41. Medical care, in particular prior to 2008, has been described as not only “inadequate and negligent, but also abusive”. Reported past practices included, for instance, long delays or denial of medical treatment, inadequate care, treatment conditioned on detainees’ cooperation with interrogators, humiliating treatment, forced drugging, forced medication for mental illness, prolonged solitary confinement in punitive conditions of detainees with mental health issues, force-feeding of hunger strikers, among others. Such practices run contrary to the right of detainees to receive adequate medical care. Additionally, subjecting detainees with mental health issues to prolonged solitary confinement in punitive conditions would not only amount to a violation of this right but could also constitute illtreatment. 42. Other concerns included deficient mechanisms for medical personnel to report abuse and their failure to do so, in contravention of international standards on effective investigation and documentation of torture and other forms of ill-treatment. 43. Medical care has improved over the years and for certain medical conditions, it has been presented to ODIHR as equivalent as or higher than in other detention facilities in the United States. 44. Adequate medical care may not be provided to military commission defendants. In addition, the limited access of attorneys and defendants to their (said to be incomplete) medical records, including documentation of acts of torture and ill-treatment, may have an impact on the outcome of their case. This would contravene international standards providing for detainees’ right to access their medical records. 45. The legislative ban on detainee transfer to the United States may prevent the aging Guantánamo population, presenting increasingly complex medical problems, from receiving timely and appropriate healthcare, especially in emergency situations. The possibility of treating detainees in the Naval Base Hospital may not present a quality alternative to ensure adequate care of detainees as it lacks certain specialty medical capabilities. CIA Rendition, Detention and Interrogation Programme 46. Under its RDI programme, the CIA secretly captured, detained and interrogated individuals in secret locations (including reportedly at Guantánamo) and transferred individuals to third countries to be secretly detained and interrogated on behalf of the United States. The report focuses primarily on the situation of those detainees who were subsequently transferred to Guantánamo under military custody, and, to a certain extent, under CIA detention. 47. Reportedly going beyond its authority to detain individuals given in the executive Memorandum of Notification (MON) of 2001, the CIA allowed the detention of not only “high-value targets” who “pose a continuing threat of violence” or who were “planning terrorist activities” but also individuals who could provide information on the high-value targets. The CIA detained at least 119 individuals as part of this programme, at least 26 of 15