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Force-Feeding is Cruel, Painful and Degrading – and American Prisons Won’t Stop

In a Colorado supermax facility, hunger-striking inmates have been force-fed and barred from sharing their ordeal with the outside world. A prisoner breaks his silence for the first time.

by Aviva Stahl, The Nation

It was November 11, 2015, and Mohammad Salameh hadn’t eaten in 34 days. The morning was stretching toward noon, and he was lying on a concrete platform that served as his bed when a team of guards dressed in riot gear appeared at his cell door and ordered him to cuff up. A week earlier, Salameh failed to comply with that demand – he’d been too weak to stand and walk to his door – so guards had entered his cell and dragged him out. Salameh didn’t want to be manhandled again, so he slowly pulled himself to his feet. He leaned against the wall and struggled slowly toward the guards.

At his door, the force team attached irons to his legs and handcuffed him. They took him to the medical-treatment room, where a physician assistant ran tests and weighed the five-foot, eight-inch prisoner at 139 pounds. “Inmate Salameh, will you drink this nutritional supplement voluntarily, by mouth?” the PA asked. Salameh refused. After the guards stepped forward and strapped him into a black chair, the PA took a long tube and inserted it through his nostril and down into his stomach. Then a liquid the color of cream dripped through the tube into his body.

It wasn’t Salameh’s first time being force-fed. He’d been in that black chair nearly 200 times in the past 10 years. After his conviction in 1994 on terrorism-related charges, he had been held in lower-security facilities, where life was tough but rarely so harsh that he felt he had to stop eating. After 9/11, though, everything changed, and by 2002 he was placed for the first time in the highest-security unit of the highest-security prison in the country: what’s known as the H Unit at Florence ADX, or the United States Penitentiary Administrative Maximum Facility in Florence, Colorado. There are only about a dozen people in the H Unit at any given time, but they may be subject to the most extreme conditions of long-term isolation of any jail or prison in the United States. It was in H Unit that Salameh began going on repeated, sustained hunger strikes to demand more humane conditions of confinement.

As with nearly everyone else held in the unit, Salameh’s ability to read, write letters and make calls was restricted by special administrative measures, or SAMs. The SAMs prohibited him from being in contact with anybody except his lawyer and immediate family members. Speaking to other prisoners was against the rules. He had no access to current news. His hunger strike, he said, wasn’t about getting out of prison or getting transferred out of the ADX. He simply wanted his life to be more bearable.

For most Americans, force-feedings bring to mind what happened at Guantánamo Bay in Cuba in 2005 and 2013. Those hunger strikes and force-feedings were covered extensively by the media; by contrast, the strikes at the H Unit have gotten virtually no attention, and that’s no accident. The SAMs don’t just isolate the men in their cells from the outside. They also wall the outside world off from what’s happening in the prison. Even family members and attorneys in touch with SAMs prisoners can be prosecuted and incarcerated for repeating anything the inmate told them—from accounts as trivial as what the prisoner had for breakfast to ones as substantive as abuses at the hands of guards. What this means is that hunger strikes are “born and [die] inside the institution,” as Salameh put it. During his 11 years in H Unit, he went on eight hunger strikes for a total of 428 days and was force-fed 220 times, he says. By his count, some men in the unit have been force-fed even more.

Decades ago, many medical associations rejected the force-feeding of mentally competent prisoners as a violation of prisoners’ bodily autonomy. Yet the brutal procedures taking place in Colorado, which many countries condemn for deliberately inflicting harm, have been hidden from the U.S. public completely – until now.

I started reporting this story because I wanted to know how the federal Bureau of Prisons operates when it is unshackled from the fear of public scrutiny. Since it’s impossible for anyone to report on what’s currently happening in H Unit, I spent 18 months interviewing men held there in the past, as recently as 2015, alongside defense attorneys and physicians with expertise in force-feeding. I spent about 13 hours on the phone with Salameh, corresponded with four other men, and submitted Freedom of Information Act requests to obtain copies of medical records and other documents.

What I’ve found is grim: Men are driven to hunger strike in the hopes of securing minor concessions like the right to call home twice per month or read or watch the news. Sometimes, the staff at the ADX accede; other times, they retaliate with brutality. During one force-feeding, Salameh was given 16 portions of a liquid meal, only to vomit up each one in turn, he said.

This investigation leaves little doubt that many of the human rights abuses perpetrated against hunger strikers at Guantánamo, often to widespread public outrage, are also occurring on American soil on a regular basis. When I asked the BOP to comment about the force-feedings in H Unit, a spokesperson cited agency guidelines: “It is BOP’s responsibility to monitor the health and welfare of inmates and to ensure that procedures are pursued to preserve life.” I also sent the DOJ detailed questions about SAMs and force-feeding; the agency declined to respond. But according to United Nations officials and medical experts, by engaging in force-feedings with the apparent intention of inflicting harm and not just providing treatment, the BOP is violating not only medical ethics but also international law.

It’s for this reason that I didn’t ask Salameh to tell me about his crimes. The harm he caused should not be forgotten, but it must be held apart. Under international law, the right to be free from torture is inalienable and absolute – and that protects all of us.

Florence ADX rests at the foothills of the Rockies, about two hours south of Denver. On the way there, prisoners might see snowcapped mountains in the distance. But as soon as a vehicle pulls into the complex, the vastness of the Colorado landscape disappears, sometimes forever.

According to experts, the ADX subjects prisoners to more extreme conditions of isolation and sensory deprivation than any other facility in the country. Architects designed the prison, which opened in 1994, to deter those locked up from plotting an escape. The cells are made entirely of concrete, with narrow windows that barely let in light. The outdoor recreation cages, each about five steps long and 10 steps wide, are built in an enclosure that resembles an empty swimming pool. Every prisoner spends 22 to 24 hours per day alone.

Salameh’s journey to Colorado began in 1994, when he was convicted of participating in the first World Trade Center attack, which killed six people and injured over 1,000. He served time in several high-security prisons without being subject to communication restrictions, but by 2002, he and a number of other men convicted of terrorism offenses were moved to the ADX.

I first spoke to Salameh in 2017, after he’d been transferred to a different prison. He’d heard that I wanted to write an article about force-feeding in H Unit and offered to tell me his story. It took some months to develop a rapport. Phone calls from the prison cut off after 15 minutes, and prisoners must wait another 30 minutes to call back. “Hello, Ms. Stahl,” he’d say in a soft Jordanian accent. “How are you doing today?” If I mentioned members of my family, he’d ask about them in subsequent calls. After I broke my wrist, he always asked about my health.

On Salameh’s telling, it was the communication restrictions, not his three years under the extreme isolation, that drove him to stop eating. In March 2005, without explanation, a group of guards took him to H Unit and handed him the gags he would live under for 11 years. Aside from his attorney, Salameh could communicate only with his parents and siblings. He could make one phone call each month and send one three-page, double-sided letter each week. The FBI monitored everything. He was barred from TV and radio news, and reading material had to be individually approved. The BOP “should call them punishment or torture, not ‘special administrative measures’ like it’s something nice,” Salameh said with a chuckle. “They are really devastating.” 

The men convicted alongside Salameh went on hunger strike right away to demand that their SAMs be lifted. He was more cautious and thought it through. Raised in Jordan, Salameh was born in Israeli-occupied Biddiya, a small village in the West Bank, and came of age when Palestinians in Israeli prisons were going on repeated hunger strikes  to protest their conditions of confinement. He knew refusing to eat could be an effective means of resistance. Before long, he started his first hunger strike in the depths of the ADX.

The Bureau of Prisons moved to create SAMs in 1996, shortly after the Oklahoma City bombing. The regulations give the attorney general, then Janet Reno, discretion to impose the measures if he or she believes there’s a “substantial risk” that a prisoner’s communications could pose a public threat. The regulations do not require the attorney general to consult a judge, and the attorney general usually justifies the measures on the basis of the prisoner’s conviction – which in Salameh’s case occurred more than a decade earlier. The Department of Justice has never disclosed what criteria it uses to evaluate risk.

After 9/11, the DOJ changed the rules to allow for harsher restrictions and less oversight. The number of prisoners under SAMs began to multiply, from 16 in November 2001 to 30 in 2009 to 51 in June 2017. The vast majority of these individuals have been Muslim, according to a 2017 report  issued by Yale Law School and the Center for Constitutional Rights, which states, “It appears that a major criterion for deciding whom to place under SAMs was not the person’s demonstrated capacity to communicate dangerous information but rather the prisoner’s religion.” 

Salameh doesn’t know for sure, but he has his suspicions about how he ended up under SAMs. In March 2005,  NBC News reported that he had corresponded with some men who were later arrested on terrorism charges. Although he had stopped communicating with the men before their arrest, the story prompted then-Attorney General Alberto Gonzales to take action. By the end of the month, Salameh was living in H Unit and on hunger strike.

His first force-feeding occurred about two weeks later, but the procedures performed on May 5 and 10 distressed him the most. The PA “does not pull the plastic tube after the feeding is completed gently, as a matter of fact, he pulls it out as he is putting it out of a bulls nose!!” wrote Salameh in an official complaint, called an administrative remedy, obtained via a FOIA request. “He was trying hard to force me to stop my hunger strike by any way of means even if he causes me excessive pain.”

Salameh’s 2005 hunger strike lasted 89 days, and he was force-fed 78 times. The feedings stopped when an official pleaded with the men to start eating and asked for 14 days to try to address their demands, Salameh recalled. He and his codefendants decided to give him a chance.

The hunger strike emerged in the late 19th century, as stocks, pillories and other forms of corporal violence gave way to incarceration. Instead of inflicting physical pain, the state wielded power over the criminal body with control, hoping to compel prisoners to change. European and American reformers saw this as progress, yet prisons remained unhappy places. Almost immediately, their inhabitants devised ways to protest their captivity. 

Laura Rovner teaches law at the University of Denver and has represented two men held at the ADX’s H Unit. “The one thing you really have control over when you’re in prison is what you put into your body,” she said. “When everything else is taken away from you and you aren’t heard in any other way, [hunger strikes] are what you have left.”

A hunger striker isn’t suicidal but is willing to risk his life for the sake of a cause. For medical professionals, this distinction is essential. “A hunger strike is not a medical situation. It is a political act,” said Dr. Sondra Crosby, a professor of medicine at Boston University and an expert on force-feeding. As with any other condition, if a hunger striker is competent and understands the risks of declining care, the physician must respect that wish, even if it means watching the patient die.

One of the first known force-feedings took place in 1909 in a jail in Birmingham, England, when a hunger-striking suffragist named Mary Leigh had a tube inserted into her nose and a pint of milk and eggs poured into her body. Many doctors at the time opposed the procedure. In 1914 a physician named Frank Moxon described force-feeding as a “prostitution of the profession” and argued that doctors were violating the Hippocratic oath in the service of prison discipline. By 1975, the World Medical Association adopted its first resolution publicly opposing the practice, yet in the United States, to this day, most courts have held that force-feeding is constitutional, including if it is done to maintain the security of the institution. (The WMA reiterated its opposition to the practice in a 1991 declaration.) Doctors or PAs who force-feed prisoners are unlikely to lose their licenses, but professional organizations have condemned the practice. During the 2013 hunger strikes at Guantánamo, American Medical Association president Jeremy Lazarus said force-feeding violated “core ethical values of the medical profession.”

After his 2005 strike, Salameh said, the officer who got him to start eating failed to obtain the concessions the strikers asked for. Nothing changed: Every morning, he opened his eyes and found himself trapped in the same small box. His solid door had two slots, one for food deliveries and the other for leg shackles, and metal strips at the bottom to prevent prisoners from communicating. The cell contained a bed, desk and stool, all made of concrete, along with a stainless-steel sink and toilet and a 12-inch black-and-white TV. His entire living space – where he ate, slept, read, urinated and defecated – was 8 feet by 10 feet. He could cross it in four steps.

In H Unit, human contact came at the cost of humiliation. In an affidavit, one of Salameh’s codefendants, Nidal Ayyad, said that some men on the unit would put their faces in the toilet and try to talk through the plumbing. “Putting my face in the toilet in order to try to talk with someone is something I’m not willing to do,” he wrote. The men could go years without being touched by someone other than a guard. Besides the rare phone call and visit, months would pass by before they exchanged more than a few words with another person. “How am I supposed to live without speaking to another human being?” another former H Unit prisoner, Uzair Paracha, asked me during a phone call.

The harms of solitary are well documented. Studies have shown long-term isolation can lead to paranoia, hallucinations, hypersensitivity to stimuli and suicide attempts; in 2011, a UN official called for prohibition of the practice in excess of 15 days. According to a lawsuit filed in 2012 and settled in 2016, men at the ADX grew so psychologically unstable from being alone that they smeared feces onto open wounds and swallowed razor blades.

Most prisoners at the ADX – those without SAMs – face fewer constraints on writing letters, accessing news or communicating with others. The additional layers of isolation weighed on the men. Salameh was granted permission to read USA Today, but for his first few years in H Unit, he could read papers no fewer than 30 days old. The ADX was allowed to take 60 business days to mail out a letter in Arabic and 60 days to process an incoming one, so if Salameh wrote to his mother in Jordan in January, he might not hear back before July. He was prohibited from writing directly to prospective attorneys or legal clinics, making it difficult, though not impossible, for him to fight his conditions in court. In a rare victory in 2014, a federal judge ruled that the DOJ violated a SAMs prisoner’s First Amendment rights by “arbitrarily and capriciously” limiting contact with family and friends. According to attorney Paul Wolf, who fought the case, the ruling helped his client but did not affect conditions in H Unit more broadly. 

Salameh’s family went to visit him at ADX just once, in 2012, the year after his father died. His mother came with one of his sisters, whom he hadn’t seen since she was a child. At the time of the visit, she was an adult with a family. When I asked him to tell me about it, he sighed, and when he began to speak, his voice trembled. It was the only time he became emotional during an interview.

Each year around the middle of March, Salameh received a letter stating that his SAMs had been renewed. Despite minor adjustments to the restrictions, there never seemed to be a clear way to get them removed. He filed hundreds of requests and approached guards informally, asking them to intervene. “I received the Special Administrative Measures (SAMs) extension for the third time without any due process or any hearing by [a] Disinterested Committee,” he wrote in an administrative remedy dated July 2007. “These SAMs restrictions are unjustified, unfair, illegal, inhumane, oppressive [and] unconstitutional.” The BOP’s Central Office responded in October, “You may object to the provisions of the SAMs, but as you were appropriately advised, the Bureau merely informs you of the requirements of the SAMs, and ensures the measures are followed,” adding that they would remain in place “until the Attorney General determines it is no longer necessary.”

The men in H Unit were alive, but what did that mean when their connection to the outside world was so tenuous? “Sometimes the unit feels like a graveyard,” wrote Salameh’s codefendant Ayyad in an affidavit. “There is no sound and everyone is in his grave [cell].” Some prisoners believed they would be on the measures until they died. 

Salameh developed a pattern of behavior. He would go on hunger strike for a while, get force-fed, stop and recuperate. Then, he’d start all over again. After the 2005 strike, he stopped demanding that the SAMs be lifted entirely, asking only for increased outside recreation time and permission to make two phones calls per month. In 2006 he went on hunger strike for 72 days and was force-fed about 35 times, he said. He also went on hunger strikes in 2007, 2008, 2009 and 2010. 

Affidavits from current and former prisoners indicate that others have fallen into a similar routine. Two individuals told me another former H Unit prisoner, Eyad Ismoil, was force-fed more than 400 times during his time there.

Salameh conveyed his determination to keep protesting with a line from a poem he translated from Arabic: “Make me drink the bitter cup, but with dignity.” Salameh accepted that he would die in prison; wasn’t that enough? 

Force-feedings occur in other U.S. prisons, too, though it’s unclear how often and where. State facilities have maintained the practice for decades, and over the past few months, The New York Times reported that detainees in ICE custody were force-fed after refusing to eat in protest of their indefinite detention. Just like the BOP, ICE and state prison systems have hunger-strike policies in place guiding how and when the procedure – which they term “involuntary feeding” – should be conducted. Yet experts believe that force-feedings in the H Unit may surpass those at any other.

Robert Hood, now a national-security consultant, was the warden at the ADX from 2002 to 2005, including when Salameh arrived at the facility. During Hood’s more than 20 years working for the BOP, he worked at nine institutions and served as a warden or associate warden at four. He said there were more hunger strikes at the ADX than at other BOP institutions and that those strikes tended to last longer than elsewhere. “To my knowledge, most involuntary feedings at the supermax would have occurred on an H Unit setting,” he said over the phone. When I asked the BOP for data on force-feeding across its facilities, a FOIA officer insisted no such data was kept. However, CBS News reported that as many as 900 “involuntary feedings” were performed on H Unit residents from 2001 to 2007. The BOP did not dispute this finding.

While the men in H Unit were prohibited from speaking to one another, they always figured out when someone else had started a hunger strike. The biggest one Salameh took part in occurred in 2009, when about 10 of 12 H Unit prisoners participated, according to two men who were there. It started after Barack Obama’s inauguration, when a prisoner on the unit requested a copy of his memoir The Audacity of Hope, along with some Islamic texts. The books were denied on national-security grounds. Within a few weeks, Salameh told me, that individual and two others were on hunger strike. Soon, the strike grew. 

Salameh didn’t join in immediately; he was still recovering from his last attempt. But he understood the impulse. He’d been denied many books, including a copy of the 2008 CIA World Factbook. “We were in the worst situation that the BOP could offer,” said Uzair Paracha, another participant. “Things couldn’t get worse for us, and they were not willing to let them get better.”

On May 5, Salameh was ready for another try. He knew what to expect: The first 24 hours would be bearable, until the pain in his stomach began. By the fifth day, he could hardly take it. After a week, his body would adjust. Still, he would grow progressively weaker until all he could do was rest; when he’d stand up, darkness and light would flutter across his vision. 

The Bureau of Prisons considers someone to be on hunger strike after they refuse meals for 72 hours. Once it becomes official, many of the prisoner’s personal belongings are taken, and the medical checkups start. Three times a week, a five-person force team amassed in front of Salameh’s cell, along with a lieutenant, a physician assistant, two guards with cameras and another carrying gear. A member of the force team would then say, “Inmate Salameh, are you willing to submit to the restraints?” If he had the strength, Salameh would walk to the door to be shackled. Then, it was off to the medical observation room – and perhaps, if the medical staff decided it was necessary, the force-feeding chair.

Salameh said the force-feedings in H Unit followed a routine. First, the guards moved him to a black chair. They secured straps around his shins, thighs, and knees and diagonally across his torso to form an X. His wrists were handcuffed behind his back during the feeding, which sometimes lasted hours. Once he was strapped in, the PA would approach with a nasogastric tube, measure it and insert it into Salameh’s nostril, attempting to guide it into his stomach, which was always very painful. On some days, the tube would come out of Salameh’s mouth. “Many, many times,” he said, it would enter his windpipe, and he would start “coughing like someone is choking [me] to death” from the inside. (These episodes cannot be corroborated, as they are not noted in his medical records, which are generally sparse.) By the time he left H Unit, his force-feedings tended to occur much later in the course of his strikes, and less frequently. 

Force-feeding is dangerous. In hunger strikes as early as 1917 and as recently as 1992, prisoners died as a result. The cause of death was usually from the tube being placed into the striker’s trachea instead of the esophagus, so the liquid entered the lungs rather than the stomach, causing the person to suffocate or develop pneumonia. Other complications include abrasions to the nasal tissue, throat, esophagus or lungs. The more frequently the procedure is conducted and the more the prisoner resists it, the greater the risks. In order to ensure Salameh did not die in his care, once the PA believed the tube was in place, he blew air into it using a syringe and listened to Salameh’s belly. Then he would start dripping the liquid meal into the tube. 

One of the most brutal force-feedings Salameh recalls was on March 20, 2006. As the Novasource, the nutritional supplement, trickled into his body, he tightened his stomach and intentionally caused himself to vomit. The PA put a bowl on his lap so the liquid wouldn’t spill onto the floor but did not stop the procedure. After Salameh vomited the first carton of Novasource, the PA poured a second one into the tube, which Salameh vomited again. At first, he vomited intentionally, but then he lost control. “I wished at that time that I can stop, but I couldn’t,” he recalled. Every time the bowl got full, the PA took it and poured the vomit into the toilet, then continued his work. 

According to his medical records, Salameh stared into the camera that was recording the procedure. “Captain, this is for you,” he said. Then he addressed the PA. “The lion does not want to be fed. I will do the same tomorrow if you try to feed me.” (All use-of-force episodes are videotaped and reviewed by senior management. I requested copies of Salameh’s tapes from the BOP and will be challenging the FOIA denial in court.) 

Over the course of 90 minutes, the PA attempted to feed Salameh 16 cartons of Novasource, about a gallon of the liquid, only to have him vomit up each one. About a week later, after several other feedings, Salameh experienced flu-like symptoms and ran a fever – a sign of possible aspiration, which can lead to pneumonia. He was prescribed antibiotics, and the symptoms subsided. Another former H Unit prisoner described a similar incident in which he was overfed to the point of becoming ill. 

After every force-feeding, the men were taken to an empty observation room, where they waited, sometimes for hours, before being allowed to return to their cells. Unlike at Guantánamo, the medical staff at the ADX would conduct daytime feedings during Ramadan, according to Salameh – a policy that he said was designed to “break [us] down.” Crosby, the Boston University force-feeding expert, reviewed Salameh’s records at my request and said there was no medical rationale behind them. “In my opinion, putting 16 cans of Ensure or some kind of nutritional supplement would not only be clinically inappropriate but, it seems to me, with an intent to punish or to cause physical discomfort.” 

At the very least, according to past statements by UN officials, force-feeding as conducted at the ADX would qualify as cruel, inhuman and degrading treatment. “When the circumstances of forced feeding include evidence of an intent to inflict pain and suffering for a purpose like punishment, intimidation or coercion, forced feeding becomes torture,” said Margaret L. Satterthwaite, who teaches international law at New York University. Salameh once told me he would have preferred to be waterboarded rather than force-fed, because the public understands that waterboarding is a form of torture. Force-feeding was done under the guise of benevolence, while its true intent was something far more sinister. “Ask why they torture us. They don’t want to save your life. They want to pressure you to stop your hunger strike.” 

In March 2015, Salameh’s SAMs renewal notification arrived, citing his previous hunger strikes as evidence of his “extremist and violent views.” The year before, an FBI agent testified in federal court that the strikes in H Unit constituted an “Al Qaeda conspiracy.” 

“That’s baloney,” said Salameh of the allegation. “They are trying to undermine our hunger strike,” to draw attention away from conditions the men were trying to protest, he explained. 

The SAMs renewal didn’t stop Salameh from striking again in the fall. After 18 days, he was transferred from H Unit to a medical-observation cell whose walls, he said, were covered in feces. He was force-fed after 34 days and soon resumed eating out of concern the medical staffers weren’t well trained. He didn’t secure his demand for more food rations. “I’m hunger striking for food!” he said, laughing. “It’s funny if you think about it.” 

Based on conversations with five former prisoners and a review of medical records, legal documents and past reporting, from 2005 to 2016, as many as two-thirds of H Unit prisoners participated in hunger strikes. They were collectively force-fed hundreds if not thousands of times. With assistance from lawyers, they won concessions, including more telephone calls, more recreation time, fewer restrictions on outside media and the ability to conduct no-contact visits unshackled. 

But these hunger strikes in H Unit didn’t prompt investigations into conditions there or condemnations from the American Medical Association or calls from elected officials about the need for change. At Guantánamo, said Pardiss Kebriaei, a lawyer with the Center for Constitutional Rights, attorneys could visit their clients on hunger strike, hand their interview notes to government censors and get some version back that could be released. Not so at the ADX. There “the hunger strike is buried,” said Salameh. “Nobody will know about it ... and that helps the government not to give up anything.” 

That’s largely because hunger strikers rely on the media to convey their concerns – and the SAMs make that task all but impossible. In 2013 nearly 30,000 people incarcerated in California went on hunger strike to protest long-term isolation. After about two months and extensive media coverage, they secured substantive policy changes. (The state successfully petitioned a court for legal permission to force-feed prisoners, but there is no indication force-feedings later took place.) 

SAMs gag those best equipped to help prisoners speak out, like lawyers and family members. “It was as if from that moment [when the restrictions were imposed], the government decided that he ceased to exist,” said the sister of a former H Unit prisoner. “I could talk about him in the past tense but not in the present tense. I could talk about who he was but not who he is.” 

The SAMs also make reporting about life in H Unit extraordinarily difficult. Nearly all the former H Unit prisoners I spoke to worried our conversations could land them back at the ADX. Salameh was put on communication restrictions for a period during my reporting and suspects it was due to our contact. Former SAMs prisoners are not restricted from speaking about their past, but out of caution, most lawyers opt not to talk about what happened to their clients on SAMs, even after the measures have been lifted – which makes reporting on the prisons even harder. Since 9/11, journalists have been denied entry to the ADX facility almost without exception. Not even the UN special rapporteur on torture has been allowed in. 

In March 2016, after years of legal challenges from his attorney, Salameh learned his SAMs would not be renewed. The news was a relief: His mental health had started deteriorating, to the extent that he’d asked for psychiatric care. Today he’s at USP Big Sandy, a high-security prison in Kentucky. The trauma of H Unit comes back to him in his dreams. But whatever violence he has endured, and whatever violence he may have caused, life goes on. In November 2017 Salameh’s sister gave birth to twins. When we spoke, he said they were “beautiful babies,” and his voice was full of light. Then came the humor: “I was thinking maybe they can name one of them ... after me, but they already named them.” 

As the time for the publication of this article neared, Salameh disclosed he’d been advised to use a pseudonym out of concern he might face retaliation from BOP staff. But he decided to risk it; he said there’s intrinsic value in bringing these long-buried truths to light. “For me, it is history,” he once told me. “It needs to be known.” 


Aviva Stahl is a Brooklyn-based investigative journalist who covers criminal justice, transphobia and Islamophobia. Her work has appeared in The Guardian, Harper’s Magazine and The Intercept, among other publications. Follow her on Twitter @Stahlidarity.

This article was originally published by The Nation ( on June 4, 2019, and reported in partnership with Type Investigations with support from the Fund for Constitutional Government and the Puffin Foundation. Reprinted with permission, with minor edits. Copyright, The Nation Company, LLC 2019.

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