The Abu Ghraib Scandal You Don't Know

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American soldiers often have a tough time with Arabic names, so to guards, he was just "Gus.'' To the world outside Abu Ghraib prison, he became an iconic figure, a naked, prostrate Iraqi prisoner crawling on the end of a leash held by Private Lynndie England, the pixyish Army Reserve clerk who posed in several of the infamous photographs that made the name Abu Ghraib synonymous with torture. Now, it emerges, there may be another dimension to Gus' story and certainly to the horrors of Abu Ghraib. In what amounted to a perversion of the traditional doctor's creed of "first, do no harm," the medical system at the prison became an instrument of abuse, by design and by neglect. As uncovered by legal scholars M. Gregg Bloche and Jonathan Marks, who conducted an inquiry published by the New England Journal of Medicine, not only were some military doctors at Abu Ghraib enlisted to help inflict distress on the prisoners, but also the scarcity of basic medical care was at times so severe that it created another kind of torture.

Medical personnel and others who worked at the prison tell TIME that, with straitjackets unavailable, tethers--like the leash on Gus--were put to use at Abu Ghraib to control unruly or mentally disturbed detainees, sometimes with the concurrence of a doctor. That such a restraint-- which is supposed to be placed around legs, arms or torsos--ended up instead around a man's neck seems to be a case of a medically condoned practice degenerating into abuse. But there was also medical disarray at the prison: amputations performed by nondoctors, chest tubes recycled from the dead to the living, a medic ordered, by one account, to cover up a homicide. That in itself would have made Abu Ghraib a scandal even without the acts of torture inflicted on the inmates by their guards.

In most cases, U.S. frontline troops in Iraq have received top-quality medical care, producing the lowest death rate of any military conflict in history. But the care at Abu Ghraib has often been at the other end of the scale of humane treatment, at least until recently. Although the prison was at times crowded with as many as 7,000 detainees, no U.S. doctor was in residence for most of 2003. Military officials say a few Iraqi doctors saw to minor illnesses but not major traumas. In a statement obtained by the American Civil Liberties Union, an Army medic based at Abu Ghraib spoke of examining from 800 to 900 detainees daily as they were admitted. If he worked a 12-hour day, that gave him less than a minute for each exam. Ken Davis, an MP who served at Abu Ghraib in late 2003, told TIME that he once escorted a prisoner who had broken his foot the day before and had still not received treatment. "He was in terrible pain," Davis recalled. "There was no doctor and really nothing we could do."