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Senate Report on CIA Torture

Rectal Rehydration

“Rectal rehydration,” also referred to as “rectal feeding,” involved inserting a tube into detainees’ anal passage and “feeding” them. Sometimes this was done in response to a hunger strike and at other times was used as a means of “behavior control.” “At least five CIA detainees were subjected to ‘rectal rehydration’ or rectal feeding without documented medical necessity.” These detainees were: Abd al-Rahim al-Nashiri, Khalid Sheikh Mohammad (KSM), Majid Khan, Abu Zubaydah, and Marwan al-Jabbur.

Descriptions of “rectal rehydration” are provided for two detainees, Abd al-Rahim al-Nashiri and Majid Kahn. For al-Nashiri, the nutrient supplement Ensure “was infused into al-Nashiri ‘in a forward-facing position with head lower than torso.'” Majid Kahn was rectally fed two bottles of Ensure and “[l]ater that same day, Majid Kahn’s ‘lunch tray’ of hummus, pasta with sauce, nuts, and raisins was ‘pureed’ and rectally infused.”

The CIA “defends the use of rectal rehydration as a ‘well acknowledged medical technique.’” However, “detainees were subjected to rectal rehydration, without evidence of medical necessity,” and medical experts say that it is never medically necessary, “since the rectum is an inefficient way to absorb nutrients.” The risks from rectal rehydration “include damage to the rectum and colon, triggering bowels to empty, food rotting inside the recipient’s digestive tract, and an inflamed or prolapsed rectum from carless insertion of the feeding tube. Detainees “Ramzi bin al-Shibh, Walid bin Attash and Adnan al-Libi were threatened with rectal rehydration,” further undermining the CIA’s claim that its use was purely medical.

The report notes that “CIA medical officers discussed rectal rehydration as a means of behavior control.” In KSM’s case, the CIA “Chief of Interrogations…ordered the rectal rehydration of KSM without a determination of medical need, a procedure that the chief of interrogations would later characterize as illustrative of the interrogator’s ‘total control over the detainee.’” In some cases rectal rehydration was used before it was authorized by CIA Headquarters, but “Headquarters failed to respond, inquire, or investigate.”