Since 2002, prisoners at Guantánamo Bay detention camp have been force-fed as punishment for hunger striking, prompting the question of at what point the medical clinic becomes a site of punitive suffering. This essay examines force-feeding as an instantiation of the tension between authority, visuality, and pain. Through a detailed analysis of prisoner testimonials, the policy manual Medical Management of Detainees on Hunger Strike, and a video project by human rights organization Reprieve featuring artist Yasiin Bey simulating the “proper” techniques for force-feeding, the author argues that pain becomes the basis of not only political subjectivity but also relationality between those held captive and the spectator.
In May 2014, lawyers from the London-based international nonprofit organization Reprieve filed a motion on behalf of Guantánamo Bay Detention Camp prisoner Abu Wa’el (Jihad) Dhiab to produce thirty-two videotapes of Dhiab being forcibly extracted from his cell and force-fed in a restraint chair. Dhiab’s lawyer described his force-feedings as being administered so incorrectly that he vomited repeatedly and lost consciousness. As a consequence, he suffered a chest infection, and his nostrils and throat were so raw that he had difficulty breathing. Then in 2015, the US government turned over, under seal, eight of the thirty-two videos with the voices and faces of Guantánamo workers redacted. The Justice Department contends that releasing the videotapes would compromise national security, “spurring extremist attacks against US personnel or encouraging resistance by Guantánamo detainees,” and argues that the footage might provide too much visualization of “prison infrastructure” (Hsu 2015) or set an example for how other prisoners might best refuse their own force-feedings. The case came to a close in 2017, when a three-judge panel of the Circuit Court of Washington, DC, ruled that the videotapes would remain under seal and not made public (see Worthington 2017).
The state’s refusal to release the video footage illustrates the ways that geopolitics and race are mobilized to propagate a xenophobic panic that reauthorizes indefinite detention at the naval base. It is precisely indefinite detention that has motivated the staging of individual and collective hunger strikes throughout the camps since 2002. Hunger striking necessarily prioritizes the life of a cause over the integrity of the body. As Banu Bargu (2010: 254) argues in her work on the Turkish death fast of the early 2000s, hunger striking resists the “hegemonic allure based on ‘mak[ing] live.’ ” This rupture to the biopolitical functioning of the state destabilizes modern sovereignty, the legitimacy of which “is built on the idea of individual preservation” (254). As such, camp protocol that authorizes the force-feeding of prisoners who, for example, have only refused meals for days or weeks “long before their lives were in danger” (254) points to the state’s mobilization of biological life as a means by which to counter political opposition at the camp. Indeed, the state and its subjects are constantly negotiating the parameters of what constitutes corporeal sovereignty, and what constitutes a just measure of life.
Critiques of force-feeding rely in large part on narratives detailing the administration of the procedure. To shift the public’s perception toward the elimination of force-feeding, the practice must be made visible as the state’s exercise of biopolitical authority. To make visible the racial and religious othering practiced by the state, one must resort to “facts” but also the more affective and relational approaches to pain and suffering that are induced by force-feeding and confinement. In Samir Naji al Hasan Moqbel’s (2013) widely circulated New York Times testimonial of the pain he endured from being forcibly fed, he insists that the spectator both listen and look at his suffering, concluding his testimony with a plea: “I just hope that because of the pain we are suffering, the eyes of the world will once again look to Guantánamo before it is too late.” Following Moqbel’s embodied approach to witnessing, this essay argues that pain becomes the basis of not only political subjectivity but also relationality between those held captive and the spectator.
As A. Naomi Paik (2016: 17) comments, “Testimonies of rightlessness contest the nationalism and racism behind camp-thinking.” Prisoner testimonials in response to force-feeding attest to the violence of “camp-thinking” and, importantly, to the desire for corporeal sovereignty. The sovereignty of the prisoner relies on others to witness the suffering induced by state practices by “build[ing] a link between the speakers and us (the rightless and the relatively rightful), to reach beyond the camp’s boundaries and connect their world to us” (15). Indeed, suffering, for Moqbel, isn’t that which numbs the spectator but what is capable of jolting one out of complacency. In what follows, I consider Moqbel’s plea and what it might mean to be an ethical witness. To do so, I consider how the metrics of force-feeding suspends political life—that is, the right to protest the conditions of one’s confinement through hunger striking and other acts of self-harm. Such metrics are undoubtedly displayed in the videos of Dhiab’s cell extractions and force-feedings, but without access to the footage one must turn to other forms of knowledge that aren’t solely visual, but sonic and felt.
By examining Moqbel’s testimony; Joint Task Force Guantánamo Bay’s Medical Management of Detainees on Hunger Strike, a thirty-page document detailing the standard operating procedures for force-feeding; and a video project by human rights organization Reprieve featuring artist Yasiin Bey simulating the “proper” techniques for force-feeding, this essay maintains that the verbal and embodied modes by which prisoners and activists resist the state’s framing of force-feeding as ethical obligation exposes how such a medical procedure is, in fact, torture. Here, testimony is crucial in that it places the spectator in a certain proximity to the men held captive, allowing for the felt pain of force-feeding to travel outside the detention camp and take on an expression of recognizability.
Witnessing and a Responsibility to Look
Moqbel (2013) begins his testimony by describing the first time he was force-fed at Guantánamo: “I will never forget the first time they passed the feeding tube up my nose. I can’t describe how painful it is to be force-fed this way. As it was thrust in, it made me feel like throwing up. I wanted to vomit, but I couldn’t. There was agony in my chest, throat and stomach. I had never experienced such pain before. I would not wish this cruel punishment upon anyone.”
Moqbel’s narrative, and the many other testimonies by prisoners that bear witness to force-feeding, opens up the possibility for pain to be more than an experience felt in isolation, but rather an experience shared with a public. Talal Asad (2003: 85) writes that “as a social relationship pain is more than an experience. It is part of what creates the conditions of action and experience.” Indeed, the legal battle that started in 2013 to end force-feeding at Guantánamo depends on the narratives from prisoners such as Moqbel to incite legal and public outrage against the pain that they insist force-feeding causes. The state must exercise its authority over life without causing pain, or at the very least there must be a clear penological purpose behind the cause of pain. The military at Guantánamo Bay claim that the feeding process is safe. The denial of the adverse health effects caused by force-feeding relies on a logic that considers Moqbel’s pain unverifiable.
The state’s refusal to see or feel the pain that these prisoners testify to, I argue, is what makes it unverifiable. The unverifiability of pain is documented well in Elaine Scarry’s The Body in Pain. Scarry (1987: 4) stresses the curious nature of physical pain to oscillate back and forth between being that which “cannot be denied and that which cannot be confirmed.” There is something about pain, for Scarry, which is beyond representation and resists language. It is true that there are cultural and communal ways of registering pain. The sounds and words emanating from the subject help communicate, convey, or expose pain, but, ultimately, the central problem remains that pain’s “resistance to language is not simply one of its incidental or accidental attributes but is essential to what it is” (5). Scarry argues that physical pain is an exceptional interior state precisely because it is “not of or for anything. . . . It is precisely because it takes no object that it, more than any other phenomenon, resists objectification in language” (5, emphasis in original). In Scarry’s account of pain, the subject can lose recourse to speech and, as such, relies on outside actors to speak on their behalf. Inherent to the verbal strategies of speaking on behalf of pain is doubt: “To have pain is to have certainty; to hear about pain is to have doubt” (13, emphasis in original). Ultimately, pain is individually experienced, lacks precision of language, and is always at risk of being appropriated.
Litigation, in turn, attempts to remedy the gap between language and experience. The motion to produce video footage of Dhiab being force-fed is an example of a human rights demand at making public pain and injury. In May 2014, Judge Gladys Kessler ordered that the thirty-two videos showing the forcible feeding of Dhiab be turned over to his lawyers but that the content of each was not to be commented on publicly. However, only eight redacted videotapes were given to Dhiab’s defense team, and in 2017 the district court in Washington, DC, ruled that the videos would remain classified. The emphasis on acquiring filmic evidence acknowledges the instability of mere descriptions of suffering. What would the video footage of Dhiab’s forcible cell extraction and tube feedings tell us that Moqbel’s narrative doesn’t? And what of the power of the visual to interrupt the reality that the authorities at Guantánamo have constructed concerning new force-feeding procedures, such as the restraint chair featured in the footage of Dhiab? Ultimately, it is not just litigation or advocates who fill the gap between language and experience but also the prisoners themselves who represent their own pain to the world. Indeed, the prisoners speak for themselves, even as the state refuses to listen.
Thinking of pain as relational takes us in a different direction than Scarry’s account—one more concerned with what Asad understands as the agentive possibilities generated by the articulation of pain. There will always be certain aspects of pain that cannot be fully conveyed to an observer and will thus remain to some degree unintelligible. There is no way to experience the exact pain that Moqbel felt as the feeding tube was thrust up his nose, but, as Asad argues, this needn’t be the point of sharing one’s pain with others. “Sufferers are also social persons (animals),” he writes, “and their suffering is partly constituted by the way they inhabit, or are constituted to inhabit, their relationships with others” (2003: 85). Importantly, there is a power dynamic involved in assuming we can feel another’s pain, as we end up substituting our own body for that of the sufferer. Pain here, however, is more than simply an experience that may or may not be verifiable but is instead the means by which relations are mediated. This is not to say that there is something inherently good about the experience of pain, but that contrary to pain being viewed as passive and commensurable only by the subject experiencing it, pain is actually active and capable of recognition.
If we take Moqbel’s pain as something more than a private event and rather something relational, then perhaps a space of plurality might be opened where the spectator feels called to take part in “new conditions for moral action” (Azoulay 2008: 144). This call is not abstract; indeed, contemporary visual culture around human rights takes what Ariella Azoulay (2008: 287) calls the “active gaze” quite seriously. This gaze necessitates an extreme attention to the image at hand and destabilizes any presumption of vision as transparent. Such a gaze, Azoulay writes (287), “holds itself humble before the image, recognizes the fact that not everything can be seen or shown, knows that removing the social prohibition of the visible will not lead to full visibility, and understands that not only is such visibility impossible, but that the passion for such visibility is precisely what thwarts the eye from seeing what is visible on the surface.”
Here a spectator must decide how to decipher images of violence and which images should and must be made public. As such, to extend the active gaze to Moqbel’s verbal testimony isn’t counterintuitive but a means by which to reorganize what is meant by the category of what Azoulay calls “authentic documentation” (421). This is to say that a multitude of textual elements are essential to one’s recognition of the visible. Embedded in Moqbel’s testimony is an opportunity to listen and imagine what we are barred from seeing. This is what it means to reconstruct and fabricate images from testimony that are spoken or written down. But, despite this gap we continue to look. Moreover, as Azoulay argues, we must look, for there is a responsibility inherent to the witnessing of the image.
Moqbel’s insistence on not only his own pain but also public acknowledgment of that pain resists the prison’s control over what audiences will have access to concerning the detention camp. After all, vision is regulated inside the camps but outside as well, through the control of what information is made public concerning hunger striking and force-feeding. Camp oversight takes the form of panoptical surveillance at the same time that it hides or prevents certain forms of life from being made visible. The sealed videotapes documenting how punishment is medicalized at the camp is one such instance of obfuscation, as is the detention camp’s decision in 2013 to no longer report to the public the number of men hunger striking. Indeed, camp officials understand that violence done to the self for the self is a powerful demonstration of sovereignty that pushes up against the state’s emphasis on biological life/existence.
The military task force that runs the facility based at Naval Station Guantánamo Bay has established itself as the authority of not only what can be said but also what can be seen. Militarization at the detention camp authorizes its own authority through methods of classification and organization of the men held captive, deciding what information does or doesn’t serve “operational purpose.” Moreover, this relation between authority and visibility is an unstable one in constant need of rearticulation. In the following section, I consider how the state frames force-feeding as ethical medical care to cover over or hide what is in fact a regime of compulsory visibility within the field of authority, power, and punishment. I ask: How does the state frame medical ethics inside the camps and documents such as the Medical Management of Detainees on Hunger Strike? How does the state’s emphasis on care obfuscate not only the demands of the prisoners but also the feeding tube as carceral technology?
The Standard Operating Procedures of Authority
In 2013 Al Jazeera asked to see Medical Management of Detainees on Hunger Strike, the document outlining the standard operating procedures (SOP) for force-feeding. The request was granted. Originally written in 2003, but updated in 2005, the SOP was designed to serve as a policy manual in the event of hunger striking at the camps. In 2013 the manual was revised again with the intention of preventing another mass hunger strike like the one that took place in 2005 (see Leopold 2013). It was put into effect on March 5 and, unlike previous versions, released without redactions.1
Unique to the 2013 manual is that it directs staff in how to handle prisoner resistance to the feeding tube itself. The introduction states that “just as battlefield tactics change throughout the course of a conflict, the medical response to GTMO detainees who hunger strike has evolved with time” (JTF 2013: 1). Here the evolution of tactics is synonymous with the alteration of medical technology and procedure—hunger strikers are no longer simply nasally fed but strapped down to restraint chairs and forcibly fed several times a day, and it is the commander—not the certified physician—who has final say over whether a prisoner is forcibly fed (see Stafford Smith 2007). The thirty-page document details twelve categories of medical management, some of which include evaluation and assessment sheets, medical equations, calculations, and electrolyte deficiency management. These categories, taken together, make up the “General Algorithm for a Hunger Strike,” a worksheet that is also included within the report. Staff use the algorithm as a guide in the event of a hunger strike to enact “involuntary enteral feeding” of prisoners who “[are] at a weight less than 85% of the calculated Ideal Body Weight” or suffering from other adverse health effects, such as seizures, muscle wasting, and significant weakness as a consequence of the prolonged refusal of food and water. The SOP guidelines also mobilize visual techniques of oversight, such as observation, examination, and documentation, in an attempt to “rehabilitate” the prisoner into a docile and normalized subject who eats rather than hunger strikes, concedes rather than objects.
The language of the report is medicalized, referring to prisoners on strike as “patients” and enteral feedings as “procedures,” as if it is a surgical operation that the prisoner has consented to. Enteral feeding is the continuous administration of nutrients to the digestive system using a tube. Intermittent feedings, in contrast, are feedings that take place at different times throughout the day. When not quoting the report, I have chosen to refer to enteral feedings as “force-feedings.” This term both highlights the coercion and abuse on the part of the state as well as respects how prisoners themselves have chosen to describe what has been done to them in response to hunger striking. The SOP’s “Policy” section specifies that it is a nasogastric tube (NGT) used to administer enteral feedings. Once admitted to the detention hospital (DH) the prisoner is administered a 10 French or 12 French (this is the diameter, or size) tube, which is inserted through the stomach, all the way down to the small intestine.
The state’s term involuntary already gestures toward a lack of autonomy for prisoners, but the use of the feeding tube at the detention camp should also be situated within a longer history of carceral punishment, where force-feeding has been used as a tactic of incapacitation meant to immobilize and stifle political defiance within the prison regime.2 This is not to say that the authority of JTF at the detention camp is totalizing. Rather, as Lorna Rhodes (1998) warns in “Pan-optical Intimacies,” although disciplinary spaces of confinement are contingent on transparency of panoptical vision, they also
invite and magnify disorder, pollution, and noise. While vision is certainly central to the effect of transparency, inmates and prison workers attest that the senses of smell and hearing predominate in some of the more aversive prison experiences and can be deployed to interfere with the pan-optical mechanism and challenge the notion of a transparent society free of zones of darkness. Their experiences serve to remind us that the visual emphasis both of the panopticon and of our use of it as a figure of modern discipline . . . is an “optical” illusion that minimizes the material, felt body even as it highlights the body as the mediator of projects of docility. (Rhodes 1998: 288)
Indeed, the restraint chair and feeding tube as instruments of discipline produce suffering in the prisoner but also resistance and strategy. The felt experiences of pain, such as lacerations in the back of the throat, trouble swallowing, and the discomfort of tape used on the face to secure the feeding tube, should not be ignored, for they demonstrate the disconnect between the SOP as policy manual and the lived experience of the prisoner who chooses to hunger strike. By biting and swallowing the tube, prisoners resist the camp’s medicalization of punishment, and incapacitation, but at the cost of physical discomfort and suffering. Pain, then, becomes one such zone of darkness that escapes the detention camp’s complex of visuality predicated on oversight and surveillance (see Mirzoeff 2011).
Surveillance and Control
The SOP document instructs staff to surveil prisoners’ bodies, recording heart rate, blood pressure, and weight. As an authoritative document, surveillance and management are legitimated through the coupling of care with the preservation of life. Medical personnel are constructed as the technicians of carceral oversight, and force-feeding as the technology of health and nutrition that most efficiently protects, preserves, and promotes life at the camp. Here life is purely biological and takes precedence over political life. As a policy manual, the SOP document focuses not on medical ethics but on targeting, disciplining, and surveilling the captive’s body with the objective of eliminating political opposition.
The SOP makes clear the centrality of isolation and immobility to incarceration: “In event of a mass hunger strike, isolating hunger striking patients from each other is vital to prevent them from achieving solidarity” (JTF 2013: 6). The medical evaluation and subsequent punishment begins by closely monitoring and recording prisoner meals. The Joint Detention Group security force notifies medical personnel of any prisoner appearing to be hunger striking, and a daily list of those perceived to be striking is sent out to “key leadership” in Joint Task Force Guantánamo. Once it is determined that a prisoner is on hunger strike, then a medical provider counsels him on the health risks of going without food and/or water for prolonged periods of time. The “Hunger Striker Medical Evaluation Sheet” documents whether the prisoner is drinking fluids, the number of meals that have been missed, and the reason for the hunger strike. It also records a full physical assessment that consists of documentation of the prisoner’s weight. Weight plays an important role on this sheet, with specifications needed for the “in processing weight,” “pre-hunger strike weight,” “current weight,” and “weight loss.”
The preoccupation with weight at the detention camp has been described by Sami al-Haj, who was released in 2008, as the only concern of physicians. He states, “All they care about is the prisoner’s weight. . . . ‘Are you sick? Are you in pain?’ Who cares? It is all about the number on the scale” (Worthington 2008). For al-Haj, a side effect of force-feeding was bloating, resulting in the impression of legitimate weight gain whenever he was made to step on the scale. Indeed, the importance of recording weight at the naval base cannot be understated, and the public release of the measurements and weight of prisoners has been used to give the illusion that the majority of the men held captive are not only healthy but also not participating in the hunger strikes (see Worthington 2009).
A behavioral assessment follows weight intake to determine the exact reasons behind the prisoner’s decision to hunger strike. Following the assessment, the prisoner is evaluated daily using the “Hunger Striker Medical Flow Sheet,” used to keep track of the prisoner’s heart rate, blood pressure, fluid intake, whether he is eating, the caloric intake of the enteral feed, weight, and comments concerning the prisoner’s mental health. All counseling efforts and treatments are recorded in the prisoner’s medical record. If it is determined that medical intervention is necessary, the prisoner will be admitted to the DH or transferred to a designated feeding block to be force-fed. The various disciplinary techniques surrounding force-feeding, such as the algorithm, medical evaluation sheet, and flow chart, keep the prisoner constantly within a line of sight, with the intention of correcting the prisoner’s behavior. The ultimate goal is that the prisoner terminate his hunger strike and return to “oral nutrition.” Staff management of hunger striking at the camp normalizes, attempting to unify behavior while also observing, judging, and making visible differences. This “normalizing gaze” is what both subjects and objectifies those being examined (Foucault 1977: 184).
However, just as Rhodes cautions against believing disciplinary spaces to be transparent, force-feeding at the detention camp is more opaque than other forms of discipline administered, both hiding and making visible its intentions. One example of this is the way in which the SOP prevents the hunger striker’s own knowledge about the health and status of the body itself in the form of concealing measurements such as weight loss or weight gain. In his testimonial, Moqbel notes that at least one month passed before he was updated on how much he weighed. And Dhiab is quoted, along with several others, in litigation as being certain that the medication Reglan is being administered without their consent. The drug is used to treat nausea and vomiting, but prolonged usage has been linked to a neurological disorder called tardive dyskinesia—the involuntary movements of the tongue, lips, face, and extremities.3 Other complications that can arise when tube feedings are administered poorly are diarrhea; dehydration; aspiration pneumonia, which is the inflammation of lung due to the entrance of food; and a number of gastrointestinal disturbances (see Plumner 1983). Prisoners reported to their attorneys that it was pointless to resist tube feedings. Regardless of whether they cooperated, the tubes only got bigger, and both insertion and removal were equally painful, causing the men “to urinate and defecate on themselves” (White 2006). These testimonials are in stark contrast to Guantánamo officials’ assertion that “medical personnel do not insert nasogastric tubes in a manner intentionally designed to inflict pain” (Rose 2006). Yet the protocol for intermittent “enteral feedings” administered in restraint chairs suggests otherwise.
Restraint chairs were introduced to the detention camp in 2005 after a psychiatrist, accompanied by three consultants from the Federal Bureau of Prisons, visited the camp. It was suggested that the SOP be revised to include the use of restraint in managing hunger strikers. The chair is described by the Constitution Project (2013: 229) as a technology that “completely immobilizes a person strapped into it, using a lap belt and straps that immobilize the head as well as wrist and ankle restraints.” The use of the chair is also described in the SOP where the guard
shackles [the] detainee and a mask is placed over the detainee’s mouth to prevent spitting and biting . . . the detainee is escorted to the chair restraint system and is appropriately restrained by the guard force . . . upon completion of the nutrient infusion and removal of the feeding tube, the detainee is removed from the restraint chair and placed in a ‘dry cell.’ . . . The guard force will observe the detainee for 45–60 minutes for any indications of vomiting or attempts to induce vomiting. . . . If the detainee vomits or attempts to induce vomiting in the ‘dry cell’ his participation in the dry cell protocol will be revoked and he will remain in the restraint chair for the entire observation time period during subsequent feedings. (JTF 2013: 7)
The will of the prisoner here is trapped, and his movements are constricted. The feeding tube both maintains biological life at the same time that it kills political life. We can also think of this in terms of the living or social death of the prisoner, or what legal scholar Colin Dayan (2013: 70) calls “soul death.” For Dayan, the prisoner is one who possesses a natural life but whose loss of civil rights illustrates how the law can make one dead in life. If, as Dayan also suggests, confinement offers prescriptions and treatments for those constructed as criminal, what kind of treatment, then, is force-feeding? The SOP illustrates how force-feeding aims for the incapacitation of the body at the same time that it keeps the prisoner alive, fulfilling Michel Foucault’s (1999: 241) definition of biopower as the power to “make live or let die.”
Biopower, the introduction of life into power, names the techniques for achieving the subjection of bodies and the control of populations. Both the terms control and population become significant, as the necessary precursor for control of a subject is life. Force-feeding presents a paradox that is at once emblematic of Foucault’s biopower while also functioning as incapacitating technique. For Foucault, at issue are two different populations: the one that will die and the one that will live a healthier life. In the case of the hunger striker, the paradox is found within the same figure. The same figure who is to be saved is also incapacitated. I name this paradox “suspended animation,” for it gets at the ways that confinement and captivity produce in subjects a state that is neither dead nor alive.
Suspended animation, itself a medical term, is a process that replaces the body’s blood with cold saline, dropping one’s temperature to 10°C, making almost all cellular activity stop. In 2014, surgeons at University of Pittsburgh Medical Center Presbyterian Hospital conducted a trial using suspended animation on gunshot victims. A doctor working on the trial clarified to a reporter that “we are suspending life, but we don’t like to call it suspended animation because it sounds like science fiction. . . . So we call it emergency preservation and resuscitation” (see Yang 2014). Although toward very different ends, the SOP, too, articulates force-feeding as emergency preservation, a procedure that in its vitalism rehabilitates the body to its proper weight and physiological functions. However, terminology aside, what is it if not the suspension of life, which is to say the suspension of one’s right to protest, an end to indefinite detention predicated on religious othering, xenophobia, and racism?
The SOP for force-feeding and the use of the restraint chair, described by one prisoner, Nabil Hadarab, as an execution chair, calls to mind Foucault’s (1977: 204) notion of the panopticon as a laboratory of power, a “privileged place for experiments on men, and for analyzing with complete certainty the transformations that may be obtained from them.” Indeed, the restraint chair has remained a powerful image in the popular imaginary for the medicalization of punishment at the detention camp. Physicians and military officials meld into one in this imaginary, and the DH becomes synonymous with a cell—or a laboratory.
The Guantánamo Bay hunger strikes offer a counternarrative to the authority of the SOP. The prisoners’ resistance to being force-fed is an attempt at reclaiming political and corporeal autonomy. The SOP points to such embodied forms of resistance: “On occasion, a detainee undergoing enteral feeding will attempt to bite the tube in an attempt to swallow the feeding tube. . . . The detainee may attempt to bite the portion of the tube outside the nose by turning his head and snaring the tube with his mouth, or may attempt to regurgitate the tube partially into the oral cavity and attempt to sever the tube covertly without opening his mouth” (JTF 2013: 12). Here we see the prisoner resisting incapacitation by attempting to bite or swallow the feeding tube. We can read this resistance as not only struggling against the administration of force-feeding but also opposing the feeding tube itself as medical apparatus. The feeding tube, as Patrick Anderson (2005: 6) asserts, “represents and facilitates the enforcement of normative alimentary exchange by the institutional apparatuses of the State—for example, clinic and prison.” Indeed, medical personnel in the clinic are cleared to restrain the prisoner in instances of resistance:
If a particular detainee displays repeated attempts to bite the tube, a weighted 10 ft tube shall be used. . . . If the detainee is able to gain the tube between his teeth, the nurse will: 1. Simultaneously turn off feed and, immediately stabilize the distal end of the tube and pull the tube from the detainee’s nose. 2. Maintain traction on the proximal portion of the tube until the detainee releases the tube from between his teeth. This may take considerable time. . . . If the detainee refuses, the RN shall immediately remove the tube, inspect it for damage, and re-insert it. (JTF 2013: 29)
How are we to understand the biting and attempts at swallowing the tube? Important is the repetition of the feeding. No matter the amount of resistance or pain on the part of the prisoner, the feeding does not cease; rather, its administration intensifies through its repeated insertion.
Similarly, Sami al-Hajj, a journalist for Al Jazeera who was held at the detention camp for seven years and whose hunger strike lasted 480 days, describes force-feeding in terms of its repetition:
They’re supposed to feed you [with] two cans, small cans . . . but they feed us 24 cans and 24 bottle[s] of water, continuous. And we [were] throwing up, it continues and we throwing up and it continues. This is one feeding; [it] would take 8 hours like that, you are in chair. Until your cell become full of [vomit]. And after that, when they come and [remove the feeding tube from the esophagus], they [would grab the tube and just walk away with it]. Then there was blood coming. And [the guard] takes it from you and he goes to another [detainee] directly and [inserts it] . . . without cleaning. (Constitution Project 2013: 227)
Such repetition is precisely what transforms enteral feeding into force-feeding and the “preservation of life” into torture. The death of spirit caused by confinement, for Dayan, is akin to suspended animation. Indeed, the feeding tube, like solitary confinement, keeps the mind and body technically whole, but at the cost of the spirit, which will deteriorate in the restraint chair or cell. Yet the suspended animation of force-feeding doesn’t completely foreclose embodied forms of opposition. Similarly, Dayan (2001: 28) argues that prisoners who self-mutilate while in solitary confinement make visible what the law seeks to mask. What do the prisoners of Guantánamo make visible about not only the law but, more specifically, the militarization of medicine? The self-inflicted pain of the hunger striker works to communicate not only the pain induced by force-feeding but confinement itself. In the next section, I turn to one of the ways in which the public has responded to force-feeding and how video and performance come to play a role in the ethics of witnessing.
On July 8, 2013, in response to the first litigation filed concerning the force-feeding of Dhiab and several other prisoners, Judge Kessler concluded that although there was sufficient evidence to suggest that force-feeding is torture, the court nonetheless lacked the jurisdiction to grant the injunction. On the same day, the human rights organization Reprieve launched a campaign in solidarity with prisoners on hunger strike, releasing a nearly five-minute video, directed by BAFTA (British Academy of Film and Television Arts) award winner Asif Kapadia, featuring the artist Yasiin Bey (formerly known as Mos Def) being force-fed according to Guantánamo’s SOP (Kapadia 2013). In July 2013 the Guardian newspaper released the video, which has over 7 million views on YouTube. By creating this video, Reprieve aimed to create public outrage and pressure President Barack Obama to close the military prison.
The video begins with a caption stating that 120 prisoners are hunger striking at Guantánamo Bay and forty-four of them are being force-fed. Yasiin Bey then enters an empty white room furnished with a feeding restraint chair, two cameras, an IV, and a table with the feeding supplies. He introduces himself and calls what we are about to see a “demonstration of the standard operating procedures for force-feeding.” The camera focuses on Bey’s attire, lingering on his expensive-looking jacket, pants, and shoes. The next shot is of him in an orange prison jumpsuit and in shackles, as his hands, feet, and head are strapped down into the feeding chair. As the procedure is about to begin, “Standard Operating Procedure: Medical Management of Detainees on Hunger Strike” appears on the frame. While the doctor, a British physician, lubricates the nasogastric tube, Bey’s eyes shift back and forth nervously. The physician proceeds to insert the tube into Bey’s nose. Bey immediately begins to physically struggle, coughing, moaning, and grunting. At this point, actors in black T-shirts enter the room to restrain Bey; the doctor removes the tube from Bey’s nose and begins to lubricate it again, restarting the procedure. As the doctor attempts to reinsert the tube, Bey becomes significantly more agitated and, at this point, begins to resist; he must be restrained at the head and neck. Bey cries toward the end of the video, “No, please, stop, stop it please, this is me, I can’t do it anymore.” He puts his head in his hands and begins to cry. The captions tell us that at Guantánamo the full procedure is carried out twice a day and typically takes two hours to complete. The video ends with Bey describing the tube being inserted into his nasal cavity as having caused a burning sensation—a feeling he describes as unbearable that goes into his brain, reaching the back of his throat to the point that he really couldn’t take it.
A criticism of the above simulation is Bey’s ability—his agency—to stop the feeding and demand that the tube be removed. Here, Moqbel’s and Dhiab’s testimonies are a sharp contrast, in which they, too, begged that the feeding stop, but to no relief. “It was so painful,” writes Moqbel (2013), “that I begged them to stop feeding me. The nurse refused to stop feeding me. As they were finishing, some of the ‘food’ spilled on my clothes. I asked them to change my clothes, but the guard refused to allow me to hold on to this last shred of my dignity.” While Bey expressed gratitude at being asked to participate in the simulation, Moqbel remained indefinitely detained, suffering for exercising his right to protest. If Bey’s simulation pales in comparison to what happens when prisoners are force-fed at the detention camp, what, then, is the utility of Bey’s representation of force-feeding? After all, what is necessarily hidden from the frame are the dozens of men unable to escape the restraint chair and feeding tube. Looking relies on not only an exchange of gazes but also the visual degradation of the other, or misrecognition of the other. Bey’s failed simulation, and by failed, I mean that he stopped the feeding before its completion, speaks to this, then, in that it moves away from the insistence that representation can successfully reproduce reality. The video neither fails nor succeeds at reproducing the SOP; instead it derives its force from highlighting the pain authorized by the SOP and the practice of force-feeding itself.
Bey’s performance deflects from the subject to orient the viewer to the felt experience of pain and the technology responsible for producing that pain. Indeed, the camera makes a point to linger on all medical technology present: the positioning and lubrication of the tube and the IV drip, both against a white backdrop.4 I would caution against any interpretation of Bey’s performance in the video as emancipatory, but I deem it important to highlight his interruption of the simulation when he pleads, “No, please, stop, stop it please, this is me, I can’t do it anymore.” His refusal to continue bars the viewer from continuing to witness his suffering and, as such, pushes against a gaze that has already naturalized the pain and suffering of the captive body. This is to say, Bey doesn’t equate his own pain with that of Moqbel, Dhiab, or any of the other men who have been forcibly fed. Rather, Bey’s participation responds to Moqbel’s call to once again look toward the detention camp. This simulation, or what I would like to call Bey’s embodied looking, centralizes pain and suffering in such a way that what began at the start of the video as, in the language of the SOP, a “medical procedure” becomes a torture session. The feeding tube is thus transformed from medical instrument that “makes live” to carceral technology that inflicts unnecessary pain and suffering.
Reprieve’s video of Bey demonstrating Guantánamo’s feeding procedures builds on the relationality between the subject in pain and the spectator watching. The video is an example of framing that provides a visualization of the punitive use of force-feeding that is otherwise offered solely through testimonials and human rights reporting. Framing is first and foremost about presentation, but also about boundaries. In other words, the frame is a boundary to the image but is also itself that which structures the image (see Butler 2010: 63–100).5 The camera’s gaze frames the feeding tube as a weapon against Bey and those being force-fed at Guantánamo. The feeding tube, here, comes to signify and critique the state’s emphasis on life, and the perceived necessary management of the captive in the service of US security. Reprieve’s video is a tactic that has the potential to reverse the authority of the state by wresting control of the gaze. This reversal of the gaze whereby documentation is used to respond back to authority by using the state’s own standard operating procedures mobilizes pain in the service of drawing visibility around the medicalization of punishment at the camp.
Reprieve’s campaign accompanying the video encouraged members of the public to undertake short-term hunger strikes in addition to drawing awareness to Guantánamo Bay with their political representatives (see Reprieve 2013). It’s unclear just how many participated in the campaign, and, ultimately, President Obama was unable to close the detention camp (see Savage and Davis 2016). However, accessing the success of Reprieve’s campaign is less of interest to me than how the video competes against the state’s refusal to release video documentation of Dhiab’s force-feedings. In doing so, the reenactment of the SOP makes pain as public as possible instead of relegating it solely to inside the detention camp where the state frames the procedure as medically sound. Although the state denies the pain it subjects onto prisoners, the video demands that Bey’s pain be seen as real by attempting to “resituate the terms of which reality is understood” (Mirzoeff 2011: 28). This resituating of reality attempted by Bey can also be likened to a reframing of the field of representation, forcing us to look at the “image outside the scene of its production” (Butler 2010: 100) where its interpretation is no longer solely controlled by the norms of the state. Our attention as spectators is turned toward the functioning of the feeding tube as a prosthetic capable of administering a pain that is authorized by the state. The video, then, is a simulation of the prisoner’s struggle for corporeal autonomy but also a demand for transparency and accountability. Bey—as both spectator and performer—provides a mode of visibility for the zone of darkness that is the detention camp, and the moans of suffering from the men held captive there. What we see in Reprieve’s video is Bey’s ability to interrupt being force-fed through his verbal commands “please stop, please . . .” but also through the sonic substance of his moans (Moten 2003).6 Bey’s attempt at simulating the SOP of force-feeding ultimately uses representation as a way by which to impose form onto the sealed videos, the absence of Dhiab’s recorded, yet sealed cries.
Reframing the Archive
This essay has argued that inherent to the punitive use of force-feeding at Guantánamo Bay is the compulsory visibility of the prisoner’s body inside the detention camp. In its attempts to normalize the hunger striker’s embodied defiance and behaviors, the SOP guidelines ultimately highlight the struggle intrinsic to state authority and the corporeal modes of resistance that are ongoing by Dhiab and those remaining at the detention camp. Integral to this struggle is the question of the visual, and the power of the state to control what information and images can be made public. The SOP of force-feeding and Dhiab’s missing video footage are central archives of visuality in that they not only further the investigation of how force-feeding has become a medicalized technique of punishment but also expose the aggressivity essential to contemporary tactics of surveillance, tactics that literally violate the corporeal integrity of the body.
Dhiab was released from Guantánamo Bay to Montevideo, Uruguay, in 2014 (see Goodman 2016). He has yet to be reunited with his family and began hunger striking in 2016 to protest his detainment in South America. His most recent hunger strike began around the same time as a nationwide US prison strike started at California’s Pelican Bay State Prison. On September 9, 2016, incarcerated people across the United States began hunger striking in protest of long-term solitary confinement (see Vongkiatkajorn 2016). Such ongoing political struggles remind one that to engage with archives of suffering and pain is to necessarily engage in its constant repetition. However, confronting pain and its visual and sonic representations can provide us with an affective engagement with images, one that urges a more relational approach during times of war and incarceration.
With the ruling against making public Dhiab’s video footage, we must look toward alternative archives of evidence not authorized by the state. The SOP and Dhiab’s court litigation, for that matter, are certainly central to this archive, but part of what this essay has attempted to do is to locate more affective resources by which to bear witness to the pain and suffering of those held captive and subjected to various techniques of power. Moqbel’s testimony, although one of many, presents an opportunity to not only look but also listen to the sounds of suffering generated by force-feeding. This phonic substance is embedded within any representation of violence and, indeed, we ought to consider both Moqbel’s statement and Bey’s enactment of the SOP as simultaneously aesthetic and political, which can be just another way to think about representation itself (Moten 2003). And if representation always already signifies an absence, as we’ve seen throughout this essay, then what I would like to propose is that within this absence is the condition of possibility for imagining a new ethics of seeing, acting, and feeling. It remains unclear what Moqbel wishes us to do once we have again wrested our gaze toward Guantánamo. Perhaps here, then, the power of looking hinges not on an ideal ethical witness but a gesture of defiance that resists transnational carceral enterprises such as Guantánamo Bay and the US supermax prison, both of whose objective is, ultimately, to disappear its subjects.
Many thanks to Samera Esmeir, Keith Feldman, Michael Mascuch, and Juana María Rodríguez for their generous engagement with drafts of this essay. I’m also grateful for Kel Montalvo-Quiñones and Emily O’Rourke’s comments and support at various stages of this project. My writing and thinking benefited greatly from the Violence and Policing Conference at Columbia University. Thank you to everyone involved with the workshop for the thoughtful feedback and suggestions.
It’s unclear when the SOP was declassified. Al Jazeera reports that the Pentagon declassified the manual several years prior to its public release in 2013, but that that version still contained redactions. In this essay, I quote from the 2013 version (see Leopold 2013).
Notable examples include the force-feeding of incarcerated British suffragettes and Irish Republicans during the early 1900s, but force-feeding also has roots in psychiatric hospitals and on the experimentation of animals.
Shaker Abdurraheem Aamer et al. v. Barack Obama, 742 F.3d 1023 (D.C. Cir. 2014).
This is not to say that Bey’s own embodiment can or should be ignored. Bey’s lived reality as a Black man and practicing Muslim is made all the more visible as he replaces his own clothing for the orange jumpsuit. Whether Reprieve consciously sought to draw a parallel between the captivity of Black men within the US prison regime and the racialized men held captive at Guantánamo is unclear. Indeed, one might argue that Bey’s blackness here is exploited to make translatable the suffering taking place, in that, as Saidiya Hartman’s Scenes of Subjection (1997) argues, blackness always already marks a social relationship of dominance and abjection. Yet she also makes clear that blackness marks the potential for redress and emancipation.
Butler, in Frames of War (2010), argues that framing, affect, and interpretation extend beyond the viewer to the camera itself. Indeed, if the presence of the camera is understood as some form of enhancement, then the photograph builds and augments an event. Thus, for Butler, both seeing and photographing are shaped by norms that frame which life is rendered destitute and abject.
Here I am indebted to Fred Moten’s (2003) idea of the phonic substance of mourning imbued in the photographic encounter.