After 100 days, Palestinian hunger striker ‘can collapse at any moment’

Despite four High Court petitions and protests against his administrative detention, Israeli authorities do not seem to care if Maher al-Akhras dies.

Palestinian hunger striker Maher al-Akhras after 100 days of his strike in protest of his administrative detention, at Kaplan Medical Center, Rehovot, October 14, 2020. (Oren Ziv)
Palestinian hunger striker Maher al-Akhras after 100 days of his strike in protest of his administrative detention, at Kaplan Medical Center, Rehovot, October 14, 2020. (Oren Ziv)

Palestinian prisoner Maher al-Akhras has been on hunger strike for 100 days to protest his administrative detention. After four petitions were rejected by Israel’s High Court of Justice, it seems the authorities simply do not care if al-Akhras dies. The state claims that the only way for him to be released is if he agrees to put an immediate end to his hunger strike and serves the rest of his detention until it ends on Nov. 26.

Al-Akhras, 49, a father of six from the village of Silat al-Dahr in the occupied West Bank, was arrested on July 28. On Aug. 7, he was placed under administrative detention for four months after Israeli authorities claimed he was a “prominent operative in Islamic Jihad,” a claim al-Akhras has repeatedly rejected outright.

He began his hunger strike on the day of his arrest and has been hospitalized at Kaplan Medical Center in Rehovot since Sept. 6, following a severe deterioration in his health. His condition led the High Court to temporarily freeze his detention, but al-Akhras has continued his strike, demanding that his detention be revoked entirely. He has repeatedly refused medical treatment.

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“It is hard to believe that he will last for [a total of] 120 days until the date of his release,” says Anat Litvin, director of the Prisoners and Detainees Department at Physicians for Human Rights-Israel. “After 100 days, he can collapse at any moment. We do not know what his condition is because he does not do any tests or monitoring, but he is at immediate risk of dying from a heart attack.”

Solidarity protest with Maher al-Akhras outside Kaplan Medical Center, Rehovot, October 24, 2020. (Heidi Motola/Activestills.org)
Solidarity protest with Maher al-Akhras outside Kaplan Medical Center, Rehovot, October 24, 2020. (Heidi Motola/Activestills.org)

Israel uses administrative detention to indefinitely detain Palestinians (and occasionally Jews) without charge or trial. Administrative detention orders are reviewed every six months, but the detainees are not told what crimes they are accused of, nor shown the evidence against them. As a result, it is virtually impossible to defend oneself against an administrative detention order.

Under international law, administrative detention should only be used in the most extreme cases. As of September 2020, Israel was holding approximately 350 Palestinians in administrative detention, including two members of the Palestinian Legislative Council.

Detention suspended, not ended

Following a petition filed by al-Akhras in September, the High Court ruled that in light of his serious health condition, his administrative detention should be suspended. Yet the ruling continued to bar him from leaving Kaplan Medical Center. The justices also ruled that the Israeli security authorities would have the option of renewing his administrative detention should al-Akhras’ health improve.

Kaplan Medical Center announced on Oct. 23 that al-Akhras would be released following his refusal to receive medical treatment. The Israel Prison Service moved him to another room and announced that his detention had been renewed and that al-Akhras would be transferred to a clinic in Ramle for treatment. On the same day, however, the High Court issued an interim order preventing his transfer to Ramle, and on October 25, the justices ruled that his detention would be suspended once again. The decision means that family and friends can remain by his bedside, since he is technically not under detention — at least until he recuperates.

Maher al-Akhras and his wife Taghreed at Kaplan Medical Center, Rehovot, October 14, 2020. (Oren Ziv)
Maher al-Akhras and his wife Taghreed at Kaplan Medical Center, Rehovot, October 14, 2020. (Oren Ziv)

Al-Akhras’ last court hearing took place on Oct. 28. Justices Amit, Baron, and Elron dismissed the petition on the grounds that al-Akhras “chooses” to go on hunger strike, after announcing that he would end it if he was transferred to a hospital in the West Bank or East Jerusalem.

The justices recognized the danger to al-Akhras’ life, noting that “there is no doubt the petitioner’s medical condition is worrying and he is in real danger, whether to his life or to his internal organs,” yet they ruled that “the hunger strike, in itself, could not bear on the decision vis-à-vis the administrative detention.” As always, part of the hearing took place ex parte, with the state presenting classified evidence to the court.

‘He will not return to his previous state’

While the state insists that al-Akhras first end his strike before he is released at the end of his detention, PHR-I’s Litvin notes that in any case it will take him a long time before he can recover. “The administrative detention ends on November 26, he will have to stay in hospital until then. Why not let him be where he trusts doctors?”

This issue of trust was also addressed by the justices at the last hearing. They noted that they knew that while al-Akhras was seeking treatment by doctors at a Palestinian hospital, there was “no advantage” to such a hospital over Kaplan Medical Center.

According to Litvin, even if al-Akhras stops striking, the damage may be irreversible. “The deterioration may stop, but he will not return to his previous state. Hunger strikers in Turkey have ended up with severe brain damage because of such long strikes.”

Palestinians and Israelis protest outside Kaplan Medical Center demanding the release of Maher al-Akhras from administrative detention, Rehovot, November 3, 2020. (Oren Ziv)
Palestinians and Israelis protest outside Kaplan Medical Center demanding the release of Maher al-Akhras from administrative detention, Rehovot, November 3, 2020. (Oren Ziv)

Dr. Lina Qassem, who has visited al-Akhras several times on behalf of PHR-I, says he is “in poor condition, weak, and dizzy. This puts him at high risk. In principle, after 55 days [of hunger strike] there are real dangers for all sorts of reasons: a weakened immune system, spontaneous bleeding due to a lack of Vitamin K that causes blood clotting, and more. He refuses to take blood tests, but has a problem with his salt levels that can cause arrhythmia and lead to cardiac arrest.”

‘A tool of the Israeli occupation’

Upon hospitalization, Kaplan Medical Center’s ethics committee gave doctors permission to force-feed al-Akhras, but so far doctors have not done so. “The doctors are in a completely impossible situation, but they can handle it,” says Litvin. ‘They have been saving lives for their entire careers, to not let a person die in front of their eyes. This is an unbearably difficult situation. According to medical ethics, he should be allowed to die if he wants to, and he says that if this [detention] is the situation, he is willing to die and should be allowed to do so.”

According to Litvin, there is concern that should al-Akras be transferred to the custody of the Israel Prison Service, it will be easier to force-feed him.

Last week, over a hundred Palestinians and Israelis demonstrated in solidarity with al-Akhras outside the medical center, and a number of Knesset members from the Joint List visited him in his hospital bed. MK Ofer Cassif, who has paid a number of visits, said, “Maher Al-Akhras is not really under arrest — he is a prisoner for all intents and purposes who is being inhumanely incarcerated. Administrative detention is a tool of the Israeli occupation to abuse Palestinians and suppress their struggle. I hope that the prime minister and the Shin Bet will come to their senses and release Maher before he dies.”

To mark a hundred days of the hunger strike, activists hung a banner from a room in Kaplan Medical Center reading “#FreeMaher.” The High Follow-Up Committee, an extra-parliamentary body that represents and coordinates activities among Palestinian citizens of Israel, held a press conference outside the hospital on Tuesday afternoon, while activists held another demonstration there in the evening.

This article was first published in Hebrew on Local Call. Read it here.