies of the deceased: “Disposition of remains shall be carried out in accordance with the above reference instruction and/or as directed by cognizant authorities…. Given the inherent difficulty in next of kin notification, no health care surrogates will be chosen. The JTF Commander will act as the health care surrogate for all detainees under advisement of the JTF Surgeon and JTF Staff Judge.”
The Mortuary Affairs memo lends credence to my report on the AFEB report of unknown early deaths at Guantanamo. However, Yund never referred to this directive in his February 19 AFEB presentation.
In 2006, the AFEB was dissolved by order of then-Secretary of Defense Donald Rumsfeld, and its functions incorporated with other advisory boards — including the Scientific Advisory Board to the Armed Forces Institute of Pathology, and the Amputee Patient Care Program Board of Governors — into the omnibus Defense Health Board.
Links to mefloquine administration
The JTF Guantanamo Surgeon in January-February 2002 was Captain Albert J. Shimkus, who was also commanding officer of the U.S. Naval Hospital at Guantanamo. In addition, Capt. Shimkus was the medical official who authorized an unprecedented presumptive administration of treatment doses of the controversial antimalarial drug mefloquine to all detainees arriving at Guantanamo. The drug was also known by its brand name, Lariam. Later, as I reported, Shimkus said that someone in his chain of command told him he wasn’t to discuss the mefloquine issue.
The use of mefloquine, a controversial drug with a high neuropsychiatric side-effect profile, was most likely an adjunct to other tortuous interrogation techniques and conditions of confinement used at Guantanamo. As a 2015 Seton Hall University School of Law report put it, “ The use of mefloquine to produce anxiety, paranoia, and other such effects at the outset of detention would fall neatly into the scheme of creating controlled chaos in the camp. It also demonstrates the perpetuation of experimental interrogation practices that lend to the image of GTMO as a Battle Lab and testing ground for world-wide interrogation training” (pg. 28).
In his February 2002 AEFB presentation, Capt. Yund also discussed antimalarial measures taken at Guantanamo, but never mentioned the use of mefloquine. In fact, Yund told me that he never heard anything about the use of mefloquine at Guantanamo. This is not surprising, as the use of mefloquine at the Caribbean DoD facility was most likely a highly compartmentalized, Special Access Program drug and interrogation experiment. The Guantanamo deaths in January-February 2002, while expected, were not part of a covert program (so far as we know), but a consequence of a heartless, bizarre rendition-to-torture program whose operations, while still secret, did not demand the deaths of detainees, except, apparently, incidentally.
According to Capt. Yund, Shimkus was the possible source of his information about the early deaths at Guantanamo.
In a December 7, 2010 email interview with Captain Yund, who was then retired, Yund stated he does “not recall that I was ever very directly involved in detainee health issues” at Guantanamo. Accordingly, he said the following in regards to his statement about detainee deaths:
“I did not make that statement from personal or direct knowledge. It may have come from CAPT Shimkus’ presentation, or possibly from conversations or meetings with other Navy Preventive Medicine personnel colleagues. It is not the type of statement I would have made without having learned it from a source I considered reliable.”
Captain Yund did insist he remembered hearing “a detailed and fascinating account” of “events and issues” at Guantanamo, though he couldn’t remember the date or place.
In a phone interview with me for my original December 2010 article, Capt. Shimkus, who was by then an Associate Professor at the U.S. Naval War College, denied any knowledge of any early deaths at Guantanamo, and denied telling Capt. Yund about any such deaths.
Shimkus said that “no deaths occurred” while he was there, but that he did speak to others in the task force at the time about preparing for possible deaths. The latter statement could be Shimkus referencing the Mortuary Affairs directive about preparing for detainee deaths. He could not offer any explanation for what Captain Yund reported.
In the AFEB transcript itself, there is no surprise expressed, or murmur of regret or sadness, or any other comment, or even any correction made regarding Yund’s announcement about the early detainee deaths. The meeting was also attended by other military medical staff, civilian medical advisers, and upper-level DoD bureaucrats. Besides Admiral Hart, also present was the new Assistant Secretary of Defense for Force Health Protection and Readiness, Dr. William Winkenwerder, and his deputy, Ellen Embrey. The meeting was held at the Island Club, North Island Naval Air Station, San Diego.
The North Island Naval Air Station, San Diego, was also the site of the Navy’s Survival, Evasion, Resistance, Escape, or SERE program, and it was Navy SERE officials who pushed hard for waterboarding to be part of the SERE curriculum. It was SERE mock interrogation techniques that were the models for much of the CIA’s “enhanced interrogation” torture techniques, as well as Guantanamo’s own torture program.
The Department of Defense spokesperson at Guantanamo, Major Tanya Bradsher, also went on the record at the time of my 2010 article, stating that the first death at Guantanamo did not occur until the three “suicides” in June 2006. (The fact that that a number of the “suicides” at Guantanamo were likely not actual suicides is something I’ve researched and discussed elsewhere. It was also the subject of an award-winning 2010 article at Harper’s Magazine, and a 2016 book by former Guantanamo prison guard, Joseph Hickman.)
As a matter of due diligence, I asked Bradsher for further clarification. In particular I wanted to know“why a Captain at an Armed Forces Epidemiological Board meeting in Feb. 2002 would refer to earlier deaths at Guantanamo, ostensibly from battlefield wounds.”
Major Bradsher responded, “I can’t speak for Captain Yund. As I have stated before, the first detainee fatality in Guantanamo was in June 2006.”
Battlefield casualties
It is not disputed that some detainees arrived at Guantanamo with serious battlefield injuries. According to Karen Greenberg, in her book The Least Worst Place: Guantanamo’s First 100 Days, hundreds of detainees had been rendered to Guantanamo by February 15, 2002, and there were many who needed major surgery.
According to Greenberg, Capt. Shimkus had been told to expect battlefield wounds. “Surgeries had become a regular event at the facility. The first of several amputations had taken place on February 7. Surgeons had also performed neurosurgery and thoracic surgery….” (pg. 180).
A February 3, 2002 article in the UK’s Sunday Telegraph reported that as of January 21 Guantanamo’s prisoner population stood at 158, fourteen of whom were termed “non-ambulatory.” The same article stated that wounded prisoners were wheeled by trolley to interrogations.
Since January 21, camp authorities had halted new arrivals for security reasons (not enough room), but new prisoners began arriving again on February 7, when 28 new prisoners arrived via military rendition, according to a February 8 Associated Press report. According to an article that same day in the Philadelphia Daily News, a report attributed to “Wire Services” stated, “Six of the [28] latest detainees were on stretchers.”
Besides battlefield injuries, it seems possible that some of the “non-ambulatory” prisoners had been wounded after their capture by U.S. forces. On February 11, Molly Moore of the Washington Post reported on multiple injuries sustained by Afghan villagers who had been wrongly targeted by the U.S. military.
“Each of the prisoners interviewed said they had been beaten, kicked and punched with the soldiers’ fists, feet and in some cases their gunstocks,” Moore wrote.
Notes from a doctor working at Guantanamo medical facility, dated February 22, 2002, which I reviewed some years ago, discussed the previous day’s cardio-thoracic and neurosurgeries at Guantanamo. A thoracotomy (excision of a portion of a lung) was said to have been performed on detainee “205.” The same day’s notes also described an incident in which a detainee was handcuffed via a broken arm.
Despite all these major surgeries, we are supposed to believe that Guantanamo doctors did not lose one patient, even after their patients were transported under onerous conditions thousands of miles from where their injuries occurred!
It does not seem out of the realm of possibility that DoD would want to keep early deaths secret during the highly sensitive period when it was first setting up its “battle lab” — as they called it — at Guantanamo. Nor can the influence of the CIA, which ran at least one black site at Guantanamo in its early days, be ruled out.
Nor is it strange that we do not have more first-hand accounts of certain events at Guantanamo, as all personnel there must sign a security clearance waiver, and are under significant legal and practical pressures not to talk about what they saw or experienced. Consider the sanctions aimed at former Guantanamo guard Albert Melise for talking to reporter Jason Leopold back in 2011.
A bureaucracy for deaths
The 2002 Mortuary Affairs directive also described in some detail how detainee deaths would be handled through the Pentagon’s large bureaucracy.
“USCINCSO [U.S. Southern Command] will notify the National Military Command Center (NMCC) when a detainee dies either en route or while incarcerated at Naval Base GTMO,” the Mortuary Affairs document explained. “The NMCC will notify the Department of State (DOS) and request that DOS notify the decedents’ home of record. NMCC will also notify the National Detainee Information Center (NDIC). The NDIC is responsible for notifying the International Chapter of the Red Cross (ICRC) of a detainee death.”
Though I have searched diligently, I could find no record of a National Detainee Information Center. Perhaps the memo’s author meant to refer to the National Detainee Reporting Center (NDRC), which sends information on detainees to the International Committee of the Red Cross, while it also “obtain[s] and store[s] information concerning unprivileged Enemy Combatants and their confiscated personal property.”
More practically, the document explains, “The processing of detainee remains shall be handled by the Command Mortician and Head, Patient Administration…. In the event a detainee is buried in GTMO, the location of the grave will be recorded with the Graves Registration Service.”
Ultimately, the Department of Mortuary Affairs was to cede authority in regards to detainee deaths to the new Joint Task Force 160 being set up at Guantanamo.
According to the FOIA-released directive, “Once the JTF is established and capable of conducting mortuary services, Navbase GTMO will transition mortuary affairs responsibility to the JTF… Limited mortuary services are available at Naval Hospital Navbase GTMO.”
Instructions for burial
The Mortuary Affairs directive also provided instructions on preparing a detainee for burial: “A Muslim should be buried within 24 hours of death, in a grave that is 6 feet in depth with the head facing Mecca and marked with a stone above the head… After the body is washed, it is rubbed with ‘Kafoud,’ a pleasant smelling substance, Muslim chaplains should have this product readily available…. The [Department of State] will contact the embassy of the decendents home of record for disposition instructions…. If determination is made that the U.S. will inter the deceased the remains will be buried at Navbase GTMO…. Burial at Navbase GTMO is authorized for detainees” (bold emphasis added).
In a strange assertion of detainee rights, given that the U.S. government argued at the time that detainees did not have the right to secure attorneys, in 2002 Guantanamo authorities were told “detainees have the right to self-determination and the opportunity to request advance directives or living wills.”
Of course, no known burial sites for any Guantanamo detainees who arrived in 2002 or later have ever been identified at Guantanamo. There is a ramshackle empty area labeled an “Islamic Cemetery” at the camp, as is shown in a photo earlier above (taken by reporter Jason Leopold). If indeed an unspecified number of detainees did die in the early weeks after the detention site was open in January 2002, their corpses do not lie in Guantanamo’s Islamic Cemetery, or if they do, their graves have no headstone. They otherwise rest in unmarked graves elsewhere in the U.S.-military controlled zone on the island of Cuba, or were dumped at sea, or otherwise disposed of.
Unanswered questions
Back in 2010, Dr. Steven Miles, author of Oath Betrayed: Torture, Medical Complicity, and the War on Terror, who wrote about the Department of Defense’s history of hiding deaths by torture and falsifying autopsies, personally shared his reaction to news of the possible deaths I reported at that time. In an email, he described the discovery of the AFEB material:
This is an enormously important event. I have tried, without success to have the DoD or the media, clarify the huge inconsistencies in prisoner death reporting to no avail. My article on this remains unpublished by the medical media and by Slate etc.
Since that time, there has been the release of the Executive Summary of the Senate Select Committee on Intelligence report on the CIA black site program. But that redacted section of the report left many questions unanswered, and no light was thrown on the mystery discussed in this article on unreported deaths.
In 2010, I wrote, “There is a tremendous need for Congressional and/or independent investigations that have full mandate and subpoena power to ferret out the truth about what has occurred at Guantanamo and other U.S. ‘war on terror’ prisons.
“The biggest obstacle to this, besides the Pentagon and the GOP, is the Democratic Party leadership itself, which refuses to undertake or fund such investigations, and whose leader in the White House, President Barack Obama, opposes — against treaty obligations described in Article 12 of the Convention Against Torture — such investigations.”
Sadly, President Obama did not ever press for further investigations. Neither did Presidents Trump or Biden. No politician in either the Democratic or Republican parties shows any appetite for doing so either. If anything, today there appears to be even less interest in investigations into CIA and Department of Defense crimes at so-called “War on Terror” prisons or detention sites than ever before. It will take public pressure — thus far sorely lacking — to change the direction of history towards accountability and justice.
Thank you for this much needed investigation. A reminder, incidentally, of the fact that the US occupation of Guantanamo has no legal basis. I look forward to the day when Cuban troops take the facility over and show us where the bodies, and I suspect that there are lots of them after more than a century, are buried.
Nothing the empire does us a big deal. A live streamed genocide isn't a big deal.
If Hitler had won, we'd be exactly where we are now... in the 4th Reich still exterminating semites.