How hunger strike could affect Palestinian prisoner Hisham Abu Hawash as he ends protest

140-day protest without food is the longest by a Palestinian detainee since 2012

Hisham Abu Hawash lies in a hospital bed after ending his hunger strike on January 4. AFP

The longest hunger strike in years by a Palestinian detained by Israel has drawn international attention to the high-risk form of protest.

After more than 140 days without food, Hisham Abu Hawash was close to death this week.

Who is Hisham Abu Hawash and why did he go on hunger strike?

Mr Abu Hawash is due to be released on February 26. His critical condition sparked protests and alarm from foreign governments, prompting Israel to agree to his release next month.

Stopping the strike was hailed by Palestinians as a victory, bringing to an end his detention without charge since October 2020.

But Mr Abu Hawash's health could continue to suffer long after he returns home to Dura, a village in the Israeli-occupied West Bank.

How do hunger strikes affect the body?

“It is extremely distressing to starve yourself to this degree,” said Dr Frank Arnold, who has worked with hunger strikers in the UK.

Mr Abu Hawash’s protest is the longest by a Palestinian detainee since 2012, according to Addameer which supports Palestinian prisoners.

He would only have been able to survive for so long through accepting vitamins, along with water.

“Survival up to that point would be almost impossible,” without supplements, said Dr Arnold, a member of rights group Medact.

The entire body can be affected with some people experiencing blurred vision, memory loss and vertigo.

Dr Bettina Birmanns, a neurologist who volunteers at Physicians for Human Rights Israel, said vitamins could help to treat some problems.

“Later the hunger strike becomes so dangerous to health because in later stages the body doesn't have reserves,” Dr Birmanns said.

When Mr Abu Hawash’s condition became critical, the International Committee of the Red Cross warned of "potentially irreversible health consequences" or death.

Despite ending the strike, he remains at risk.

What treatment is required after a hunger strike?

“The person needs to be re-fed and if it’s not done right it can cause severe problems and can also be dangerous,” Dr Birmanns said.

The process starts with increased fluids and vitamins, before gradually introducing small amounts of food.

If this is not correctly managed, Dr Arnold said “you effectively poison yourself” and cause brain or heart damage.

Why do people go on hunger strike?

Such a protest has a long history, with 10 prisoners starving themselves to death in 1981 during the Northern Ireland conflict.

Indian independence leader Mahatma Gandhi and the Suffragettes, who were detained as they campaigned for women’s rights, are among other famous figures to have launched hunger strikes.

Mr Abu Hawash's strike was the last in a series of such protests last year by Palestinian prisoners.

Israel is holding about 500 Palestinians without charge, Addameer said.

“When they use their bodies it is literally their last resort to protest [against] their ill treatment,” said Milena Ansari, an international advocacy officer at Addameer.

The NGO is one of six Palestinian rights groups designated a terrorist organisation by Israel last year, in a move that was condemned by the UN and other international observers.

What are the long-term effects of a hunger strike?

The ability of someone to fully recover from a hunger strike depends on their health before, along with their treatment during and after.

Dr Arnold said medics have “no idea what the long-term consequences are” due to a lack of follow-up.

He recommended physiotherapy as patients recover from muscle loss, as well as monitoring for nerve damage and mental health problems.

Functioning normally will take time after a hunger strike, said Dr Birmanns, although most people were able to regain their health.

“It’s amazing what the human body can do,” she said.