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On hunger strikes: A brief background
 
 

A growing number of Egyptian prisoners have joined a widespread wave of hunger strikes, including well-known activists associated with the January 25 revolution who were detained on charges related to the Protest Law, as well as detainees serving sentences related to pro-Muslim Brotherhood protests.

Although Egypt’s prison chief has officially denied that the country’s inmates are hunger striking, several people are still protesting through self-starvation, though it is difficult to know the precise numbers. The Freedom for the Brave campaign said that at least 138 inmates are currently hunger striking, in addition to several activists outside of prison. Demands range from better prison conditions and fair trials, to the release of political prisoners and the revocation of the Protest Law.

Over 40,000 people have been detained since former President Mohamed Morsi was ousted on July 3, 2013, according to WikiThawra, an initiative created by the Egyptian Center for Social and Economic Rights (ECSER) to document all those detained, arrested and killed since the January 25 uprising. It estimates that of those arrested, 89 percent were detained on political grounds, and 4 percent on terrorism-related charges.

Who are hunger strikers detained on political charges?

Ahmed Douma, Mohamed Adel

Two days after detained activist Alaa Abd El Fattah (who has been jailed by every administration since the fall of former President Hosni Mubarak) started his hunger striking campaign from Tora prison on August 18, activists Ahmed Douma and Mohamed Adel launched the We are Fed Up campaign with Wael Metwally and Mohamed Abdel Rahman. They called for other detainees held on protest-related charges to join them in a mass hunger strike. 

Douma and Adel were sentenced to three years imprisonment for protest-related charges. Abd El Fattah, Metwally and Abdel Rahman were in prison pending retrial after being sentenced in absentia — although they were outside the court when the sentence was handed down — to 15 years in prison in June for charges of protesting without permit, assaulting a police officer, blocking the road and vandalism.

Abd El Fattah, Metwally and Abdel Rahman were released on September 15, pending trial, on LE5,000 bail. Twenty-two others were also sentenced, but not detained.

After suffering from previous health problems in prison, Douma’s medical condition has rapidly deteriorated during his hunger strike.

In a short statement to media reporters waiting for him outside Tora prison on the day of his release, Abd El Fattah said that the hunger strike campaign would continue until all detainees imprisoned under the Protest Law were set free.

In an open letter announcing his hunger strike, Abd El Fattah wrote that though he initially dismissed hunger striking out of concern for his family, he decided to join on realizing that his family have become prisoners like him, “subject to the dictates and the moods of an organization devoid of humanity and incapable of compassion.”

Seven of those convicted in the Shura Council case on charges related to the Protest Law announced an open-ended hunger strike and sit-in at the National Council for Human Rights on September 7. The group said they launched their hunger strike against “the regime’s arbitrary arrests … and physical and emotional torture and the violation of the most basic of human rights.”

Sanaa Seif

Abd El Fattah’s sister Sanaa Seif, 20, joined the strike following the death of their father, prominent human rights activist Ahmed Seif. She was arrested in June at a march against the Protest Law demanding the release of political prisoners. She is currently being held in Qanater women’s prison, pending trial.

In addition to protesting against the conditions that kept her away from her father’s side as he was dying, her sister, activist Mona Seif, wrote on her Facebook page that Sanaa’s “hunger strike is directed against the Protest Law which has resulted in her unjust imprisonment, and the imprisonment of thousands of others.” Sanaa, Mona and their mother, Laila Soueif, remain on hunger strike.

On August 24, leftist activist and lawyer Mahienour al-Massry, detained at Damanhour prison on charges of violating the Protest Law, joined the hunger strike. She called it off two days later, however, out of concern for the health of elderly prisoners who had joined her on the hunger strike.

On September 21, a court suspended Massry’s sentence and released her.

The campaign then began gathering momentum. On September 13, several liberal and leftist political parties including the Constitution Party, the Egyptian Social Democratic Party and the Strong Party declared they had joined the hunger strike campaign.

Mohamed Soltan

Detainee Mohamed Soltan, son of Muslim Brotherhood leader Salah Soltan, has been on hunger strike since January.

Soltan, who holds a US passport, was arrested last August from his home after returning to Egypt in March to be with his sick mother. According to his family, security forces raided the home to arrest his father, who was not there at the time, and so they arrested Mohamed instead.

Soltan began his hunger strike in protest against his continued detention, and to demand that he be tried in court and that the charges against him be openly declared.

A medical assessment carried out by US Embassy physician Fatma Bayad in June indicated that 80 days into his hunger strike, Soltan had lost over a third of his body weight. Bayad added that four people had to help Soltan get on the weighing scales as he was no longer capable of standing or walking due to his frail health.

Soltan has underlying health issues which have been aggravated by the hunger strike. Bayad’s report stated that Soltan’s condition could be life-threatening due to his ongoing hunger strike. He has been hospitalized numerous times.

On October 8, Soltan was transferred to an intensive care unit due to the deterioration of his condition. Doctors report he may be hemorrhaging from the brain.

Ibrahim al-Yamany

Ibrahim al-Yamany, a senior at Al-Azhar University’s medical school, is now on his second hunger strike. His first lasted 89 days. He was detained on August 18, 2013 against the backdrop of clashes between Brotherhood supporters and security forces after the violent dispersal of pro-Brotherhood sit-ins at Rabea al-Adaweya and Nahda Square. He has yet to face trial.

Rasha and Hind Mounir

On August 8, sisters Rasha and Hind Mounir began a hunger strike. Detained at Qanater women’s prison and facing life imprisonment, they were arrested while participating in a protest in August 2013 denouncing the violent dispersal of the Brotherhood sit-ins. Their 25-year sentence came one year after their detention. Over 40 other detainees in Qanater prison reportedly joined the hunger strike in solidarity with the two sisters.

Ibrahim Halawa

Eighteen-year-old Ibrahim Halawa is an Egyptian-Irish national. He was arrested along with his three sisters during protests against the violent dispersal of the Brotherhood sit-ins and has been held in Tora prison without charges ever since. He began a hunger strike on August 13 in protest against his conditions and lack of due process.

Ahmed Gamal Zeyada

Ahmed Gamal Zeyada, a journalist with the privately owned Yaqeen news network, has been in detention since December 2013. He was arrested while covering clashes at Al-Azhar University. He began a hunger strike in August, which the Freedom for the Brave Facebook page reported he was strong-armed into ending. He was threatened with solitary confinement or a transfer back to the police station “where they will deal with him” should he continue his protest action, the statement claimed.

Karima al-Serafy

Karima al-Serafy, daughter of former President Mohamed Morsi’s adviser Ayman al-Serafy, was released from detention on August 13 after 72 days on hunger strike. Serafy was taken by security forces from her house last March and, along with her father and other Morsi aides, faced charges of conspiring with foreign powers to destabilize Egypt’s national security. Prior to her hunger strike, the 20-year-old thought her case would go on indefinitely, in a cycle of renewed detentions. She began her strike after security guards assaulted her and other detained women.

In May, Muslim Brotherhood groups announced that 20,000 prisoners were participating in a week-long hunger strike in protest against the poor treatment and torture that detainees are subjected to in Egypt’s prisons.

In another case, 34 detainees declared a hunger strike on August 31 after they were beaten for calling for medical help for a fellow inmate. The same day, security forces threatened to fire tear gas to coerce them into ending their hunger strike, according to a statement released by the Freedom to the Brave group.

Abdullah al-Shamy

A journalist with the Qatar-based Al Jazeera network, Abdullah al-Shamy was arrested on August 14 during the dispersal of the pro-Muslim Brotherhood Rabea al-Adaweya sit-in. His detention was extended several times, though he was never brought to trial.

Shamy declared a hunger strike on January 21, and was released in June.

According to Shamy’s brother, photojournalist Mosaab al-Shamy, the prison administration ignored and denied the journalist’s hunger strike for two months, until photos circulated showing his dramatic weight loss. He was then transferred to solitary confinement.

Shamy’s wife Gehad Khaled also went on a hunger strike for over 40 days.

Mosaab warns that it may not be possible to replicate his brother’s success. Given that he was a journalist, his case attracted particular attention in the media and from high-profile figures. He also says pictures and videos Abdullah had taken from the start of his hunger strike that showed the dramatic effects on his body, and which were then leaked and circulated on the Internet, were also crucial to his success. By the time the state released competing pictures showing Shamy eating — prompting his family to issue a statement stating that their son had been forced to eat ­­— it was too late to win the media battle.

What happens to the body of a hunger striker?

Changes to the body start to occur after several days of fasting. Hunger strikers sometimes consume water with salt, minerals and sugar, enabling the body to survive for longer without food. Refusing both food and water is rare, because this would lead to death due to dehydration within 8-10 days.

For the first few days of a fast, the body uses stores of glucose in the liver and muscles for energy. Once these glucose stores are used up, the body turns to fat stores. The brain normally uses glucose to function, but if no food is consumed, it switches to fat-derived ketone bodies as an alternative energy source. This allows the body to endure weeks, even months of starvation.

The length of time the hunger striker can survive depends on the body’s initial fat and protein stores. Once the fat stores have been used up, the body turns to muscles and vital organs and the body starts to waste away.

Serious medical problems begin to occur when the hunger striker has lost around a fifth of their initial body weight, and starvation becomes life-threatening when 30 percent is lost. The symptoms progress in stages, with the final stages consisting of loss of hearing, blindness, hemorrhaging and heart collapse.

What does international law say about hunger strikes?

The World Medical Association (WMA), a body of 102 nations on which the United Nations bases its opinions, defines a hunger striker as “a mentally competent person who has indicated that he has decided to embark on a hunger strike and has refused to take food and/or fluids for a significant interval.”

The WMA established guidelines for medical standards on hunger strikers and the treatment of prisoners in the Tokyo and Malta Declarations.

Medical authorities have repeatedly affirmed that force-feeding prisoners constitutes “cruel, inhuman or degrading treatment,” which is prohibited by the 1948 Geneva Convention and other international treatises.

In the 2006 update of the Declaration of Malta on Hunger Strikers, the WMA states: “Forcible feeding is never ethically acceptable. Even if intended to benefit, feeding accompanied by threats, coercion, force or use of physical restraints is a form of inhuman and degrading treatment. Equally unacceptable is the forced feeding of some detainees in order to intimidate or coerce other hunger strikers to stop fasting.”

There are conditions under which artificial feeding can be administered, according to the WMA, such as if the prisoner agrees to it, has been placed under no pressure to do so, or if more than one physician rules that the prisoner is mentally incompetent.

What are some world-renowned cases of hunger strikes?

Throughout history, hunger strikes have been staged most often by prisoners because refusing food remains one of the few means available for inmates to make demands.

Hunger strikes require public attention to be effectual. Several cases, however, pass under the radar. In August this year, a Moroccan student activist died due to a 72-day hunger strike. There was little international condemnation.

Hunger strikes have been taken up as a tool for both violent and non-violent resistance, and for a variety of political causes and aims. Examples of prominent hunger strikers include Mahatma Gandhi and other figures in the Indian independence movement, British suffragettes campaigning for women’s right to vote, Mexican-American Cesar Chavez in the fight for farmers’ rights and the establishment of the first farmers union in the US, and Anna Hazare as she protested against corruption in contemporary India.

Here are a few others:

Bobby Sands and other Republican prisoners

Republican prisoners in Northern Ireland’s HM Prison Maze staged a hunger strike protesting against the British government’s revocation of the “special category” accorded to political prisoners. Republican prisoners undertook hunger strikes a number of times throughout the 20th century.

The 1981 hunger strikes led by Republican figure Bobby Sands were organized so that each week a new prisoner would join, building pressure on the British government.

During the strike, Sands was elected as a member of parliament. He died the following month, 66 days into his hunger strike, and his funeral was attended by over 70,000 people. The British prime minister at the time called him a “convicted criminal” who “chose to take his own life.”

By the time the hunger strikers ended their protest in October, 217 days after it began, 10 prisoners had died. Although the British government never officially reinstated the special category for political prisoners, over time privileges associated with the status were for the most part restored.

Palestinian prisoners

Earlier this year, almost two-thirds of Palestinians held in administrative detention by Israel went on hunger strike. Mass hunger strikes of Palestinian prisoners in Israeli jails have occurred several times before. Strikes in autumn 2011 and spring 2012 brought Israel’s long-running practice of administrative detention to international attention.

Administrative detention refers to the system whereby a military court can order suspects to be detained indefinitely, subject to renewal every six months, without charge or trial.

Three cases in particular attracted worldwide attention.

Khader Adnan ended a 66-day hunger strike after a deal was struck to release him at the end of a four-month period of detention in 2012.

Hana Shalabi ended a 43-day hunger strike on March 29, 2012, after reaching a deal with Israel in which she was deported to the Gaza Strip and not allowed to leave for three years. Amnesty International said the deal could amount to forcible deportation, which is contrary to international law.

She was arrested and issued a six-month administrative detention order on February 23, just two days after Khader Adnan ended his hunger strike. Shalabi was one of five people to be rearrested after being released during the Gilad Shalit prisoner swap between Hamas and Israel in October 2011.

Samer Issawi was released to his home in East Jerusalem after a 266-day hunger strike. Issawi had also been among those prisoners released in 2011 and later rearrested. In August 2012, he launched a hunger strike in protest against his renewed detention. Issawi had faced over 20 years in prison, the remainder of his original sentence imposed in 2002.

The three cases electrified Palestinian society, sparking solidarity hunger strikes by other Palestinian prisoners and demonstrations across the West Bank and Gaza. This led to attention not only from human rights groups, but compelled a number of actors to criticize Israel publicly, from the Palestinian Authority leadership to European Union policy chief Catherine Ashton — key players who are normally reticent to take such a vocal stance against Israel.

Several commentators at the time suggested that in each case, it was fear of further unrest that pushed Israeli authorities to reach a deal.

Expressions of solidarity between Palestinians and other oppressed groups is common. The Bobby Sands Trust expressed solidarity with the Palestinian hunger striking prisoners, and in 2013, former hunger striker Adnan issued a solidarity statement with thousands of hunger striking prisoners in US prisons in California. The strike’s demands included an end to long-term solitary confinement along with other abusive conditions and policies.

In Adnan’s statement, he “ask[ed] that the American people and the government end the policy of isolation of the detainees and the prisoners, and comply by human rights law that forbids continuous isolation because of its destructive effects on the mental and physical health of detainees.”

Guantánamo

There have been several cases of mass hunger strikes at the Guantánamo Bay detention camp in Cuba by prisoners held by the United States for terrorism-related charges. The first incident to gain much attention was in 2005 during former President George W. Bush’s administration, and again in 2013 during President Barack Obama’s tenure. Prisoners went on hunger strike to protest against harsh prison conditions and the lack of legal recourse available to them.  

Several of the detainees had been captured in Afghanistan in the aftermath of the September 11, 2001 attacks and during the war on Iraq, and were imprisoned for several years without facing trial or charges.

In 2005, up to 200 prisoners took part in a hunger strike — a third of the camp population at the time. In 2013, the hunger strike lasted sixth months, and at its peak a majority of the 166 detainees were participating.

Camp authorities responded in both cases by force-feeding the prisoners, drawing the ire of both professional medical associations and human rights groups. There were reports of extreme violence and unhygienic procedures undertaken without the required use of anaesthesia. Some physicians refused to carry out the force-feeding measures, and the Department of Defense began to screen doctors to ensure their willingness to administer force-feeding.

In 2005, the strike ended when prison authorities agreed to bring Guantánamo into compliance with the Third Geneva Conventions that regulate the treatment of prisoners detained in international armed conflict.

Following the 2013 hunger strike, Obama lifted a moratorium on repatriating low-level detainees to Yemen. At the time, there were 56 Yemeni nationals eligible for transfer, but the transfers of prisoners had been halted for over two years.

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