5-30. Detainees will receive medical care that is consistent with the standard of medical care that applies for U.S. military personnel in the same geographic area. Medical personnel will provide detainees with the same care rendered to U.S. military personnel in the theater, which is generally a higher level of care than what is available locally. Medical support and the level of care available during detainee operations will vary based on the location of the facility, the situation, and the availability of qualified medical personnel and resources. The levels of care may be characterized as follows:
Level I and II care includes—
Emergency and essential dental care. Daily (sick call) routine care. Monthly health assessments. Simple laboratory work. Optometry.
Level III care normally includes (in addition to Level I care)— An intensive care unit.
An operating room.
A radiology unit and a full lab.
5-31. Medical care at a DCP is provided according to necessity and is limited to emergency medical care only. DHA medical care is limited, but may include Levels I and II care. A TIF must provide at least Level II care and may be capable of Level III care. A hospital with the capabilities to support detainee operations is normally found at a SIF. (See appendix I for more information on medical support to detainee operations.)
5-32. Medical personnel are required to identify, treat, and document existing medical conditions and injuries of detainees. Distinguishing scars, marks, and tattoos will be documented by medical personnel and entered into the Detainee Reporting System by the facility Detainee Reporting System operator at theater level facilities for identification purposes. Medical personnel also prepare medical documentation, generate and control the disposition of medical records, and manage the release of medical information.
5-33. All medical screenings, examinations, and/or treatments conducted at prior locations, such as the DCP or DHA, will be available for review and inclusion in the detainee’s medical record. All information that the Level I or Level II medical treatment facility documented on DD Form 1380 (U.S. Field Medical Card), Standard Form (SF) 558 (Medical Record–Emergency Care and Treatment [Patient]), and SF 600 (Health Record–Chronological Record of Medical Care), and/or other medical forms will accompany the detainee throughout the levels of medical care. Many times, these forms contain important information regarding the detainee’s health status immediately after capture. Each entry helps provide a chronological picture of the detainee’s medical condition during the time of the initial detention. In addition, the medical treatment facility may have taken useful photographs of injuries that were healing or were already healed by the time the detainee arrived at the TIF.
5-34. Commanders must consider the following when establishing medical care at the internment facility: A credentialed health care provider examines detainees monthly and records their weight on DA Form 2664-R (Weight Register [Prisoner of War]). The Detainee Reporting System requires weight data from the medical community.
The general health of detainees, their nutrition, and their cleanliness are monitored during inspections.
The detainees are examined for contagious diseases (especially tuberculosis), lice, louse-borne diseases, human immunodeficiency virus (HIV), and sexually transmitted diseases.
All medical treatment facilities must provide immunizations for, and isolation of, detainees with communicable diseases.
Retained medical personnel and detainees with medical training are used to the fullest extent possible in caring for sick and wounded detainees.
Detainees who require a high level of care are transferred to military or civilian medical installations where the required treatment is available.
Military police escort detainees to medical treatment facilities and remain with them until medical examinations are complete.
Detainees interned at the TIF receive Level II or higher medical care as required (including dental and optometric care).
Note. Details of medical operations specific to the DCP, DHA, TIF, and SIF are provided in each location discussion. (See appendix H and AR 190-8.)
5-35. All Behavioral Science Consultation Team members are authorized to make psychological assessments of the character, personality, social interactions, and other behavioral characteristics of interrogation subjects and to advise authorized personnel performing lawful interrogations regarding such assessments. Those who provide such advice may not provide medical care for detainees, except in an
consultation team members serving in behavioral science consultant positions should receive structured training on their roles and responsibilities while functioning in this capacity. In addition, MI personnel should clearly understand the defined roles, responsibilities, and limitations of behavioral science consultants.
5-36. Military police will provide security, retain custody, and maintain control of detainees during all medical interactions, to include simple examinations. Detainee health care personnel will not provide detainee security, custody, or control for even brief instances, nor will there ever be the perception that health care personnel provide such functions (for example, they will not carry handcuffs or disposable restraints). Detainees are entitled to receive, and medical personnel will try to allow, some level of privacy consistent with security requirements. The medical staff finds contraband on a detainee during the course of a medical examination, they will give it to appropriate security personnel.
5-37. Military police also provide behavioral control. Any detainee who fails to follow orders or rules can be disciplined appropriately by military police. Medical personnel should not discipline or participate in the discipline of detainees. They will immediately report any problems to the onsite military police authority. 5-38. Medical interactions must always involve military police overwatch, whether inside or outside the compound. As a rule, medical personnel will not carry weapons within the detention compound. (This is for their safety and is generally dictated by the MPC.) Since most outpatient care occurs inside the detention compound, military police must be vigilant in protecting the safety of medical personnel. Even the most friendly or helpful detainee may be harboring the desire to harm a Soldier, even if that Soldier is a medical provider.
5-39. Military police or other internment facility personnel will never have routine access to open medical records, and a detainee’s medical information will never be used during interrogation. Medical personnel will provide military police medical information required in the Detainee Reporting System. Further, medical personnel must keep military police and MI personnel apprised of any medical conditions that detainees have when could affect the conduct of detainee interrogation operations. For example, military police and MI personnel should know that a detainee is diabetic to prevent harm that might result from changes in the detainee’s diet. Because the internment facility military police chain of command is ultimately responsible for detainee care and treatment and the welfare of assigned personnel, they require and should receive adequate and appropriate medical information to keep apprised of detainee medical conditions. (See appendix H.) For example, detainees who are suspected of having infectious diseases should be separated from other detainees. Guards and other personnel who come into contact with such detainees should be informed about their health risks and apprised on how to mitigate those risks. When transferring detainees from one facility to another, sealed medical records may be transported by military police who are escorting them.
5-40. Any detainee refusing food for 72 hours is considered to be on a hunger strike. Military police will refer detainees who are refusing food to medical personnel for evaluation and possible treatment.
5-41. Medical personnel will immediately report allegations or suspicions of abuse to military police or CID personnel, but will not conduct investigations. When physical, sexual, or emotional abuse is alleged or suspected, medical personnel will immediately report the situation to the military police and the supporting CID unit. It is the role of CID personnel and/or the military police are responsible for investigating allegations, collecting evidence (such as photographs), and identifying perpetrators.