London, United Kingdom – Heba Muraisi and Kamran Ahmed, Palestine Action-linked British activists on the brink of death, are determined to keep up their prison hunger strike until their demands are met, their friends and relatives have told Al Jazeera.

They have refused food for 67 and 60 days, respectively, as part of a rolling protest that began in November. Five of the eight individuals who have participated overall have ended their hunger strikes over health fears. Lewie Chiaramello, who turned 23 on Thursday, is the third prisoner also refusing food.

list of 4 itemsend of list

Muraisi, the longest fasting member of the group, “looks very pale and thin”, said her friend Amareen Afzal, who visited the 31-year-old on Wednesday. “Her cheekbones are quite prominent. She looks quite emaciated.”

Muraisi, a Londoner who had worked as a florist and lifeguard, is reportedly suffering from muscle spasms, breathlessness, severe pain and a low white blood cell count. She has been admitted to hospital three times over the past nine weeks. Afzal has also noticed the decline of Muraisi’s memory and said it is now “more difficult for her to stay engaged conversationally”.

“She speaks of herself as dying and she’s very aware and she is worried,” Afzal said.

But Muraisi is “intent on carrying on until the demands are met”, she added.

The group of remand prisoners are being held in various jails over their alleged involvement in break-ins at the UK subsidiary of the Israeli defence firm Elbit Systems in Bristol and a Royal Air Force (RAF) base in Oxfordshire. They deny the charges against them.

Their protest demands include bail, the right to a fair trial and the de-proscription of Palestine Action, which the UK in July designated as a “terrorist organisation”, putting it on par with ISIL (ISIS) and al-Qaeda. They are calling for all Elbit sites to be closed in the UK and have demanded an end to what they call censorship in prison, accusing authorities of withholding mail, calls and books.

All eight individuals will have spent more than a year in prison before their trials take place, well beyond the UK’s usual six-month pre-trial detention limit.

At the time of publishing, the Ministry of Justice had not responded to Al Jazeera’s request for comment.

‘It feels like now every time you see him, it could be the last’

Ahmed, a mechanic from London, has lost hearing in his left ear, suffers with chest pains, breathlessness and dizzy spells, and has a low heart rate that intermittently drops below 40 beats per minute, said Shahmina Alam, who visited her 28-year-old brother on Sunday.

He was admitted to hospital on Tuesday for a sixth time since he began refusing food in November, she said.

“He’s skinny. I describe him a bit like a piece of paper,” she told Al Jazeera. “Where his body’s lost a lot of weight, he’s a bit hunched over.

“His cheeks are sticking out. … When he got up to leave, it’s really like slow steps, and you can tell it takes a lot of energy to lift his legs.

“It feels like now every time you see him, it could be the last.”

She feels anxious as “the more time that’s going, the more resolved he is to continue it and ensure that his demands are met.”

Ahmed is “aware that at this stage he could suddenly pass away”, she said, but “he’s still determined.”

The group’s lawyers are calling for a meeting with David Lammy, the deputy prime minister and justice secretary, hoping to discuss the prisoners’ welfare. Despite criticism from doctors, United Nations experts, some politicians and leading barristers, the government has refused, saying hunger strikes are not unusual in prisons and policies regarding food refusal are being followed.

“We wouldn’t be in this position had the government chosen to engage in a meaningful conversation with … [Ahmed’s] legal representatives or even just a mediator,” Alam said.

Doctor warns of death, irreversible health damage

Chiaramello has refused food every other day for several weeks because he has type 1 diabetes.

He has been “almost perpetually quite ill”, said his partner, Nneoma Joe-Ejim, a trainee solicitor, who visited him on Wednesday. She fears he is at a higher risk of a diabetic coma.

On the days he fasts, he suffers from disorientation, dizziness and sluggishness, she said, adding that she is worried about his new feelings of depression.

“He does seem depleted a lot of the time,” she said.

James Smith, an emergency physician who is among a group of doctors advising the hunger strikers, warned of a critical phase in which death and irreversible health damage are increasingly likely. He also criticised the manner and level of medical care within the prison system.

Teuta Hoxha, who ended her hunger strike after 58 days, is understood to be in hospital while Amu Gib, who paused their protest after 50 days, remains “physically weak”, Gib’s friend Nida Jafri said.

“Amu has no [doctor’s] advice on refeeding right now,” she told Al Jazeera. “They’re left to using their own judgement to figure out how much and of what food they should eat. We, as loved ones, are terrified of this. We are aware that the reintroduction of food can be deadly if done incorrectly.”

Lewie Chiaramello, a landscaper and children’s football coach alleged to have participated in a break-in at an RAF base, is refusing food on alternative days because he has type 1 diabetes [Courtesy of Nneoma Joe-Ejim]

Muraisi is “wasting away”, Smith said, adding that her muscle spasms as well as Ahmed’s hearing loss could signal neurological issues. Chiaramello’s diabetic state is likely worsening and could cause long-term damage, he said.

“The trajectory that they are on at the moment can only end in one way, which is progressive decline and eventually death,” he told Al Jazeera. “The organs can hold out for quite some time, particularly in young healthy individuals, and then they can collapse very quickly.”

Hundreds of doctors have called on the UK government to increase the frequency of medical observations of the hunger strikers.

Several of the activists are said to have been handcuffed and restrained while in hospital, leading to claims of degrading and dehumanising procedures that overreach stated prison policies.

“It really is the most undignified treatment that I have ever come across in an NHS [National Health Service] environment in my career as a doctor,” Smith said.

Alam concurred, saying Ahmed fears hospital admissions because he finds the experience “mentally difficult”.

“He’s cuffed constantly” while in hospital, which has led to bruised wrists, and is surrounded by a larger number of prison guards, she said.

On Wednesday, supporters of the protesters drew parallels with history-shaping hunger strikes.

The current action is said to be the largest coordinated hunger strike in British history since 1981 when Irish Republican inmates were led by Bobby Sands. Sands and nine others died of starvation.

Muraisi’s 66th day of refusing food was “significant because it was on the 66th day of hunger strike that Bobby Sands died at the hands of the state”, the Prisoners for Palestine group said.

Francesca Nadin, the group’s spokesperson, told Al Jazeera that she accuses the government of “complete contempt for the safety and for the lives of these innocent young people because they are innocent until proven guilty.

“The government seems to forget about that.”