Doctor Describes and Denounces C.I.A. Practice of ‘Rectal Feeding’ of Prisoners

GUANTÁNAMO BAY, Cuba — Over the years, the Central Intelligence Agency’s use of waterboarding and other forms of torture in its secret overseas prisons after the Sept. 11, 2001, attacks has been revealed in government leaks, testimony and a damning Senate investigation.

But an expert’s testimony this week in pretrial hearings at Guantánamo Bay offered some of the most graphic details made public about the C.I.A.’s shadowy use of rectal feeding on its prisoners, a discredited practice kept secret long after other torture methods had been exposed.

Dr. Sondra S. Crosby, a court-approved expert on torture and other trauma, testified in a long-running defense effort by lawyers for Abd al-Rahim al-Nashiri, who is accused of orchestrating the 2000 bombing of the U.S.S. Cole. The lawyers are seeking to suppress from his eventual trial admissions he made to federal investigators as tainted by torture.

She held up a tube that is designed to be put in a patient’s windpipe and said that — according to the agency’s once-secret records —C.I.A. prison staff inserted one just like it into Mr. Nashiri’s anus in May 2004. Agency personnel then used a syringe to inject a protein enriched nutritional shake into his body.

She testified that at Guantánamo Bay in 2013, Mr. Nashiri confided that, years earlier, C.I.A. personnel grabbed him from his cell, stripped him naked, shackled him at the wrists and ankles, bent him over a chair and administered the liquid.

He asked that she never again speak to him about it. And he did not attend the court session when she discussed it at length on Thursday.

“This was a very, very distressing painful, shameful stigmatizing event,” Dr. Crosby testified. “He experienced it as a violent rape, sexual assault.”

Another year would pass before Dr. Crosby found corroboration of the account. In December 2014, the Obama administration released a 500-page summary of a classified Senate study of the C.I.A.’s so-called black site program. It revealed the agency’s practice of using “rectal rehydration” and “rectal feeding” to punish prisoners.

At the time, the C.I.A. defended it as a sound medical procedure. The group Physicians for Human Rights then condemned the practice as “sexual assault masquerading as medical treatment.”

But this week the agency declined a request for a comment on the descriptions that were attributed to the C.I.A. in open court. Nor would an agency spokeswoman respond to Dr. Crosby’s testimony that Mr. Nashiri also told her that he was sodomized with a broom stick while the C.I.A. held him in a cell, nude with his wrists shackled above his head.

The testimony emerged in pretrial hearings in which the judge, Col. Lanny J. Acosta Jr., is being asked to decide which evidence can be used at Mr. Nashiri’s eventual capital trial. Mr. Nashiri, 58, is accused of orchestrating Al Qaeda’s Oct. 12, 2000, suicide attack on the U.S.S. Cole destroyer that killed 17 U.S. sailors during a refueling stop at the port of Aden, Yemen.

Defense lawyers argue that the testimony, in tandem with other litigation, should persuade the judge to exclude statements the prisoner gave to interrogators in 2007, soon after he was transferred to Guantánamo for trial — or, alternatively, to remove the possibility of a death sentence.

Dr. Crosby is a Boston internist who has been evaluating and treating torture victims since the 1990s. She is paid by the Pentagon to serve as a consultant to Mr. Nashiri’s legal defense team and was granted a security clearance.

In preparation for her testimony, Dr. Crosby said, she was given access to C.I.A. materials. She related the facts that she found in a clinical fashion.

“They left the tube in for an additional 30 minutes ‘to aid in colonic absorption,’” Dr. Crosby said, dismissing the procedure as bogus. The liquid nutritional supplement “would have acted just like an enema, and it would been expelled.”

Daniel Jones, who led the research for the Senate investigation, hailed the testimony as consistent with the findings of his team, which consulted medical experts and found the practice of rectal feeding or hydrating to be anything but health care.

“C.I.A. officers consistently discussed it as a technique to punish or manipulate detainees — writing that it was done to gain ‘total control over the detainee’ or to help ‘clear a person’s head,’” he said. “No medical personnel or C.I.A. officers were ever held accountable for these actions.”

In court, Dr. Crosby held up a breathing tube, 7 millimeters in diameter, that she said was like the tube the C.I.A. used for Mr. Nashiri’s “rectal feeding.” She offered an explanation of how human beings process foods through the stomach — “it cannot be done in reverse” — and then offered a history lesson.

In battlefield situations, medics have forced fluid into the rectum of gravely wounded soldiers to rehydrate them, she said. But an experiment carried out on medical students in the 1930s showed that the practice of trying to nourish people that way was ineffective. “There is no medical benefit ever to administering any form of nutrition through the rectum,” she said.

The testimony was the most detailed public accounting of the procedure, from a medical perspective.

In October 2021, the since-released prisoner Majid Khan told his sentencing jury that C.I.A. agents used “green garden hoses” connected to a faucet to force water inside his rectum. His descriptions of what the C.I.A. did to him so troubled a military jury that they urged the Pentagon to grant Mr. Khan clemency.

At a hearing in 2018 in the Sept. 11 conspiracy case, a prosecutor read aloud from a C.I.A. cable that described something similar being done to Khalid Shaikh Mohammed in March 2003, his first month of detention, for twice refusing an interrogator’s order to drink a glass of water.

Mr. Mohammed was taken to another room, “placed on a plastic sheet” and a C.I.A. “medical officer,” carried out the procedure. “When he was returned to the interrogation room, he then complied and drank water.”