about the ability of detainees to maintain meaningful contact and communication with other detainees which appears to be limited to yelling across their cells and talking to each other during short periods of recreation.430 These practices cannot be considered as allowing meaningful contact with other detainees. At a minimum, all detainees who spend 22 hours a day in segregated cells are thus undoubtedly held in solitary confinement. 227. Solitary confinement can have a negative impact on detainees’ health after just a few days. These harmful effects then dramatically increase with each additional day spent in isolation.431 Prolonged solitary confinement can lead to severe mental distress,432 and its harmful effects can be even more pronounced among vulnerable individuals who suffer from pre-existing mental disorders or other mental health problems such as the ones caused by past abuses, including post-traumatic stress disorder.433 The Special Rapporteur on torture explained that combined with the prospect of indefinite detention, its use at Guantánamo is even more likely to amount to torture or ill-treatment. Moreover, where solitary confinement is imposed as punishment for breaching prison discipline and leads to severe pain or suffering, or where it is used to extract information or a confession, it always violates the prohibition of torture and ill-treatment.434 228. Moreover, in the course of the ongoing proceedings against him, Al-Nashiri has complained about the use of a form of body restraint known as “belly chains” while being transported within the detention facility.435 ODIHR welcomes the information that the United States would no longer use belly chains as a matter of policy,436 and wishes to reemphasize that the use of restraints during transportation should be strictly limited to what is necessary under particular circumstances. Moreover, Ramzi Bin al Shibh has alleged that he has been deliberately subjected to exposure to sounds and vibrations.437 If al Shibh’s allegations are substantiated, his intentional exposure to sounds and vibrations may amount to cruel or inhuman treatment, also because such treatment may have caused additional 430 Ethics Abandoned: Medical Professionalism and Detainee Abuse in the “War on Terror” (New York: Institute on Medicine as a Profession, 2013), p. 45, <http://www.imapny.org/File%20Library/Documents/IMAP-EthicsTextFinal2.pdf>. See, also, GAO November 2012 Report, op. cit., note 425, pp. 17-18, 21. 431 UN Special Rapporteur on torture, Interim report to the General Assembly, A/66/268, op. cit., note 306, para. 62. 432 Ibid.; Ethics Abandoned, op. cit., note 430, p. 44. 433 Buried Alive, op. cit., note 428, p. 32. See, also, UN Special Rapporteur on torture, Interim report to the General Assembly, A/66/268, op. cit., note 306, para. 63. 434 UN Special Rapporteur on torture, Interim report to the General Assembly, A/66/268, ibid., paras. 71-76; UN Special Rapporteur on Torture, Interim report to the General Assembly, A/63/175, op. cit., note 307, para. 80. 435 United States Military Commission, United States of America v. Abd Al-Rahim Hussein Muhammed Al-Nashiri, AE 118, “Defense motion to cease the use of belly chains on the accused by JTF-GTMO”, 24 September 2012, pp. 6-7. In this motion, the defence complained that a middle restraint (or belly chain) was used to restrain Al-Nashiri during transportation within the camp. Because the restraints were used to torture him in the past, his attorneys argued that the use of such chains would likely retraumatize him. See, also, United States Military Commission, United States of America v. Al-Nashiri, “Unofficial/unauthenticated transcript of motions hearing dated 6/11/2013 from 9:03 AM to 10:30 AM”, p. 1775. 436 United States Military Commission, United States of America v. Al-Nashiri, “Unofficial/unauthenticated transcript of motions hearing dated 6/11/2013 from 9:03 AM to 10:30 AM”, ibid. 437 United States Military Commission, United States of America v. Mohammad et al., “Unofficial/unauthenticated transcript of motions hearing dated 12/17/2013 from 9:04 AM to 11:50 AM”, pp. 7272-7273; United States Military Commission, United States of America v. Mohammad et al., AE 152J, “Government Motion for R.M.C. 909 Hearing in April 2014 and Direct Inquiry by the Military Judge to Mr. BinalShibh Regarding his Capacity to Stand Trial by Military Commission”, 4 February 2014, p. 2; ODIHR interview with Navy Lieutenant Commander Kevin B. Bogucki, JAGC, op. cit., note 255. 97