'Close to death': What 60 days on hunger strike is doing to Palestine Action prisoners

Medical experts warn that activists linked to Palestine Action who have been on hunger strike for more than 60 days are now entering a phase where damage may be permanent and the risk of death and irreversible harm increase sharply.

Two of the remaining hunger strikers, Heba Muraisi, who has passed day 66 without food, and Kamran Ahmed, who is on day 60, are described by family members as being in extreme physical decline.

Earlier this week, Muraisi told journalists she is “dying in her cell”, while Ahmed’s family said he is facing irreversible damage as his muscles and organs weaken under prolonged starvation.

In a statement shared by relatives and legal representatives, Ahmed was described as being “close to death”, as his physical condition continues to deteriorate.

Lawyers representing the two hunger strikers have also written to UK Justice Secretary David Lammy this week, for the fourth time, urging him to meet them to discuss a possible resolution.

In the letter, the lawyers raised concerns about Muraisi’s health and noted that Ahmed’s deterioration – including intermittent hearing loss, a low pulse, and breathlessness – is preventing them from taking instructions from him over the phone.

The hunger strike began in protest against their continued detention on remand and prison conditions, according to supporters.

'At this stage, organ systems can tip from coping to failure very quickly'

– Dr James Smith, emergency doctor

Dr James Smith, an emergency medicine doctor and lecturer at University College London, is one of several doctors supporting the families of the hunger strikers.

He explained to Middle East Eye the profound physiological toll a hunger strike of this length can take.

“While 60-plus days represents a morbid milestone of sorts, the risks the hunger strikers are facing now are risks they have been facing for several weeks,” Smith told MEE.

“The risk grows with every day; but the processes taking place inside the body have already been under way since week three or four.”

As the body exhausts its initial energy reserves, it switches from using stored fat to breaking down muscle tissue for energy.

“That breakdown of muscle causes the visible wasting we associate with severe malnutrition,” Smith said.

Over time, this catabolism affects not just skeletal muscle but also the heart and breathing muscles, weakening core bodily functions essential for survival.

When the body runs out of fuel

Once those fat reserves are depleted, the body begins breaking down muscle tissue – including muscles essential for the heart, breathing and movement.

“Muscle mass and fat are lost across the entire body, simply to survive a little while longer,” Smith said.

This process affects every system. Weakness intensifies, breathing becomes harder, and the heart becomes increasingly fragile.

Electrolytes, the heart and the brain

Beyond weight loss, Smith warned of severe deficiencies in micronutrients and electrolytes – minerals, such as potassium and magnesium, that regulate the heart and nervous system.

“People are not receiving the essential vitamins and minerals you would normally get from a healthy diet,” he explained.

“Deficiencies in key vitamins and electrolytes pose a risk of irreversible neurological harm and heart arrhythmias, among a host of other problems.”

While hunger strikers often receive supplements such as thiamine and multivitamins, Smith cautioned that these alone may not be enough.

“When people are profoundly deficient, oral supplements are rarely sufficient,” he said. “The body, slowly and relentlessly, is breaking itself down.”

Why 60 days matters

Historically, hunger strikers have died anywhere between 45 and 75 days, though survival varies with hydration, medical supervision and the individual's health.

Smith’s concern is not only the risk of death, but the risk that damage can no longer be reversed.

“At this stage, organ systems can tip from coping to failure very quickly,” he said. “Someone can appear relatively stable, then decline precipitously – and by the time that happens, it is often too late.”

Heart failure, kidney injury and neurological damage become increasingly likely as the body consumes itself to survive.

Damage that can last a lifetime

Even if a hunger striker resumes eating, Smith warned, the consequences may continue.

“There is a very high risk of irreversible harm,” he said. “The question is not simply whether someone survives, but what function they are left with afterwards.”

Long-term complications may emerge months or years later, including weakness, chronic organ disease and cognitive problems.

Based on historical hunger strikes, Smith believes the hunger strikers are already in the most fragile period.

“These activists are now in that critical phase where something catastrophically bad – or irreversible – could happen at any moment,” he said.