WASHINGTON — Twice a day at the military detention center at Guantanamo Bay, Cuba, guards take a number of detainees from their cells, one at a time, to a camp clinic or a private room on their block.
The detainees are offered a hot meal or a liquid nutritional supplement and, if they refuse, they are strapped into a chair. A nurse then passes a tube through their noses and down into their stomachs; for one to two hours, they are fed a drip of Ensure while a Navy corpsman watches.
Those who have experienced force-feeding have described it as painful. But, as the prisoners at Guantanamo Bay are well aware, fasting and then enduring the procedure can also bring political advantage.
From British-run prisons in Ireland to detention facilities in Israel, the hunger strike has long been a political weapon wielded by the imprisoned or the powerless. With their protest, the 100 men refusing food at Guantanamo — 23 of whom are being fed through a nasogastric tube — have forced the largely forgotten issue of their indefinite detention back on to Washington's agenda.
The hunger strike has also reopened a debate about whether it is ethical for medical personnel at Guantanamo Bay to force-feed some of the protesters. When a hunger striker falls to 85 percent of his ideal body weight and continues to refuse food, a military medical doctor writes a prescription for what officials at Guantanamo call an"enteral feed."
The hunger strike at Guantanamo Bay began in early February over allegations that the guard force improperly handled Korans during searches -- charges strenuously denied by the military. But the number of hunger strikes has since skyrocketed, and the protest has taken on broader meaning for detainees seeking to protest Guantanamo's seeming permanence and the Obama administration's failure to make good on it promise to close the facility.
President Obama said Tuesday that he would renew efforts to shut the detention center, a challenge that, if anything, is more politically demanding than it was when he signed an executive order to close Guantanamo on his second day in office in January 2009. White House officials said Obama is considering appointing a senior State Department official to oversee the transfer of detainees who have been cleared for repatriation or resettlement — the post is vacant — and will also accelerate efforts to start a periodic review process for others being held without charge.
There are 166 detainees at Guantanamo, 86 of whom have been cleared for transfer by an interagency task force. The policy of slowly emptying the facility by sending detainees home or finding them third countries in which to live has been moribund for a year.
The administration blames the paralysis on congressional restrictions, but the secretary of defense can still act by certifying that a particular transfer is in the national security interests of the United States. Lawyers for the detainees said the administration should move quickly to exercise that option.
"Let's start with the 86; there can be no argument about that," said Carlos Warner of the federal public defender's office in the Northern District of Ohio, which represents 11 Guantanamo detainees. "There could be transfers home in one month, two months."
The White House would still need to engage Congress so it doesn't further restrict options for handling detainees, said an administration official, who spoke on the condition of anonymity. The official, who was not authorized to discuss the issue, noted that 56 of the 86 cleared detainees are from Yemen.
The administration suspended transfers to Yemen after a plot to bring down a U.S. commercial airline over Detroit was found to originate in that country. Any decision to lift that suspension would require the administration to help Yemeni authorities manage a staggered return of their nationals.
Warner said visible movement on transfers, coupled with a willingness by the military to negotiate with detainees on matters such as the handling of the Koran, could end the hunger strike.
The American Medical Association and the International Committee of the Red Cross have said they oppose force-feeding. They each cite a declaration by the World Medical Association that states that "where a prisoner refuses nourishment and is considered by the physician as capable of forming an unimpaired and rational judgment concerning the consequences of such a voluntary refusal of nourishment, he or she shall not be fed artificially."
Obama defended the practice Tuesday, saying, "I don't want these individuals to die."
The Pentagon has not responded to a letter from the AMA on the issue, but Lt. Col. Samuel House, a spokesman for Joint Task Force Guantanamo, said the military wants to preserve lives.
There are a handful of detainees at Guantanamo who have been on a hunger strike and force-fed since 2005, according to House.
But the scale of the current protest has forced the military to move additional medical personnel onto the base to monitor detainees and cope with the rising numbers of forced feedings. There is nearly one nurse or corpsman for every detainee, he said.
There are no participants in the hunger strike at Camp 7, the high-security, classified facility that holds 14 high-value detainees, including Khalid Sheik Mohammed, the self-proclaimed mastermind of the Sept. 11, 2001, attacks.