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



TRIPOLI 00000229 002 OF 004





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



TRIPOLI 00000229 003 OF 004





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



TRIPOLI 00000229 004 OF 004





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