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Political prisoner jailed for criticising government still requires urgent medical treatment; psychiatric pretext for his confinement dubious, says doctor

(HRW/IFEX) - The following is a 29 March 2008 Human Rights Watch press release:

Libya: Free Hospitalized Political Prisoner
Seriously Ill Fathi al-Jahmi Getting Medical Care in State Custody

(Washington DC, March 29, 2008) - The Libyan government should release without conditions ailing political prisoner Fathi al-Jahmi, who remains in state custody despite recent reports of his discharge, Human Rights Watch and Physicians for Human Rights said in a joint statement today.

Al-Jahmi's health is improving after better medical care in recent months at a state-run hospital in the capital Tripoli, Human Rights Watch and Physicians for Human Rights said, but he is considerably sicker than at the time of his arrest four years ago. He was detained in March 2004 after calling for a free press and free elections in Libya.

Representatives of Human Rights Watch and Physicians for Human Rights visited al-Jahmi, 66, at the hospital in mid-March 2008 and spoke privately with him, his family, and his doctor, as state security officers stayed outside the room. The visit was facilitated by the Qadhafi Foundation, run by Mu'ammar al-Qadhafi's son, Saif al-Islam.

"We're glad al-Jahmi's health is improving, but dismayed he's not yet free," said Fred Abrahams, a senior researcher at Human Rights Watch who met al-Jahmi in Tripoli. "He should be able to leave the hospital and seek medical care of his choice, either in Libya or another country."

Despite recent improvements, al-Jahmi's health had substantially worsened following his March 2004 arrest, Human Rights Watch and Physicians for Human Rights said.

"There's no doubt that negligent care contributed to the serious deterioration of al-Jahmi's health during his early detention," said the doctor who examined him, Dr. Scott Allen, an adviser to Physicians for Human Rights and co-director of the Brown University Center for Prisoner Health and Human Rights. "Even though his health improved in the last few months, he remains very ill. He's stable and can be treated as an outpatient.

As of March 28, al-Jahmi remained in the Tripoli Medical Center and security officers were controlling access to visitors. Al-Jahmi's hospitalization under guard stems from a May 2006, court decision, which determined him mentally unfit for trial and ordered him detained at a psychiatric hospital. The authorities failed to make the hearing or the decision public, or to inform the family. Human Rights Watch and Physicians for Human Rights asked for, but have not yet received, a copy of the court's order, as well as al-Jahmi's full medical records.

During the roughly one year al-Jahmi spent at the psychiatric hospital, his health significantly declined, forcing his transfer to the Tripoli Medical Center in July 2007. Al-Jahmi told Human Rights Watch and Physicians for Human Rights that during his detention in the psychiatric hospital the authorities denied him access to needed medications and a doctor, as well as family visits.

According to the family, they had no information on al-Jahmi's whereabouts during this time.

On March 13, 2008, Allen conducted a thorough examination of al-Jahmi, in private, in his room in the Tripoli Medical Center. He reviewed al-Jahmi's medical records and concluded that his health had improved in recent months, apparently after the intervention of the Qadhafi Foundation. Al-Jahmi's health had deteriorated badly, apparently due to improper treatment and denial of medications.

This medical examination was a follow-up to a February 2005 check-up ( http://physiciansforhumanrights.org/library/documents/reports/medical-assessment-of-fathi-el-jahmi.pdf ) conducted by a doctor from Physicians for Human Rights and the International Federation of Health and Human Rights Organizations. At the time, the doctor received assurances that al-Jahmi would receive proper medications and medical care. Human Rights Watch received the same assurances during a visit to al-Jahmi in May 2005.

Al-Jahmi suffers from diabetes, hypertension, and heart disease, Allen said. According to al-Jahmi's doctors, he was experiencing severe heart failure at the time of his transfer from the psychiatric facility to Tripoli Medical Center in July 2007. On admission, an echocardiogram showed a dangerously impaired heart muscle.

Despite the recent improvements, significant and pressing health problems remain, Human Rights Watch and Physicians for Human Rights said.

"Mr. al-Jahmi is in urgent need of a cardiac catheterization to evaluate ongoing heart disease," Allen said. "While Tripoli Medical Center appears well-equipped for this procedure, there is impaired trust in an environment of state control."

Human Rights Watch and Physicians for Human rights said they left Libya with the distinct impression that al-Jahmi and his family were not free to make independent decisions about his medical care due to real or perceived pressure from the government. The real or perceived pressure is detrimental to adequate care and taints the principle of informed consent.

Allen found no evidence of significant mood or thought disorders despite the fact that al-Jahmi had been confined for psychiatric reasons. He was not taking any psychiatric medications at the time of the evaluation, and it is unclear if he had received psychiatric medication in the past.

"This raises the question of the misuse of medical professionals to confine a patient under the guise of medical treatment, a violation of medical ethics and human rights," Allen said.

The legal aspects of al-Jahmi's detention also raise serious concerns, Human Rights Watch and Physicians for Human Rights said. Arrested for a second time in March 2004 for criticizing Libya's political system and its leader, the Internal Security Agency at first detained al-Jahmi, his wife and eldest son, purportedly for their own protection.

The secret trial began in late 2005, with al-Jahmi apparently charged with trying to overthrow the government, insulting Libyan leader Mu'ammar al-Qadhafi, and contacting foreign authorities. The third charge, al-Jahmi said, resulted from conversations he had with a US diplomat in Tripoli. Al-Jahmi was provided, but rejected, a court-appointed lawyer.

"Fathi al-Jahmi has never used violence or called for the use of violence," Abrahams said. "He never should have been arrested in the first place. He has suffered four years of detention and health deterioration for speaking about a free press, free elections and nonviolent democratic reform."

(. . . )

For the complete press release, see: http://www.hrw.org/english/docs/2008/03/29/libya18390.htm

To view Dr. Allen's medical report on Fathi al-Jahmi, please visit: http://physiciansforhumanrights.org/library/documents/reports/2008-fathi-al-jahmi-evaluation.pdf

For more information on the human rights situation in Libya, please visit: http://hrw.org/doc/?t=mideast&c=libya

Updates the al-Jahmi case: http://www.ifex.org/en/content/view/full/90371

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