(New York) – Horrific accounts by former detainees in Syria corroborate allegations of mass deaths in custody by a military defector. Four former detainees released from the Sednaya military prison in 2014 described deaths in custody and harsh prison conditions that closely match the allegations of the defector, who photographed thousands of dead bodies in military hospitals in Damascus.

In January, a team of senior international lawyers and forensic experts published a report concluding that Syrian authorities had committed systematic torture and killing of detainees. According to the report, a military defector, code-named Caesar, had taken 55,000 photographs of an estimated 11,000 bodies in military hospitals and other locations in Damascus. The bodies showed signs of starvation, brutal beatings, strangulation, and other forms of torture and killing.

“The accounts of the four recently released detainees we interviewed lend further credibility to the already damning evidence about mass deaths in Syria’s prisons,” said Ole Solvang, senior emergencies researcher. “When the Syrian authorities are held to account, the deaths in custody will be one of the first crimes they will have to answer for.”

All four former detainees told Human Rights Watch that they had witnessed the death of fellow detainees in Sednaya prison in Damascus following a combination of beatings, torture, malnutrition, and disease. The former detainees, who were held for between 21 and 30 months, most of the time at Sednaya, described abhorrent conditions, including overcrowding, lack of food, inadequate heating and ventilation, poor medical services, and extremely poor sanitary conditions that caused detainees to develop skin diseases and diarrhea. The detainees said that they had lost significant weight during their detention. One said that he lost more than half of his body weight, weighing only 50 kilograms when he was released.

The detainees’ description of the dramatic weight loss is consistent with Caesar’s photographs, Human Rights Watch said. The bodies in the photographs are severely emaciated, with ribs and hip bones clearly visible and a hollow facial appearance. “He looked exactly like the bodies in the Caesar photos,” one former detainee said of a friend who died from diarrhea in the same cell. Human Rights Watch has reviewed some of the photographs, but has not conducted a thorough independent analysis of them.

Two of the former detainees said they had seen bodies being taken from Sednaya Prison to the Tishreen military hospital, also known as Hospital 607, in northern Damascus, corroborating Caesar’s claims that some of the bodies were collected at the hospital, where he photographed them.

One former detainee said there were seven bodies on the floor of the truck that took him to Tishreen hospital for medical treatment. Another detainee said there were two bodies in the vehicle when he was transported to the Tishreen hospital for a second time. The hospital guards forced him to put about 20 bodies into body bags during his two stays in the hospital, he said.

The former detainees also described the prison authorities’ practice of assigning identification numbers to both prisoners and bodies when transporting them to the hospital, often writing the numbers on their foreheads. In many of the Caesar photos reviewed by Human Rights Watch somebody is holding up a sheet of paper with an identification number and in some cases the numbers were written directly on the deceased.

The former detainees also told Human Rights Watch that they had suffered and seen horrific acts of torture, both in Sednaya and in other security service branches where they were initially detained, including the Military Intelligence branches 293, 215, the so-called Palestine branch, the Air Force Intelligence branch in Mezzeh and in the Military Intelligence branch in Latakia. In a 2012 report, Torture Archipelago, Human Rights Watch documented the widespread and systematic use of torture in 27 detention facilities run by Syria’s security services, including those five.

Spurred in part by a presentation about the Caesar photos, the United Nations Security Council, on May 22, voted on whether to refer the situation in Syria to the International Criminal Court (ICC), which would have jurisdiction to investigate alleged violations by all parties in Syria. Over 100 nongovernmental organizations urged the council to approve the resolution, more than 60 countries co-sponsored it, and 13 of the council’s 15 members voted for it. Russia and China blocked the resolution, however, using their veto-powers.

The Syrian government should allow independent international monitors and the Commission of Inquiry on Syria to visit all its detention facilities, Human Rights Watch said. Syria should also comply with Resolution 2139, which called for an end to torture in all Syrian prisons and the release of all arbitrarily detained people.

“The evidence of the Syrian government’s crimes is already well documented, but these photographs represent further strong evidence of the government’s horrible treatment of its opponents,” Solvang said. “What more compelling evidence does the Security Council need to agree to international measures to deter Syria from further crimes.”

Torture and Conditions in Sednaya Prison

The four former detainees recently interviewed by Human Rights Watch corroborated important aspects of the photographs taken by the military defector known as Caesar. Two of the four had been released from Sednaya prison, 30 kilometers north of Damascus, in January 2014, and two in June, under a Syrian government amnesty. Two were interviewed in person and the others by phone. The names of all four have been changed for their protection.

Sednaya prison is under the control of the military. It consists of at least two buildings. Before the 2011 uprising in Syria, it was traditionally used for pretrial detention of people held by Military Intelligence, Air Force Intelligence and State Security as well as those sentenced by the State Security Court, an exceptional court abolished in 2011. Since the start of the crisis, it has held civilian protesters and political activists as well as defectors, including those being tried before the Counterterrorism Court and the Military Field Court .

The detainees told Human Rights Watch that when they arrived at Sednaya prison, the prison authorities placed them in small cells intended for solitary confinement on the ground floor or on one of the prison’s two underground floors. The cells, less than two meters square, held between five and nine detainees each, the former detainees said. Samir, who was held in a solitary confinement cell with four others, told Human Rights Watch:

Two of us could sleep at a time while the others had to stand. We were naked except for our underwear. When the door opened we had to face the wall. The prison guards hit us either with pipes or cables. Sometimes they poured water on us, which made it very cold since the temperature was probably below 10 degrees Celsius at that time. Or they threw the food on us or placed it in the toilet hole in the middle of the room so we had to get it from there.

Samir, an officer in the Syrian special forces who immediately confessed when he was detained to planning to defect, spent only five days in the cell. The other detainees Human Rights Watch interviewed were there longer. Khaled, a 22-year-old student, spent 17 days in a solitary confinement cell with eight others. Jalal and Amer spent five months there with eight other people.

Later, the prison authorities transferred the detainees to bigger cells on the upper floors. The cells, about 7 by 8 meters, contained 27, 28 and 25 detainees respectively. Samir said:

In the beginning, 15 guards would enter the cell twice a day bringing food. Every time they beat us and they did not stop until they saw blood, which could last from 5 to 10 minutes. They used electric prods, metal or plastic pipes. Later they would come only once a day. The beating varied in intensity with how the fighting was going: if the opposition made progress they would beat us more.

Human Rights Watch researchers saw and documented scars and bruises on the backs of the two former detainees interviewed in person. The marks were consistent with the men’s accounts that prison guards had beaten them on their backs with pipes. The marks on one of the men clearly showed the outline of a long object, such as a pipe.

Spread of Diseases and Lack of Proper Medical Assistance

The poor conditions in Sednaya prison and in other detention facilities where the detainees were initially held caused severe cases of diarrhea, scabies, and sores. The former detainees also said that fleas caused an incontrollable urge to scratch their skin. Khaled said:

I started having sores all over my body. The sores are like holes in the body resulting from continuous scratching the skin. Sometimes you keep scratching until the bones appear.

The detainees said that there was no effective medical assistance. Jalal said that two doctors checked on the detainees every two weeks. One provided limited medical assistance, he said, but the other would beat detainees who asked for medicine or complained about pain.

The poor hygienic conditions were compounded by the lack of fresh air. Samir, who spent two and a half years at Sednaya, said that he could remember only five times when the guards allowed him to leave his cell: once for a court proceeding at the military court in Qaboun, three times for communal washing in a shower on the same floor, and once when they took him to the hospital because of severe stomach problems. Amer, who spent five months in the solitary confinement cell, said he left the cell only twice, because his family had paid to see him.

Two of the former detainees said that their families could visit them, for a price.

Deaths and Transport of Bodies

All four detainees told Human Rights Watch that they saw detainees dying in Sednaya prison.

Amer and Jalal, who were in the same cells in Sednaya, both described the death of two people in their group cell. They said that Mostapha Dawbil, born in 1985, died in the beginning of November 2013. Amer said:

Mohamad died because of some infection in his mouth. They were like sores that grew and he stopped eating. A week before he died sores on his body started secreting fluid. We used to wash him every day, but the smell was unbearable.

The second person was Mohamad Taba, born in 1987, who died in October 2013, suffering from malnutrition, diarrhea and scabies, the two men said. “He looked exactly like the bodies in the Caesar photos,” Amer said.

Amer said that his friend Ali Chahine also died during their five months in the solitary confinement cell:

Ali had diarrhea for two months without seeing a doctor. He had sores and slept on the toilet because there was no room. Sores on his back and feet secreted fluids. We told the guards that he was sick, but they did nothing.

Jalal said that a man going by the name Abu Oqab al Abed, born in1981, also died in the cell, but Jalal did not know his real name. He said that the detainees were afraid to call for the guards when a detainee’s health deteriorated because the guards would beat them. The guards, he said, repeatedly gave instructions to inform them only when someone died. “Every day the guards shouted. ’Who died today?’ ” he said. “If somebody replied, “Number 7, sir,” it meant that somebody in cell 7 had died.

The Violations Documentation Center, a local monitoring group, has registered the names of Taba, Dawbil and Chahine in their database of people who died in detention.

Khaled told Human Rights Watch that during his 17 days in the solitary confinement cell he heard the guards say four times that somebody in one of the other cells had died. He believes that as many as 20 people might have died in the wing of his floor during his year and three months there.

Samir, the officer, told Human Rights Watch that one of the 28 detainees in his cell died. Samir said that prison authorities sent Abdulaziz Mohrez to the hospital because he had been suffering from severe diarrhea for several days. A fellow detainee who also went to the hospital told Samir upon his return that when they arrived at the hospital, Mohrez fell off the truck, unable to walk. The prison guards then beat and kicked Mohrez until he died, the detainee told Samir, and the guards made the other detainees put him in a body bag.

Transport of bodies to the Tishreen Military Hospital

Three of the former detainees told Human Rights Watch that they either saw or heard from other detainees that the bodies of detainees who died in the prison were transported to the Tishreen military hospital in the same vehicles that were used to transport sick detainees for treatment. The Tishreen hospital is in northern Damascus, about 20 kilometers from Sednaya prison.

Samir told Human Rights Watch that he first heard about the bodies from another detainee who became sick and was taken to Tishreen hospital. Samir said that when the sick detainee returned, he told the other detainees that there had been several dead bodies on the floor of the truck that took them to the hospital.

When Samir himself became seriously ill in the end of April, toward the end of his detention, he said:

We were four sick people being taken to the Tishreen hospital that day. On the floor of the truck there were seven dead bodies. When we arrived at the hospital, the guards took off our blindfolds and handcuffs. They threw the bodies on the ground and we had to move them to the side. We then had to open the zipper and read the number that was written on their foreheads. An officer wrote them down on a list.

Khaled told Human Rights Watch separately that a cellmate who returned from treatment in the Tishreen hospital told him that there had been 15 bodies on the floor of the truck that had transported him to the hospital. Khaled also told Human Rights Watch that his cellmate had seen numbers written on the forehead of the bodies when the bodies were unloaded at the hospital.

Amer told Human Rights Watch that guards at the hospital had forced him to put about 20 bodies in body bags during two stays in the Tishreen military hospital for treatment for scabies:

The bodies had no clothes on. I recognized one man who was in detention with me in branch 291, but I don’t know his name. They were all men aged between 20 and 50. After we bagged the bodies we carried them to a car. I don’t know what happened to them after that.

Jalal did not go to the Tishreen hospital, but he told Human Rights Watch that he had seen several dead bodies wrapped in clothing on the floor in a room in the prison on three occasions when he was waiting to see his family during prison visits.