An ICE detainee on a hunger strike finally began eating again, but immigration officials force-fed him anyway—and the procedure went so badly that one of the guards in the room thought the man was having a stroke, according to court filings obtained by The Daily Beast.
Hamad Mohsen Thabit Saad Sayad, a 28-year-old asylum-seeker from Yemen, said he fled his homeland after facing persecution by Houthi rebels. He has been in ICE detention since Dec. 16, 2020, and was facing deportation until a federal judge halted Sayad’s removal as his case is further reviewed. In January, Sayad, who tested positive for COVID-19 that same month, launched a hunger strike to protest his conditions. After he missed 73 meals and lost nearly 17 percent of his body weight, ICE went to court and got permission to physically restrain Sayad and feed him through a nasogastric tube, something the American Medical Association (AMA) deems a form of torture.
ICE said medical staff at the privately-run detention facility in Arizona where Sayad is being held told him that continuing to starve himself could kill him. An ICE psychologist found Sayad to be of sound mind, without any sort of condition that would prevent him from eating. In a previous court filing, ICE said Sayad had shown an “inability to stand due to headaches and dizziness; unsteadiness on feet and having to sit after approximately two minutes of standing; and no measurable urinary output.” His condition was expected to keep declining, with potential brain damage, if Sayad did not take sufficient nutrients.
ADVERTISEMENT
“He has already suffered serious enough symptoms as to require hospitalization twice,” ICE said in court, noting that Sayad was in danger of renal failure, liver failure, or could slip into an irreversible coma.
But by March 16, Sayad was once again eating, according to an outside doctor’s report filed in court by Sayad’s lawyers. That morning, Sayad had eaten a pureed breakfast “and was open to other nutrition including soups and juices,” the report states.
“He attempted and was documented as eating half of his solid food lunch (black beans, rice, and chicken) but he notes that chewing was very difficult for him,” it goes on. “It was only when the facility forced an immediate transition to solid foods and he had difficulty eating the foods that he declined—while still being amenable to other foods.”
While a liquid diet “is not a preferred long-term diet,” the doctor said in the filing that it “is medically appropriate for the first few weeks after starvation.” In order to avoid the risk of “refeeding syndrome,” a potentially deadly condition that can occur when a hunger striker introduces too much solid food back into their system too quickly, the person’s digestive system must be given ample opportunity to adjust. However, the guards supervising Sayad instructed him to eat his entire meal within the time limit they gave him, “rather than allowing him to listen to what his body needed,” the filing states. If he didn’t eat right then and there, the guards told Sayad that a doctor would then run a feeding tube from his nose to his stomach, states a separate filing by Sayad’s lawyers. In notes taken by an ICE doctor included in the immigration lawyers’ filing, the agency said: “medical staff had exhausted their options and that the procedure was necessary to ensure that Mr. Sayad received nutrition.”
A federal judge had previously given ICE permission to force-feed Sayad if he was in danger of dying from starvation, the filing points out. However, it claims Sayad “had been gaining weight and eating and there was no medical reason that he needed immediate nutrition.” In fact, the doctor wrote, Sayad “had adequate calorie reserves to wait a few hours and try again with one of the many options he suggested.”
Regardless, the ICE guards and medical staff “then attempted to insert the nasogastric tube,” the filing says. “According to Mr. Sayad, these attempts lasted around 30 minutes and they tried 5 times but he began bleeding profusely from both nostrils and his arm, and in the end they could not get the tube in either nostril. Mr. Sayad saw that the staff was taking videos and pictures of what the doctor\other staff were doing but they turned off the camera around the time the bleeding began. Several times one of the officers present said they needed to stop trying to insert the tube because Mr. Sayad was having a stroke.”
Eventually, the medical staff gave up without successfully inserting the nasogastric tube. “Since that time, Mr. Sayad has not been able to use his left hand as he cannot open and close several of his fingers,” the filing says. “He has also had an intense amount of pain where they tried to insert the tubes. Mr. Sayad has not been taken to a hospital to evaluate the possible neurological and/or physical damage that occurred when the officers attempted to place the nasogastric tube.”
The outside doctor’s report concludes, “There is no documented inability of hand weakness or inability to move the fingers prior to the incident and a clear and sudden onset afterwards… While some symptoms such as general weakness and stammering can develop as a cause of severe malnutrition, his prior symptoms are unrelated to these new neurologic deficits. It is extremely unlikely that his new hand weakness is due to his hunger strike.”
The most likely culprit, the doctor surmised, is damage to Sayad’s ulnar nerve from “prolonged restraint during the attempted nasogastric procedure,” specifically, “prolonged compression of the elbow or wrist.”
Following the incident, Sayad should have been taken immediately to a neurologist for an examination, the doctor stated in the filing. But ICE medical staff waited another four days before submitting a “non-urgent referral” for a specialist, a delay which could ultimately result in permanent nerve damage, the filing says.
A 2021 report by the ACLU and Physicians for Human Rights identified a half-dozen instances of force-feeding by ICE at federal detention centers between 2013 and 2017. In 2019, a group of asylum seekers on a hunger strike were force-fed at an ICE facility in Louisiana, according to Freedom for Immigrants. Many hunger strikers do so to protest “lengthy periods of detention in inhumane conditions, and arbitrary denial of parole and bond as a motivation,” the nonprofit said. Also in 2019, ICE admitted involuntarily feeding six detainees in Texas, and one in Arizona.
On March 30, ICE officials notified Sayad’s lawyers that he was being transferred that evening from the facility in Arizona to another lockup in Florida. ICE said the Florida facility can provide better medical treatment, to which Sayad’s lawyers responded that ICE had previously assured them that the Arizona facility could give Sayad perfectly adequate care.
“Additionally, the timing of this decision to send Mr. Sayad on a long plane ride to Florida—when the agency claims that he is so medically fragile as to require force-feeding—suggests that this is being done in retaliation for Mr. Sayad’s claims against ICE,” states a filing by Sayad’s lawyers.
Reached on Friday by The Daily Beast, Sayad’s attorneys declined to comment.
In a statement to The Daily Beast, an ICE spokesperson said, “It is ICE policy to not comment on pending litigation.”
