Guantanamo Bay Naval Base (Cuba) (AFP) - Behind the barbed wire of Guantanamo Bay prison, hunger-striking inmates are routinely force-fed, a practice defended by officials as necessary medical treatment but labeled by critics as torture.
But, for all the debate surrounding the practice, information about it is scarce, and force-feeding remains shrouded in secrecy.
"We don't talk about this," said Rear Admiral Kyle Cozad, commander of Joint Task Force-Guantanamo, arguing the silence is designed to prevent inmates scoring misleading propaganda points.
"Detainees manipulate the media, on a routine basis, and I say that with confidence and conviction," Cozad added, speaking to a small group of journalists at the naval base in Cuba last month.
Among the prison's 148 detainees, it is unclear exactly how many have staged hunger strikes or how many have been force-fed.
The US military detention center has not released any information about the force-feeding of inmates since October 2013, and prison authorities recently banned filming the act.
Previously, the graphic recordings of the forced feedings and cell removals of hunger strikers were the only record of those events.
A federal judge has ordered the redacted release of the videotapes, but granted a request by President Barack Obama's administration for a month-long pause on releasing them.
The government is expected to appeal the release order.
Last year, Guantanamo prisoners staged the largest protest in the prison's history -- involving two thirds of all detainees at its peak and spanning six months.
Prisoners say they are being held in legal limbo.
Up to 46 of the hunger strikers, according to official figures, were fed by force using so-called "enteral feedings" through a tube inserted through the nose and directly into the stomach.
- Torture or medical necessity? -
Rights groups decry the practice as torture, and have demanded more transparency from prison officials about force feeding.
Cozad said the decision to tube-feed prisoners -- even against their will -- is based on medical assessments, to prevent them from dying of lack of nutrition, and continues only until the inmate is considered healthy again.
"It's a matter of medical concern and that's the only reason we would enteral-feed one of the detainees," said Cozad.
"When they begin to eat or they become nutritionally stable, then we make the determination to take them off of that list."
According to the command in charge of Guantanamo, prisoners who are involved in "non-religious fasting" are removed from their cells in a so-called "forced cell extraction" by guards and strapped to a restraint chair to be force-fed.
A feeding tube is inserted into a prisoner's stomach through his nose and he is fed a nutritional supplement for 20 minutes. Hunger-strikers are sometimes administered painkillers.
- 'No moral or ethical issues' -
Cozad decides after consulting with his medical staff whether to feed a prisoner by force.
"I have no moral or ethical issue with it," he said, adding that he is only acting to "preserve the health of the detainee population."
"We are an isolated place... we don't have the ability to medevac somebody who is gravely ill who maybe went on non-religious fast for a prolonged period of time," Cozad added.
In a legal complaint, Syrian detainee Abu Wa'el Dhiab asks that prison authorities stop force-feeding him, saying the practice amounts to torture.
Several media outlets have asked the government to make the 28 known videos of his force-feedings public.
The videos show Dhiab as a feeding tube is inserted and removed from his nose, as well as the location of guards and the room used during the procedure.
Last year, US District Judge Gladys Kessler said "it is perfectly clear... that force-feeding is a painful, humiliating and degrading process."
But in a reversal last week, she agreed with the government that force-feeding is a "medical necessity" to prevent the detainee from dying.
She also said there was not "sufficient evidence" that guards force-feed Dhiab "in order to deliberately cause him pain or suffering."
Kessler did, however, order the release of the videos.
Since then, Cozad has banned filming the feedings.
"The reason I've opposed that is because they reveal some of our tactics, techniques and procedures.
"It's a procedure in the military manual that would impact my force. It's an operational security issue and it's a potential safety issue for my people."