Doctors Petition UK Home Secretary Over Julian Assange
November 23, 2019
Doctors from around the world have written an open letter to the UK home
secretary about the plight of the WikiLeaks' publisher in London's Belmarsh
prison.
Open Letter to UK Home Secretary Priti Patel
and Shadow Home Secretary Diane Abbott
We write this open letter, as medical doctors, to express our serious
concerns about the physical and mental health of Julian Assange. Our
professional concerns follow publication recently of the harrowing
eyewitness accounts of Craig Murray and John Pilger of the case management
hearing on Monday 21 October 2019 at Westminster Magistrates Court. The
hearing related to the upcoming February 2020 hearing of the request by the
US government for Mr Assange's extradition to the US in relation to his work
as a publisher of information, including information about alleged crimes of
the US government.
Our concerns were further heightened by the publication on 1 November 2019
of a further report of Nils Melzer, the United Nations Special Rapporteur on
Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, in
which he stated: 'Unless the UK urgently changes course and alleviates his
inhumane situation, Mr Assange's continued exposure to arbitrariness and
abuse may soon end up costing his life.'
Having entered the Ecuadorian Embassy in London on 19 June 2012, Mr Assange
sought and was granted political asylum by the Ecuadorian government. On 11
April 2019, he was removed from the Embassy and arrested by the Metropolitan
Police. He was subsequently detained in Belmarsh maximum security prison, in
what Mr Melzer described as 'oppressive conditions of isolation and
surveillance.'
During the seven years spent in the Embassy in confined living conditions,
Mr Assange was visited and examined by a number of experts each of whom
expressed alarm at the state of his health and requested that he be allowed
access to a hospital. No such access was permitted. Mr Assange was unable to
exercise his right to free and necessary expert medical assessment and
treatment throughout the seven-year period.
Julian Assange
A chronology, based on information available to the public, of relevant
visits, events and reports from a medical perspective follows:
.On 31 July 2015, a dentist reported that Mr Assange's 'upper right first
premolar (UR4) tooth had fractured along with the filling that was in it and
the dental pulp of the tooth was exposed' and 'that failure to treat this
promptly would lead to infection of the root leading to a dental abscess and
pain.' The dentist advised 'saving this tooth would require root canal
treatment', however, 'due to the specialised equipment and radiographic
requirements this treatment could not be completed in the domiciliary
setting.' 'Extraction of the tooth' was identified as 'another option but
[.] it may need a surgical extraction.' This was 'not recommended in a
domiciliary setting especially as we would need preoperative radiographs to
assess the root shape and the proximity of the root to the floor of the
maxillary sinus. Extractions in this area carry a risk of creating a
communication between the mouth and the sinus which could need surgical
closure hence radiographs would be essential to assess this risk.' The
dentist 'advised Mr Assange he should seek treatment in a clinical setting
to prevent further progression of his symptoms as soon as possible.'1
.On 4 December 2015, an opinion of the United Nations Working Group on
Arbitrary Detention (UNWGAD) was formally adopted and it was published on 5
February 2016. It concluded that Mr Assange was being arbitrarily detained
by the governments of the UK and Sweden. Crucially, it was made clear at the
time that any continued arbitrary detention of Mr Assange would constitute
torture. The group concluded that 'the Embassy of Ecuador in London is far
less than a house or detention centre equipped for prolonged pretrial
detention and lacks appropriate and necessary medical equipment or
facilities - it is valid to assume, after five years of deprivation of
liberty, that Mr Assange's health could have deteriorated to such a level
that anything more than a superficial illness would put his health at a
serious risk, and he was denied access to a medical institution for a proper
diagnosis, including a magnetic resonance imaging test.'2
.On 8 December 2015, a doctor who saw Mr Assange reported: 'progressive
inflammation and stiffness affecting his right shoulder. This requires an
MRI scan to determine the exact diagnosis in order to inform a suitably
qualified physiotherapist as to how best to treat him in an appropriately
equipped medical facility. His current circumstances significantly
compromise the ability to satisfactorily investigate and treat him.'3 Mr
Assange was refused access to a hospital by the Foreign and Commonwealth
Office.4
.On 11 December 2015, a further doctor, a trauma and psychosocial expert,
reported: 'Mr Assange scored 15 out of 20 on the Patient Health
Questionnaire [.] a multipurpose instrument for screening, diagnosing,
monitoring and measuring the severity of depression. [.] A score of 15
indicates that Mr Assange suffers from Major Depression (moderately
severe)'; 'At a minimum, it is recommended that his urgent medical
complaints regarding the pain in his shoulder be investigated with
appropriate equipment'; 'The Embassy is not a medical setting. The only way
Mr Assange can access either urgent medical care or investigations would be
to place himself in the hands of the British authorities. Mr Assange is in
an invidious position of having to decide between his physical health and
the risk of being extradited to the United States. His inability to access
proper medical care and assessment - without placing himself into the hands
of the authorities - transforms each physical complaint no matter how simple
into something that could have catastrophic consequences either for his
health or his liberty. He lives in a state of chronic health insecurity';
and 'The unusual circumstances place Mr Assange in a precarious situation.
The effects of the situation on Mr Assange's health and well-being are
serious and the risks will most certainly escalate with the potential to
becoming life threatening if current conditions persist.'5
Home Secretary Priti Patel
.In October 2017, Doctors Sondra S. Crosby, Brock Chisholm and Sean Love
visited Mr Assange.6 The group examined him for 20 hours over Three days.7
In an article for the Guardian published on 24 January 2018 they wrote: 'We
examined Julian Assange, and he badly needs care - but he can't get it'; 'We
call on the British Medical Association and colleagues in the UK to demand
safe access to medical care for Mr Assange and to oppose openly the ongoing
violations of his human right to healthcare.'8
.On 19 June 2018, Dinah PoKempner, General Counsel at Human Rights Watch,
stated: 'Concern is growing over his access to medical care. His asylum is
growing more and more difficult to distinguish from detention. The UK has
the power to resolve concerns over his isolation, health, and confinement by
removing the threat of extradition for publishing newsworthy leaks.'9
.On 22 June 2018, Dr Sean Love, who over the course of the previous year had
visited Mr Assange several times at the Ecuadorian embassy, reiterated his
concerns regarding Mr Assange's health and repeated his call in the British
Medical Journal for him to be given access to healthcare.10 Dr Love wrote
that 'Assange's detention continues to cause a precipitous deterioration in
his overall condition' and that 'Because of his health issues, in 2015,
Ecuadorian authorities requested that he be permitted humanitarian safe
passage to a hospital in London; however, this was denied by the UK.' Dr
Love stated that 'To this day, Assange remains unable to access hospital
based diagnostic testing and treatment-even for a medical emergency. In
effect, he has gone without proper access to care for the duration of his
six years in confinement.'
.On 21 December 2018, the United Nations Working Group on Arbitrary
Detention (UNWGAD) issued a further statement opposing the continued
unlawful detention of Mr Assange: 'States that are based upon and promote
the rule of law do not like to be confronted with their own violations of
the law, that is understandable. But when they honestly admit these
violations, they do honour the very spirit of the rule of law, earn enhanced
respect for doing so, and set worldwide commendable examples.' It added:
'The WGAD is further concerned that the modalities of the continued
arbitrary deprivation of liberty of Mr Assange is undermining his health,
and may possibly endanger his life given the disproportionate amount of
anxiety and stress that such prolonged deprivation of liberty entails.'11
.On 5 April 2019, Nils Melzer, the United Nations Special Rapporteur on
Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment,
issued a statement following reports that Mr Assange may soon be expelled
from the Ecuadorian Embassy. He said, 'According to information I have
received, Mr Assange is at risk of extreme vulnerability, and his health is
in serious decline. I therefore appeal to the Ecuadorian authorities to
continue to provide him, to the fullest extent possible in the
circumstances, with adequate living conditions and access to appropriate
medical care.'12 On 11 April 2019, Mr Assange was expelled from the Embassy
and arrested by the Metropolitan Police.
.On 1 May 2019, Mr Assange was described as suffering from 'moderate to
severe depression' at a hearing at Southwark Crown Court at which he was
sentenced to 50 weeks imprisonment for a bail infringement dating back to
2012.13
.On 3 May 2019, the UN Working Group on Arbitrary Detention issued a
statement noting it was 'deeply concerned' over Assange's 50 weeks
imprisonment. 'The Working Group regrets that the Government has not
complied with its Opinion and has now furthered the arbitrary deprivation of
liberty of Mr Assange.14
.On 9 May 2019, Mr Melzer, the UN Special Rapporteur on Torture and Other
Cruel, Inhuman or Degrading Treatment or Punishment, visited Belmarsh prison
accompanied by two medical experts, with special expertise in assessing
victims of torture. This involved a 60-minute conversation with Mr Assange,
an hour-long physical examination and a two-hour psychiatric examination.
.On 23 May 2019, the US government brought charges under the Espionage Act
of 1917 against Mr Assange for his publishing activities on behalf of
WikiLeaks. On 29 May 2019, Mr Assange was moved to the 'hospital wing' at
Belmarsh prison following a reported significant deterioration in his
health. On 30 May 2019, Mr Assange was too unwell to appear in court, even
via video link, for a preliminary extradition hearing.15 It should be noted
that the medical facilities and staffing at Belmarsh prison 'hospital wing'
have never been divulged to the public.
.On 31 May 2019, Mr Melzer, the UN Special Rapporteur on Torture, reported
on his 9 May 2019 visit to Mr Assange, 'we all came to the conclusion that
he showed all the symptoms that are typical for a person that has been
exposed to psychological torture over an extended period of time.'16
.On 22 October 2019, Craig Murray, a former British Ambassador, published a
detailed and shocking eye witness account of Mr Assange's hearing the
previous day, stating that he 'exhibited exactly the symptoms of a torture
victim.'17 His report was corroborated by the eyewitness account of John
Pilger, the renowned investigative journalist and filmmaker.18
.On 1 November 2019, UN Special Rapporteur on Torture Nils Melzer reiterated
his alarm at the continued deterioration of Julian Assange's health since
his arrest and detention earlier this year, saying his life was now at risk.
Mr Melzer said, 'What we have seen from the UK Government is outright
contempt for Mr Assange's rights and integrity,' and 'Despite the medical
urgency of my appeal, and the seriousness of the alleged violations, the UK
has not undertaken any measures of investigation, prevention and redress
required under international law.' Mr Melzer concluded: 'Unless the UK
urgently changes course and alleviates his inhumane situation, Mr Assange's
continued exposure to arbitrariness and abuse may soon end up costing his
life.'19
Nils Melzer (UN Photo)
Medical doctors have a professional duty to report suspected torture of
which they become aware, wherever it may be occurring. That professional
duty is absolute and must be carried out regardless of risk to reporting
doctors. We wish to put on record, as medical doctors, our collective
serious concerns and to draw the attention of the public and the world to
this grave situation.
The World Health Organisation Constitution of 1946 envisages 'the highest
attainable standard of health as a fundamental right of every human
being.'20 We are indebted to those who have sought to uphold this right in
the case of Mr Assange.
From a medical point of view, on the evidence currently available, we have
serious concerns about Mr Assange's fitness to stand trial in February 2020.
Most importantly, it is our opinion that Mr Assange requires urgent expert
medical assessment of both his physical and psychological state of health.
Any medical treatment indicated should be administered in a properly
equipped and expertly staffed university teaching hospital (tertiary care).
Were such urgent assessment and treatment not to take place, we have real
concerns, on the evidence currently available, that Mr Assange could die in
prison. The medical situation is thereby urgent. There is no time to lose.
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