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Mar 21, 2020

COVID-19 in the ER

Co-produced with PRX Logo

As the new coronavirus spreads, an ER doctor in Seattle explains how he and other front-line physicians are learning to treat patients and keep themselves safe. Plus, more than eight years after the end of the Iraq War, an Iraqi man is suing a U.S. company that ran interrogations at the notorious Abu Ghraib prison.

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Credits

WNYC logo

United States of Anxiety logo

This week’s show was produced by Emily Harris with help from Jennifer Gollan, Byard Duncan and Elizabeth Shogren. Taki Telonidis edited this show.

The story about the Iraqi prisoner seeking justice from a U.S. private contractor was reported by Seth Freed Wessler, a Puffin reporting fellow with Type Media Center, and produced by Christopher Werth from WNYC.

Thanks to Ibrahim Hussein, Hanin Shakrah, Cayce Means, Karen Frillmann, Marianne McCune and Anjali Kamat for their work on the Abu Ghraib story. 

Our production manager is Mwende Hinojosa. Our sound design team is Jim Briggs and Fernando Arruda, who had help from Bryson Barnes, Najib Aminy and Amy Mostafa. Esther Kaplan is our executive editor. Our executive producer is Kevin Sullivan. Our host is Al Letson. 

Support for Reveal is provided by the Reva and David Logan Foundation, the John D. and Catherine T. MacArthur Foundation, the Jonathan Logan Family Foundation, the Ford Foundation, the Heising-Simons Foundation, Democracy Fund, and the Ethics and Excellence in Journalism Foundation.

Transcript

Reveal transcripts are produced by a third-party transcription service and may contain errors. Please be aware that the official record for Reveal's radio stories is the audio.
Al Letson: From The Center for Investigative Reporting and PRX, this is Reveal. I'm Al Letson. The number of Americans with COVID-19 keeps growing. Dr. Nick Mark is treating more and more of them.
Dr. Nick Mark: Some of these patients are very sick. Their lungs can't transport enough oxygen into the bloodstream so we have to use machines and other therapies to support them.
Al Letson: He's in Seattle where the first known US case appeared but figuring out how to treat the disease means doctors are improvising because it's brand new.
Dr. Nick Mark: When something is new, you don't know exactly how to treat it. We're doing a lot of learning. Every one of these patients is teaching us more. Some of the things we've learned or we've learned that they seem to respond well to certain settings on the ventilator. There are certain ways to ventilate them that work better than others. We're also learning that there are important strategies to protect ourselves.
Al Letson: There are a lot of doctors comparing notes around the country. It's almost like they're crowdsourcing the information. You posted on Twitter a one-page guide, the How to Treat COVID-19 in the Intensive Care Unit. What do doctors not know?
Dr. Nick Mark: There's a lot of things we don't know. That was the motivation for me to put that together. I think for me personally, feeling like I don't know what's going on makes me feel very out of control. That's a very scary feeling. One of the ways that I confront that is by reading everything that I could about this. I just boil that down, distill that to its essence that one page, which I shared with colleagues. It's been an amazing crowdsourcing effort. I think now we've got it in nine or 10 languages, which is pretty exciting.
Al Letson: What kind of questions are you hearing from other doctors?
Dr. Nick Mark: One of the biggest unknowns about this is we know how to take care of people with respiratory failure but we don't know how to treat COVID specifically. There's a lot of therapies that have been tried in China and in the rest of the world. For example, there's a HIV medication called Lopinavir-Ritonavir, which has been used. There's antiinflammatory medicines. There's a new anti-viral medication called Remdesivir. All of these are being tried. We don't know yet which of these is best, which of these work, which patients it's best to use, which medication.
Al Letson: Are patients being put at risk by trying these different therapies?
Dr. Nick Mark: I think at this point, we're doing the best we can to give people the best chance of recovery. People who were very sick from COVID are being treated with medications that maybe effective based on the experience elsewhere in the world but aren't proven yet. This is moving so fast. We just don't have time to wait for large clinical trials to be done. In many cases, we know that these drugs are safe because they're drugs that have been used for other conditions. What we don't know is how effective are they.
Al Letson: There's a lot of confusing guidance out there for everybody, for regular life. It also seems like doctors are getting mixed messages. Even different guidance from for example, the Centers for Disease Control, the World Health Organization, local health departments. The World Health Organization said the virus isn't airborne but there's research that says that's the opposite. How do we know it's true?
Dr. Nick Mark: Yeah. That's a big challenge. One of the biggest scary things is the lack of information. Not knowing definitively some of these key things about it. You mentioned the question of airborne versus droplet spread. There's definitely conflicting messages going around. There's definitely conflicting policies. Some hospitals are telling workers that it's spread by droplets so you don't need to wear the more sophisticated masks. We don't know if that is as good. There may be some added risk there.
Al Letson: We obtained some internal communication from a medical organization in Seattle that explicitly tells staff to say nothing to friends and family and direct them to the organization's website. Do you think that information should be curtailed?
Dr. Nick Mark: I think it's really hard when you have loved ones who are worried about you to not tell them what's going on.
Al Letson: Yeah.
Dr. Nick Mark: I understand that hospitals want to control information. I think that makes sense. I don't think it's a coverup. I think they're just trying to speak with one voice. That said, it's really hard. I think you want to avoid misinformation but you don't want to shut down communication altogether. I think A, it's not going to work and B, that's not really who we are.
Al Letson: Yeah. Those internal communications that we obtained, they also gave staff guidance about testing. They had no special consideration for possible exposure. This is for frontline medical staff who we know are at high risk of exposure. There's a doctor in Seattle on a ventilator now with Coronavirus. What do you want as far as the guidelines for medical staff?
Dr. Nick Mark: That's a great question. Yeah. As you said, a colleague of mine is on a ventilator in the hospital where he works right now. Many other friends and colleagues have had close calls and have gotten tested or getting tested because they were potentially exposed. Every single one of those is a horrible, nerve-wracking experience. We need clear guidance for when to do that. The guidance has changed a lot. Who to get tested, when to isolate yourself. We don't have a great sense of all of that yet.
Al Letson: Have you handled the risk personally for yourself and your family?
Dr. Nick Mark: That's one of the worst parts of this frankly. One of the nice things about critical care is that even though it's very intense work, you can leave a lot of that stress in the door. When you worry about literally taking the disease home with you, it's hard to do that. My wife and I have had a lot of what if conversations. We've had conversations with our friends who are also doctors, who also have kids about if we were sick, if we were incapacitated, could you take our kids and vice-versa? I also have a bit of a ritual of taking off my scrubs in the garage, washing hands.
Dr. Nick Mark: Just doing everything I can to prevent bringing this home with me. Being as careful as I possibly can be at work.
Al Letson: Yeah. You've contributed to a guide for medical folks about how to communicate with the public. It's one about tough conversations like this one. Why can't my grandma get into ICU? Are you discriminating against her because she's old? We're hearing doctors say that if they have to choose who to put on ventilators, that they need to choose people who will likely come out of it well. What do you say to that grandmother?
Dr. Nick Mark: I should say a couple of things to preface this. This is just ICU care in general. There's a lot of things that we can do but they're not always a good idea to do. Doing everything for everybody is not always the right thing. In this case, it's even harder because COVID seems to disproportionately cause severe illness in older people and in people who have medical comorbidity. People who were already going into this at a disadvantage and that's tough. There have been just heart-wrenching accounts from Italy about not having nearly enough ventilators and having to give them to only a select few.
Dr. Nick Mark: I want to reassure your listeners, that's not the situation in Seattle. We're all worried that it could be. We're not at the peak of this yet. It looks like based on the numbers, they're about 10 days ahead. Our numbers are tracking exactly with where theirs were 10 days ago.
Al Letson: That's a hard answer to hear. Because what's going on in Italy is really heartbreaking.
Dr. Nick Mark: It is, yeah. We often think about limited resources in terms of machines, beds but the most valuable resource in the hospital is the people who know how to use those machines and know how to take care of people in the beds. One of the things that I worry about is not just that the amazing ICU nurses and respiratory therapists and other support staff are going to get sick. They're going to get tired. They're going to get burned out.
Al Letson: Yeah.
Dr. Nick Mark: This is likely to be a marathon, not a sprint. We're probably on Mile 2 or Mile 3 of it.
Al Letson: Dr. Mark, this is a great conversation but very sobering.
Dr. Nick Mark: Yeah. Can I say something else real quick?
Al Letson: Please, please.
Dr. Nick Mark: I think this is a really important thing to remember because this is scary. This is a disease that you can get from somebody else. This is an infectious disease. I think it's really important to remember the shared humanity that the people who have this are people. That's important for us in the hospital to remember that these people are profoundly afraid. They're hearing about how terrible and scary this virus is. They're cut off. In many cases, we don't let them have visitors because we don't want to spread this. People are in a room with no support from their family.
Dr. Nick Mark: Everybody who comes in is scared to be there and they're wearing protective equipment. Remembering what these people are going through is really important. I think anything that we can do to be compassionate to them, whether it's helping them FaceTime with their loved ones so they can have some contact. Whether it's just as healthcare providers, spending an extra minute or two, putting your hand on somebody's shoulder. Little things like that I think are really important now.
Dr. Nick Mark: I mean, those things are always important but I think they're especially important when people are feeling as scared and isolated as they are with this.
Al Letson: Yeah. Dr. Nick, man, thank you for your work on the front lines and taking time to talk to us.
Dr. Nick Mark: Thanks for having me.
Al Letson: Nick Mark is a critical care specialist in Seattle. While we're in the Coronavirus crisis, just like everyone has to make a shift, here at Reveal, so do we. That means we're delaying the release of our serial project, American Rehab. We'd originally planned to launch it next week. It's about another public health crisis, drug addiction in America. We investigated drug rehab programs that are putting people to work without paying them. Tens of thousands of people a year are affected. It's important reporting and some of the best radio we've ever made but the timing just isn't right.
Al Letson: For now, we'll cover the Coronavirus and continue to bring you other in-depth investigative stories you've come to rely on us for. Like our next story. The President has compared fighting the Coronavirus with going to war. In a moment, we look back at the Iraq war and one man's effort to seek justice from his American interrogators at Abu Ghraib prison. You're listening to Reveal.
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Al Letson: From The Center for Investigative Reporting and PRX, this is Reveal. I'm Al Letson. This month marks 17 years since President George W. Bush went on television and announced the start of the Iraq War. The legacy of his decision is still being fought over. The war was controversial even before it started. A war of choice justified by reasons that were never proven.
George W. Bush: Saddam Hussein and his regime are concealing their efforts to produce more weapons of mass destruction.
Al Letson: There are questions about how the US military fought the war. Hiring private companies to work alongside US soldier. Iraq, along with the war in Afghanistan was a test case for using private contractors on a scale we've never really seen before. In both wars, there were just as many private contractors as members of the US military. The way some of them did their job raised big questions. After the war, there was a series of video clips that came to light. They've been filmed during the conflict and set to heavy metal music.
Al Letson: In one of them, employees of a private military contractor called Blackwater drive a convoy of trucks down a wide open boulevard in Baghdad. A woman in a black burka waits to cross the street and then, one of the trucks suddenly swerves right into her and knocks her to the ground. A man on the street runs to help her but the trucks just keep going. In another video clip, contractors with the same company drive around the city harassing residents to the point that they're randomly firing guns at people in their cars.
Al Letson: Today, we want to bring you the story of one man, an Iraqi who came face to face with private contractors in the war. Contractors he says took part in abusing him. Years ago, he filed a lawsuit against the company. His case has been making its way through the legal system. It may soon be taken up by the Supreme Court. Our story is a collaboration with the United States of Anxiety. A podcast from WNYC Studios. It was reported by Seth Freed Wessler, a reporting fellow with Type Media Center. I want to warn you. This episode contains graphic depictions of violence.
Speaker 5: [foreign language 00:15:07]
Al Letson: Hi. Thank you. Hi.
Seth Freed Wess...: Hi.
Al Letson: Seth, great to meet you. First, I want to introduce you to a family living far from the place they'd always called home.
Speaker 7: [foreign language 00:15:19] Home.
Salah Hasan: My name is Salah Hasan. I am from Iraq.
Al Letson: Salah Hasan Nusaif al-Ejaili is from a province just outside Baghdad.
Salah Hasan: Now, I am in Sweden in Vasteras City.
Al Letson: He and his wife, Amal and their three kids.
Salah Hasan: How are you?
Al Letson: Taqua, Quaith and Mustafa. They moved to Sweden as refugees. The thing about Sweden at the time I visited them in the spring and summer is that the days are really, really long.
Speaker 7: This one never sits.
Al Letson: Yeah. More than 20 hours long. It was Ramadan, which means they were fasting for 20 hours. We were in the kitchen preparing all of this delicious food that we'd eat in a couple of hours.
Speaker 7: A fact about the soup, we do it every single night of Ramadan.
Al Letson: The kids, all they could talk about was the food and the meal they were going to eat.
Speaker 9: My favorite things to do with the rice, I take ketchup and put it on it and then take potatoes and put it on it and the little pieces of noodles and then I put it on it and I eat it all.
Al Letson: This is a really lovely family. They're effusive. They're laughing together all the time trying to find work, learning a new language. What time is school in the morning?
Speaker 10: Usually 8:30.
Al Letson: Yeah. They're here ultimately because of-
George W. Bush: US war ships and planes.
Al Letson: ... The war in Iraq.
George W. Bush: The opening salvo of Operation Iraqi Freedom.
Al Letson: When President Bush, George W. Bush announced the American invasion of Iraq in March of 2003. Salah was working in Diyala, a province where he's from in a machine shop. Amal was working as a teacher there. They have a newborn baby. Taqua had just been born.
George W. Bush: The people you liberate will witness the honorable and decent spirit of the American military.
Al Letson: As anyone who remembers this time will remember, there was widespread condemnation of this war all over the world. In Iraq, the resistance emerged soon after the Americans invaded.
Speaker 11: Some embassy staff uninjured by the blast were chased by the mob.
Al Letson: At the start of it all, Salah was looking for some way to do something meaningful. In this terrifying period in his country. He saw this job posting to be a reporter at Al Jazeera, the TV network based in Qatar. Al Jazeera was hiring lots of people as reporters in Iraq to cover the war. They were hiring people who sometimes didn't have all that much experience as reporters and he got the job basically as a cameraman and field reporter.
Al Letson: Right away, after a bit of training, he was sent out to report on major incidents of violence, explosions, generally, the chaos that was erupting around the region that he was from. He was out reporting all the time. At least in his community, in Diyala, people knew him. He was the local reporter. One day in November of 2003, Salah went to cover a bombing in the city of Baqubah. He speaks mostly in Arabic so we hired a translator.
Speaker 12: Me along with other outlets such as France Press and Reuters, we went in there to cover the story. I was there filming the car that had exploded. I even interviewed one local politician who was there. I was talking to people and filming the surrounding site.
Al Letson: When I sat down to talk with Salah about this moment, he said that as he was doing all this reporting, there were also members of the American military police at the site. They asked all these reporters to gather around and they began to ask them questions.
Salah Hasan: [foreign language 00:19:50]
Speaker 12: We were about five, six journalists and we lined up. I was third in the line. When my turn came, he asked my name and which TV station I represent.
Salah Hasan: [foreign language 00:20:08]
Speaker 12: When I said my name and that I work for Al Jazeera, he said, "You're under arrest." When I said, "Why?" He said, "You know why."
Al Letson: At first, Salah thought this must be a mistake. At this point in the Iraq War, just a mere eight months into the invasion, the US had begun broadening who it considered to be the enemy. Al Jazeera, which was one of the leading, if not the leading Arabic news outlets-
Speaker 11: Became the most watched TV outlet in the Middle East-
Al Letson: ... Had been reporting on the gruesome facts of the war. It had become this kind of target of the Bush administration.
Donald Rumsfeld: We know that Al Jazeera has a pattern of playing propaganda.
Al Letson: Donald Rumsfeld, then the Secretary of Defense had falsely claimed that Al Jazeera was fabricating stories about civilian casualties. That it was acting as Al Qaeda's mouthpiece.
Donald Rumsfeld: What they do is when a bomb goes down, they grab some children and some women and pretend that the bomb hit the women and the children.
Al Letson: Al Jazeera offices both in Iraq and Afghanistan had been bombed.
Speaker 14: The United States hit that office and killed Tareq Ayyoub.
Al Letson: In Salah's case, he was pulled out of that press scrum and he was taken to a place that he'd only ever heard horrors about for years.
Speaker 15: Abu Ghraib prison where Saddam Hussein subjected prisoners to hideous torture.
Al Letson: Abu Ghraib was an Iraqi prison that stood for Saddam Hussein's brutality.
Speaker 16: Their bodies were eaten by dogs, torture, electrodes coming out of walls, scratches on the wall. It was an awful place.
Al Letson: It was a place where people disappeared.
Speaker 17: Iraqis were too afraid to come to Abu Ghraib and ask for information on their family members.
Al Letson: Then after the invasion, after the US invaded and occupied the country, the Americans made the jail into their own prison. When Salah was detained there, one of the first things that happened to him was that the Americans stripped him naked.
Salah Hasan: [foreign language 00:22:21]
Speaker 12: They were shouting that I should confess. "Confess." I asked, "Confess to what?" They said, "You know what. Confess to everything."
Salah Hasan: [foreign language 00:22:34]
Speaker 12: After I was forced to remove my clothes, they placed a black bag over my head. They tied my hands together behind my back. I was left outside from the evening until the morning.
Salah Hasan: [foreign language 00:22:50]
Speaker 12: That first night, I heard the American outside singing," Happy Birthday, Al Jazeera." That's when I thought, understood that this arrest concerns me and Al Jazeera coverage of the country.
Al Letson: He spent six weeks inside of Abu Ghraib where he was interrogated, asked questions about Al Jazeera, about why he worked there. Hearing suggestions that he must know something about the insurgency. Inside, he was treated horrifically. His arms were often chained to a post above his head, unable to move, being threatened by an aggressive military dog, barking, growling at him.
Salah Hasan: [foreign language 00:23:37]
Speaker 12: Especially when you have the dogs approaching you and you are in handcuff, you cannot do anything about it. Standing there naked, I felt paralyzed. They have full power over me. I even thought that they were capable of killing me anytime and throwing my corpse aside.
Salah Hasan: [foreign language 00:23:58]
Speaker 12: It was very painful to hear prisoners screaming in pain and realizing that your time will come to be tortured and beaten.
Al Letson: Salah said every two or three days, he'd be interrogated. He didn't know exactly who was questioning him. He was often hooded. Those he could see somewhere in military uniform, somewhere in civilian clothes. What we now know is that the interrogations inside of Abu Ghraib, they were carried out not only by members of the American military but also by employees of a private contractor, an American company called CACI.
Speaker 18: This is CACI.
Al Letson: Which had been paid millions of dollars.
Speaker 18: America's priorities are our priorities.
Al Letson: To provide interrogation services inside these American military prisons.
Salah Hasan: [foreign language 00:24:53]
Speaker 12: For interrogation, the regular Army soldier would take us and deliver us to these people and just leave us with them and just hand us over into their hands.
Salah Hasan: [foreign language 00:25:05]
Speaker 12: It was very apparent that they had another kind of power and authority than the regular military.
Salah Hasan: [foreign language 00:25:14]
Al Letson: One of the things Salah remembers is that while he was chained inside of that cell, he vomited on the floor in front of him. Then he was ordered by somebody to use the orange jumpsuit that he'd been given as his only piece of clothing to wipe up the vomit on the floor. He was then told to put the jumpsuit back on.
Salah Hasan: [foreign language 00:25:38]
Speaker 12: One of the moments that always come back to me is the feeling of being observed, looked at as if we were animals in a zoo. This is what I felt in the prison.
Salah Hasan: [foreign language 00:25:50]
Al Letson: He says that on days when it was sunny, there would be just a sliver of light that would shine into the cell where he was held and that was his measurement of a day passing.
Salah Hasan: [foreign language 00:26:07]
Speaker 12: The spot was about half a meter and it would only appear for 30 minutes. I try to step into that spot and move with the light so I can feel the sun. I can feel something from the outside world. I would track that spot until the sunlight disappeared.
Salah Hasan: [foreign language 00:26:30]
Al Letson: At the end of December 2003, Salah was just released. He was driven out of Abu Ghraib and dumped on a street outside of Baghdad and left there. He went home to Amal, his wife and their baby daughter back in Diyala.
Seth Freed Wess...: Can you tell me about when he came home? Can you tell me about that moment?
Speaker 7: [foreign language 00:27:01]
Speaker 19: When I heard, I couldn't believe the news because they told us that the people who were taken to Abu Ghraib, they might spend years or at least many months there.
Speaker 7: [foreign language 00:27:15]
Speaker 19: When he did get out, he was completely transformed.
Speaker 7: [foreign language 00:27:22]
Speaker 19: It was half of my husband. His head was shaven.
Speaker 7: [foreign language 00:27:31]
Speaker 19: He approached Taqua and saying, "Daddy, I'm here." She didn't respond to him.
Speaker 7: [foreign language 00:27:45]
Speaker 19: I remember being joyful that day. I think more joyful than I was on our wedding day. When I first saw him, I saw that he was still alive. That he was still with us.
Speaker 7: [foreign language 00:28:09]
Al Letson: When he got out, he said his editors at Al Jazeera asked him to file a memo on what had happened to him. When they read it, they were in disbelief.
Salah Hasan: [foreign language 00:28:24]
Speaker 12: They couldn't believe that any of this could be true. Even journalists couldn't believe how could such an incident happen without us knowing about it.
Salah Hasan: [foreign language 00:28:37]
Al Letson: Salah felt that what had happened to him was just his to bear. That since he had no hard proof, nobody would ever really believe him. Then in April 2004 ...
Speaker 14: This is a picture of an Iraqi prisoner of war.
Al Letson: CBS News in the United States runs this story about Abu Ghraib.
Speaker 14: The Army confiscated some 60 pictures of Iraqi prisoners being mistreated.
Al Letson: Releases these images of people being tortured inside of that American prison.
Speaker 14: We want to warn you, the pictures are difficult to look at.
Al Letson: These are the images that probably have been most burned into all of our minds about the Iraq War.
Speaker 14: Americans did this to an Iraqi prisoner.
Al Letson: The image of a man, a hood over his head, standing on a box with his arms outstretched and electrical wires attached to his fingers.
Speaker 14: According to the US Army, he was told that if he fell off the box, he would be electrocuted.
Al Letson: There's an image of a stack of naked men who'd been forced to create a pyramid one on top of another.
Speaker 14: In some, the male prisoners are positioned to simulate sex with each other.
Al Letson: In those photographs are members of the American military holding on to leashes.
Speaker 14: Posing with naked Iraqi prisoners.
Al Letson: Smiling in pictures of people being abused in the most terrible of ways.
Speaker 15: Arab TV labeled the acts atrocities.
Al Letson: These images are splashed across the world's television screens.
Speaker 15: Headlines around the world screamed torture.
Al Letson: Suddenly, everybody sees it. It's impossible to not believe it.
Speaker 15: America's reputation already battered has suffered even more.
Al Letson: When you first saw those images, what was that like?
Salah Hasan: [foreign language 00:30:33]
Speaker 12: When the images surfaced, it confirmed that this actually happened to me where nobody believed me because I had no proof. Now, I could say, "See? These are the facts." Second, everything was coming back to me. The insults, the beating, the pain started to re-emerge again.
Salah Hasan: [foreign language 00:30:57]
Al Letson: Salah believes that he's in one of those photographs that a group of lawyers showed him later. It's a photograph shot from above of a man chained to a post inside of a cell. In front of this man's body is a puddle of dark liquid, of vomit. It's exactly what Salah said happened to him.
Salah Hasan: [foreign language 00:31:19]
Speaker 12: I had told them all of these details and they shocked me when they showed me this photo. I told them, "Yes. This is it."
Speaker 20: President Bush said today that he was disgusted by pictures of Iraqi prisoners being abused by American soldiers.
George W. Bush: Their treatment does not reflect the nature of the American people.
Al Letson: You know, the scandal that was Abu Ghraib immediately exposed the lie of a war of liberation, which is how the Bush administration had tried to justify the invasion. 11 people, members of American military ultimately were charged or disciplined for their part in these abuses.
Speaker 15: Four men are charged with maltreatment and indecent acts.
Al Letson: Some went to prison.
Speaker 15: For shoving and stepping on detainees.
Al Letson: Salah watched these prosecutions and he couldn't but feel that this wasn't enough going after a handful of American soldiers.
Speaker 21: Seeing these pictures may reflect the actions of individuals but by God, it doesn't reflect my Army.
Al Letson: Salah knew those soldiers were part of a bigger system. Who was giving them orders? What about those people in civilian clothes who were working alongside them? Those civilians as it turns out work for the private contractor CACI that was hired by the US military to manage interrogations. When we come back, we meet one of those contractors who worked at Abu Ghraib.
Eric Fair: There's no excuse for me at the time having to have been able to look at those things and recognize that I didn't want to do them but I did.
Al Letson: You're listening to Reveal. From The Center for Investigative Reporting and PRX, this is Reveal. I'm Al Letson. Today, we're looking at the role US private contractors played in abusing people who were detained at Abu Ghraib prison during the Iraq War. There are hundreds. Possibly thousands of people like Salah who were scarred by what happened to them. Some are still in Iraq. Others like him are refugees trying to build a life in a new country. There are the people here in the US who worked inside American military prisons, people who abuse detainees.
Al Letson: Reporter Seth Freed Wessler from Type Media sent her pics of the story and again, a warning that this piece contains descriptions of physical abuse. Hi, Eric.
Eric Fair: Al, how are you?
Al Letson: A few months ago, I drove out to a house at the end of a quite suburban street to meet Eric Fair.
Eric Fair: I live in Bethlehem, Pennsylvania.
Al Letson: Fair worked as an interrogator in American military prisons in Iraq including Abu Ghraib. He got there just after Salah was released.
Eric Fair: I spend my days coaching little league.
Al Letson: He's been remarkably open about what he was part of. He's spoken out, talked tot he press. He wrote a book about his time working in Iraq when he was an employee of this private company called CACI.
Eric Fair: Of course, I get asked about CACI.
Al Letson: He says, "Abu Ghraib is a place he can't shake."
Eric Fair: For me, it's sort of a movie that just keeps playing. It's not something that happened 15 years ago. It's something that's happening right now.
Al Letson: Can you describe what you remember most physically about the place?
Eric Fair: I do remember seeing my prisoners for the first time. I was overwhelmed by the numbers. How many people we had put in prison. Abu Ghraib was filthy and poorly run. It was overcrowded. There was a violation of human morality and it was a crime.
Al Letson: How did you, as a contractor end up engaging in the kind of abuse or torture that you did? How did that happen?
Eric Fair: I don't know. I've spent so many years thinking about how that happened and in some ways, giving excuses. The big question is if I had it do to over again, would I go back and do it differently? Would I change things? Of course, I would but I can't. It was who I was. I was someone who was willing to employ those types of techniques. They weren't things that I made up in my mind or that I created or I'd seen on TV. These were techniques that were written down and were instructed and described. It was an awful thing to do.
Al Letson: Fair came home from Iraq, returned to Pennsylvania and he watched-
Speaker 15: Leading the physical and sexual torture-
Al Letson: As members of the US military were tried and went to prison.
Speaker 15: Sentenced Army Specialist Charles Graner to 10 years in prison.
Al Letson: He waited for somebody to come for him.
Eric Fair: If there is a prosecutor out there that is going to make a case to prosecute CACI or for any of its employees for torture, then I am the easiest case. The evidence is there and I've done a really good job of making it really easy for someone to hold me responsible.
Al Letson: Nobody ever did. Nobody ever came to charge or prosecute the contractors, the civilian contractors who'd been inside of Abu Ghraib and who Fair says did what they did.
Eric Fair: I absolutely sympathize with the idea that a lot of people got away with a lot of awful things and that there should be some consequences. Everyone on some level needs to be held accountable for what they did in war.
Al Letson: Fair believes that we all need to reckon broadly and deeply as a country with the wars we start and the violence we're responsible for. Holding Americans accountable for what they did in war is not so easy. There was one case that dragged on for more than a decade where federal prosecutors criminally charged employees of another contractor, Blackwater for a massacre in Iraq. For people like Salah, a non-US citizen living in a different country, pursuing any accountability on their own behalf, that's incredibly hard. One of the main reasons for that is this doctrine called Sovereign Immunity.
Al Letson: It's a weird carryover from British common law. It means the King can do no wrong. In the American version, it basically means as a legal matter, the government can't be held liable for wrongdoing. Even in Iraq, in a prison that the US was in full control of. There was something Salah could do. He could file a civil lawsuit against the contractors who played a role in the abuses in Abu Ghraib. He could sue CACI. In 2008, a group of lawyers including The Center for Constitutional Rights did just that.
Al Letson: They filed a lawsuit on behalf of Salah and three other men who've also been held in Abu Ghraib and like Salah who'd been released without charge.
Speaker 23: This is the deposition of Suhail Najim Abdullah Al Shimari.
Al Letson: Suhail Al Shimari is one of the other plaintiffs in the case.
Speaker 23: Will the witness please raise his right hand?
Al Letson: In his deposition, Al Shimari told the court what had happened to him.
Suhail Al Shima...: [foreign language 00:38:38]
Speaker 25: He kept hitting me, hitting me, hitting me all over my body.
Suhail Al Shima...: [foreign language 00:38:43]
Speaker 25: On my face, on my cheeks.
Al Letson: Like Salah, he recalled terrible abuse and torture.
Speaker 23: Plaintiff calls Shimari was subject to gratuitous and humiliating sexual touching when on multiple occasions guards forced him to bend over and inserted their fingers into his rectum. Did that happen at Abu Ghraib?
Suhail Al Shima...: [foreign language 00:39:10]
Speaker 25: Yes.
Al Letson: An investigation by the US government of what had happened inside of Abu Ghraib.
Antonio Taguba: Members of the committee, good morning all. I am Major General Antonio M. Taguba.
Al Letson: It actually said that at least one CACI employee had been part of making decisions about how detainees were interrogated there and instructed military police to abuse to prisoners.
Antonio Taguba: We gathered evidence pertaining to the involvement of several military intelligence personnel or contractors assigned to the 205th MI Brigade in the alleged detainee abuses at Abu Ghraib.
Al Letson: Members of the US military who were put on trial over the violence at Abu Ghraib said on the stand that CACI employees had instructed them to abuse prisoners, which were damning allegations. Remember, Salah had spent months unable to get anyone to fully believe what he had said happened to him.
Salah Hasan: [foreign language 00:40:05]
Speaker 12: I know CACI company was there. Interrogators were from CACI company. This was obvious and we have evidence on this, which we filed in the court.
Salah Hasan: [foreign language 00:40:21]
Al Letson: He and his lawyers, they felt like they had this very clear case of CACI's complicity in this well-documented abuses. That according to testimony and reports, the company had been part of making decisions about detainee treatment. He and the other plaintiffs felt they'd finally be able to bring this story before an American judge and a US court.
Speaker 23: Be seated.
Al Letson: That's not exactly what happened.
Speaker 23: All right. We're ready to proceed in Al Shimari versus CACI.
Al Letson: What happened is that right away, CACI began to fight the case against it tooth and nail.
John O'Connor: Good morning. May it please the court. My name is John O'Connor and along with my co-counsel, Bill Dolan, we represent CACI in this appeal.
Al Letson: CACI or C-A-C-I tried out every argument it could think of to convince the court that since it was the federal government that had hired them, they're protected. So far, for 12 whole years, it's managed to keep this case from going to trial.
John O'Connor: The court has a number of different ways that it could resolve this case and end this case essentially here today.
Al Letson: No one, not even CACI ever contested that Salah was held at Abu Ghraib. The company argued that whatever had happened to him there, he couldn't prove that CACI had anything to do with it.
John O'Connor: The record does include some allegations, mostly in government reports of discreet acts of misconduct. None of which I think would in any way qualify as torture.
Al Letson: Another argument and this really was a kitchen sink approach was that this case wasn't anything that a judge should be weighing at all. That what happens at war is a political issue, not a legal one. That it's something for Congress and the President to deal with.
Speaker 28: This case has been going on quite a while.
Al Letson: It's been thrown out, reinstated, delayed, appealed repeatedly. Remarkably, it's still standing. I asked CACI for an interview. The company didn't respond but it strongly denied allegations of wrongdoing. In a past statement, it said, "These lawsuits are completely without merit and designed to pursue a political agenda."
Speaker 28: What do you suggest are next steps?
Al Letson: CACI tried another argument, too.
Speaker 29: May it please the court, Judge-
Al Letson: Remember that idea, Sovereign Immunity. It's the idea that you can't sue the king. CACI's lawyers put forward this other argument. They said that CACI had what they call derivative sovereign immunity. Effectively, the company's saying that they are operating like they're the king's honor. They're under the control of the king's head. If the king can't be sued, well then, you can't sue the king's arm. CACI has taken this argument all the way to the Supreme Court. We're still waiting on the justices to decide if they're going to take this case.
Al Letson: If they choose not to, then it might finally go to trial in front of a jury. If they do take the case, for Salah and the other plaintiffs, there's real reason to be concerned. Because of who now sits on the nation's highest bench.
Speaker 28: 7001 et al Salah and individual et al versus CACI International Inc.
Al Letson: Justice Brett Kavanaugh who's lauded by conservatives heard a very similar case when he was on the DC Circuit Court a decade ago. Another case about US military contractors including CACI.
Brett Kavanaugh: The treatment of prisoners in a war zone by US military contractors could be governed by the enemy's law.
Speaker 28: No. It's-
Al Letson: This case also dealt with accusations of torture at Abu Ghraib.
Speaker 28: One of the mechanisms in our system of American jurisprudence that keeps corporations abiding by the law is a spector of tort liability.
Brett Kavanaugh: Any evidence of that?
Al Letson: Kavanaugh who was very skeptical of the detainees' arguments threw out the case. There's reason to think he would act in a similar way now, which as Salah himself recognizes could prevent his case and others like it in the future from going to trial.
Salah Hasan: [foreign language 00:44:40]
Speaker 12: I think the law should be applied to individuals everywhere. Otherwise, this would give immunity to Americans to go outside the borders, commit heinous crimes and there would be no consequences.
Al Letson: This is beautiful. Thank you-
Salah Hasan: You're welcome.
Al Letson: ... Very much. Once the sun finally set in Sweden, the night I went to visit Salah and his family, we sat down for a meal.
Speaker 7: [foreign language 00:45:15]
Al Letson: As I looked around the table, it occurred to me, these kids, this case has been going on their entire lives. Salah and his wife, Amal have waited and waited through the starts and stops of this case. For years to have their moment in court. The Iraq War and what happened to Salah has completely uprooted this family.
Speaker 7: [foreign language 00:45:45]
Speaker 19: The day we left Iraq, I knew inside that this was a farewell without return. That there was no going back. The country was being broken and that we wouldn't return.
Al Letson: After they left, the war deepened. Civil War, the rise of the Islamic state, skyrocketing unemployment, corruption, it's been a barrage. For Salah and Amal, their trauma doesn't go away. Amid all of this wreckage, they've stayed with this pursuit as its ground forward and back in the American courts.
Speaker 7: [foreign language 00:46:25]
Speaker 19: As they say, the road to reckoning is long but the ultimate goal was that what happened to Salah should never happen to anyone again.
Al Letson: For those of us who were never there, we have a way of very quickly putting things like Abu Ghraib behind us. For Salah and people like him, there's been very little space to actually tell their stories. Salah's still working as a journalist. Filing freelance stories from Sweden but when it comes to what happened to him, there's still real questions. For him, a big part of this case is about putting the facts on the table in an American court.
Salah Hasan: [foreign language 00:47:09]
Speaker 12: There is another point to be made, which is the memories will remain but I can't have hate inside me. There could come a point where as they say, the forgiver is generous. Where that mission of guilt could come and where we say, "Okay. I forgive them."
Al Letson: There have been a series of lawsuits like this one filed to hold contractors accountable for abuses and crimes in war. They've all been thrown out or settled out of court. This is the last one standing. Beyond that, at a time when the President has supported the use of waterboarding and even pardon those who've been charged with war crimes, this may be the last chance for Salah and other victims of American abuses in war to forest what happened back into view. Over the past year, CACI has been awarded several new US government and military contracts worth up to nearly $3 billion over the coming years.
Al Letson: In the meantime, we're still waiting on the Supreme Court to decide whether to hear the case. Our story was reported by Seth Freed Wessler, a [inaudible] reporting fellow with Type Media Center. It was produced and edited by Christopher Worth. This story is in partnership with The United States of Anxiety. A podcast hosted by my dude, Kai Wright from WNYC Studios. I highly recommend you check out the show's latest season where they trace the origin of today's most contentious political debate to their roots in the reconstruction era following the Civil War.
Al Letson: They dive in school segregation, immigration and racist housing policies. You can find The United States of Anxiety wherever you get your podcast. Our Coronavirus coverage is produced by Emily Harris with help from Esther Kaplan, Jennifer Gollan, Byard Duncan and Elizabeth Shogren. Taki Telonidis edited the show. Thanks to Ibrahim Hussein, Hanin Shakrah, Casey Mise, Karen Froman, Mary Ann McCune and Angeli Comet for their work on the Abu Ghraib story. Victoria Baranetsky is our general counselor. Our production manager is Mwende Hinojosa.
Al Letson: Original score and sound design by the Dynamic Duo, Jay Breezy, Mr. Jim Briggs and Fernando, my man, Arruda and Bryson Barnes. They had helped this week from Amy Mustafa. Our CEO is Christa Scharfenberg. Matt Thompson is our Editor-in-Chief. Our executive producer is Kevin Sullivan. Our theme music is by Camerado Lightning.
Al Letson: Support for Reveal is provided by the Reva and David Logan Foundation, The John D. and Catherine T. MacArthur Foundation, the Jonathan Logan Family Foundation, the Ford Foundation, The Heising-Simons Foundation, the Democracy Fund and the Ethics and Excellence in Journalism Foundation. Reveal is a co-production of The Center for Investigative Reporting and PRX. I'm Al Letson. Remember, the only way we get through this is together.
Speaker 31: From PRX.