The health of several individuals recently concluded a 73-day hunger strike is causing significant concern among families and medical professionals, particularly regarding the clinical management of their refeeding process. Kamran Ahmed, Heba Muraisi, and Lewie Chiaramello were the last of seven protesters to end their demonstration on Thursday, following the UK government’s cancellation of a £2 billion contract with Israeli arms company Elbit Systems. However, the relief over this political victory is tempered by fears for the prisoners’ wellbeing as they navigate the perilous stage of nutritional rehabilitation.
## Concerns Mount Over Refeeding of Palestine Action Hunger Strikers
The immediate priority for Ahmed and Muraisi is “refeeding,” a carefully managed medical process designed to restore body weight and electrolyte balance after prolonged starvation. This process, while essential, carries substantial risks. “Refeeding syndrome,” a potentially life-threatening condition characterized by severe fluid and electrolyte shifts, is a major worry if refeeding isn’t conducted meticulously. Families and doctors are voicing anxieties that the current approach within the UK prison system is inadequate and potentially endangering the lives of those involved.
Dr. James Smith, an emergency doctor who has been providing support to the hunger strikers and their families, emphasized the critical nature of this moment. “This is a very fraught moment,” he told Middle East Eye. “One of the highest risk stages of a hunger strike is, counterintuitively to many people, the moment that you decide to stop, and that is because of all of the additional risks that then present themselves if it’s not managed effectively.” The delicate balance required during refeeding demands constant monitoring and specialist intervention, something families fear is not being provided.
## Premature Discharge and Worrying Symptoms
Reports suggest that the concerns are not unfounded. Families claim that two of the earlier hunger strikers were discharged from prison “prematurely” in December, despite exhibiting “various unusual symptoms” that alarmed medical staff. These symptoms, according to sources speaking to MEE, indicated complications arising from the refeeding process that required continued hospital care.
Qesser Zuhrah, held at HMP Bronzefield, ended her strike on December 17th and was discharged after just five days. Her next of kin, Ella Moulsdale, revealed that doctors had advised a minimum of one week of hospital observation due to “worrying” symptoms, including vision loss. However, Moulsdale received a call from Zuhrah’s prison number at 8 pm that same night, indicating her unexpected return to custody. “The prison made the final call of when she was discharged, which overrode the doctor’s orders at the hospital,” Moulsdale stated.
Similarly, friends of Amu Gibb, also at HMP Bronzefield, reported a discharge after only three days following the end of their strike on December 24th. “The refeeding doesn’t seem to be managed in prison,” said Jessie Dolliver, Gibb’s next of kin. “The prison is not monitoring their medical observations anymore. Amu is alone in trying to re-feed in a safe way,” adding that Gibb hasn’t regained weight and continues to struggle with mobility. These accounts paint a concerning picture of a system prioritizing expediency over patient safety.
## Allegations of Mistreatment and Restraint
Beyond the concerns surrounding refeeding protocols, allegations of mistreatment during hospital stays have surfaced. Moulsdale described the conditions in the prison’s medical wing as “a really distressing” environment, characterized by constant noise and distress, likening it to “a form of psychological torture.” Zuhrah requested a transfer back to her regular cell to escape the harrowing atmosphere.
Upon her return, however, Zuhrah found her cell had been “turned upside down,” with personal belongings rifled through and most of her clothing confiscated. When she inquired about her possessions, she was told they had been “donated to charity.”
Perhaps the most disturbing allegation involves the routine use of restraints. Moulsdale reported that Zuhrah was consistently handcuffed to a police officer during her hospital stay, and that the guard was switched to a male officer while she was sleeping, despite her being a young Muslim woman. “She would wake up handcuffed to a male guard, with no female guard in the room,” Moulsdale explained. “It’s appalling they can’t seem to find a female guard.” This practice extended to invasive medical procedures, including toilet and shower visits.
## Medical Ethics and the Role of the Prison System
Dr. Smith raised serious ethical concerns about the shackling of hospitalized prisoners, arguing that restraints should only be employed in “exceptional circumstances.” He cited guidance from the British Medical Association (BMA) which emphasizes that the primary risks in such cases are escape or violence, and that restraint should be proportionate to those risks. Given the weakened state of the hunger strikers, Smith believes they posed no flight risk.
He further contends that the restraints likely hindered their medical treatment. He recounted difficulties in obtaining blood samples from Kamran Ahmed, exacerbated by the handcuffs. Ultimately, a specialist attempted to insert a cannula between Ahmed’s knuckles, but the procedure failed, leading to his premature discharge back to prison with staff stating “there was nothing more they could do for him.”
The BMA guidance explicitly states that health professionals should advocate for the removal of restraints if they interfere with treatment or if the patient is too incapacitated to pose a threat. Smith believes the state is deliberately “trying to make an example out of these individuals” and treating them “horrifically badly” as a result. The situation highlights a critical tension between security concerns and the ethical obligations to provide adequate medical care.
## Ongoing Protests and Future Action
The concerns surrounding the treatment of these individuals are far from resolved. Ahmed and Muraisi are considered at “extreme risk” of refeeding syndrome, requiring intensive medical oversight. Reports indicate Ahmed is already exhibiting symptoms, including potential heart shrinkage and hearing problems.
Prisoners 4 Palestine has announced that another hunger striker, Umer Khalid, will initiate a “thirst strike” in five days if the government refuses to engage in dialogue. Khalid, who suffers from limb-girdle muscular dystrophy, is protesting the denial of religious accommodations and alleged physical assault by prison officers.
Shahmina Alam, Kamran Ahmed’s sister, expressed a “bittersweet” sentiment regarding her brother’s decision to end his hunger strike. While relieved he is no longer deteriorating, she remains deeply worried about his refeeding and frustrated by the lack of communication from the prison. “This isn’t the end,” she affirmed, signaling a continued commitment to advocacy and mobilization. The case underscores the urgent need for transparency and accountability in the medical care provided to prisoners, particularly those engaging in protest through hunger strikes.
