HRW/PHR VISIT FATHI EL-JAHMI, EXPECT HIM TO RETURN HOME SOON

C O N F I D E N T I A L SECTION 01 OF 04 TRIPOLI 000229

SIPDIS

SIPDIS

DEPT FOR NEA/MAG AND DRL

E.O. 12958: DECL: 3/17/2018
TAGS: PGOV, PREL, PHUM, PINR, LY
SUBJECT: HRW/PHR VISIT FATHI EL-JAHMI, EXPECT HIM TO RETURN HOME
SOON

REF: A) TRIPOLI 223, B) TRIPOLI 183

CLASSIFIED BY: Chris Stevens, CDA, Embassy Tripoli, Dept of
State.
REASON: 1.4 (b),(d)
1. (C) Summary: Representatives of Human Rights Watch and
Physicians for Human Rights (HRW/PHR) visited Tripoli in
mid-March to perform an independent medical assessment of
detained human rights activist Fathi el-Jahmi and discuss his
release with interlocutors from the Qadhafi Development
Foundation (QDF). El-Jahmi is expected to be released from the
hospital by late March in exchange for his tacit agreement to
remain silent about his detention and refrain from making
political statements. He is expected to convalesce initially in
Tripoli for several weeks in lodging provided by the QDF, before
traveling to either Benghazi for further recovery at his family
home there, or to the U.S. for further diagnosis and treatment.
The QDF has indicated that it does not oppose facilitating
issuance of a passport to el-Jahmi or his travel abroad,
provided that he honors the terms of the agreement for his
release. El-Jahmi's medical condition remains serious but is
essentially stable; PHR assesses that he is medically able to
return home provided he receives needed ongoing care on an
outpatient basis. El-Jahmi's family has expressed concern about
underwriting such treatment; the QDF may help defray those
expenses. HRW/PHR, which will likely issue a press statement
coordinated with QDF today or tomorrow, believe the focus for
the next several weeks should be on confirming el-Jahmi's safe
return home, verifying his access to needed outpatient care and
facilitating issuance of a passport and arranging travel abroad
for further care. End summary.

2. (C) Human Rights Watch (HRW) Senior Emergencies Researcher
Fred Abrahams and Acting Regional Relations Director Gasser
Abdel Razzak gave P/E Chief a readout March 15 of their meetings
in Tripoli with detained human rights activist Fathi el-Jahmi
and his family. Physicians for Human Rights (PHR)
representative Dr. Scott Allen, who accompanied Abrahams and
Abdel Razzak and performed an independent medical assessment of
el-Jahmi, had already departed Tripoli. Abrahams and Abdel
Razzak conveyed the substance of his medical assessment.
El-Jahmi's daugher, Najla, who lives in Benghazi, traveled to
Tripoli to meet with HRW/PHR and discuss next steps in her
father's case. El-Jahmi's son, Muhammad, and his wife also met
with the HRW/PHR team.

EL-JAHMI FREE TO LEAVE HOSPITAL, IN FAMILY'S CUSTODY

3. (C) The Qadhafi Development Foundation's (QDF) Human Rights
Director, Saleh Abdulsalam, was the primary interlocutor for
HRW/PHR; Abrahams and Allen also spoke by telephone with QDF
Executive Director Dr. Yusuf Sawani, currently on travel outside
the country. HRW/PHR described the QDF's cooperation as
"superb, forthright and professional". Abdulsalam stressed that
from the perspective of the GOL and the QDF, el-Jahmi's legal
issues were "closed matters" and the GOL was "out of the
picture". El-Jahmi had been free to return home since his
"release" was announced on March 11; his family, who have legal
custody of him now, may take him home at any time provided that
his treating physician signs a medical release indicating it is
medically safe to do so. (Note: El-Jahmi's treating physician
told P/E Chief March 12 that in his professional opinion,
el-Jahmi could safely leave hospital (ref A). He has since then
indicated that el-Jahmi requires an additional one week to ten
days in the hospital for "beta blockers" treatment for his
heart. The Libyan doctor has consulted both the family and
PHR's Allen regarding this recommended treatment, and the family
is in agreement. End note.)

EL-JAHMI EXPECTED TO BE RELEASED BY LATE MARCH

4. (C) The family, led by daughter Najla, told HRW/PHR and the
QDF they are prepared to take el-Jahmi home as soon as they can
prepare his room in the family home in Tripoli. (Note: The home
was ransacked and then occupied and damaged in 2004 when
el-Jahmi, his wife and his son, Muhammad, were detained. The
QDF has offered to provide a small house or apartment in Tripoli
for el-Jahmi to stay in while the family's Tripoli home is being
rennovated. End note.) The tacit condition for his release to
his family is that he remain silent about his detention and
refrain from making political statements. (Note: This is
consistent with what Sawani told P/E Chief on March 3 (ref B).
End note.) El-Jahmi's daughter, Najla, reportedly played a key
role in convincing her father that he should agree to remain
quiet, stressing to him that his focus - for now - should be on
recovering his health and protecting his family.

TRAVEL ABROAD FOR TREATMENT POSSIBLE, IF EL-JAHMI REMAINS QUIET

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ABOUT DETENTION

5. (C) Conceding that HRW's preference would have been to
physically escort el-Jahmi out of the hospital and to his home,
Abrahams said the QDF flatly rejected that scenario, stressing
the need to avoid the perception that HRW/PHR and/or the U.S.
had "dictated" el-Jahmi's release to the GOL. The plan,
coordinated with the QDF, is for el-Jahmi to convalesce for
several weeks at the family home in Tripoli. After that, it is
expected that he will fly either to Benghazi to continue
convalescing at his family home there, or to Cairo and onward to
the U.S. for further medical evaluation and treatment. Allen
stressed that el-Jahmi will not be fit to travel by air for at
least several weeks. Abdulsalam, confirming earlier remarks to
Emboffs, told HRW/PHR that the QDF "is not opposed" to el-Jahmi
traveling abroad for treatment, but stressed that he would need
to honor the terms of his release in order for such to occur.
HRW/PHR will engage with Abdulsalam in coming weeks to encourage
the GOL to issue el-Jahmi a new passport so he may travel; Post
will dual-track those efforts with Sawani.

HRW/PHR STATEMENT EXPECTED

6. (C) Allen and Abdel Razzak departed Tripoli on March 15;
Abrahams is scheduled to depart today. HRW/PHR will remain in
telephone and email contact with multiple members of el-Jahmi's
family to confirm that he is eventually transferred home without
complication. HRW/PHR intend to release a joint press
statement, previewed with the QDF, on/about March 18. According
to Abrahams, the statement will: 1) confirm el-Jahmi's release
and welcome it as a positive development; 2) acknowledge the
QDF's constructive role in securing el-Jahmi's release; 3)
stress that el-Jahmi should not have been detained in the first
place and express concern about the manner in which legal
proceedings were conducted, and 4) note that while his medical
care dramatically improved in the last two months, there is no
question but that the net result of his detention and the delay
in providing him treatment was a dramatic deterioration in his
health. The QDF's Abdulsalam disputed the last point, asking
how HRW/PHR could determine that el-Jahmi's deterioration
resulted from conditions of his detention. Reprising arguments
we've heard from Sawani, Abdulsalam claimed that many factors,
including el-Jahmi's age (he's 66 years old) and the possibility
that he had refused treatment, may have precipitated his medical
complications. HRW/PHR pushed back and made it clear that the
language will be included in the statement.

MEDICAL CONDITION: RELATIVELY STABLE (FOR NOW),BUT FURTHER CARE
NEEDED

7. (C) HRW/PHR visited el-Jahmi several times at the Tripoli
Medical Center (TMC),where he remained as of March 15. Four to
five plainclothes security officers were present. The man
described as el-Jahmi's nurse, Abdullah Bashir, was also present
and facilitated access to el-Jahmi. Allen reviewed el-Jahmi's
case extensively with his treating physician, Dr. Abdulrahman
Mehdy, and performed an independent medical examination of
el-Jahmi. Allen and Abdel Razzak were the only individuals in
the room during the examination. Allen concurred in Mehdy's
diagnosis and virtually all prescribed treatment, which he
conveyed directly to el-Jahmi's family, as well as to Mehdy and
the Qadhafi Development Foundation. (Note: There were
professional differences over the relative merits of different
medications, but no other points of disagreement. End note.)

MARKED IMPROVEMENT IN CARDIAC CONDITION

8. (C) Allen assessed el-Jahmi's condition as being essentially
stable, but noted that his heart condition is serious and that
he is at some risk of heart attack "at any time". El-Jahmi was
"not a well man" and had been "pushed, medically, to the edge"
by the lack of treatment in 2007. Nonetheless, el-Jahmi's his
treatment at the TMC - once initiated in late December/early
January - was "good" and his health had improved "markedly".
El-Jahmi was able to walk (with difficulty) and his heart
efficiency rate improved from 17 percent in July 2007 to 38
percent in late February, and to 52 percent on March 14. Allen
performed a basic cognitive awareness test and assessed that
el-Jahmi did well considering his long period of isolated
detention and lack of access to needed medication. He did show
signs of short term memory loss; Abrahams and Abdel Razzak said
there were points during their visit when el-Jahmi "wasn't
there, mentally". Allen concurred with Mehdy's assessment that
from a medical standpoint, el-Jahmi may be safely released from

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the TMC and treated on an outpatient basis. Allen noted that
given his current condition, el-Jahmi would have already been
discharged from a western hospital to free up bed space.

FURTHER DIAGNOSTIC EXAMS NEEDED

9. (C) Nonetheless, el-Jahmi does have medical issues that will
require ongoing care. Allen recommended that el-Jahmi undergo
two procedures in the next several months: a biopsy of his
enlarged prostate gland and a heart catheterization procedure to
evaluate blockages and bloodflow. Both procedures are performed
regularly at the TMC; Allen assessed the overall quality of care
and the center's ability to safely perform the two procedures as
good. El-Jahmi agreed to undergo the biopsy procedure; he has
not yet consented to the heart catheterization. In addition,
Allen assessed that the stent implanted in el-Jahmi's heart in
Jordan in 1995 is likely nearing the end of its lifespan and
will need to be replaced.

OUTPATIENT CARE CRITICAL

10. (C) Allen stressed to the family the need for proper
outpatient care after el-Jahmi's expected release. The QDF
clearly understands ongoing, outpatient treatment and access to
prescribed medications and diagnostic exams will be needed, and
agreed to help facilitate those. Per the QDF, there will be no
restrictions on el-Jahmi's ability to return to the TMC for
ongoing care on either an inpatient or outpatient basis;
however, the family flatly stated they do not trust Dr. Mehdy
and will seek another treating physician in consultation with
Allen. The family believes it will not be a problem to identify
a physician in Benghazi should el-Jahmi return there in future;
however, they expressed concern about identifying an appropriate
physician in Tripoli. HRW and PHR requested copies of el-Jahmi's
full medical records, including treatment at the TMC and any
treatment administered prior to his admission there.

FAMILY CONCERNED ABOUT FINANCING CARE, QDF MAY HELP

11. (C) Abrahams stressed the family's concern about how they
will underwrite el-Jahmi's ongoing care. Family properties in
Benghazi and Tripoli had been confiscated or damaged in
connection with el-Jahmi's long-running criticism of the GOL;
some properties were also sold to help make ends meet. (Note:
El-Jahmi's contentious relationship with the GOL goes back more
than two decades and has progressively worsened. End note.)
The family asked HRW whether it could request compensation from
the QDF and/or GOL. Stressing that HRW would not/not be
directly involved in such negotiations, Abrahams said QDF Human
Rights Director Saleh Abdulsalam suggested the QDF could help
defray el-Jahmi's medical expenses and explore the possibility
of compensation. El-Jahmi's son, Muhammad, is to contact
Abdulsalam directly to follow up on those issues.

NEXT STEPS

12. (C) Abrahams said that from the perspective of HRW/PHR, the
focus in the next several weeks should be on: 1) confirming that
el-Jahmi has safely returned home; 2) verifying access to
appropriate outpatient care (to include resolving attendant
financial issues),and 3) urging the QDF and GOL to issue
el-Jahmi a passport and facilitate his travel abroad for further
treatment. HRW/PHR may try to facilitate a visit by a
cardiologist from Cairo or Tunis in approximately two weeks to
assess el-Jahmi's condition and outpatient care.

13 (C) Comment: HRW/PHR believe that the QDF and GOL have an
interest in seeing that el-Jahmi's health does not seriously
deteriorate while he is in Libya and will therefore be likely to
facilitate his travel abroad for care. We concur, but his
physical security in the near-term remains a concern. Sawani
told P/E Chief on March 3 that the QDF had to intevene in 2004
to pre-empt efforts by unspecified regime elements to kill
el-Jahmi outright (rather than detain him) after he gave an
interview to satellite television channel al-Hurra criticizing
Leader Muammar al-Qadhafi and the GOL. The presence of security
officials outside el-Jahmi's room at the TMC is doubtless
motivated in part by a desire to monitor his activities and
visitors, but also by the GOL's interest in ensuring his
physical safety. Post will remain in contact with el-Jahmi's
family members and will visit him at home after his expected
return to assess his condition there and arrangements for his
outpatient treatment. We will also remain in contact with the
QDF to urge issuance of el-Jahmi's passport and dispensation for

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him to travel abroad. Whether el-Jahmi honors the terms of the
tacit agreement for his release will be critical in determining
the extent to which we, the QDF and HRW/PHR are able to ensure
his physical safety and facilitate issuance of a passport and
travel abroad for treatment. End comment.
STEVENS