Update: 20 March 2012 - Hana al-Shalabi denied admission to hospital despite grave condition
According to Addameer and Physicians for Human Rights - Israel (PHR-I), the Israel Prison Service has refused to transfer Hana al-Shalabi to hospital despite her grave medical situation due to more than a month of hunger strike and immediate risk of death. In a joint release, the two organizations stated:
As of today, the Israeli Prison Service (IPS) is refusing to transfer Ms. Shalabi to the hospital, despite yesterday’s urgent reports by her doctor that she should be transferred immediately. Addameer, PHR-Israel and Al-Haq are certain that the quality and facilitation of medical care administered by the IPS is not adequate to attend to her current condition. Meanwhile, today, the Israeli military judge of the Court of Appeals postponed yet again making a decision regarding Ms. Hana Shalabi’s four-month administrative detention order following a meeting with her lawyers and the military prosecution.
Following an urgent report issued by the PHR-Israel doctor who examined Ms. Shalabi yesterday, 19 March, which concluded that Ms. Shalabi is in immediate mortal danger and should be immediately transferred to a hospital for close observation, Ms. Shalabi was transferred to the civilian Meir Hospital last night. However, for unknown reasons, she was not admitted to the hospital the IPS transferred Ms. Shalabi back to the IPS medical center in Ramleh Prison Hospital later on the same night. Ms. Shalabi’s doctor was not informed of this transfer until today. Addameer, PHR-Israel and Al-Haq share fears regarding the adequacy and timeliness of the medical care available in Ramleh, especially given the growing concern about her rapidly deteriorating condition.
The Addameer/PHR-I statement reports that the Israel Prison Service is placing bureaucratic obstacles in the way of transferring al-Shalabi to hospital and subjecting her to further mistreatment which puts her at even further risk:
Ms. Shalabi reported to the PHR-Israel doctor that during her various transfers yesterday, she was handled violently, including being “dragged across the floor”. Her PHR-Israel doctor is particularly worried about Ms. Shalabi in light of this mistreatment, which undoubtedly is having an effect on her already-fragile state. Any further deterioration or aggravation of her condition, including emotionally, could cause a heart attack.
The statement also says that once again an Israeli military judge has failed to set a date for when he will decide on al-Shalabi’s appeal against her detention without charge or trial by Israeli occupation forces.
Original post: Hana al-Shalabi at risk of “imminent death”
Hana al-Shalabi is at risk of “imminent death” after more than a month on hunger strike against her violent, arbitrary detention by Israel has led to a serious deterioration in her health. She has been transferred from HaSharon prison to Meir Hospital in Kfar Saba.
Meanwhile, many more Palestinian prisoners are on hunger strike in solidarity with al-Shalabi including 72 year-old Ahmad Al-Hajj Ali, one of two dozen elected members of the Palestinian Legislative Council being held by Israel without charge or trial.
The statement also alleges violations of medical ethics by the Israel Prison Service including consideration of force-feeding, and it “calls upon the local and the international community to act immediately and intervene for the release of Shalabi, and to act to end Israel’s use of administrative detention.”
However the statement says that “The Prison Service has announced that it has transported Shalabi to the Meir Hospital in Kfar Saba pursuant to the recommendation of the physician.”
Al-Shalabi spent two years in so-called “administrative detention” without charge or trial until she was released last October as part of a prisoner exchange negotiated by Israel and Hamas. However, on 16 February, al-Shalabi’s home in the West Bank village of Burqin was violently raided by Israeli occupation forces and she was re-arrested.
On 23 February Israeli occupation forces issued a new six-month administrative detention order. The military court has repeatedly delayed hearing an appeal against the order. Currently 309 people are held by Israel in administrative detention.
Risk of death
According to PHR-I, the deterioration in al-Shalabi’s health is “significant” and “she risks death.” The statement says that:
The deterioration is expressed in a process of muscle breakdown, with a weight loss of 14 kg (31 lb.) since the onset of the hunger strike, a very slow pulse, and a drop in blood sodium levels. These symptoms could indicate grave damage to the heart and the beginning of the breakdown of the heart muscle, which could lead to heart failure at any moment.
Al-Shalabi is suffering other severe conditions including low blood pressure, severe weakness and inability to move about on her own and serious pain throughout her body.
The statement expresses concern over “problematic conduct” by the Israel Prison Service, including pressuing al-Shalabi to end her hunger strike, providing her with misleading information and that “that medical teams are still considering the possibility of force-feeding her, despite the fact that international treaties prohibit this.”
At least 24 prisoners on hunger strikeAt least 24 Palestinian prisoners are on various stages of hunger strike, according to Palestinian prisoners’ rights group Addameer which has been providing information via its Twitter feed and Facebook page.
Kifah Hattab has been on hunger strike for 20 days and Bilal Diab and Thair Halahleh have been on hunger strike for 19 days, according to Addameer, while PLC member Ahmad Al-Hajj Ali declared his hunger strike on 14 March.
The hunger strikers also include Ahmad Saqer, currently the longest held administrative detainee.
Hana al-Shalabi’s sister speaks out: videoIn a brief video, shot and edited by Vivien Sansour, Hana’s sister Zahera speaks out about Hana’s hopes and dreams including going to university, getting a driver’s license and getting married. Zahera talks about the family’s constant anxiety as they worry about Hana dying alone in Israeli custody and the importance of solidarity from the local community, Arabs, internationals and Jewish people.
Full text of Physicians for Human Rights - Israel statement
On the 33rd day of her hunger strike, administrative detainee Hana Shalabi is in danger of imminent death. An independent physician from Physicians for Human Rights - Israel (PHR-Israel) examined her today and determined that she must be hospitalized immediately
Physicians for Human Rights: the Prison Service treatment of Shalabi violates medical ethics
Hana Shalabi, an administrative detainee held at the Sharon Prison, has been on hunger strike for more than a month, in protest of her violent detention, the humiliating and hurtful search that was conducted on her upon her detention, and also in protest of being held in administrative detention. A hearing on her case is expected to be held at the military court.
This morning (March 19th) an independent physician visited Hana Shalabi on behalf of PHR-Israel, and she states that there has been a significant deterioration in her condition, and that she risks death. The deterioration is expressed in a process of muscle breakdown, with a weight loss of 14 kg (31 lb.) since the onset of the hunger strike, a very slow pulse, and a drop in blood sodium levels. These symptoms could indicate grave damage to the heart and the beginning of the breakdown of the heart muscle, which could lead to heart failure at any moment.
Additionally, her body temperature is low (hypothermia), recorded at 35.05C (95.09F), with Shalabi reporting that she feels cold. This finding indicates that the energy production in her body is mostly directed at the essential organs, which also indicates possible damage to the heart, which could be expressed in arrhythmia, systemic deterioration, or sudden death. The attending physician adds that Shalabi is not taking medications, has gone from ambulatory independence to being dependent on others for locomotion, and suffers from significant weakness, low blood pressure, serious pain throughout her body, significant sensitivity in her upper abdominal region, and serious dizziness.
The results of the blood test taken on March 14th indicate a drop in the levels of blood glucose and sodium, and damage to the thyroid functions. The thyroid plays a critical role in maintaining body temperature, as well as heart, liver, and brain function. Significant damage to the thyroid gland could lead to a coma, and this possibility is clearly present with regard to Shalabi. Additionally, blood work done today indicates disruption of the clotting functionality, and a significant lack of iron and vitamins.
Following her examination, the physician has determined that Shalabi is in immediate danger to her life, and recommended that she be transported to a hospital with no delay, for close supervision and follow-up. The Prison Service has announced that it has transported Shalabi to the Meir Hospital in Kfar Saba pursuant to the recommendation of the physician.
Physicians For Human Rights Israel today calls out the problematic conduct by the Israeli Prison Service in its treatment of Hana Shalabi:
Great pressure is being exerted on Shalabi to stop the hunger strike, both by the Prison Service Ethics Committee and the Muslim cleric who is a member of that committee.
The Chief Medical Officer for the Prison Service communicated with the PHR-I physician, asking that she persuade Shalabi to stop her strike. This clearly violates the principles of medical ethics.
Hana’s communication with the PHR-I physician who is supposed to follow up closely on her health - is very limited. For example, when Shalabi asked to see the PHR-I physician last week, the Prison Service did not inform the physician of this request.
The results of Shalabi’s blood tests, as communicated to the PHR-I physician last week, over a phone call with the Chief Medical Officer for the Prison Service, were found to be different from the printed results, which were sent from the lab and given to the PHR physician to review physically today. The results conveyed presented a different medical picture than that which actually existed in reality.
It seems that the question of force-feeding has not been ruled out, and that the discussion of this matter continues in the Prison Service Ethics Committee.
It appears that an attempt is being made to undermine Shalabi’s faith in the independent physician by presenting her with incorrect information. In the course of the physician’s examination today, Shalabi indicated that she had been told by the Prison Service representatives that the PHR independent physician had given the blood tests to the Prison Service, and that she did not wish to take them herself.
Physicians For Human Rights again expresses extreme concern for Hana Shalabi’s life. The organization expresses its dismay at the fact that medical teams are still considering the possibility of force-feeding her, despite the fact that international treaties prohibit this.
The organization calls upon the local and the international community to act immediately and intervene for the release of Shalabi, and to act to end Israel’s use of administrative detention.
For reports of prior examinations by the PHR physician see: March 13th.
On 23 February 2012 an administrative detention order for six months was issued for Ms. Hana Shalabi. On 29 February there was a hearing regarding her detention in Ofer military court. On 4 March the military court decided to reduce the detention period from six to four months, but without promising to extend or renew it. As a result, Ms. Hana Shalabi announced she would continue to hunger strike until her release. On 7 March, an appeal hearing regarding the court’s decision was held at Ofer, and the military judge ordered the parties to try and reach a compromise by Sunday 11 March, but no agreement has yet been reached.
Administrative detainees’ protests are growing. Two additional administrative detainees, Bilal Diab and Thair Halahleh declared hunger strikes on 1 March, which they claim will continue until their release from administrative detention. On 3 March, two other administrative detainees declared hunger strikes until their release. Since the beginning of March, a number of administrative detainees have refused to acknowledge the military court and refused to participate in legal hearings of their cases. Due to Israel’s use of administrative detention, and the unwillingness of the military court to interfere in this practice, a hunger strike serves as a non-violent and the sole tool available to administrative detainees to protest and fight for their basic human rights.
Approximately 309 Palestinians are currently held in administrative detention in Israeli prisons. Administrative detention allows Israel to hold detainees for indefinitely renewable six-month periods. The arrest is granted on the basis of “secret information” and without a public indictment. Therefore, administrative detainees and their lawyers cannot defend against these allegations in court.