Sunday, February 14, 2016

Fail Caesar Part 6-C: Torturing to Kill Thousands and Trying to Save a Few?

Fail "Caesar" Part 6C
"Torturing to Kill" Thousands and Trying to Save a Few?
February 14, 2016
(incomplete - last edits May 9, 2016)


<< Part 6: Evidence the Victims Were NOT Prisoners of the Government 

It's said they clearly illustrate the systematic elimination, even "genocide," of people taken priosner by a deranged Syrian government. But one of the stronger points illustrating that the "Caesar" photos do NOT show that is how several victims display signs that a professional medical staff encountered that person, and treated their life-threatening problems, but in the end the person dies. There are two main options for the middle part, and it's contested:

1) as argued by "Caesar" and others: these were tortured detainees or people injured otherwise, who were stabilized, then were arrested or taken back, with devices intact, abused and tortured and caused new problems that were finally fatal.
2)  the abuse was done in unknown (likely terrorist-run) locations, the victims were left for dead with others who were dead, the life-saving measures came after that and just failed.

Hospital Abductions?
The SNHR report, speaking to "Caesar" and others, decided "some bodies  still had medical tubes attached to (them) which proves that the victims were arrested while receiving treatment in a hospital." (p 13, point 17). He says some victims were "treated" at the trauma department of Military Hospital 601 (also called Martyr Youssef Al-Adhma Hospital, at the garage of which the photos were taken),  but not due to abduction from there: "Some detainees died in the Trauma Department while they were being treated." (p. 6)

... the "trauma department" the same report describes as built decades ago and abandoned until 2011, when it was transformed into a detention center of horrors. It had medical aspects, but  doctors were not allowed to do most care, with guards (all security forces members) were left in charge of dressing wounds, installing catheters, and injecting people. This was done "to increase the detainees' torment,"  so many died in the hospital from medical negligence.

Further, they heard, "executions at the trauma hospital happened at night after dinner was served," and through the walls other prisoners they spoke to could "hear the battering sounds" of baton on flesh until the person died. Cleaners would "untangle the detainee from the metal chains..."  and bodies were then stuffed into the bathrooms. (p 6 ) Of the 250-350 bodies total hauled every 3-4 days from the Hospital 601 garage, most were "from different security branches" but there were "two or three victims from the Trauma Department daily." (p. 15)

There's no need to abduct from THIS hospital to kill - it must have been elsewhere there were successful or professional efforts to help people. At least, according to those sources... Their "Trauma Department" sounds like a euphemism for another alleged place in the hospital, and not the actual, functioning center one would expect to handle violent trauma - at a military hospital - in the capitol city of a nation plunged into a brutal sort of conflict.

Outside of opposition activist ... should be a normal medical facility in that it tries to save people, perhaps like the one described by the OPCW's investigators after a visit there (report PDF via The Trench). They  visited in May and August, 2015 to investigate ten alleged chemical attacks by rebel forces in the Damascus area against government troops (allegedly using chlorine, sarin, and other), and just in a five-month span from April to September, 2014 - this hospital treated 92 military casualties (not fatalities), showed the investigators the records, some of which were missing due to data storage limitations, and facilitated interviews (they did not conclude chemical weapons were used, though it seems likely).

The OPCW report makes no mention specifically of visiting a "trauma department" there. Maybe that really was the festering pit of human misery the "witnesses" described? If so, they wouldn't be taken there.

According to the photos ... we see treatment that seems to be recent, and came after the displayed abuses - one set of people harmed these victims, while someone else tried to save them. Being seen after all that at the garage behind  hospital 601, proximity suggests, it was medics at hospital 601 that tried to save them.

Feeding Tubes/Central Venous Catheters
Let's start with one of the more visible indicators one might find, and it's been found in five cases so far. First  j-5063-24-6-2013 (the "j" says he's another AF intelligence victim). I've been trying not to share the SAFMCD photos, but this below is just from a screen grab, preview size, to illustrate this point. Same for any others after that.

He appears moderately starved, but that wasn't the cause of death. He has dried mucous in his mouth and nose, and some redness, but these signs too are mild. And it doesn't seem any of this was totally fatal - a medically knowledgeable source tells me this victim  appears to have a central venous catheter inserted. This (right under the SAFMCD logo on the right side of his neck (our left)) is for intravenous feeding, for those unable to eat the regular way. As the source explains:
"...  In this procedure, a flexible plastic cannula with needle is inserted into a vein  above or below the collarbone, and pushed down (after withdrawing the needle) into the superior vena cava (large vein running from neck to heart).   This is a highly skilled procedure - an anesthesiologist or ICU specialist would probably be the one to carry it out." 
A CV catheter (or cannula) has other uses as well...
Intravenous feeding is only one of several possible indications for a central venous cannula.  It might be their standard procedure for anyone admitted to the intensive care unit (guaranteed access to the circulation, can be left in for a week or more, and allows measurement of the filling pressure in the heart).
For whatever reason, this procedure will be done:
* After starvation or depletion (perhaps by captors) and/or other medical problems.
* After coming into the care, usually, of decent people with medical training and good equipment. The job appears relatively professional, and would usually happen in ICU or perhaps trauma department.
* Before death. You can't feed a corpse.

So for the above example, these are the main logical options:
A) abuse round 1 of starvation, or maybe a fit young man in a siege area unable to feed himself - gets to the hospital somehow, is treated - then is abducted from the hospital and somehow killed, in abuse round 1 or 2 depending - causing no visible wounds or bleeding, and with the tube still in - brought (back?) to this hospital to document and cover up
B) he was starved and mostly-killed in one round, found alive and given the tube here, but died anyway and was documented here as unidentified.

Clearly the second option makes more sense.

My source says other victims seen with such a tube near their neck likely have the same, even if we can't see the connection. Here's a starved man blamed on branch 248 with tubing around his neck. The adjacent entry wears a surgical mask; this might suggest a hospital abduction, or be set up to suggest that.

Two other examples are in the j folder - one is less clear on the connection:  j-8005 (000 folder, possibly Jan. 2013) is a bearded older man, seeming fairly emaciated (right). He also displays skin redness, yellow stains on one side, and eye damage, all consistent with the most common type of chemical exposure seen in the photos. But he was apparently found alive. The tubes out seem to contain blood, but the insertion point is covered with gauze.

J-1198 (4-6-2013) is a fit, clean-shaven younger man, who has a central venous cannula, but connected to the jugular vein, this time on his left. However he clearly wasn't starved much if at all, so there must have been another reason ... he has dried blood in the nose, traces on the lips, possible cyanosis evident in the eyes, so possibly one of the victims of a mystery chemical that seems to cause this - like 8005 above, he may have suffered acute inhalation injury, as it's properly called, to the mouth and airways. This makes normal feeding difficult. And although he doesn't appear emaciated, everyone need nutrients eventually ...

In other cases, maybe where lesser nutrient loads are required, the feeding tube is attached to the arm instead (could apply above, but ...). Victim 215-1002 seems starved, like many but not all in his stretch. A victim next to him on the left has a venous cannula and an injection port, apparently in the left arm.  It's not clear who that is. Adjacent victim 1001 is severely emaciated, but 1003 hasn't been located and 1003 is also lean. And it could well be someone else right next to him - as we can see, they don't have to be emaciated.
 
 
Another victim, identified as Mohammad Jnaid al-Qiq from Daraa (VDC entry) is listed by SAFMCD as victim 003 of unknown branch and has 2 photos - 332781 (photo1) and 644748 (photo 22, shown), both dated 11-2011 - one of the earliest victims. This is another jugular-connected catheter like J-1198. 





Breathing Assistance
The bandage round the neck of j-9088 (2-2013) looks as if it might have been holding a tracheotomy tube in place, most likely due to a neck injury that left him unable to breathe well. But when he was found face-down (after some time, dumped), he was still alive enough to bother with this procedure. perhaps to allow keeping the patient on a ventilator.

Who found him and went to all this hassle to correct what would have been a fatal condition? Again, if just by proximity, someone at or connected to Hospital 601 is the most logical guess. So is it injury-hospital-abduction-murder? Or is it just delayed death from the first?

And then ...227-694 (folder: 1-7-2012 - right: cropped, rotated, enhanced a bit) has purple skin and swollen eyes, and blood coming from the mouth and nose, probably related to the breathing problems treated with the tube into his mouth.

The patient's build is solid, perhaps larger than average - the kind who might wind up as the survivor in a pile of bodies. It seems likely he was a victim of acute inhalation injury from breathing toxic material, who survived the initial exposure but later developed pulmonary edema. This was apparently treated, but unsuccessfully - and it was probably in hospital 601. For clarity, this photo - unlike the others - was taken in what looks like a hospital setting, but in pretty dark conditions. 

Other
Majid Abu Draa of the contested branch - seen in hospital (SNHR stamped photo, right) has injuries treated as one would for a living person - three bandages, one on the side and one on each shoulder and cream applied to a badly burned right hand. He also has electrodes attached, likely for heart testing - that might be what got them going on the rest. But the tests came back negative before they got to anything as involved as a CV catheter.

Or ... did someone do all this for him, and then he was dragged away and killed, with all these delicate touches left in place, down to the hand cream?

And finally, the woman victim Rihab Allawi has a tube in her left arm - maybe to administer drugs (she seems in no need of feeding). She also, as noted at the linked profile, seems possibly alive in the photos, if possibly drugged... Anyway, she was reported killed weeks after abduction from her home, not from a hospital.

The Exception, and the Rule
There is at least one case that's a more logical fit with the hospital abduction narrative; as covered ..., 251-3836 - had some bad luck (unclear) but that improved with a cv catheter installed at the collarbone. But then he died anyway, and somewhere along the way his body was taken somewhere less caring, and left rotting in slime.

But that exception and its own questions aside, these signs of medical intervention argue strongly against the victims being government-held prisoners. Instead, they suggest large numbers of recently-killed people were found, a small few of whom were actually not quite dead.

Others that clearly don't appear here might have started in that category, and then pulled through to recovery and a return home. HRW claims to know what they'd say "if the dead could speak," based largely on what the defector from Hospital 601 said. But I bet they never asked the people who still work there ... maybe some of "the dead" could speak, and gave their own explanation how they and the other got this way. We haven't heard any such news, but of course we probably wouldn't. 

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