Starvation was likely the leading cause of death for a Palestinian teenager who died in an Israeli prison, according to an Israeli doctor who observed the autopsy.

Seventeen-year-old Walid Ahmad, who had been held for six months without being charged, suffered from extreme malnutrition, and also showed signs of inflammation of the colon and scabies, said a report written by Dr. Daniel Solomon, who watched the autopsy, conducted by Israeli experts, at the request of the boy’s family.

Solomon is a member of Physicians for Human Rights Israel (PHRI), an organization that advocates for Palestinian human rights.

The Associated Press obtained a copy of Solomon’s report from the family. It did not conclude a cause of death but said Ahmad was in a state of extreme weight loss and muscle wasting. It also noted that Ahmad had complained to the prison of inadequate food since at least December, citing reports from the prison medical clinic.

Ahmad died on March 22 after collapsing in Megiddo Prison and striking his head, Palestinian officials said, citing eyewitness accounts from other prisoners. Israel’s prison service said a team was appointed to investigate Ahmad’s death and its findings would be sent to the authorized authorities.

“Upon receiving the initial report of the prisoner’s condition, a medical team was called to the scene and provided assistance as required,” the prison service said in a statement reported last week by Haaretz.

“As in any case of a prisoner’s death, an investigative team was appointed to check the incident, and with the conclusion of its activities, the findings will be passed to the appropriate authorities,” it said.

Ahmad is the youngest Palestinian prisoner to die in an Israeli prison since the start of the Gaza war, according to PHRI, which has documented Palestinian prisoner deaths. He was taken into custody from his home in the West Bank during a pre-dawn raid in September for allegedly throwing stones at soldiers, his family said.

The autopsy was conducted on March 27 at Israel’s Abu Kabir Forensic Institute, which has not released a report of its findings and did not respond to requests for comment. The Ahmad family’s lawyer, Nadia Daqqa, confirmed Solomon, a gastrointestinal surgeon, was granted permission to observe the autopsy by an Israeli civil court.

Rights groups say they have documented widespread abuse in Israeli detention facilities holding thousands of Palestinians who were rounded up since the Gaza war started with the devastating Hamas-led October 7, 2023, invasion of southern Israel.

The Palestinian Authority says Israel is holding the bodies of 72 Palestinian prisoners who died in Israeli jails, including 61 who died since the beginning of the war. Israel often holds on to the bodies of dead Palestinians, citing security grounds or for political leverage.

Conditions in Israeli prisons have worsened since the start of the war, former detainees have told the AP. They described beatings, severe overcrowding, insufficient medical care, scabies outbreaks, and poor sanitary conditions.

Megiddo Prison, a maximum security facility where many Palestinian detainees, including teens, are held without charge, is regarded as one of the harshest, said Naji Abbas, head of the Prisoners and Detainees Department at Physicians for Human Rights Israel.

Israel’s prison service said it operates according to the law, and all prisoners are given basic rights.

Ahmad’s lawyer, Firas al-Jabrini, said Israeli authorities denied his requests to visit his client in prison, but three prisoners held there told him Ahmad suffered from severe diarrhea, vomiting, headaches, and dizziness before he died. They suspected it was caused by dirty water, as well as cheese and yogurt prison guards brought in the morning and that sat out all day while detainees were fasting for the Muslim holy month of Ramadan, the lawyer said. Ramadan began on February 27 this year.

According to Dr. Solomon’s report, the autopsy showed that Ahmed likely suffered from inflammation of the large intestine, a condition known as colitis that can cause frequent diarrhea and can, in some cases, contribute to death.

However, medical experts said colitis usually doesn’t cause death in young patients and was likely exacerbated by severe malnutrition.

“He suffered from starvation that led to severe malnutrition and in combination with untreated colitis that caused dehydration and electrolyte levels disturbances in his blood which can cause heart rate abnormalities and death,” said Dr. Lina Qasem Hassan, the head of the board for Physicians for Human Rights Israel who reviewed the report at the request of the AP.

She said the findings indicated medical neglect, exacerbated by Ahmad’s inability to fight disease or infection because of how malnourished and frail he was.

Dr. Arne Stray-Pedersen, a professor of forensic medicine at the University of Oslo in Norway who was not involved in the autopsy, said the report suggests there was a period of prolonged malnutrition and sickness lasting at least a few weeks or months. “Based on the report, I interpret the underlying cause of death to be emaciation-wasting,” he said.

Scabies rashes were also noted on his legs and genital area, the report said. There was also air between his lungs that expanded into his neck and back, it said, which can cause infection. Air can come from small tears in the lungs, which can occur from severe vomiting or coughing, it said.

Ahmad’s family said he was a healthy high schooler who enjoyed playing soccer before he was taken into custody. His father, Khalid Ahmad, said his son sat through four brief court hearings by videoconference, and he noticed at one of them, in February, that his son appeared to be in poor health.

The family hasn’t yet received a death certificate from Israel, the elder Ahmad said Friday, and are hoping Dr. Solomon’s report will help bring his son’s body home.

“We will demand our son’s body for burial,” he said “What is happening in Israeli prisons is a real tragedy, as there is no value for life.”