<html>
<body>
<font face="Comic Sans MS" size=4>A Report by Physicians for Human
Rights<br>
June 2008<br>
<a href="http://brokenlives.info/" eudora="autourl">
http://brokenlives.info/<br>
</a></font><font face="Comic Sans MS" size=7 color="#C50000"><b>BROKEN
LAWS,<br>
BROKEN LIVES<br>
</font><font face="Comic Sans MS" size=6>Medical Evidence of Torture
by<br>
US Personnel and Its Impact<br><br>
</b></font><font size=6>List of Acronyms<br><br>
</font><font size=2><b>BHS: </b>Behavioral Health Science Teams<br>
<b>CIA: </b>Central Intelligence Agency<br>
<b>CIDT: </b>Cruel, Inhuman, or Degrading Treatment<br>
<b>DoD: </b>Department of Defense<br>
<b>DTA: </b>Detainee Treatment Act of 2005<br>
<b>ECHR: </b>European Court of Human Rights<br>
<b>ERB: </b>Ethics Review Board<br>
<b>FBI: </b>Federal Bureau of Investigation<br>
<b>IACHR: </b>Inter-American Court of Human Rights<br>
<b>ICRC: </b>International Committee of the Red Cross<br>
<b>ICCPR: </b>International Covenant on Civil and<br>
Political Rights<br>
<b>ICTR: </b>International Criminal Tribunal for Rwanda<br>
<b>ICTY: </b>International Criminal Tribunal for Yugoslavia<br>
<b>IRF: </b>Immediate Reaction Force<br>
<b>IRCT: </b>International Rehabilitation Council for<br>
Torture Victims<br>
<b>MCA: </b>Military Commissions Act of 2006<br>
<b>MDD: </b>Major Depressive Disorder<br>
<b>NOS: </b>Not Otherwise Specified<br>
<b>OLC: </b>Office of Legal Counsel, Department<br>
of Justice<br>
<b>PHR: </b>Physicians for Human Rights<br>
<b>POW: </b>Prisoner of War<br>
<b>PTSD: </b>Post-traumatic Stress Disorder<br>
<b>SERE: </b>Survival, Evasion, Resistance, and<br>
Escape training<br>
<b>SOP: </b>Standard Operating Procedure<br>
<b>TVPA</b>: Torture Victims Protection Act of 1991<br>
<b>WCA: </b>War Crimes Act<br><br>
<br>
</font><font size=7><b>T</b></font><font size=2>his report tells the
largely untold human story of<br>
what happened to detainees in our custody when<br>
the Commander-in-Chief and those under him<br>
authorized a systematic regime of torture. This story is<br>
not only written in words: It is scrawled for the rest of<br>
these individual’s lives on their bodies and minds. Our<br>
national honor is stained by the indignity and inhumane<br>
treatment these men received from their captors.<br><br>
The profiles of these eleven former detainees, none<br>
of whom were ever charged with a crime or told why<br>
they were detained, are tragic and brutal rebuttals to<br>
those who claim that torture is ever justified. Through<br>
the experiences of these men in Iraq, Afghanistan, and<br>
Guantanamo Bay, we can see the full-scope of the damage<br>
this illegal and unsound policy has inflicted —both on<br>
America’s institutions and our nation’s founding values,<br>
which the military, intelligence services, and our justice<br>
system are duty-bound to defend.<br><br>
In order for these individuals to suffer the wanton<br>
cruelty to which they were subjected, a government<br>
policy was promulgated to the field whereby the Geneva<br>
Conventions and the Uniform Code of Military Justice<br>
were disregarded. The UN Convention Against Torture<br>
was indiscriminately ignored. And the healing professions,<br>
including physicians and psychologists, became<br>
complicit in the willful infliction of harm against those<br>
the Hippocratic Oath demands they protect.<br><br>
After years of disclosures by government investigations,<br>
media accounts, and reports from human<br>
rights organizations, there is no longer any doubt as to<br>
whether the current administration has committed war<br>
crimes. The only question that remains to be answered<br>
is whether those who ordered the use of torture will be<br>
held to account.<br><br>
The former detainees in this report, each of whom<br>
is fighting a lonely and difficult battle to rebuild his life,<br>
require reparations for what they endured, comprehensive<br>
psycho-social and medical assistance, and even an<br>
official apology from our government.<br><br>
But most of all, these men deserve justice as required<br>
under the tenets of international law and the United<br>
States Constitution.<br><br>
And so do the American people.<br><br>
</font><font size=3><b>Major General Antonio<br>
Taguba, USA (Ret.)<br>
</b></font><font face="Comic Sans MS" size=2><i>Maj. General Taguba led
the US Army’s official<br>
investigation into the Abu Ghraib prisoner abuse<br>
scandal and testified before Congress on his<br>
findings in May, 2004.<br><br>
</i></font><font size=6>Preface<br>
</font><font size=1>1<br>
</font><font size=7><b>T</b></font><font size=2>his report provides
first-hand accounts and<br>
medical evidence of torture and cruel, inhuman,<br>
or degrading treatment or punishment (“illtreatment”) <br>
of eleven former detainees who were held<br>
in US custody overseas. Using internationally accepted<br>
standards, Physicians for Human Rights (PHR) conducted<br>
medical evaluations of the former detainees to document<br>
the severe, long-term physical and psychological<br>
consequences that have resulted from the torture and
illtreatment.<br><br>
The evaluations provide evidence of violation<br>
of criminal laws prohibiting torture and of the commission<br>
of war crimes by US personnel.<br><br>
Four of the men evaluated were either arrested in or<br>
brought to Afghanistan between late 2001 and early 2003<br>
and later sent to Guantánamo Bay, Cuba, where they<br>
were held for an average of three years before release<br>
without charge. The other seven were detained in Iraq<br>
in 2003 and released without charge later that year or in<br>
2004, with an average period of detention of six months.<br>
All of the former detainees evaluated by PHR reported<br>
having been subjected to multiple forms of torture or<br>
ill-treatment that often occurred in combination over a<br>
long period of time.<br><br>
The medical evaluations were based in each case<br>
on intensive two-day clinical interviews that included<br>
diagnostic testing and, in two cases, review of medical<br>
records. With this evidentiary record, this report provides<br>
the most detailed account available thus far of the experience<br>
of detainees in US custody who suffered torture — a<br>
war crime — at the hands of US personnel. Additionally,<br>
this report provides further evidence of the role health<br>
professionals played in facilitating detainee abuse by<br>
being present during torture and ill-treatment, denying<br>
medical care to detainees, providing confidential medical<br>
information to interrogators, and failing to stop or document<br>
detainee abuse.<br><br>
Methods of torture experienced by the former<br>
detainees evaluated by PHR included interrogation and<br>
detention practices such as isolation, sleep deprivation,<br>
forced nakedness, severe humiliation and degradation,<br>
and sensory deprivation that were officially authorized<br>
by military and civilian officials during certain periods<br>
when these men were incarcerated.</font><font size=1>
</font><font size=2>Additional practices<br>
recounted by the interviewees including beatings<br>
and other forms of severe physical and sexual assault<br>
that, while not officially authorized by government documents<br>
now part of the public record, came to be part of<br>
a regime of brutality at the facilities where the detainees<br>
were held.<br><br>
This report demonstrates that the permissive environment<br>
created by implicit and explicit authorizations by<br>
senior US officials to “take the gloves off”</font><font size=1>4
</font><font size=2>encouraged<br>
forms of torture even beyond the draconian methods<br>
approved at various times between 2002 and 2004.</font><font size=1>5
</font><font size=2>In an<br>
environment of moral disengagement that countenances<br>
authorized techniques designed to humiliate and dehumanize<br>
detainees, it is not surprising that other forms<br>
of human cruelty such as physical and sexual assault<br>
were practiced. The fact that these unauthorized torture<br>
practices happened over extended periods of time at<br>
multiple US detention facilities suggests that a permissive<br>
command environment existed across theatres and<br>
at several levels in the chain-of-command. This climate<br>
allowed both authorized and unauthorized techniques to<br>
be practiced, apparently without consequence.<br><br>
Given the limited number of detainees evaluated, the<br>
findings of this assessment cannot be generalized to the<br>
treatment of all detainees in US custody. The patterns of<br>
abuse documented in this report, however, are consistent<br>
with numerous governmental and independent investigations<br>
into allegations of detainee ill-treatment,</font><font size=1>6
</font><font size=2>making<br>
it reasonable to conclude that these detainees were not<br>
the only ones abused, but are representative of a much<br>
larger number of detainees subjected to torture and illtreatment<br>
while in US custody.<br><br>
</font><font size=4>Methods<br>
</font><font size=2>PHR identified individuals through referring
nongovernmental<br>
organizations and law firms that provide<br>
legal representation to former and current detainees in<br>
US custody. The evaluations were conducted between<br>
December 2006 and September 2007, after consent was<br>
obtained by the individuals. No former detainee PHR<br>
located who was eligible and consented to an evaluation<br>
was excluded from the study. For each former<br>
detainee, a team of two experienced clinicians evaluated<br>
the individual and documented allegations of torture<br>
and ill-treatment in accordance with the guidelines for<br>
assessing physical and psychological evidence of torture<br>
set out in the </font><font face="Comic Sans MS" size=2><i>Istanbul
Protocol, Manual on the Effective<br>
Investigation and Documentation of Torture and Other<br>
Cruel, Inhuman or Degrading Treatment or Punishment<br>
</i></font>(hereafter <font face="Comic Sans MS" size=2><i>Istanbul
Protocol</i></font>).<font size=1>7 </font><font size=2>Sources of
information<br>
for the medico-legal reports include the clinical interview,<br>
psychological testing, physical examinations and<br>
medical diagnostic tests. The Guantánamo Bay detention<br>
medical records of one individual and an independent<br>
medical record of another former detainee were available<br>
for review as well. In each case, the clinicians provided<br>
opinions on possible torture and ill-treatment based on<br>
correlations between individual allegations of torture<br>
and specific physical and psychological evidence. They<br>
found no evidence of deliberate exaggeration in any<br>
case. The study was approved by PHR’s Ethics Review<br>
Board. In order to protect confidentiality, the names of<br>
the individuals evaluated were changed and information<br>
that could potentially identify the former detainees has<br>
been omitted.<br><br>
</font><font size=4>Summary of Findings<br>
</font><font size=3><b>Synopses of the Cases of Former Detainees<br>
Profiled<br><br>
</b></font><font size=2>The following summaries of three evaluations of
the<br>
eleven cases illustrate the torture and ill—treatment<br>
that the detainees experienced and the resulting<br>
long-term physical and psychological harm. The torture<br>
and ill-treatment described were corroborated by the<br>
medical evidence.<br><br>
</font><font face="Comic Sans MS" size=2><b><i>Kamal </i></b></font>is in
his late forties. He served in the Iraqi Army<br>
during the 1980s and later became a businessman and<br>
Imam of a local mosque. In September 2003 he was<br>
arrested by US forces. At the time of his arrest, he was<br>
beaten to the point of losing consciousness. After being<br>
brought to Abu Ghraib prison, he was kept naked and<br>
isolated in a cold dark room for three weeks, where both<br>
during and in between interrogations he was frequently<br>
beaten, including being hit on the head and in the jaw with<br>
a rifle and stabbed in the cheek with a screwdriver.<br><br>
He was then placed in isolation in a urine-soaked<br>
room for two months. When Kamal was allowed to wear<br>
clothes, they were sometimes soaked in water to keep him<br>
cold. On approximately ten occasions he was suspended<br>
in a stress position, causing numbness that lasted for a<br>
month. He was made to believe that his family members<br>
were also in prison and that they were being raped and<br>
tortured. He recounted, “[T]hey were telling me, making<br>
me hear voices of children and women, and told me they<br>
were my children and [wife].” He was eventually transferred<br>
to a tent area of Abu Ghraib, where he remained<br>
for seven months until his release in June 2004.<br>
PHR’s clinicians found physical and psychological<br>
evidence consistent with the abuse Kamal reported.<br><br>
He continues to experience chronic pain in his jaw and<br>
numbness from the suspensions. He also meets diagnostic<br>
criteria for several psychiatric diagnoses, including<br>
major depressive episodes, a panic disorder, and posttraumatic<br>
stress disorder (PTSD) that are attributable to<br>
his experience in detention. Particularly striking is the<br>
severity of Kamal’s depressive symptoms, with feelings<br>
of hopelessness, worthlessness, and guilt, and difficulty<br>
sleeping. His symptoms are indeed so severe that, in the<br>
opinion of PHR’s clinicians, they would qualify him for<br>
hospitalization in the United States.<br><br>
<font face="Comic Sans MS" size=2><b><i>Amir </i></b></font>is in his
late twenties and grew up in a Middle<br>
Eastern country. He was a salesman before being<br>
arrested by US forces in August 2003 in Iraq. After his<br>
arrest, he was forced, while shackled, to stand naked<br>
for at least five hours. For the next three days, he and<br>
other detainees were deprived of sleep and forced to run<br>
for long periods, during which time he injured his foot.<br><br>
After Amir notified a soldier of the injury, the soldier<br>
threw him against a wall and Amir lost consciousness.<br>
Ultimately, he was taken to another location, where he<br>
was kept in a small, dark room for almost a month while<br>
being subjected to interrogations that involved shackling,<br>
blindfolding, and humiliation. Approximately one month<br>
later, he was transferred to Abu Ghraib. At first he was<br>
not mistreated, but then was subjected to religious and<br>
sexual humiliation, hooding, sleep deprivation, restraint<br>
for hours while naked, and dousing with cold water. In<br>
the most horrific incident Amir recalled experiencing, he<br>
was placed in a foul-smelling room and forced to lay face<br>
down in urine, while he was hit and kicked on his back<br>
and side. Amir was then sodomized with a broomstick<br>
and forced to howl like a dog while a soldier urinated<br>
on him. After a soldier stepped on his genitals, he<br>
fainted. In July 2004, he was transferred to the prison<br>
at Camp Bucca, where he reported no abuse. He was<br>
returned to Abu Ghraib in November 2004 and released<br>
two days later.<br><br>
Amir continues to experience physical symptoms<br>
consistent with the abuse he reported. Physical examination<br>
revealed features consistent with his account,<br>
including tenderness of one of his testicles and rectal<br>
tearing. Psychologically, he continues to suffer from<br>
debilitating symptoms of severe PTSD, disturbed sleep,<br>
moodiness, anxiety, sexual dysfunction, hostility and<br>
outbursts of anger, and very frequent suicidal thoughts.<br>
He has changed from a stable provider for his family to an<br>
unemployed man. Although stressors related to the war<br>
in Iraq may exacerbate his symptoms, his most debilitating<br>
symptoms are attributable to his experience of<br>
torture and sexual violation. “No sorrow can be compared<br>
to my torture experience in jail,” he said. “That is the<br>
reason for my sadness.”<br><br>
<font face="Comic Sans MS" size=2><b><i>Youssef</b> </i></font>is in his
early thirties. Unable to find work in his<br>
country of origin, he sought employment in Afghanistan.<br>
In late 2001 or early 2002, Youssef was detained as he<br>
attempted to cross the Afghanistan-Pakistan border<br>
without a passport while trying to return home. He was<br>
held in a Pakistani prison for two months, where he was<br>
often shackled in unsanitary conditions and given little food.<br>
During this time, he was interrogated by US personnel<br>
and eventually hooded, shackled, and transferred to the<br>
US detention facility in Kandahar, Afghanistan.<br><br>
In Kandahar, Youssef was immediately interrogated<br>
and subjected to beatings with sticks and fists as well as<br>
kicking, although he did not sustain serious injuries at the<br>
time. After that, he was stripped naked. The first night he<br>
was not allowed to sleep, as guards hit the detainees and<br>
threw sand at them. While in Kandahar, Youssef endured<br>
forced nakedness, intimidation by dogs, hooding, and<br>
repeated assaults by being thrown against a wall. He was<br>
subjected to electric shock from a generator, feeling “as<br>
if my veins were being pulled out.”<br><br>
After about six weeks, he was transferred to the US<br>
detention facility at Guantánamo Bay, Cuba. During the<br>
transatlantic flight he was dressed in an orange suit,<br>
fitted with dark goggles and headphones and shackled<br>
to the floor of the plane. The tight cuffs caused his wrists<br>
to swell. Upon arrival, he was stripped, sprayed with<br>
water and examined by a doctor. Like other detainees,<br>
he described the conditions at Camp X-Ray as deplorable,<br>
with detainees living in cages that were extremely<br>
hot and denied anything but a bucket for a toilet. In Camp<br>
X-Ray lengthy interrogations accompanied by sleep<br>
deprivation began. Small infractions such as speaking<br>
with other detainees led to beatings, and a person whom<br>
he perceived to be a doctor checked the injuries of the<br>
detainees after the beatings. In order to avoid beatings,<br>
Youssef was compliant. Nevertheless, the Immediate<br>
Reaction Force (IRF) team forced him into stress positions,<br>
including sitting on his knees with his hands<br>
pressed together behind his back or head and tied to<br>
his feet, forcing his legs up.<br><br>
After approximately three months, Youssef and others<br>
were transferred to Camp Delta, where general cell<br>
conditions were better, although detainees were rarely<br>
let out of their cells. He was beaten once for hiding food<br>
in his cell. An IRF team also sprayed him in the eyes with<br>
what may have been pepper spray, so that “my whole<br>
body would feel like it was burning — not just my face,<br>
but my whole body…I felt like I was losing consciousness<br>
from the burning.”<br><br>
His interrogations, which took place almost every<br>
other day during his initial period at Guantánamo and he<br>
would be kept in the interrogation room for as long as<br>
eighteen to twenty hours. He denied having been beaten<br>
during the lengthy interrogations or while being held in<br>
the interrogation room. Youssef described these episodes<br>
as some of his most painful experiences at Guantánamo.<br>
He was chained and forced to assume stressful positions;<br>
at times, ice-water was poured on him and, at<br>
other times, loud music was played. He was deprived<br>
of access to the toilet and time for prayer. While being<br>
held in the interrogation room, the temperature in the<br>
room would be made extremely cold or hot for extended<br>
periods of time. Demands for confessions were constant,<br>
accompanied by claims by interrogators that his name<br>
was found on documents and that his brother, who has<br>
leukemia, had been arrested; soldiers also threatened<br>
to shoot him. Humiliation was part of the interrogation<br>
regime: he was forced to look at pornography, and<br>
soldiers ripped the Koran apart and threw it in the toilet<br>
in front of him. He described being horrified by an incident<br>
in which a naked woman entered the interrogation<br>
room and smeared what he believed to be menstrual blood<br>
on him. He reported being given injections of unknown<br>
substances against his will, and these injections often<br>
caused rashes several hours later. He believes that in<br>
some interrogations medical personnel were present and<br>
that they examined him periodically. Although he was not<br>
privy to the discussions between the medical personnel<br>
and interrogators, it appeared to Youssef that that the<br>
medical personnel were being consulted as to whether<br>
interrogations should continue. They always did.<br><br>
At one point while at Camp Delta at Guantánamo,<br>
Youssef asked to speak with a psychologist because of<br>
the distress and sadness he felt due to the separation<br>
from his family. He believes that not only did his interrogators<br>
have access to the information he shared<br>
with the psychologist, but that they exploited it by<br>
threatening that he would spend the rest of his life in<br>
Guantánamo. Following this interrogation session, he<br>
was moved to what he believed to be the worst section<br>
of Camp Delta, where he was not allowed to have a<br>
blanket or mattress.<br><br>
After being transferred out of Camp Delta and signing<br>
a form, he was released in the fall of 2003. He was again<br>
handcuffed and chained to the floor of the plane during<br>
the lengthy flight. Upon returning home, he served over<br>
a year of military service, during which he was mostly<br>
confined in a psychiatric hospital because he was deemed<br>
“too aggressive.”<br><br>
On physical examination, Youssef was noted to have<br>
surgical scars on his wrists consistent with his report of<br>
surgery following his release for chronic wrist pain as a<br>
result of shackling during his detention. Pain in his right<br>
wrist still persists. He also has a scar on the back of his<br>
left wrist consistent with the handcuffing he described.<br>
While Youssef experienced symptoms of depression<br>
before detention, PHR’s evaluators concluded that these<br>
symptoms became more pronounced, disabling and<br>
chronic as a result of his experience; he also now suffers<br>
from moderate PTSD. Many of his physical symptoms,<br>
including shortness of breath and “heart problems,” are<br>
consistent with a panic disorder. Youssef acknowledged<br>
difficulty functioning and has not found steady employment<br>
since his detention.<br><br>
<font size=3><b>Common Experiences of Torture and Ill-Treatment<br><br>
</b></font><font size=2>Even though the eleven detainees examined by PHR
were<br>
held at different places, and each person’s experience<br>
was unique, certain detention and interrogation practices<br>
appear over and over again in the accounts.<br><br>
</font><font size=3>Beatings During Arrest, Transport, and Initial
Custody<br><br>
</font><font size=2>Many of the most severe injuries from beatings
that<br>
the former detainees reported were sustained shortly<br>
after they were arrested. All seven of the men who<br>
were detained in Iraq (hereafter referred to as “the<br>
Iraqi former detainees”) recounted experiencing violent<br>
treatment during their arrests, some of which involved<br>
severe physical assault on their family members as well<br>
as destruction or looting of their homes.<br><br>
The beatings inflicted on detainees at US facilities at<br>
Bagram and Kandahar in Afghanistan were particularly<br>
intense, and included beatings with sticks and fists, kicks<br>
to the stomach and genitals and blows to the head. As a<br>
result, Haydar, who was held at Kandahar before being<br>
transferred to Guantánamo, lost three of his teeth and<br>
Rasheed, who was held at both Bagram and Kandahar<br>
facilities, lost consciousness and was hospitalized.<br><br>
Similarly, all former detainees held at Guantánamo<br>
reported that the most intense and widespread physical<br>
beatings they experienced at the facility took place during<br>
transfer and shortly after arrival there.<br><br>
The Iraqi former detainees also reported severe beatings<br>
during the first days and weeks of detention at facilities<br>
including one at Baghdad International Airport. Hafez,<br>
who was held at a US facility at Baghdad International<br>
Airport and Abu Ghraib for over seven months, was forced<br>
to the ground and beaten severely on his legs and back,<br>
causing his lips, forehead, and nose to bleed; he also<br>
reported being stripped and having his chest and pubic<br>
hair ripped out by hand and being simultaneously beaten,<br>
hit, and choked while being doused with cold water.<br><br>
While physical evidence of beatings often may not be<br>
detectable in later medical evaluations, findings from<br>
bone scans of six of the former detainees as well as<br>
scars and lesions visible during physical examination<br>
are consistent with the history of beatings described by<br>
the victims.<br><br>
</font><font size=3>Deprivation of Basic Necessities and Sanitary
Conditions<br><br>
</font><font size=2>All of the former detainees reported frequent
denial<br>
of basic necessities during periods of their detention;<br>
over half of the men evaluated reported being denied<br>
food on at least one occasion. Each former detainee<br>
also reported being subjected to extreme temperatures<br>
during his confinement.<br><br>
The conditions detainees in Iraq endured were particularly<br>
appalling. Among the conditions one or more of<br>
the detainees reported were placement in a urine-soaked<br>
punishment room, being forced to wear soiled underwear,<br>
often for weeks or months at a time, denial of access to<br>
food, water and toilets of any kind, and exposure to cold<br>
without blankets.<br><br>
Two of the detainees who were held in Guantánamo<br>
during the first year the facility was in operation reported<br>
harsh physical conditions and being housed in steel<br>
cages. Although as time passed, the physical conditions<br>
improved there, deprivation sometimes accompanied<br>
by acts of cruelty continued. Haydar reported that in<br>
Guantánamo the soldiers would often either spit in or<br>
throw out part of their food rations.<br><br>
</font><font size=3>Stress Positions: Forced Standing, Handcuffing, and
Shackling<br><br>
</font><font size=2>All of the former detainees reported having been<br>
subjected to painful stress positions that involved having<br>
their hands and feet bound for extended periods of times,<br>
or suspension from walls or barbed wire. These positions<br>
were often coupled with the use of blindfolding,<br>
sleep deprivation, isolation, and exposure to temperature<br>
extremes, either as components of interrogations<br>
or conditions of confinement.<br><br>
For example, three former detainees evaluated by<br>
PHR reported that in Guantánamo they were kept in<br>
extremely hot or cold interrogation rooms, chained in a<br>
crouching position to a ring on the floor for eighteen to<br>
twenty hours. Two of the Iraqi former detainees reported<br>
losing consciousness as a result of being subjected to<br>
stress positions.<br><br>
Findings on medical examination were consistent with<br>
these accounts. All of the former detainees reported that<br>
they continue to suffer from a wide range of musculoskeletal<br>
pains. For example, Laith, an Iraqi former detainee<br>
who was held in Abu Ghraib for nine months, reported<br>
arm numbness and weakness following being suspended<br>
by his arms, which is highly consistent with a brachial<br>
plexus (nerve group supplying the upper extremity) injury<br>
that often results from suspension.<br><br>
</font><font size=3>Isolation, Sensory Deprivation, or
Bombardment<br><br>
</font><font size=2>A) Prolonged Isolation<br>
All of the former detainees reported being subjected<br>
repeatedly to lengthy periods of isolation that ranged<br>
from ten days to as long as two months in duration. The<br>
interviewees reported that, while being kept in isolation,<br>
they were subjected to shackling, blindfolding,<br>
physical abuse, humiliation, sexual humiliation, and<br>
stress positions, as well as temperature extremes and<br>
light control.<br><br>
During periods of isolation, the Iraqi former detainees<br>
consistently reported being kept hooded and naked in<br>
small, dark holding cells that made Rahman, who was<br>
held at Abu Ghraib for nine months, feel “claustrophobic.”<br>
Similarly, former Guantánamo detainees reported that<br>
they were repeatedly held in isolation. The psychological<br>
impact of isolation and other forms of abuse was<br>
enormous. Rasheed engaged in hunger strikes, exhibited<br>
psychotic behavior, and even became suicidal after<br>
prolonged isolation.<br><br>
B) Hooding/Blindfolding<br>
Sensory deprivation by means of hooding or other types<br>
of blindfolding was frequently used in combination with<br>
other techniques in the places the former detainees were<br>
held (Afghanistan, Iraq, and Guantánamo Bay, Cuba).<br>
According to the detainees, blindfolding and hooding<br>
instilled in them a sense of fear, disorientation, and<br>
dependency on their captors.<br><br>
According to the detainees evaluated, sensory deprivation<br>
was employed in Afghanistan during arrest and<br>
transportation between facilities as well as during<br>
interrogations. At Guantánamo, however, the four<br>
detainees evaluated experienced hooding only when<br>
being transferred. In Iraq, hooding was routinely used<br>
during interrogations and general detention and was<br>
combined with forced nakedness and isolation, among<br>
other techniques.<br><br>
C) Sensory Bombardment<br>
Eight former detainees reported that sensory bombardment<br>
with loud noise or music was utilized frequently<br>
in what appeared to be a strategy to disorient them or<br>
disrupt detainees’ sleep.<br>
The detainees who were held in Afghanistan reported<br>
that they were subjected to loud music over long periods<br>
of time, and in one case exposed to powerful flood lights<br>
twenty-four hours a day. At Guantánamo, Rasheed<br>
reported that during a period of isolation and frequent<br>
lengthy interrogations, his cell was bombarded with loud<br>
unpleasant noise.<br><br>
The former detainees reported that in Iraq this technique<br>
was combined with forced running, isolation, and<br>
sleep deprivation. Similar to three other Iraqi former<br>
detainees, Morad, who was held in various facilities for<br>
a total duration of ten months, was subjected to “deafening,<br>
loud music” while being held in Saddam Hussein’s<br>
former ranch (used as a US detention facility).<br><br>
</font><font size=3>Threats of Harm to Detainees and Their
Families<br><br>
</font><font size=2>Almost all of the detainees reported being
threatened<br>
with severe harm, most commonly through verbal<br>
threats during interrogations. Eight of the eleven men<br>
reported that the US military utilized dogs to instill fear<br>
in the detainees. Two of the Iraqi former detainees were<br>
threatened with execution, and two others were threatened<br>
with forced disappearance since they did not have<br>
prisoner identification numbers, were unregistered, and<br>
therefore considered “ghost” detainees. Youssef recalled<br>
being threatened with being shot by a guard during an<br>
interrogation in Guantánamo.<br><br>
Interrogators also told detainees that their families<br>
would be killed or severely harmed. Laith told PHR that<br>
the interrogators “were threatening me…they were saying<br>
‘Then you will hear your mothers and sisters when we are<br>
raping them.’” Interrogators also threatened detainees<br>
with harm or torture following their release. Strikingly,<br>
transfer to Guantánamo was a threat used on half of<br>
the former detainees held in Iraq. Yasser recalled being<br>
told he would be sent to Guantánamo “where even dogs<br>
won’t live.”<br><br>
</font><font size=3>Use of Extreme Temperatures<br><br>
</font><font size=2>All of the former detainees reported being exposed
to<br>
extremes of temperature in their cells. For some of the<br>
Iraqi former detainees, this practice was coupled with<br>
weeks of isolation and sexual humiliation; for others,<br>
this practice was used as a form of group punishment.<br>
Four detainees, of whom three were held in Guantánamo,<br>
reported that cold water was poured on them during<br>
interrogation. In the cases of three individuals who were<br>
held in facilities in Iraq, cold water was used in combination<br>
with lengthy interrogations, sensory bombardment,<br>
beatings, and sexual humiliation.<br><br>
</font><font size=3>Electric Shocks, Sexual Assault, and Physical
Assault<br><br>
</font><font size=2>In addition to the beatings upon arrest, initial<br>
detention and transfer described earlier, some of the<br>
detainees were physically assaulted again later during<br>
their detention. Two former detainees were sodomized<br>
with a broomstick or a rifle at Abu Ghraib and three were<br>
subjected to electric shock (two in Iraq and one while at<br>
Kandahar, Afghanistan).<br><br>
Physical assaults during detention included being<br>
kicked, stepped on, dragged, slapped, and forcefully<br>
thrown against a wall. Adeel, who was later transferred<br>
to Guantánamo Bay, reported receiving daily beatings<br>
while he was held at the Bagram facility. The Iraqi former<br>
detainees described being struck with a rifle, stabbed<br>
in the cheek with a screwdriver, burned on the chest<br>
with a cigarette, and other episodes of severe physical<br>
abuse during interrogations that in some cases resulted<br>
in loss of consciousness. Five former detainees reported<br>
soldiers exploiting detainees’ injuries. For example,<br>
Yasser, who was held at Abu Ghraib for four months,<br>
stated that his injured hand was deliberately stepped on<br>
and squeezed by soldiers at Abu Ghraib.<br><br>
Of the Guantánamo detainees, only one reported<br>
routine physical abuse: Rasheed reported frequent beatings<br>
and one episode of harsh beatings during an interrogation.<br>
Youssef and Haydar stated that multiple times<br>
the IRF teams (referred to by the former detainees as<br>
the “riot police”) subjected them to chemical spray and<br>
pressurized water, which left Haydar “writhing on the<br>
ground in pain.”<br><br>
Many of the physical assaults reported would likely<br>
have resulted in bruises and soft tissue injuries that<br>
would not leave lasting physical marks. However, the<br>
bone scan findings of six individuals, and scars and<br>
healed lesions observed on physical examination of<br>
all detainees corroborated their specific allegations<br>
of physical assault. Scarring on Yasser’s thumbs was<br>
highly consistent with the scarring caused by electric<br>
shock. Further, reports of rape and sexual assault were<br>
corroborated in two cases by medical examination.<br><br>
</font><font size=3>Sleep Deprivation<br><br>
</font><font size=2>Nine of the eleven former detainees evaluated
reported<br>
that they were often subjected to sleep deprivation, in<br>
combination with other techniques, through loud noise<br>
or banging, use of cold water, or stress positions. Laith<br>
explained: “If you ask me about being chained to the<br>
window [standing], it was every day. They were especially<br>
doing that at night, to prevent me from me sleeping.”<br><br>
</font><font size=3>Sexual, Religious, Cultural, and Other Forms of<br>
Degrading Treatment<br><br>
</font><font size=2>According to detainee accounts, humiliation was<br>
pervasive in detention facilities in both Iraq and Afghanistan.<br>
Guards taunted, shamed, insulted, spat and urinated<br>
upon, and embarrassed detainees, forced most to be<br>
naked, observed some on the toilet, wrote degrading<br>
phrases in indelible marker on the body of one, and forcibly<br>
cut the beards and shaved the heads of others. In<br>
one incident, Amir reported having been pulled by a leather<br>
dog leash in Abu Ghraib and was ordered to “howl like<br>
dogs do.” He was repeatedly kicked when he refused<br>
to do so.<br><br>
Cultural and religious humiliation was reported by<br>
more than half of the individuals evaluated, and took many<br>
forms, including taunting men at prayer and desecrating<br>
the Koran. Rasheed stated that in protest of such<br>
practices, detainees in all five blocks of Guantánamo<br>
held a simultaneous uprising by banging their heads<br>
against the walls and demanding “an end to the mocking<br>
of their religion.”<br><br>
One of the worst forms of humiliation detainees<br>
reported, though, was sexual, and it was reported by virtually<br>
all of the individuals evaluated by PHR, at facilities<br>
in Afghanistan, at Guantánamo, and in Iraq. The forms<br>
of sexual humiliation were as varied as they were cruel:<br>
parading men naked in front of female soldiers, forcing<br>
them to disrobe before female interrogators, touching or<br>
provoking them in a humiliating way, and forcing them to<br>
watch pornography or real or feigned sexual activities.<br>
Furthermore, nakedness became the normal mode of<br>
operation in the Iraqi detention facilities, especially in<br>
Abu Ghraib, where the detainees were forced to be naked<br>
for long periods of time. Kamal stated that his genitals<br>
were touched multiple times during interrogations in Abu<br>
Ghraib. Further, he reported that when the American<br>
soldiers “got me naked, they used to bring all female<br>
soldiers to look at me and say, ‘Hello, Imam’.”<br><br>
</font><font size=3>Witnessing Torture and Cruel Treatment<br><br>
</font><font size=2>More than half of the former detainees evaluated<br>
by PHR recounted witnessing torture and other cruel,<br>
inhuman or degrading treatment towards other detainees<br>
by US personnel. Two detainees witnessed other detainees<br>
being bitten by dogs; others witnessed detainees being<br>
subjected to various forms of sexual humiliation. In Abu<br>
Ghraib, Rahman recounted that he was forced to watch<br>
other detainees being forced to simulate anal intercourse<br>
and recalled that the detainees “were begging, ‘This is a<br>
sin against our religion, please show mercy.’ The soldiers<br>
were pushing them into each other, and these guys were<br>
trying to push away, and this was more than half an hour<br>
and this was in front of our eyes.”<br><br>
</font><font size=3><b>Health Professional Complicity and Denial of<br>
Medical Care<br><br>
</b></font><font size=2>Health professionals in detention settings are
required by<br>
domestic and international standards not only to provide<br>
medical care to detainees but to protect their health and<br>
well-being. A few of the former detainees reported that<br>
they received appropriate care from health professionals<br>
while in US custody.</font><font size=1>8 </font><font size=2>Adeel was
diagnosed and treated<br>
for tuberculosis while detained in Guantánamo, and<br>
Morad received “humane treatment” from a doctor for<br>
his diabetic foot ulcer.<br><br>
At the same time, former detainees reported that<br>
medical personnel played a role in facilitating torture<br>
and ill-treatment in all three theatres of operations<br>
through the monitoring of abuse during interrogations,<br>
providing medical information to interrogators, denying<br>
medical care, and failing to take action to stop and/or<br>
document detainee abuse. Three of the Iraqi former<br>
detainees and one former Guantánamo detainee reported<br>
that individuals acting in a health professional capacity<br>
examined their condition during an episode of torture or<br>
physical abuse but made no effort to stop it. Two former<br>
Guantánamo detainees suspected that the psychologist<br>
shared information about them with interrogators.<br><br>
Several men reported facing difficulties accessing<br>
care while in detention. At Guantánamo, Youssef<br>
recounted that he never received treatment despite<br>
his “many, many” requests for medical attention to his<br>
persistent stomach pain, as well as for swelling in his<br>
wrists. Two men detained at Abu Ghraib reported being<br>
denied medical treatment, including for injuries inflicted<br>
by soldiers. In response to PHR’s query whether or not<br>
any doctors treated Amir’s injuries in Abu Ghraib; he<br>
responded: “Did I need to ask for help? I was there naked<br>
and bleeding… .These were not real doctors.”<br><br>
In addition, all the former detainees from Guantánamo<br>
reported that they were given injections or medication<br>
without their consent and medical procedures were<br>
performed on them against their will.<br><br>
The medical records of one of the former detainees,<br>
Rasheed, illuminate the role of medical personnel at<br>
Guantánamo, and PHR’s evaluators were able to compare<br>
his account with entries in his medical file. The records<br>
are largely consistent with his own account: shortly after<br>
arriving at Guantánamo in 2002, Rasheed’s mental health<br>
began to deteriorate; he attempted suicide and other acts<br>
of self-harm, including self-mutilation. Mental health<br>
staff at Guantánamo responded with heavy doses of<br>
medication, which made him feel unbearably hot and<br>
made his skin and joints ache. When his acts of selfharm<br>
continued, medical staff placed him in restraints<br>
and treated his access to bottled water and blankets as<br>
privileges. In response to his repeated requested to be<br>
removed from isolation, the medical files note that the<br>
psychiatric personnel “informed him that [they] had no<br>
control over that and told him to ask his interrogator to<br>
have him moved.”<br><br>
It is not clear exactly how long Rasheed was kept in<br>
isolation or how long Rasheed’s interrogations continued<br>
after his severe signs and symptoms appeared —<br>
although it appears to have been at least one year. What<br>
is clear, though, is that during the critical periods in<br>
2002 and 2003 when his health severely deteriorated,<br>
his health condition did not result in halting interrogations,<br>
nor in relieving a regime of isolation and sleep<br>
deprivation; nor do the records indicate that the medical<br>
staff connected his ill-treatment — including use of isolation,<br>
sleep deprivation, physical assault, violation of his<br>
religious and moral codes, and the use of sexual humiliation<br>
— to the obvious decline in his mental condition.<br>
Nor is there evidence from the records that the medical<br>
staff intervened to end his torture, except for one note<br>
with a recommendation that resulted in a brief move out<br>
of isolation. Instead, the thinking of the medical staff<br>
appears reflected in a medical note that mentions him<br>
being subject to “routine stressors of confinement.”<br><br>
Further, one of the most likely diagnoses for Rasheed’s<br>
psychological symptoms, PTSD, is never mentioned in<br>
the medical record. The medical staff thus not only failed<br>
to document that Rasheed was being tortured through<br>
the use of isolation and other methods (and presumably<br>
did not report it), but also became complicit themselves<br>
in his abuse. Indeed their mental health interventions<br>
may have worsened Rasheed’s suffering by patching<br>
him up so that further interrogation and torture could<br>
be inflicted.<br><br>
</font><font size=3><b>Short-Term and Lasting Harm from Torture<br>
and Ill-Treatment<br><br>
</b></font><font size=2>All the detainees experienced severe, even
excruciating<br>
physical pain from being kicked, punched, choked,<br>
shocked or sodomized, and many were terrorized by both<br>
the experience of the assaults on them and threats of<br>
more to come. Most of the detainees lost consciousness<br>
at least once as a result of beatings or other physical<br>
assaults. Some experienced bruising and trauma to<br>
their genitals. Some of the men were not only severely<br>
injured as a result of torture, but they then had to endure<br>
additional pain from the exploitation of those injuries by<br>
their tormenters. Almost all of the men PHR interviewed<br>
continue to experience physical after-effects from the<br>
torture they experienced, including chronic headaches as<br>
well as persistent pain in their limbs, joints, back, muscles,<br>
and ligaments from being beaten or kept suspended or<br>
in other stress positions for long periods of time.<br><br>
The experience of torture was horrifying to the men as<br>
it was taking place. Men experienced shame, humiliation,<br>
and terror that they or their loved ones would suffer even<br>
more; others were terrified by the claustrophobic conditions<br>
of isolation. These in turn brought about symptoms<br>
ranging from chest pain to severe anxiety to sleeplessness.<br>
One reported: “I was having really bad nightmares…<br>
I felt like I couldn’t breathe.” According to medical files,<br>
during an interrogation session in Guantánamo one<br>
detainee had a seizure and “was unresponsive and fell…<br>
[while] his feet [were] buckled.”<br><br>
</font><font size=3>Lasting Psychological Consequences<br>
of Ill-Treatment<br><br>
</font><font size=2>With one exception, the former detainees have
experienced<br>
and continue to experience severe psychological<br>
effects of torture and ill-treatment as a result of their<br>
detention in US custody. All but one feel utterly hopeless<br>
and isolated, and lack the ability to sleep well, work, or<br>
engage in normal social relationships with their families.<br>
Seven individuals disclosed having contemplated<br>
suicide either while in detention or after being released.<br>
Most of the released detainees, to this day, live with<br>
severe anxiety, depression, and post-traumatic stress<br>
disorder, including intrusive recollections of trauma<br>
suffered in detention, hyperarousal (persistent symptoms<br>
of increased arousal, e.g., difficulty falling or<br>
staying asleep, anger, and hypervigilance), avoidance<br>
and emotional numbing behavior. PHR’s clinicians determined<br>
that these symptoms were directly related to the<br>
torture and ill-treatment reported having taken place<br>
while in US custody, even after taking into account the<br>
fact that the released Iraqi former detainees are living<br>
in a war-torn environment. Amir explained, “These are<br>
the memories that I can never forget. I want to forget,<br>
but it is impossible.”<br><br>
For the four detainees who had experienced symptoms<br>
of depression or other mental disorders prior to detention,<br>
torture and ill-treatment by the US Personell severely<br>
exacerbated these conditions, and in one case it ignited<br>
such deep despair and dysfunction as to lead the detainee<br>
to repeated suicide attempts while at Guantánamo.<br><br>
</font><font size=3>Diminution of Social and work Life After
Detention<br><br>
</font><font size=2>Many former detainees reported encountering
social<br>
stigma and fear in their communities as a result of their<br>
status as former US detainees. Some relocated, and others<br>
attempted to do so unsuccessfully. All except one have<br>
lost their livelihood and are facing financial hardships,<br>
and many were concerned about their physical safety and<br>
security. These fears are not unfounded as three Iraqi<br>
former detainees were rearrested and detained by both<br>
American forces and the Iraqi government, though subsequently<br>
released. Since the interviews were completed,<br>
PHR has authoritatively learned that one of the former<br>
Guantánamo interviewees has been arrested in his home<br>
country and is still being detained.<br><br>
</font><font size=4>Legal Prohibitions Against Torture<br>
and Ill-Treatment<br><br>
</font><font size=2>All of the abusive interrogation techniques and
patterns<br>
of ill-treatment endured by these eleven men — including<br>
beatings and other forms of severe physical and sexual<br>
assault, isolation, sleep deprivation, forced nakedness,<br>
severe humiliation and degradation, and sensory deprivation,<br>
many of which were experienced over long periods of time and<br>
often in combination with other prohibited acts — constituted<br>
acts of torture as well as cruel, inhuman or degrading<br>
treatment under domestic criminal statutes and international<br>
human rights and humanitarian treaties, including<br>
the Convention Against Torture and the Geneva Conventions,<br>
that were in effect at the time the acts were committed.<br><br>
According to courts and entities responsible for interpreting<br>
the Convention Against Torture, including the UN<br>
Special Rapporteur on Torture and the UN Committee<br>
Against Torture, each of the interrogation techniques<br>
and conditions of incarceration and treatment identified<br>
in this report, when considered on its own, constitutes<br>
prohibited conduct in the form of torture or cruel,<br>
inhuman or degrading treatment or punishment. In<br>
fulfilling its obligation to assess and report upon the<br>
human rights conditions in other countries, the US State<br>
Department relies upon international human rights treaties<br>
including the Convention Against Torture; in innumerable<br>
instances, it has identified the very practices<br>
evidenced by this study, when committed in foreign countries,<br>
as torture or cruel, inhuman or degrading treatment<br>
or punishment. In addition, based on the severity<br>
of physical and psychological pain and suffering caused<br>
by these practices, the
</font><font face="Comic Sans MS" size=2><i>Istanbul Protocol
</i></font>has determined<br>
that they constitute torture and/or ill-treatment.<font size=1>9
</font><font size=2>Likewise,<br>
the medico-legal evidence leaves little doubt that the interrogation<br>
methods used by US personnel constitute torture<br>
under the US Torture Act,</font><font size=1> </font><font size=2>the
Uniform Code of Military<br>
Justice (UCMJ),</font><font size=1>11 </font><font size=2>and other
laws.<br><br>
</font><font size=4>Recommendations<br><br>
</font><font size=2>Based on the findings of this investigation, the
United<br>
States should take the following actions:<br>
The executive branch must repudiate all forms 1. of<br>
torture and cruel, inhuman or degrading treatment.<br>
It should explicitly and in writing establish a uniform<br>
standard of conduct for all agencies that prohibits<br>
any of its military, intelligence or other officials,<br>
including all forms of contract personnel, from<br>
engaging in torture and cruel, inhuman or degrading<br>
treatment, including but not limited to any of the<br>
following interrogation or conditions of confinement<br>
methods, either alone or in combination:<br><br>
<dl>
<dd>• Stress positions
<dd>• Beatings and other forms of physical assault
<dd>• Use of extremes of temperature
<dd>• Waterboarding or any other form of simulated
<dd>drowning
<dd>• Threats of harm to the detainee, his family, or
<dd>friends
<dd>• Sleep deprivation
<dd>• Sensory bombardment through the use of
<dd>extreme noise and/or light
<dd>• Violent shaking
<dd>• Religious, cultural, and sexual humiliation
<dd>including, but not limited to, forced nakedness
<dd>• Prolonged isolation
<dd>• Sensory deprivation, including, but not limited
<dd>to, hooding and blindfolding
<dd>• Use of psychotropic, mind-altering, or other
<dd>drugs for the purpose of decreasing resistance
<dd>or gaining information
<dd>• Mock execution
<dd>• Exploitation of phobias, psychopathology, or
<dd>physical vulnerability
<dd>• Rape and sexual assault
<dd>• Electric shocks
<dd>• Deprivation of basic necessities and sanitary
<dd>conditions<br><br>
</dl>Congress should enact into law the prohibitions listed<br>
above and establish criminal liability for their violation.<br>
The executive branch and Congress should establish<br>
an independent commission to fully investigate and<br>
publicly report on the circumstances of detention<br>
and interrogation in Bagram, Kandahar, and elsewhere<br>
in Afghanistan, Iraq, Guantánamo Bay, and other<br>
locations since 2001. This independent commission<br>
should have subpoena power to compel witnesses<br>
and have full access to all classified materials<br>
concerning interrogation techniques and conditions<br>
of detention, including medical records and documentation<br>
by behavioral health science consultant<br>
personnel, in order to establish a full public record.<br><br>
The investigation should extend to individuals in the<br>
position of making policy as well as those who carried<br>
those policies out, including all healthcare profes-<br>
sionals who were in the position of providing care or<br>
supporting the interrogation of detainees.<br><br>
All individuals who played any role in the torture<br>
or ill-treatment of detainees, including those<br>
who authorized the use of methods amounting to<br>
torture or exercised command authority over them,<br>
should be held to account through criminal and civil<br>
processes (such as disciplinary action). Officials at<br>
every level should be held accountable for crimes<br>
they committed or for the acts of officials subordinate<br>
to them. Health professionals, both civilian<br>
and uniformed, who engaged in or facilitated the<br>
abuse of detainees and/or failed to report torture<br>
and ill-treatment should be investigated, appropriately<br>
sanctioned, and disciplined via the Department<br>
of Defense, other executive branch agencies, and<br>
state licensing boards.<br><br>
The government should issue a formal apology to<br>
detainees who were subjected to torture and/or illtreatment<br>
as part of US military and intelligence<br>
operations since fall 2001 in Afghanistan, Iraq,<br>
Guantánamo Bay, Cuba, and elsewhere.<br><br>
The government should establish a fair process for<br>
compensation and victim assistance, including<br>
access to rehabilitation and re-integration services, for<br>
individuals subjected to torture or ill-treatment in<br>
US custody.<br><br>
All places of detention operated by the United States<br>
should be subject to monitoring by international<br>
bodies that investigate detainee treatment and<br>
are capable of reporting findings to the public and<br>
government, including the UN Special Rapporteur<br>
on Torture, the UN Committee Against Torture, and<br>
the International Committee of the Red Cross. These<br>
organizations tasked by treaties to which the United<br>
States is a party must be granted full access to<br>
detainees, their medical records, and all other pertinent<br>
files documenting past and current treatment<br>
of detainees during their incarceration. Furthermore,<br>
Congressional and executive branch oversight of<br>
US military and intelligence activities relevant to<br>
detainee treatment and interrogation should be<br>
immediately strengthened and improved.<br><br>
The US Department of Justice should publicly<br>
release all legal opinions and other memoranda<br>
concerning standards regarding interrogation and<br>
detention policy and practices.<br><br>
<br><br>
</font><x-sigsep><p></x-sigsep>
<font size=3 color="#FF0000">Freedom Archives<br>
522 Valencia Street<br>
San Francisco, CA 94110<br><br>
</font><font size=3 color="#008000">415 863-9977<br><br>
</font><font size=3 color="#0000FF">
<a href="http://www.freedomarchives.org/" eudora="autourl">
www.Freedomarchives.org</a></font><font size=3> </font></body>
</html>