Settling Gitmo Detainees in the U.S., Very Unsettling

Here we go again…

khalid Sheik Mohammed - There goes the neighborhoodThe prospect of a moving Gitmo prisoners to alternate locations in the U. S. has again raised its ugly head. This action whether based on political or economic interests is one which should be carefully considered. Some years ago I wrote several articles questioning such a move. One for the Examiner;  was ironically titled “Gitmo Detainees to Rural Mid-America – Illinois Bound?”.  And another from 16 September 2009. And one from July 2009 on our old blog. The point is that we have all been through this ad nauseam.

At one point in my military healthcare career, I was assigned to the Military Disciplinary Barracks (USDB) in Leavenworth Kansas and was subsequently assigned to the Army Hospital at Fort Leavenworth. Leavenworth Kansas is also the home of the high profile Federal Prison facility; between the two have been housed the most dangerous criminals in the nation. These facilities are and have been an important source of employment and revenue to the area.

To our knowledge, there have been no recent escapes from Leavenworth Lock-ups. One would assume that this community would welcome an increase in numbers for their thriving enterprise. In the past, the community has been challenged by the occasional group of prisoners’ relatives and other miscreants who follow some of the most celebrated guests. The more notorious, the greater the attention from the outside. Even so, up to this point serious attempts to free the incarcerated have not materialized. The community’s faith in the prison system is unshakable. Keeping terrorist detainees behind bars was not in question when this was first debated three years ago, the concern was the specter of large groups of family and potential terrorist sympathizers living among them and threatening their community. This concern outweighed the potential economic gains in several locations.

The idea of a Gitmo-North in Manhattan received a lot of well-deserved resistance.

A new home in Illinois where a new prison just happened to be available for Gitmo-Mid-America, recently purchased by the Federal government, poses the same set of concerns expressed by the good citizens of Leavenworth Kansas.

Guantanimo PrisonOur immediate concern relates to the Public health and Healthcare sector’s lack of preparedness for the additional threats that accompany such moves. Hospitals and healthcare locations have long been considered soft and desirable places –  to be used as escape routes. As the healthcare industry scrambles to reduce “costs”, the reduction of physical safety and security is a prime target. Violence in the healthcare workplace is four times as great as other service-related locations. Threats go up, and physical safety and security go down. Movement of Gitmo detainees to any location in the United States would be a “self-inflicted additional risk”.

The Fort Leavenworth USDB Policies and Practices for the transfer of hardened criminals from prison site to hospitals and healthcare sites is the world’s best. At the time, everyone was convinced that the hospital had all their bases covered for any event. The hospital’s prison ward was a virtual fortress. Back-up security personnel at the USDB were 5 minutes away.

Emergency management protocols for the movement of hospitalized inmates called for a one-on-one prison guard to inmate ratio when evacuating (in the case of tornado) to the hospital’s basement. There were two prisoners in the prison ward and two guards. An anxious call to the USDB for an extra guard met with a response that the tornado had resulted in downed trees and other debris blocked access to the hospital. This happened at a time that both prisoners were very dangerous prisoners with life sentences.*

Sold to the US TaxpayerMost prisons have a limited healthcare delivery capacity, and it is common practice for local hospitals to contract for the care of inmates when their condition exceeds the prison’s healthcare capacity. Hospitals are viewed as soft on security and criminals take advantage of the vulnerabilities in the system to escape. One of the lessons learned during the 2009 “Novel Flu” event was that those Hospitals and Healthcare organizations located in proximity to prisons have underestimated the impact of their contract responsibilities to provide care for prison populations.  And against a small, determined group with assault rifles?

Prison populations are extremely vulnerable to pandemic-like threats. Large numbers of inmates have multiple disease exposures (HIV, TB, etc.) which make them at greater risk than the population in general. During the 2009 “Novel Flu” event, prisoners were given a higher priority for limited vaccines, receiving the vaccines before local school districts.

The healthcare system is ill-prepared to deal its’ extant forensic populations. These inmates are at least restrained by a will to survive which would not be the case in dealing with others who wish to do us harm.

Setting aside the legal issues of access to community healthcare, the security issues posed by bringing these terrorists into the country and unsecure healthcare facilities, presents a considerable and avoidable risk to the trusting public.

Doing this under the guise of fulfilling a political promise or reducing future government expenditures defies credibility.

*The rest of the story- The hospital had a 24/7 list of USDB Security Guard patients in house, two were well enough to escort inmates to the basement.