Bahrain's best known human rights activist, Abdulhadi al-Khawaja, who is on the 57th day of a hunger strike, could die in jail at any moment say those who have seen him recently.
"His heart could stop at any time or he could slip into a coma," said his daughter Maryam. Mr al-Khawaja, 51, who was sentenced to life in jail last year for an alleged plot to overthrow the Bahraini monarchy, says he will continue his hunger strike until he is freed or he dies.
His death is likely to ignite violence in Bahrain where members of the majority Shia community have protested against his imprisonment. It would also discredit the attempt by the Bahraini government to persuade the international community it is seriously pursuing legal and constitutional reforms.
The detention of Mr al-Khawaja, has lead to calls for the cancellation of the Bahrain Formula One race later this month. The government has been publicising the race as a sign that Bahrainis are united and the situation on the island Kingdom has returned to normal. "They are using it as a celebration that we are one nation while people are being killed weekly," says Zaynab, another daughter of Mr al-Khawaja.
Mary Lawlor of the human rights group Front Line Defenders, who led a team on a three-day visit to Bahrain this week, said: "I don't see how the Formula One can go ahead if Abdulhadi al-Khawaja dies in jail." She said she had asked him to end his fast, but he refused. "He has lost 25 per cent of his body-weight and he was already a thin man," she said.
Ms Lawlor says the Bahraini government may not realise the seriousness of his condition. Other sources say he cannot sit up in bed in the al-Qalaa prison prison where he has been transferred.
The Bahrain government says Mr al-Khawaja is being well cared for. "All policies and procedures of the prison facilities in Bahrain meet international human rights standards and all detainees have consistent and reliable access to professional medical care," said Major General Tariq al-Hassan, a spokesman for the Interior Ministry, in a statement. Mr al-Khawaja's condition "is under constant surveillance" and he receives daily medical attention said Maj-Gen al-Hassan.
Mr al-Khawaja, the founder of the Bahrain Centre for Human Rights, was arrested last April by security men who dragged him down the stairs of his apartment building, breaking his jaw in four places. He underwent a four hour operation and says he was later tortured, beaten and threatened with rape. He was among 2,929 Bahrainis arrested after the government started a campaign of repression on 15 March, in which many of those imprisoned were tortured, often being forced to sign confessions saying they were planning to overthrow King Hamad bin Isa al-Khalifa and had received aid from Iran.
The monarchy has launched a campaign to restore its reputation, saying it is dedicated to reform and to preventing a recurrence of abuses. It commissioned a report by the jurist Cherif Bassiouni, published in November, that confirmed the use of torture and said there was no evidence of Iranian involvement in Bahrain.
The US and Britain have been embarrassed by the repression which opened them up to charges of hypocrisy, given their tolerance of abuses in Bahrain and outrage at similar actions in Libya and Syria. Mr al-Khawaja has joint Danish-Bahraini citizenship and the Danish government has tried to have him sent to Denmark for treatment but without result.
Mr al-Khawaja's family were hopeful when his case was brought before a Court of Cassation in Bahrain this week that he and other defendants would be granted bail. But the judge deferred the hearing until 23 April, the day after the Formula One on 20-22 April. Despite the repression there have been continual demonstrations in Shia villages across Bahrain over the last year.
There is growing international consensus that Bahrain is not carrying out reforms recommended by the Bahrain Independent Commission of Inquiry under Mr Bassiouni. Human Rights Watch says hundreds of people who were unjustly imprisoned during the repression are still in jail and no senior officers have been held to account for overseeing torture on a mass scale.
Letter of love: To my dear family...
My dear and beloved family, from behind prison bars, I send to you my love and yearning. From a free man, to a free family. These prison walls don't separate me from you, they bring us closer together. Our connection and determination is stronger than ever. We take our strength from beautiful memories. Remembering every trip, every meal we ate together, all the conversations, remembering every smile, all the jokes and the laughter. The distance between us disappears, through our love and faith.
It's true: I am in here, and you are out there. But, you are in here with me, and I am out there with you. Our pain is made more bearable when we remember we chose this difficult path and took an oath to remain on it. We must not only remain patient through our suffering, we must never allow the pain to conquer our souls. Let our hearts be filled with joy, and an acceptance of the responsibility we have been given, for in the end this life is about finding a path of truth towards God.