Doctors Treat Detainees With Same Respect, Concern As Other Patients
By Rudi Williams
American Forces Press Service
WASHINGTON, July 19, 2002 Navy Dr. (Lt.) Sandra A. Schaffranek had a bit of the jitters when she arrived at Naval Station Guantanamo Bay, Cuba, about three months ago to treat detainees at Camp Delta. It didn't take long for the nervousness to subside.
Even though some of the detainees have threatened to kill Americans, she's now at ease when treating the potentially dangerous patients.
"The military police staff has been phenomenal as far as providing safety and security for us," she said. "We've been assured that safety and security comes first. So if there is ever a question in our minds, most of us will step back and readdress the issue before proceeding with the initiation of medical treatment."
Schaffranek is one of the physicians who provide medical care for the captured enemy combatants from 39 different countries. About 80 nurses, medical corpsmen and other medical service support staff help with the history-making tasks. The initial advanced medical party numbered more than 100 personnel.
The potential danger posed by the patients doesn't change the way doctors and other medical professionals treat them, she pointed out.
"We all took the Hippocratic oath," the doctor said. "I treat them with the same respect in medical care that I would any of my patients back in the states." The only difference is security and safety primarily come before medical care, she said.
"We have two different types of medical care that are provided for the detainees," Schaffranek pointed out. "One is the fleet hospital form for inpatient care. There are two physicians and a consultant there. We also have two physicians that run the Camp Delta program, which is basically like an outpatient clinic."
The fleet hospital is enclosed within Camp Delta, where the detainees are held.
Detainees receive excellent medical care, the doctor said. "They have more one-on-one attention and availability than most other patients have," she noted. The care has been a godsend for many of the men because doctors have discovered a variety of conditions, including two cases of active tuberculosis, which have been cured.
Doctors have detected numerous cases of latent TB, Schaffranek noted. Many detainees come from countries with high TB exposure rates, she said. The bacteria conceivably could have been present and dormant for years.
"In that case, we treat them to prevent reactivation, just as we would do for our patients in the states," she said. "They've been treated long enough that they're no longer considered infectious."
Schaffranek said she wasn't at the camp hospital when most of the detainees with battle injuries arrived. "But when I arrived on the island, some of them were still hospitalized due to bone infections, which are oftentimes difficult to treat and require months of intravenous antibiotics."
Some detainees arrived with infected amputated limbs and some had to have amputations. They were given prostheses. Eyeglasses were provided for those needing them. Requests for hearing aids are under consideration.
She said detainees with serious medical conditions are treated by specialists who rotate through as needed. For instance, she related, one TB patient had a neurological problem that required surgery. "We were able to bring a neurosurgeon to the island to help treat him," she said. "We're constantly trying to figure out how to meet any demands that come up."
Though she missed the acute incidents, Schaffranek said she's seeing the chronic phases of illnesses. But, she reviewed the patients' records and determined that all did well -- some evidence is most detainees admitted with battle injuries have been released back into the general population.
When detainees complain about a stomachache, headache and other conditions, Navy corpsmen visit their living units to check out the problem.
"If there is no medical emergency, we do like we do for our active duty folk (administer) over-the-counter medication to help alleviate the problem," Schaffranek said. "If the corpsman thinks it's something that needs a higher level of care, we'll bring the detainee to our clinic for an evaluation."
Sick call for active duty service members lasts for three to four hours, but sick call for detainees "runs 24 hours a day, seven days a week, she said. Most complaints are addressed within 24 hours after registration with the guards.
Specialists who come to the island to care for active duty service members and their dependents oftentimes treat detainees, she noted.
"Being here is actually a phenomenal case for international medicine, because we have seen malaria that has become reactivated, typhoid fever, and multiple cases of leishmaniasis that's transmitted by sand fly bites, and several cases of hepatitis B and C -- none are active, but the men had been exposed to the virus," Schaffranek said.