Approved for Release 2016 06 10 C06541721 3 NatSec Act CENTRAL INTELLIGENCE AGENCY Office of Inspector General REPORT OF AUDIT CIA-controlled Detention Facilities Operated Under the 17 September 2001 Memorandum of Notification NatSecAct Report No ClAAct NatSecAct 006 14 June 2006 ISSUE DATE NatSecAct Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 C06541721 bX1 NatSecAct 14 June 2006 MEMORANDUM FOR Acting Executive Director FROM John L Helgerson Ianector General NatSecAct SUBJECT HF Report of Audit CIA-controlled Detention Facilities Operated Under the 1'7 September 2001 Memorandum of Notification 2005-0017-AS NatSecAct 1 'Attached is our final report on CIA-controlled detention facilities operated under the 17 September 2001 Memorandum of NOtification Recommendation 1 is directed to you It is my understanding that you are in agreement with the recommendation Please provide me a written response within 60 days setting forth the actions that have been taken to implement the recommendation and or a timetable for eventual implementation 2 U All of the recommendations in the report are considered significant The status of the recommendations as well as corrective actions taken to address them will be included in an appropriately sanitized way in the Inspector General's next semiannual report to the Director Central Intelligence Agency 3 -6- This audit responds to a recommendation in the Classified Annex to the Joint Explanatory Statement of the Committee of Conference accompanying the Intelligence Authorization Act for Fiscal Year 2002 that the Central Intelligence Agency Inspector General audit each covert action program at least every three years Our report will be provided to the Congressional oversight committees 30 days from the date of this memorandum NatSecAct bxs CLiAct When Separated From Attachment NatSecAct NatSecAct Approved for Release 2016 06 10 006541721 Appgxeld for Release 2016 06 10 C06541721 roe-seesaw NatSecAct mew-rm 14 June 2006 MEMORANDUM FOR Acting Executive Director FROM John L Helgerson Inspector General SUBJECT 13A 115' Report of Audit CIA-controlled Detention Facilities Operated Under the 17 September 2001 bX1 Memorandum of Notification NatSecAct 1 NF Attached is our final report on CIA-controlled detention facilities operated under the 117 September 2001 Memorandum of Notification Recommendation 1 is directed to you It is my understanding that you are in agreement with the recommendation Please provide me a written response within 60 days setting forth the actions that have been taken to implement the recommendation and or a timetable for eventual implementation 2 U All of the recommendations in the report are - considered significant The status of the recommendations as well as corrective actions taken to address them will be included in an appropriately sanitized wayain the Inspector General's next semiannual report to the Director Central Intelligence Agency 3 H57 This audit responds to a recommendation in the Classified Annex to the Joint Explanatory Statement of the Committee of Conference accompanying the Intelligence Authorization Act for Fiscal Year 2002 that the Central Intelligence Agency Inspector General audit each covert action program at least every three years Our report will be prbvided to the Congressional oversight committees 30 days from the date of this memorandum NatSecAct Tee seesaw my When Separated From Attachment 3 NatSec Act m NatSecAct Approved for Release 2016 06 10 C06541721 Approved for Release 2016 06 10 C06541721 Mme NatSecAct U Table of Contents U EXECUTIVE SUMMARY 1 U BACKGROUND 3 CIA Counterterrorism Authorities 3_ U AUDIT RESULTS AND - IONS 4 El bile Natsm 22222222222221 4 2321 El 22222222222222 4 UIIFGUQJ Standar Recordkeeplng Are Generally Sufflaent I 6 W1 HEMP 2 eakness in Detention W3 Facilities Operations 2 ed 7 1 61 r- 5 Are Needed for NatSecAct inpatient Treatment for 3 7 sl he Timely Access to Critical Medical 1 Information on Detainees ls Needed in the Field 11 W3 NatseCACt unease Facilities Staffs Lack Training in Safe Food Handling and Preparation 12 NatSecAct NF Policy on Response to the Death of a NatSecAct Detainee 5 ea ed 1 6 ClAAct W3 Approved for Release 2016 06 10 006541721 1 MM NatSeCAct b 3 NatSecAct_s Approved for Release 2016 06 10 006541721 NatSecAct F A Shortage of Debriefers at Detention Facilities May Have Negatively Impacted Intelligence Collection 18 NatSecAct U Objectives Scope and Methodology A 1 NF CIA-controlled Detention Facilities That Were in Use at the Time of the Audit EXHIBIT 5 trvr - gigantic at of the Audit EXHIBIT 1 i b Detentt fdriggm Were Not if NF Detention Facilities mm m we 09% -managed Detention U Recommendations EXHIBIT UIIFGUO Audit Team Me EXHIBIT NatSeCAct NUT-U Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 006541 721_ TSP-SEGRET 1 I 3 NatSecAet NatSecAet Report of Audit rs 1 NF CIA-controlled Detention Facilities-Operated Under the 17 September 2001 Memorandum of Noti cation U EXECUTIVE NatSecAct NF The objectives of this audit were to determine whether the Central Intelligence Agency CIA Developed and adhere i133 iate standards and guidelines for opera tetra NatSecAet est National Clandestme Serv1ce 4 4 Detainees Group RDG were eat 7 it staffed to securely and safely contain detainees and promote 1113371 gence exploi I it of detainees Detainees at facilities operated by ' 31 5 of shelter clothing nourishment and hygiene medi examinations and treatment limited dental and vision care op 1 igeal exercise and intellectual religious and recreational pursuits f if 1 ta with facility staff Detainees are held In SOlltaW con nement in clima NatSeeActgusl mattress a sink and a toilet At the time we visited the hted aboveground window-less hat are equipped with a IA controlled detention 1 facilities in use no detainees were being interrogated all detainees were in the NatSeeActebrie ng phase of their con nement None of the detainees showed any apparent physical signs of mistreatment 3 NatSeCAct is responsible for ensuring that each detenti n facility is properly staffed and has developed a staffing plan for each facility in response to a recommendation contained in a prior Office of Inspector General OIG report Special Review Counterterrorism Detention and Interrogation Activities September 2001 - October 2003 2003-7123-IG May 2004 At the time NatSeCActat we visited thejdetention facilities in use except for a shortage of debriefers the facilities were staffed with sufficient numbers and types of personnel including chiefs of base COBS support officers communications of cers security officers interrogators and linguists as detailed in the staf ng plans Personnel from the CIA Off cc of General Counsel and the CIA Directorate of Support Office of Medical Services developed generally suf cient b 3 1 1 NatSeeAet A AA NatSeeAet Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 C06541721 3 NatSecAct standards and guidelines for operating CIA controlled detention facilities maintaining the health of detainees and safely handling detainees Facilities staffs generally followed the standards and guidelines in the conduct of their duties and responsibilities With minor exceptions responsible of cials maintained adequate records of the detainees con ned at CIA-controlled detention facilities operated by However additional or more detailed standards guidelines plans and training are needed to address certain areas of weakness in detention facilities operations that could jeopardize the health and safety of both detainees and detention facility staff NatSecAct CT detention facilities are not equipped to provide medical treatment to mad 0 develop serious physical or mental disorders and operable plans are Laplace tot ide inpatient care for detainees Facilities staffs do not have 1mm t access cal information on detainees that may be needed to safely and effeetaist ly respond toiaimedical emergency CIA off cers and other personnel at RD ention facilities have not been trained in safe food handling and preparation and st iidards fti'd procedures designed to avoid the introduction and transmission dim j ages have not been instituted at the facilities NatSecAct 121 1 NatSecAct lled detention facilities have experienced a shortage of quali ed debriefers which may have negatively impacted intelligence exploitation of detainees Some CIA personnel who successfully completed a specialtraining program to be debriefers of high value detainees HVDs have been unavailable for temporary assigmnent to detention facilities NatSecAct 'e 1 351 $3133 sprigs Assistant Inspector General 0111111111 NatSecAct Approved for Release 2016 06 10 006541721 Approved for Release _ 2016 06 10 006541721 3 NatSecAct 110mm U BACKGROUND NatSeCAct NatSecAct 1 NatSecAct Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 006541721 rep-seemed NatSecAct m1 AUDIT RESULTS AND RECOMMENDATIONS NatSecAct The CounterTerrorism Center Program for Operating Detention Facilities Has Been Effective NatSecAct program for operating detention facilities has been effective in providing secure and safe custody of persons detained by the CIA under authority of the 17 September 2001 MON The CIA-controlled detention facilities that were in operation during the time of our audit were constructed equipped and staffed to provide detainees essent1 lter clothing nourishment and mo omphed with the standards and g I I Iii If alities At the time we waited the detention facilities no detainee 3 5 eing int Ited all detainees were in the debrie ng phase of their con ni None of a i tainees at the time that we visited detention facilities 0pm by 133 owed any apparent physical signs NatSeCACtmistreatment 7 it bio 7 NF 1 1-- JRDG Det- Facilities Were Designe'y 13 1 eet NatSecAct NatSecAct 1 - CIA-controlled detention facilities operated by were designed constructed and equipped to securely and safely contain detainees and to promote intelligence exploitation of detainees We visited theS NatseCAcEtention facilities that were in use at the time of our audit S i manages the detention facilities twenty four hours a day w1th CIA sta and cleared contractor personnel Detainees are held in solitary con nement they generally are not physically restrained while in their cells Detainees are held in climate-controlled lighted aboveground window-less cells 1 Hhat are equipped With a mattress a sink and a toilet Detainees are prov1ded three balanced meals per day adequate clothing and access to showers and personal hygiene products Detention faciliti es staff personnel consult with an OMS dietician regarding detainees meal plans and nutritional requirements Each detention facility has an exercise room which encoura ed to use detainees are NatSecAct i TII NatSecAct Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 C06541721 NatSecAct mm NatSecAct NE Detainees are given medical examinations every six to eight weeks or more often if required by the detainee s medical condition OMS physicians and physician assistants wrath Headquarters-based personnel and regional medical of cers travel to the detention facilities to conduct medical examinations ClAAct has also arranged for limited dental and vision care 1 for detainees NatSecAct g4 i 75 384 ' fs are sensitive to the detainees religious and cultural requirements 6 access to the Koran and the Bible a prayer mg a prayer schedule t for daily prayer Detainees are sa cultural requirements and speci i customs associated with religio g a prolonged solitary con nement 117 movies and games Facilities it an 3 4 3 0 have daily contact with each detainee during debrie ngs rap sess t e i informal cell visits and when delivering meals The Director 75 CounterTerr a 3 13 Center Director CTC has advised us that beginning 1n Fe 1 tit 2006 sele ainees individually have been afforded social visits with anot getainee for 3 cximately one hour 1n 3 controlled and monitored setting lvisits ti the Director CTC believes that the and coping skills NatSecAct is responsible for ensuring that each detention facility is properly staffed and has developed a staf ng plan for each facility in response to a recommendation contained in a prior OIG report Special Review bll1 Counterterrorism Detention and Interrogation Activities September 2001 October NatSecAct03 2003 May 2004 At the time we visited the etention facilities in use except for a shortage of debriefers the facilities were staffed with suf cient numbers and types of personnel including COBs support of cers communications of cers security of cers interrogators and linguists as detailed in the staf ng plans CIAAC f cers were providing physical NatseCAgiecurity at the facilities and had responsibility for the safety of both facility staff and detainees at the time of our site visits 1 NatSecAct rep seeker W3 Approved for Release 2016 06 10 C06541721 Approved for Release 2016 06 10 006541721 bosom NatSecAct b NatSecAct I 3 NatSecAct me are discussed in Exhibit of this report During the audit we visited another facility NatseCACtsigned and built to be a CIA-controlled detention facility I I is unique among the facilities in the program in that it was b designed for was completed in b NatSeCAct at a cost of approximately illion but has not been used Senior I CTC of cials told us that not all Iapprovals have been received for its use 1 by the We also obtained information on but did not visitSother CIA- atSeC Actintrolled detention facilities that either were not in use or were under construction at the time of our audit other detention facilities that were not in use are discusse NatSecAct I Standards W Recordkeeping Are Ge- NatSecAct I 2 erva CTC ooc OMS and Facilities staffs generally follo f v 1 standard guidelines 1n the conduct of their 3' exceptloni f'i onsible of cials maintained adequate records of the detainee on ned at Exp A I '36personnel promulgated guidance Guidelines on Con nement Con- 3 5 IA Detainees govern the conduct of interrogations and the conditions of con nement for detainees The OMS guidelines provide general guidance on medical and issues during 1 rendition and initial interrogation 2 sustained debrie ng and 3 long term care Although the DCI and OMS guidelines contain appropriate provisions they speak in very general terms concerning how the guidelinesand standards contained therein should be implemented The DCI and OMS guidelines are discussed in Exhibit of this report NatSecAct 4384 To supplement the DCI and OMS guidelines RDG has developed and issued a number of standard operating procedures SOPs that address the day-to-day operation of its detention facilities The SOPs address staffing of the facilities biweekly reportin of detainees con nement conditions managing books and other print media provided to detainees development of meal plans cutting NatSecAct I The guideiines are currently under revision in response to a recommendation contained in a prior OIG report Special Review Counterterrorism Detention and Interrogation Activities September 2001 October 2003 200 7123-10 May 2004 6 NatSecAct Momma Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 C06541721 rep-seener l 13in NatSecAct W and trimming detainees hair and beards and handling of detainees in a variety of situations Of cials at each of the detention facilities established additional SOPs atSeC Acted on each facility s operational environment 1 land the provrsron of additional amenities to 5 detainees NatSecAct -151 1x13 COBs at detention facilities maintain SOPs in read-in les at each facility and require all permanently assigned and temporary duty personnel to read and acknowledge the procedures in writing upon arrival SOPs have been updated as needed to re ect the ch 2 11 erational environment Other records related to detention facilities and detainee _7 detamees medical records are available electronically and 1n hardg ined at Headquarters NatSecAct Areas of we knees in Detention mm NatSecAct 1 13 - generally sufficient standards and guidelines for in detention facilities maintaining the health of detainees and safegg WHewever additional or more detailed standards guidelines '3 weakness 1n detention facilities a 1 1' ations that co of both detainees and detention NatSecAct Needed for Providing Inpi for Detainees mu NatSecAct 1-8 1 NF detention facilities are not equipped to i provide medical treatment to detainees who have or develop serious physical or mental 1 disorders and operable plans are not in place to provide inpatient care for detainees i As a result there have been delays in providing necessary medical treatment for i detainees and CIA funds have been wasted in constructing and equipping a medical 1 facility that was later determined not to be a viable option for providing inpatient care detainees T-Sa l FN-E At leastS detainees in detention facilities have physical illnesses or conditions that require the detainees to be hospitalized for treatment NatSecAct was NatSecActliagnesed with hepatitis in September 2003 and should have a liver biopsy performed b NatSecAct NatSecAct Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 C06541721 mm Mam NatSecAct Masai mama NatSecAct In August 2005 an OMS of cer discovered during a routine medical examination thatl lgll j nl NatSecAct 1 1 1 1 1 Although most detainees are in good health the of an unforeseen acute medical condition that would require a detainee to be immediately hospitalized In December 2005 I exhibited that at first suggested appendicitis were 1 determined to be attributable to kidney stones and was successfully ire NatSecActated at I 1 Th 3M issued by OMS recommend that in situations where a detainee medicj 131 1113 not be adequately treated at the atSeCACtetentlon facility detention facility station personnel arrange access 1 to the host country s health care detention facilities ha a te ex nerienCEEI medical emergency that required atS A he cooperation of the host-coun arranging immediate Clospitalization for a detaineethat treatment of detainees with non-emergency inpatient requiremm Melt It a 53321 and until ecame bll t1c1pateprox1m1tytoa 1 nnerational CTC and OMS of 1 NatSecAct Department of Defense Do ac1hty would 1 fe it convenient to obtain treatment for CIA detainees at 3 mih ospital came into CIA custody re uirin additional medical trea i fmilitary hospital But Pll3 NatSecAct has not become a 31% tional and and OMS of cials told us that i the CIA IS currently denied acces 3 i'il facilities to obtain treatment for CIA detainees CIA station and ha i 1 491 support in obtaining medical treatment for detainees from host-cod ee e e but they have had NatseCAleited success lhave reneged on I previous assurances that they would arrange inpatient treatment or have declined to 2 become involved in providing medical treatment for CIA detainees The medical facilities and personnel of certain foreign countries that have agreed to provide medical treatment for CIA detainees have been determined by OMS personnel to be of unacceptable quality In March 2006 CTC OMS and CIA station personnel obtained medical treatment for at a third-country medical facilit bll3 NatSecAct The same country s facilitated 1 medical treatment for but has indicated its unw1 mgness to provide treatment for additional CIA detainees - i NatSecAct NatSecAct 8 NatSecAct Approved for Release 2016 06 10 C06541721 Approved for Release 2016 06 10 C06541721 WU Sl NatSecAct b NatSecAct T871 NF As an alternative means of providing inpatient treatment for detainees began in May 2005 to construct and equip a medical treatment facility nearl b ClAAct NatSecAct 3 NatSecAct 1 Whel tnedical facility was completed and illy epuipped in late December 2005 ata co egg NatSecAc mm ClAAct NatSecAct lmedical treatment - facility has never been used 1 IONS NatSecAct iiOPerable pla controlled detention facility for p g mg emerg be will-1 NatSecActat access to medical facilities 1 writ an option The Guidelines on Con nement for CM Detainees require that provisions be made to protect the welfare of detainees including the provision of adequate medical care However the guidelines do not assign responsibility for ensuring that detainees are provided necessary medical treatment Although the security aspects of providing inpatient treatment for detainees will need to be coordinated closely with each detention facility staff and local CIA station personnel the substantive knowledge of OMS personnel makes them better suited to make critical decisions concerning the viability of plans for providing inpatient care for detainees ClAAct NatSecAct NatSecAct Approved for Release 2016 06 10 C06541721 Approved for Release 2016 06 10 006541721 mem NatSecAct NatSeCAct NatSeCAct NatSecAct NatSeCAct 10 'Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 C06541721 Mme NatSecAct b ClAAct NatSecAct NatSecAct Access 10a Critical Medical lnfor 0 6n on Detaine ls hm Needed the Field 3 A fang-J2 g a See l Sl 13%ng information on detainees IS not immediately available to the staff o g le d detention facilities Program of cials told us that medical les on detainee are not maintained at each detention NatSecAct Accordmg to program ottmals a medical officer at a detent1on facrlity who needs medical information on a detainee can either contact Headquarters where medical les on all detainees are maintained or search through the facility s cable database for 1 medical information Both of these options are dependent on the detention facility s NatSecAct SS 0 A search of the detention fac111ty s scable database for medical information in addition to being time consuming would yield information on a particular detainee only for the period that the detainee was held at that facility Neither option appears to be a viable solution when immediate medical information on a detainee IS needed to respond to a medical emergency 11 NatSecAct Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 C06541721 mm bl 3 NatSecAct NatSecAct Detention facility managers and OMS of cers told us that because of the number of detainees with chronic medical conditions and the lack of on site medical personnel at they believe it NatSecAct necessary to have hardcopy records containing critical medical information on detainees available at detention facilities The on-site medical records need not contain a complete medical history of a detainee and the results of every medical and examination but should contain critical infonnation needed to safely and effectively respond to a medical emergency involving the detainee such as'information on chronic illnesses medical conditions and behavioral problems allergies to particular medications or contagious diseases uiring special handling of the detainee during treatment NatSecAct - 1 Recommendation 3 signi cant For the Chief of Medical Services in coordin gig with the Chief CounterTerrorism Center Renditions and Detainees Group Maintain hardcopy records at CIA-controlled detention facilities that contain critical that may be needed by 1 facility staff and medical personnel to safely and effectively respond to a medical NatSecActemergem3 a detainee In comments on a draft of this report the Chief of Medical Services stated that f dcopy medicaL summaries that include information on detainees medical conditions med1cations allergies and blood borne pathogens have been provided to each detenhqn retention and reference 1n the event of a medical emergency The ChicfofMedtcai Services provided us copies of the medical summaries Recommendation 3 is closed blill Facilities Staffs Lack Training in NatSecAct 1 Safe Food Handling and Preparation NatSecAct 313574 CIA of cers and other personnel at 1ave not been trained in safe food handling and ipreparation f cers at re are ortion and serve all meals to the detainees TEE guar at repare and portion detainees NatSecAct'ealS 1n the uards kitcheni then serve the meals Sef cers at prepare and serve most of the detainees meals None of these persons have been trained in safe food handling We observed certain practices and conditions that were inconsistent with avoiding contamination of food and transmission of food borne illnesses For example we observed angof cer using the back of his bare hand to check the temperature of a meal he was heating for a detainee At a detention ClAAct ClAAct NatSecAct NatSecAct NatSecAct Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 C06541721 rep Secesr l Noam NatSecAct facility that has experienced rodent infestation we noted that the kitchen an 1 5 left NatSeCACtl an unsanitary condition following meal clean up 2 Staff bathrooms at Act 5 facilities including a bathroom immediately adjacent to the kitchen at 1 were uipped with communal cloth towels IDZOOS five staff personnel at reported acute gastrointestinal illness which a visiting physician assistant NatseCAQtagnosed as giardiasis 3 Within days the facility reported similar in a detainee The physician assistant believed that the giardia were likely introduced by food or water contamination U The US Department of Services Centers for Disease Control and Prevention CDC and MAdministration collaborated with the US Department of Agriculture gum g5 Inspection Service 1n 2005 to produce the latest edition of the l i fl agar provides practical guidance and factors known to cause food- at document for regulatory agencies that ensures 13 2 at greparat 11 51 that contribute to food supplies each user a clean towel device at each hand NatSeCActashing sink - -- Infid isof food-borne illnesses at CIA- controlled detention facilities have been rare th 2005 illnesses a were NatSeCA cts only reported cases However because of the ortage of appropriate personnel to staff CIA detention facilities and the dif culty involved in providing inpatient treatment to detainees the CIA can ill afford outbreaks of food-borne illnesses at its NatSeCACtlention facilities that could be prevented by proper food handling and good hygiene practices Personnel who are involved in the handling and preparation of food at CIA 1 NatSeCAci NatSeCAct 2 m Certain staff living areas at including the kitchen dining area and bathrooms are communal in nature personnel residing at the facilities are responsible for cleaning these areas on a rotating daily schedule 3 U The giardia parasite according to the CDC resides in the intestine of infected humans or animals The parasite is found in soil food water or surfaces that have been contaminated with the feces from infected humans or animals and individuals can become infected after accidentally swallowing something that has come in contact with the feces of a person or animal infected with the parasite The CDC notes that giardia may be spread via 'g contaminated bathroom xtures and recommends the washing of hands with soap and water after using the toilet and before eating or preparing food 13 WWR NatSecAct Approved for Release 2016 06 10 C06541721 Approved for Release 2016 06 10 C06541721 i 3 NatSecAct illUl detention facilities should receive basic training in safe food handling In addition standards and procedures designed to avoid the introduction and transmission of food- le borne illnesses should be developed and instituted at detention facilities NatSecAct NH Recommendation 4 significant For the Chie CounterTerrorism Center Renditions and Detainees Group in coordination with the Chief of Medical Services 1 Provide training in safe food handling for personnel involved in the preparation of meals and handling of food at controlled detention facilities 2 Develo and institute standards and procedures designed to avoid the ask and transmission of food-borne illnesses at CIA-control ed detention facmties a NatSecAct 1 1 1 I to implement it Since NatSe CCA ctngage under contract at least cleared professional To date have cleanliness and sanitation standardsand procedures with food service guidelines at that facility The grief of Medical Serwces also advised us in his comments that trained cooks have been i'etained by CTC and that training and instruction on correct food preparatlon have beenfprowded to staff and contract personnel assigned to CTC detention facilities rst b NatSecAct 14 NatSecAct Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 006541721 mm mm mm bX3 NatSeCAct NatSecAct 15 W I 1 NatSecAct F I Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 006541721 mm NatSecAct Egg NatSecAct NatSecAct Policy on Response to the Death of a Detainee ls Needed NatSecAct I CIA employees and contractor personnel assigned to CIA-controlled detention facilities have not been provided standard procedures for responding to the death of a detainee In 2003 the Of ce of Inspector General Investigations Staff initiated an investi ation into the circumstances surrounding the NatseCACtovember 2002 death of a detaineegg la CIA detention facility that Operated from August 2002 to May NatSecAct 1 However the lack of formal procedures to be followed 3 3 oath of a detainee in CIA custody - 7 1 nit 55 examiner autopsy or an OIG investia vi i isturbing the detainee 5 body and or the death scene Adherence to prescribed procedures in the event of a detainee death could protect facility staff from being wrongly accused of detainee mistreatment or responsibility in the detainee s death NatSecActw NatSecAct 4 Isl lns of cials told us that the facility was not part of the detention program and was not managed by CTCIRDG at the time of the detainec 5 death CTC Renditions Group which was renamed assumed Headquarters management ofC b on 2002 Prior to that time other CTC components4 NatSecAct - loversaw operations ad The death of the detainee at was reported on by In Death ofa 2003- 7402-10 27 April 2005 NatSecAct 16 W0 1 NatSecAct Approved for Release 2016 06 10 006541721 TSP-SEGRETI Approved for Release 2016 06 10 006541721 NatSecAct NatSecAct ClAAct NatSecAct NatSecAct NatSeCAct ClAAct NatSecAct 17 1 NatSecAct Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 006541721 l bm NatSecAct imR ClAAct NatSecAct NatSecAct MN m A Shortage-of Debriefers at Detention atS ee A et Facilities May Have Negatively Impacted Intelligence Collection 135i NF CIA detention facilities have experienced a shortage of quali ed debriefers which may have negatively impacted intelligence exploitation of detainees i ClAAct NatSecAct 18 W3 NatseCACt Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 006541721 b1 IQP SEERET NatSeeAet NatSecAct ltd-F9 To help ensure that enough quali ed debriefers would be available to CIA detention facilities CTC began a formal program in 2004 to develop a cadre of persons with the necessary skills and requisite knowledge to elicit intelligence from the high value detainees being held in CIA detention facilities Participants are recommended to the program by their components management and are required to successfully complete specialized HVD debriefer training NatSeCAet NatSeeAct l J-Fj Staf ng CIA detention facilities with a suf cient number of quali ed debriefers is a continuing challenge for NatSecAet 19 NatSeCAet mum Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 C06541721 W 1 W1 NatSecAct 1 NatSeCAct NatSecAct li ed debriefers at detention NatSecAct 20 NatSeCAct Approved for Release 2016 06 10 C06541721 Approved for Release 2016 06 10 C06541721 1 mn ms NatSecAct NatSecAct NatSecAct 21 NatSecAct Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 C06541721 I1 NatSecAct NatSecAct NatSecAct 22 - NatSecAct Approved for Release 2016 06 10 C06541721 Approved for Release 2016 06 10 006541721 Mew NatSecAct NOFORNTIMR A ExhibitA g at 9C Ct U Objectives Scope and Methodology I The objectives of this audit were to determine whether the Central Intelligence Agency CIA 0 Developed and adhered to appropriate standards and guidelines for operating CIA controlled detention facilities and maintaining detainees glv' 3 atS eC Act Maintained adequaterl itf le detention facilities and the detainees fag 1H s lM3 if FEE ether the CIA developed and adhered to appropriate standards and gu1deii%es for operating g CIA-controlled detention facilities and - holding detainees we 3 1 A atSeCAct 0 Reviewed the scope 6f authorized under the l17 September 2001 Memorandum i' cation Qj Examined guide gs and precede or the operation of 3 I3 3 ional Clandestine NatSecAct detention Service N CS 3 between August 263% 2006 0 Interviewed current an %f cials responsible for CIA- controlled detention facilities from the Directorate of NatSecAct Support DS Of ce of Medical Services thel l and NatSecAct - Reviewed cable traf c Contained in databases reports and other documents related to CTC covert action CA activities maintained by the NCS Ewe NCS Operations and Resource Management Staff NatSeCAct the DS and the Office of the Chief Financial Of cer 1 foe-seeml NatSecAct Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 C06541721 b 1l Wanna NatSecAct Reviewed the National Security Act of 1947 Title 5 Accountability for Intelligence Activities the Central Intelligence Agency Act of 1949 as amended Section 8 and Executive Orders 12333 and 13354 Reviewed detention program-speci c policies standard operating procedures and guidelines pertaining to the conduct of CA activities promulgated by the Director of Central Intelligence CTC and OMS Assessed the atl NatSecAct NatSecAct eel To determine whether the CIA maintained adequate records of the detention facilities and the detainees we Reviewed les maintained on each detainee by OMS Reviewed operational les maintained on each detainee by Received a demonstration of CTC Eecord keeping database Reviewed cable traf c contained in databases NatSecAct 2 NatSecAct Approved for Release 2016 06 10 C06541721 1 WW 7 NatSeCACt l ilities ssor i facilities NatSecAct Approved for Release 2016 06 10 C06541721 4 I 1 NatSecAct Momma 3 NatSecAct During the audit we receiv assurances from senior CTC of cials that we had access to all relevant databases and other operational records and that there were no other CIA controlled detention 1 b b 3iClAAct b NatSecAct Because no being conducted at the time that we visited the detention facilities we did ot ob- any interrogation activities Moreover interrogation techniquesrm - 'ci this audit and we did not review US Department of Justice gui lines for ogations or examine the evolution of interrogation techni employed atcui'rent CI A-controlled detention 'e did not examine activities associated with the renditions deti atneCEnd we examine on a case- by case basis the Just1 cat10ns for holding parti 6 did not assess the value of intelligence obtained from the dgiiginees We di 13' the costs associated with constructing detention facilities i i 'Wut we did not examine contract and expense documentation ebruary 2006 and in accordance with generally accepted governm i5 diting sta 8 Comments on the draft report were received from the Acting Exe af-z 1 1 Director of the National Clandestine Service the Director for Welagrigs the Acting General Counsel the Director CIA CounterTerrorism Center-5 and the Chief of Medical Services and were considered 1n the preparation of this report '2 NatSecAct Approved for Release 2016 06 10 C06541721 Approved for Release 2016 06 10 C06541721 - NatSecAct MOFORWMR NatSeCAct Exhibit 151 14F CIA-controlled Detention Facilities That Were in Use at the Time of the Audit ClAAct NatSecAct 1 W0 NatSecAct m Approved for Release 2016 06 10 C06541721 WW1 NatSecAct Approved for Release 2016 06 10 C06541721 Lemma NatSecAct 2 NatSecAct Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 C06541721 LWXS NatSeCAct ClAAct NatSecAct 7 NatSeCAct Approved for Release 2016 06 10 C06541721 Approved for Release 2016 06 10 C06541721 TOP-SECRET NatSecAct NatSecAct A I NatSecAct Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 C06541721 NatSecAct ClAAct NatSecAct 5 gnaw 1 NatSecAct Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 006541721 NatSeCAct Momm NatSecAct in MN Approved for Release 2016 06 10 006541721 Approved for C06541721 NatSecAct ClAAct NatSecAct 7 1 I NatSecAct Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 C06541721 kaxsi NatSecAct NatSecAct NatSecAct Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 C06541721 NatSecAct Wm ClAAct NatSecAct 9 W mama W3 NatSecAct Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 C06541721 bX3 NatSeCAct NatSecAct 10 NatSecAct Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 006541721 Mme NatSecAct NatSecAct mm NatSecAct Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 C06541721 NatSecAct 1W ClAAct NatSecAct 12 NatSecAct Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 C06541721 NatSecAct NatSecAct NatSecAct Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 006541721 W4 W NatSeCAct ClAAct NatSecAct 14 f0 NatSecAct WR- Approved for Release 2016 06 10 006541721 Approved for Release _ 2016 06 10 006541721 We NatSecAct NatSeCAct - Exhibit JFSI VHF Detention Facilities That Were Not in Use or Were Under Construction at the Time of the Audit NatSecAct i 1 WM NatSecAct Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 006541721 - NatSecAct 1m ClAAct NatSecAct mm 1 NatSecAct Approved for Release 2016 06 10 006541721 Wmm NatSeCAc r Approved for Release 2016 06 10 C06541721 b 1 NatSeCAct NatSecAct '2 MN Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 006541721 W3 NatSecAct 1 491 9me NatSecAct 4 1 NatSecAct Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 C06541721 NatSecAct 8 NatSecAct NatSecAct Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 006541721 NatSecAct NatSecAct D- Guidelines for Managing CIA-controlled Detention Facilities blxs JI Foum ocr GUIDELINES its 011 28 January 2003 the Director of Central Intelligence DCI signed the DCI Guidelines on Interrogations and the atSeC Actruzdelmev on Con nement Detainees The rst set of guidelines applies to CIA employees the CIA engaged 1n interrogations 1 131 1 he second sic %f gurdelinesz he DCI atS ec Actwdelines on Confinement Con 1 1th for CM Detainees is applicable to individuals held in detention facilities operae ndeg control of the CIA The 3 guidelines mandate that to protect the welfare of detainees to include the provisio my a 11 clothing basic sanitary facilities medical care and periods of ph fea exermse idelines note that although 3 atSeCACtmditions of con nement at deen facilities art required to conform to US prison or other established stand 13 detainees sh 1 3123 receive periodic evaluations by quali ed medical professionals $1 21 'sure their ifi'ng and the results of medical and evaluations of g t mees shoulb records The guidelines further redim e that 33$ 1 me 3 48 Fig - W3 - Of cers involved with the i etion or operation of detention facilities will be appropr1at fy1veited and trained prior to their ClAAct NatSecAct The will ensure that the designated responsible CIA officer who operates a detention facility and other officers both those assigned permanently and those on temporary duty who participate in any aspect of the CTC Renditions and Detainees Group RDG detention program are provided both sets of DCI guidelines to read understand and formally acknowledge by cable NatSecAct The responsible CIA of cer is generally the chief of base COB at the detention facility 1 I1 NatSecAct Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 006541721 NatSecAct The guidelines require that a quarterly review be conducted by Headquarters of the conditions at each detention facility and that the review include a written report to the Associate Deputy Director for Operations ADDO DDO General Counsel Deputy Director of Central Intelligence DDCI and DCIEZ UIIFOHQ CIA OFFICE OF MEDICAL SERVICES GUIDELINES NatSecAct NF The Chief of Medical Services disseminated guidelines concerning medical support to CIA interrogation and detention activities in April 2003 to Of ce of Medical Service i 1 personnel assigned to detention 35faCIlItIes 3 According to OMS the gaidgf i hg a comnIlatIon of oreVIouslv Issued uidance OMS ha i riodically fp sed and updated the draft guidelines and disseminated the fall OMS personnel involved in the detention program In response to a reco May 2004 Office of Inspector General special assessment 5196 f Wti SEE terterrorism Detention and bx I guidelines were issued in nal it Ahe guidelines were revised in NatSeCACtotember 2005 S fif by ji nes address three phases of the o 1 39 5 $81 3% detention process 1 rendition is if devoted to the rendition and 3 long-term care The majority S interrogation phase as this is the risi detention process and involves aspects of care iffamiliar to most OMS of cers The guidance on how to handle detainees during renditions and'the use of interrogation techniques is very speci c Post-interrogation guidelines which were the focus of this audit address generally applicable and more familiar aspects of health care OMS guidelines for the care of detainees in the post interrogation phase require that periodic medical and evaluations be performed and the results documented 45 353 2 Ii $660 In April 2005 the President established the positions of Director and Deputy Director of National 1 Intelligence effectively eliminating the positions of and DDCI respectively The Director CIA and his deputy were thereafter known as DCIA and DDCIA respectively In October 2005 the DCIA announced that NatSecAct Directorate of Operations became part of the National Clandestine Service NCS The positions of ADDO and DDO therca er became known as Deputy Director NCS and Director NCS respectively 31 3 Draft OMS Guidelines on Medical and Hydrological Support to Detainee tS AIn torrogat ionr a GC 0 5 OMS Guidelines on Medical and Support to Detainee Rendition i Interrogation and Detention b3 1 5 Additional OMS guidance entitled Part 2 and Support to inee Interrogations dated December 2003 remains in draft NatSecAct 2 W0 NatSecAct AA Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 C06541721 NatSecAct Absent any speci c medical problems medical evaluations of detainees held at facilities under the direct control of the US Government are to be conducted and documented Acute problems are to be addressed in a clinically appropriate no NatSecAcit altar e In addition to detecting and treating health problems the OMS guidelines require medical of cers to assess detainees for indications of inadequate nutrition Detainees weights are to be obtained and recorded at least In the event of a hunger strike by a detainee medical of cers are to evaluate the detainee for evidence of dehy f 1 and starvation The OMS guidelines authorize intervention on a hunger $th1 v Ttyithout the detainee consent when necessary to preserve the life of th life or health Treatment 15 to bettinued gtainee is seen resuming voluntary eating and drinking gig NatSecAct I81 guidelines aote that it is important that detainee cells be kept clean and thhitthere be pro hygiene All detainees are to be 5 care OMS arranges vision testing ail for detainees arranges for a r tist to provide urgent dental care NatSecAct A 3 is To promote the long-term health of the detainee population the OMS guidelines make recommendations on the use of vitamins and vaccines If a detainee will not be exposed to sunlight for a sustained period OMS 1 recommends supplementing the detainee s diet with calcium and Vitamin D OMS also offers and recommends the tetanus diphtheria MMR mumps measles and I rubella hepatitis combined with hepatitis if possible and in utmza vaccines The guidelines note that all detainees with hepatitis or should receive appropriate hepatitis immunizations to reduce the risk of additional liver damage FIN-E The OMS guidelines provide some information on handling violent detainees OMS advocates a stepped approach that ranges from discussions with the detainee to the use of physical restraints and medication The OMS guidelines stress that a decision to involuntarily administer medication to control a detainee s behavior should be a last resort The guidelines prescribe that medical of cers alone are authorized to make this determination and to administer medications 3 ism 1 W11 W3 'Approved for Release 2016 06 10 006541721 NatSecAct b ClAActprepared by NatSecAct 6181 1151 3 i3 3 NatSecAct Approved for Release 2016 06 10 006541721 Wow NatSecAct to control a detainee s behavior The guidelines provide that if medication is administered involuntarily the medical officer is to remain at the facility until the detainee has recovered and a long-term treatment plan is developed Speci c guidelines on the use of medications intended to control detainee behavior including information on speci c substances and recommended dosages are included in the OMS guidelines EFS hi In situations where a detainee 3 medical condition cannot be adequately treated at the detention facility OMS guidelines recommend that detention facility staff and local CIA stationzesonnel obtain through the host-country g health care system ClAAct NatSecAct b 3 to Detainee Inter rogation fbt i problems All do f are to be given addressed 1n an appendix to the OMS i Contingency plans for handling mental health emergencies are to be developed for each CIA detention facility A mental health emergency is de ned as behavior that is a marked change from the detainee s usual behavior and may be agitated impulsive potentially harmful to self or others or In the event of 'a mental health emergency the Senior Site Of cer is directed to consult with the CIA at the tacllity or 11 none 15 present a assigned to or ClAAct ClAAct NatSecAct A medical and examination should be administered to the detainee at the earliest time possible If a medical officer is present he may use medication to sedate the detainee NatSecAct 6 NE The COB at the detention facility is generally the Senior Site Officer 1 ClAAct 4 NatSecAct W12 Approved for Release 2016 06 10 006541721 mu Approved for Release 2016 06 10 C06541721 Joe-seenenl W Momma NatSecAct until the behavior abates and further evaluation can take place The or medical of cer will then manage the emergency until it has resolved and the detainee has been judged to be stable from a mental health medical perspective NatSecAct OMS also encourages medical of cers 1n its guidelines to refer to outside sources on prison medical care The guidelines speci cally cite the US Department of Justice Bureau of Prisons website which outlines its clinical practice guidelines Other references cited in the OMS guidelines include Standards for Health Services in Prisons a regular publication of the National Commission on Correctional Health Care and Clinical Practice in Correctional Medicine by Michael Puisis published in 1998 5 NatSeCAct Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 C06541721 top semen W3 NatSecAct Exhibit NatSeCAct NatSecAct Approved for Release 2016 06 10 C06541721 Approved for Release 2016 06 10 006541721 I NatSecAct Exhibit U Recommendations NatSecAct NatSecAct commendation 3 signi cant For the Chief of Medical Services coordinati $8031 59 CounterTerrorism Center Vain 132 5% Renditions and Detainees Gro led ih 51NatSeoAct i that may be needed by facility 5 respond to a medical emergency involving a detain NatSecAct 21 54 W 15 37 i CounterTerrorism Center In Group' on coordination with the involved In the preparation of me ti of food at CIA-controlled detention facilities 2 Develop and standards and procedures designed to avoid the introduction and transmission of food-borne illnesses at CIA- controlled detention facilities NatSecAct Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 C06541721 NatSecAct ClAAct NatSecAct ClAAct NatSecAct NatSecAct NatSeCAct NatSecAct NatSeCAct Approved for Release 2016 06 10 006541721 Approved for Release 2016 06 10 C06541721 WET NatSeCAct U Audit Team Members Exhibit UHF-SHED This audit report was prepared by the Operations Division Audit Staff Of ce of Inspector General Exhibit is Unclassi ed W030 When Separated From Report NatSecAct Approved for Release 2016 06 10 006541721 This document is from the holdings of The National Security Archive Suite 701 Gelman Library The George Washington University 2130 H Street NW Washington D C 20037 Phone 202 994-7000 Fax 202 994-7005 nsarchiv@gwu edu