Talk:Hunger strike (in prison)

Medical
About the hunger strike of Hassan Almrei (Muslim detainee in Toronto, June-August 2004): I have been asked for advice about similar strikes in US prisons, and really have no clue. I just ran off malnutrition signs (which include liver toxicity due to hydrolysis? of protein once fat reserves get low.) I wonder if my info (which is about chronic anorexia nervosa) applies to hunger strikes?

Cigarettes, alcohol, and coffee are also implicated in liver toxicity, and particularly at-risk are prisoners, alcoholics, sex workers, or users of crack or injectable drugs who are at higher risk for hepatitis. Other at-risk folks: diabetics, people with compromised immune systems, people with heart disease or kidney disease, people over 65.

Supportive care (again, for anorexia ... don't know enough about hunger strikes specif.) is to discourage toxin intake, even if it is appetite suppressant, encourage massive clean water intake to aid in eliminating toxins / help the liver, and if available, encourage bitter herbs (in tea or tincture) such as dandelion, burdock, (but NOT milk thistle) to support and clean the liver. Also, some strikers will eat no solid food, but drink nutritious fluids like broth, pedialyte, or liquid jell-o. That will also support their health for longer, and keep their body from breaking down proteins for longer (which leads to ketoacidosis).

In the US federal prison system, prison doctors sort of watch hunger strikers, and when they start to show some signs (I don't know what), initiate IV or suppository force-feeding. One good side to hunger strikes is that when people in administrative segregation (control units / protective custody / solitary confinement) hunger strike, they sometimes get a spot in the infirmary (out of isolation!).

Lots of times hunger aggravates social conflict. Strikers need to be really clear that they all agree on what the terms of the strike are (what intake they are avoiding specifically, what terms will make them quit their fast.)



Signs of longer-term not eating
 * weight loss of 15% or greater below the expected weight
 * absence of menstruation
 * skeletal muscle atrophy
 * loss of fatty tissue
 * low blood pressure
 * blotchy or yellow skin

Complications from longer-term not eating The presence of any of these suggests a severe disease, and hospitalization may be required:
 * severe dehydration, possibly leading to cardiovascular shock
 * electrolyte imbalance (such as potassium insufficiency)
 * cardiac arrhythmias related to the loss of cardiac muscle and electrolyte imbalance
 * severe malnutrition
 * thyroid gland deficiencies which can lead to cold intolerance and constipation
 * appearance of fine baby-like body hair (lanugo)
 * bloating or edema
 * decrease in white blood cells which leads to increased susceptibility to infection
 * osteoporosis

What's important for a support person to do is force the prison to allow an outside Doctor to check up on the prisoner as part of a campaign to bring pressure on the prison.

Post-hunger strike healthcare info. After Danny's 60 day strike, the guards fucked with him by taking all his liquids so that his diet was only concentrated ice cream mix (with no water), and he ended up in the hospital real bad with blocked or ruptured bowels. After the six-day death fast, they sprayed a full canister (1 gram) of OC pepper spray on his food; his mouth and esophagus erupted in blisters from second-degree chemical burns. So we're not providing care or working in good situation; we're more advocates than anything else. We help doctors + lawyers + campaigns flourish; demands get met and the prisoner lives.

Trying to get Dan's medical records released....

Gobblehook 09:10, 27 October 2006 (UTC)

Advocacy
Assessment and advocacy are two things that need to be done

> the ability to receive calls from prisoners, > basic assessment form, > baseline of info about how to get medical aid for hunger strikers

It seems there's 10 prisoner hunger strikes for every free-world hunger strike, and it is harder to get care info in the class/physical situation of a prisoner. That's why my focus is there.

Getting a Doctor there is about the most important thing for medical support to do DURING the hunger strike. Because prison Docs are usually collaborators who fabricate shit. You think regular Docs are bad and uncaring + concerned with profit, you should see some of the scumbags who get their license yanked and then go to another state and work in a correctional facility. Not to mention LPNs "doing physicals" and handing down "diagnoses" for some scumbag Doc to sign off on as their own work.

Or the Doc in Louisiana who signed that he checked on 22 year-old Shawn Duncan in five-point restraints every 12 hours (and the Deputies who signed that they checked on him every 15 minutes), but didn’t notice that Shawn was not allowed to use the bathroom or given water for 42 hours, didn’t notice when he began yelling, screaming, and thrashing, and finally were notified by another prisoner that he had died (the autopsy found that he died of dehydration). (Reference: http://www.aclu.org/pdfs/prison/OPP1.pdf)

It takes a lot of work to get a sympathetic Doc in there (prisoners often refuse fluids until they can get a sympathetic Doc, if they have the support outside pulling the necessary strings.) But in a hunger strike, the point is not to stay healthy, the point is to get as sick and close to death as possible, as quick as possible. If a prisoner is in danger of checking out permanently, it doesn't even matter all that much (except in the state's yearly "suicide" statistical report) unless they have an outside campaign. A key part of a strong outside campaign is ACCURATE medical reports taken from physical exams and lab tests supervised by a sympathetic Doc. It's a strong tool for building legal as well as social pressure.

Gobblehook 09:10, 27 October 2006 (UTC)

Medical Advice Not Tactical Advice
Now I think that BEFORE the strike begins, a key thing is "health + safety" stuff and anticipatory guidance, and AFTER a key thing is advocacy or direct care for support through recovery or lengthy disability; particularly around the first few meals. There's a high risk to die, just after winning, from eating too much or the wrong kind of food.

It's not our job to explain history and strategy to potential strikers. It's such a simple strategy, which is why it's used so often by people who have no other choice: just quit eating and tell people on the outside to pressure whoever. You don't need some kind of training to do it, and people will continue to do it with or without street medic help / training.

I was telling this to Eowyn back around Miami-time. She wanted to make tactical decisions for the padded bloc. We wrote back and forth a few times, and I (a former wearer of padding) told her some of the things we ought to consider when working with PBers. But just because she or you or I know about health doesn't mean we know about tactics. And if we keep trying to be the big sisters of our heroes + tell them how to conduct their struggles, we will lose their trust for good reason.

Even after our project, most hunger strikers in the world will have no medical support at all, and those we do reach will already be ten days in before we find out.

Gobblehook 09:10, 27 October 2006 (UTC)

The Plan for a Project:
What I want to do is work with a Doc/practitioner to write a short info-sheet giving a basic overview like Mike Greger used to do (A-M posts 3081, 3327). Post the info-sheet to the list and in a library like the BALM Squad’s.

Then, work with an illustrator to make a very comprehensible booklet for support people detailing ONLY HEALTH NOT TACTICAL considerations in hunger striking and recovery. It will help strikers to better advocate for themselves. It will be less than 8 pages. Distribute it through whatever channels would be good.

Things I can think of that we need, as of now:		(by Soph)
 * Reports on Hunger Strikes (Maybe giving the Irish Hunger Strikers a page, The Thess 5 a page, etc, describing circumstances and medical problems - if research indicates that this will be useful, i.e. if med info is wildly disparate because of factors unknown to us or varying legal intricacies arose)
 * Medicolegal information (i.e. the World Medical Association’s 1991/92 Declaration on Hunger Strikers [Declaration of Malta], torture and implied consent statutes, and caselaw)
 * Risk Factors (i.e. diabetes, kidney problems, any other preexisting factor)
 * Emotional and Moral Support (for allies of hunger strikers)
 * What Medics Can Do: support, advocacy, planning, advising about what may happen, etc.
 * Palliative Care (i.e. appropriate remedies for various symptoms of starvation)
 * Chronic Illnesses Post-strike

Gobblehook 09:10, 27 October 2006 (UTC)