The problems with that approach became clear in October 2017 when, according to emails released through the courts, a visiting surgeon tried to fuse the spine at the neck of a detainee, Abd al Hadi al Iraqi. A doctor at the hospital declared the operation a failure and said the best course of action would be to transport Mr. Hadi to a naval hospital in Portsmouth, Va., “or any medical center that has the support systems in place to perform these complex procedures.”
The doctor notified the prison commander at the time, Rear Adm. Edward Cashman, that the prospect of doing such a complicated operation at the Guantánamo base hospital “scares the hell out of me.” Guantánamo medical personnel, at the admiral’s request, then figured out what it would take to medevac Mr. Hadi from the base.
Admiral Cashman never sought permission to move Mr. Hadi, said Col. Amanda Azubuike of the Army, a spokeswoman for the United States Southern Command, which oversees the prison. She called the discussion of airlifting Mr. Hadi “part of medical mission analysis/brainstorming.”
Mr. Hadi ultimately underwent five spine operations at Guantánamo, all by visiting surgical teams. He has experienced chronic pain and back spasms in the aftermath, and prison officials have set up a hospital bed at the court complex where he is to face trial on charges he commanded Al Qaeda and Taliban forces in Afghanistan in 2003 and 2004.
Raha Wala, the senior director of governmental affairs at Human Rights First, an advocacy group, said the health care transfer provision would be consistent with the Defense Department’s “obligations under the Geneva Conventions to provide adequate medical care” to its war prisoners.
So far, he noted, it has never gotten further than conference committees because “Congress has not been particularly interested in having a fight about Gitmo.”
This year should be different, Mr. Wala said, because Mr. Smith, the chairman of the House Armed Services Committee, has consistently sponsored amendments to lift transfer restrictions.
“As the detainees are aging, we are going to increasingly see acute medical emergencies that are going to require, frankly, treatment that isn’t available at Guantánamo,” Mr. Wala said. ”Having the ability to be able to transfer someone out for urgent medical treatment is quite important. A detainee’s life could be at risk if the authority isn’t granted.”