URGENT ACTION

jailed cancer patient tortured in prison
Critically ill prisoner of conscience and human right defender Arash Sadeghi is being tortured through the intentional and purposeful denial of his access to cancer treatment, causing him severe pain and suffering. A serious post-operation infection has developed in his right arm due to lack of care in prison, leaving it swollen, paralysed and without sensation. He has also been denied critical bone marrow tests to monitor if his cancer has spread. His life is being put at risk. 

TAKE ACTION: WRITE AN APPEAL IN YOUR OWN WORDS OR USE THIS MODEL LETTER

Minister of Health Dr Saeed Namaki  
The headquarters building (Sakhteman-e Setad-e Markazi)
Ivanak Boulevard, Farahzadi Boulevard, Qods Town 
Tehran, Iran 
Dear Dr. Saeed Namaki,

The life of critically ill human rights defender Arash Sadeghi, imprisoned in Raja’i Shahr prison in Karaj, is being put at risk through the denial of his access to urgent follow-up cancer treatment. After months of delays, on 12 September 2018, he underwent major surgery in a hospital outside of prison to remove a cancerous tumour in his right arm. The authorities returned him to prison three days later on 15 September 2018, despite strong advice from hospital doctors who said that he should remain hospitalized for at least 25 days to undergo intensive specialised care to prevent serious risks to his health and life. His surgery was carried out at his family’s expense, even though international standards stipulate that states should pay the medical expenses of all prisoners, completely and without discrimination.  

Back in prison, Arash Sadeghi’s health has seriously deteriorated. Without adequate post-operative care, a serious infection has developed in his right arm, leaving it swollen, paralysed and without sensation. It has been months since he was last seen by a cancer specialist and underwent the critical bone marrow tests that he requires every two months to monitor if the cancer has spread. He is experiencing severe pain in his shoulders but, instead of addressing the causes of his condition, the authorities have simply told his family to buy him strong painkillers. He is also suffering from digestive problems resulting from a prolonged hunger strike in late 2016. Prison doctors have repeatedly said that he should be transferred to a specialized medical centre outside prison, but the authorities have dismissed the advice. Doctors have warned that, without ongoing treatment, including chemotherapy, the cancer could spread.

The deliberate refusal by the authorities to provide Arash Sadeghi with medical care constitutes torture as defined in international law, since such deprivation is intentionally inflicting severe pain or suffering, apparently for the purpose of punishing him for his high-profile activism as a human rights defender and in reprisal for his peaceful hunger strike between October 2016 and January 2017, which attracted a major public outcry on his case. The denial of his access to life-saving medical care also violates his right to life. 

I urge you to immediately provide Arash Sadeghi, at the state’s expense, with the specialized medical care he needs at the appropriate medical centre outside prison, including cancer treatment. I further call on you to release him immediately and unconditionally, as he is a prisoner of conscience held solely for peacefully exercising his rights to freedom of expression, association and assembly. Finally, I urge you to initiate an independent and efficient investigation into Arash Sadeghi’s torture and bring those responsible for persistently denying him medical care to justice in proceedings that meet international fair trial standards.
Yours sincerely,
Additional information
Arash Sadeghi, who has been in prison since 2016, has been convicted of multiple spurious national-security charges stemming directly from his human rights activism and sentenced, in two separate cases, to a total of 19 years in prison (MDE 13/2520/2015). He learned in June 2018 that he had a tumour in his arm that may be cancerous and that he should be immediately tested for bone cancer. This was after experiencing persistent pain in his elbow and shoulders for 18 months, which had been ignored by the authorities (MDE 13/8687/2018). Following extensive delays, Arash Sadeghi finally received a number of tests in August 2018, which established that he has a rare type of cancer called chondrosarchoma. Doctors subsequently advised that he must be immediately admitted to the Cancer Institute of Imam Khomeini Hospital in Tehran to undergo surgery to remove the tumour. However, the prosecution and prison authorities refused to authorize his transfer until early September 2018. On 8 September 2018, prison authorities were contacted by Tehran’s Imam Khomeini hospital several times to arrange his transfer there to undergo surgery. Doctors at the hospital had wanted Arash Sadeghi transferred there at least three days prior to his operation to monitor him in preparation for what would be a major operation. However, the prison authorities chose to transfer him late on 11 September 2018. The surgery took place on 12 September and lasted over seven hours. 
After the surgery, doctors intended to keep Arash Sadeghi in the recovery room for at least one hour. However, members of the security forces removed him prematurely and shackled his left hand and left leg while he was still unconscious. Security forces then blocked the area around his hospital bed, which resulted in the medical team being unable to conduct routine post-operative checks, despite protests from hospital staff. This treatment violates the absolute prohibition on torture and other cruel, inhuman or degrading treatments under international law; Iranian authorities have an obligation to provide prisoners adequate health care as well as to treat prisoners respectfully in accordance with their inherent dignity as human beings. 
On 15 September 2018, less than three days after his surgery, he was transferred back to Raja’i Shahr prison. This was against medical advice that he remain hospitalized for at least 25 days following the operation so that he could be monitored by specialist doctors. Doctors had said that they needed this post-operative recovery period to assess whether he required chemotherapy, radiation therapy or additional surgery. On 22 September 2018, he was booked for a morning appointment with his surgeon, who had specified his availability as limited to the morning. However, the prison guards transferred him in the afternoon, by which time the surgeon was no longer available. He was instead examined by a general practitioner who diagnosed a serious infection in his surgical wound. The general practitioner assessed that the infection would have been much less likely if he had remained hospitalized. Under the UN Standard Minimum Rules for the Treatment of Prisoners (the Nelson Mandela Rules), clinical decisions should only be taken by the responsible health-care professionals and not be overruled or ignored by non-medical prison staff. 
After persistent pleas from his family, the authorities transferred him to hospital again on 13 October 2018 to be seen by the surgeon who had conducted the operation on him. The surgeon said that he should undergo chemotherapy, but that this was not possible as long as he was held in prison, especially considering the authorities’ pattern of delaying or cancelling his transfers to hospital. According to information obtained by Amnesty International, while at the hospital, members of the security forces physically assaulted Arash Sadeghi, twisting his left hand and punching the area of his right arm on which surgery had been performed. When medical staff protested, members of the security forces reportedly said that their behaviour was in line with orders they had received from the head of the prison.
Arash Sadeghi and his family have not been allowed to access his medical records and told that the records have been taken away by the Revolutionary Guards. Under the Nelson Mandela Rules, all prisoners and those appointed by them should be granted access to their files upon request.
The Iranian authorities have continuously denied Arash Sadeghi adequate medical care since he waged a hunger strike in late 2016 in protest at the imprisonment of Golrokh Ebhraimi Iraee (MDE 13/5811/2017). 

PREFERRED LANGUAGE TO ADDRESS TARGET: Persian, English
You can also write in your own language.

PLEASE TAKE ACTION AS SOON AS POSSIBLE UNTIL: [24 09 2019] 
Please check with the Amnesty office in your country if you wish to send appeals after the deadline.

NAME AND PREFFERED PRONOUN: Arash Sadeghi (he/him)

LINK TO PREVIOUS UA: https://www.amnesty.org/en/documents/mde13/8687/2018/en/
Additional TARGETS

Hamid Mohammadi 
Head of Raja’i Shahr prison
Moazzen Boulevard 
Gohardasht, Karaj, Iran

Also send copies to diplomatic representatives accredited to your country.

HIS EXCELLENCY MR HAMID BAEIDINEJAD Embassy of the Islamic Republic of Iran 16 Prince’s Gate SW7 1PT 020 7225 4208-9 Fax: 020 7589 4440 iranemb.lon@mfa.gov.ir  

Please check with your section before sending appeals after the above date.