Airstrike Hits Doctors Without Borders Hospital in Afghanistan


Doctors Without Borders staff members at a hospital in Kunduz that was badly damaged in an airstrike on Saturday.

Doctors Without Borders

KABUL, Afghanistan — At least 19 people were killed when a hospital run by Doctors Without Borders in the northern city of Kunduz was badly damaged early Saturday after being hit by what appears to have been an American airstrike, sparking international outrage.

The United States military, in a statement, confirmed an airstrike at 2:15 a.m., saying that it had been targeting individuals “who were threatening the force” and that “there may have been collateral damage to a nearby medical facility.” The strike will bring renewed pressure on the United States, which has been playing an increasingly active role in Afghanistan amid a resurgence of the Taliban, particularly in Kunduz, but has long been criticized for causing civilian casualties from the air.

The airstrike Saturday set off fires that were still burning hours later and a nurse who managed to climb out of the debris described seeing colleagues so badly burned that they had died. At least 12 hospital staff members were killed in the strike.

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“A few are still missing, they might have been buried in the rubble,” he said, declining to give his name because employees of Doctors Without Borders are not allowed to speak to reporters without authorization.

In a statement, the aid group accused the American military of continuing the bombing for 30 minutes after receiving phone calls telling military contacts that the hospital was being bombed.

“All parties to the conflict including in Kabul and Washington, were clearly informed of the precise location [GPS Coordinates] of the MSF facilities — hospital, guesthouse, office,” the statement said. “MSF urgently seeks clarity on exactly what took place and how this terrible event could have happened,” it said.

President Ashraf Ghani’s office released a statement Saturday evening saying that Gen. John F. Campbell, the commander of American forces in Afghanistan, had apologized for the strike. However, Gen. Campbell said in a statement that he was “aware of an incident that occurred at a Doctors without Borders hospital in Kunduz” but also stopped short of taking responsibility, saying that the airstrike “was conducted against insurgents who were directly firing upon U.S. servicemembers advising and assisting Afghan Security Forces.”

He said that the military would investigate the incident, echoing an earlier statement by Defense Secretary Ashton Carter.

Airstrikes resulting in civilian casualties have caused tensions verging on hostility between the Afghan government and the United States for years. The former president, Hamid Karzai, was often in the uncomfortable position of explaining to his countrymen why Afghanistan’s biggest ally was killing innocent Afghans.

Mr. Ghani has been largely spared such confrontations since taking power last year. Although the United States military has kept up a steady stream of airstrikes, it has mostly targeted small groups and there have been far fewer mistakes.

The strike on the hospital Saturday was condemned by the United Nations High Commissioner for Human Rights, Zeid Ra’ad Al Hussein, who called for a swift and transparent investigation into the airstrike Saturday.

“This event is utterly tragic, inexcusable, and possibly even criminal,” Zeid said. “International and Afghan military planners have an obligation to respect and protect civilians at all times, and medical facilities and personnel are the object of a special protection. These obligations apply no matter whose air force is involved, and irrespective of the location.”

The strike on the hospital came as the United States, for the first time since it began withdrawing most of its soldiers from Afghanistan, has begun to play a sustained and active role in the fight there. It is trying to support Afghan troops overwhelmed by the Taliban in the northern province of Kunduz.


Surgeons in a Doctors Without Borders hospital in Kunduz, after an American airstrike. American officials acknowledged “there may have been collateral damage to a nearby medical facility.”

Médecins sans Frontières, via Reuters

The Taliban took the control of Kunduz City on Monday and despite sporadic but often intense fighting over the last three days, their white flag is still flying over the main square.

Accounts differed as to whether there had been fighting around the hospital that might have precipitated the strike. Two hospital employees, an aide who was wounded in the bombing and a nurse who emerged unscathed, said that there had been no active fighting nearby and no Taliban fighters in the hospital.

But a Kunduz police spokesman, Sayed Sarwar Hussaini, insisted that Taliban fighters had entered the hospital and were using it as a firing position.

The hospital treated the wounded from all sides of the conflict, a policy that has long irked the Afghan security forces.

Video posted Saturday morning of the hospital grounds showed fires still burning, blackened walls and, in one building, a collapsed ceiling. One side of one building appeared to be pockmarked by bullets or possibly shrapnel, suggesting that there could have been fighting there. But it was impossible to tell whether the marks were new.

Doctors Without Borders, which released the casualty numbers, said 37 people were wounded of whom 19 were hospital staff and 18 were patients or their caregivers, which means mostly family members. The organization described the facility as “very badly damaged.”

In a statement, the aid group accused the American military of continuing the bombing for 30 minutes after receiving phone calls telling military contacts that the hospital was being bombed.

“All parties to the conflict including in Kabul and Washington, were clearly informed of the precise location [GPS Coordinates] of the MSF facilities — hospital, guesthouse, office,” the statement said. “MSF urgently seeks clarity on exactly what took place and how this terrible event could have happened,” it said.

A military spokeswoman in Kabul, Susan Harrington, said that she could not comment while the investigation was open.

The hospital nurse, who asked not to be identified because he had instructions not to speak to reporters, said that two nurses had been killed, as well as three doctors, a pharmacist and two guards. “Most of my colleagues died in the fire after the bombing,” he said.

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“When the bombing occurred, we were treating patients; then we lost our way, everyone stumbled and fumbled to escape,” the nurse said. “I don’t even remember how I got out.”

Another nurse described treating himself because there was no one to help him.

Doctors Without Borders said 105 patients and caretakers had been at the hospital, along with 80 staff members. The hospital was “partially destroyed” in the bombing, the group said, adding that it had been “hit several times.”

When the military describes a single airstrike, it can mean that more than one bomb was dropped on a single target. Similarly, if an attack is carried out by helicopters or drones, there may be more than one bomb dropped, but if there is a single target, it is often described as just one airstrike, according to the military.

The Afghan Army has also been using helicopters to attack targets in Kunduz, and a spokesman for the Afghan Army brigade in Kunduz, Ghulam Hazrat, said that Afghan helicopters were “maneuvering and targeting enemies last night.” It was not yet clear whether its aircraft had been involved in the overnight attack.

The International Committee of the Red Cross also condemned the bombing as did the United Nations in Afghanistan.

“This is an appalling tragedy,” said Jean-Nicolas Marti, the head of the organization’s delegation in Afghanistan. “Such attacks against health workers and facilities undermine the capacity of humanitarian organizations to assist the Afghan people at a time when they most urgently need it.”

The United Nations special representative in Afghanistan also condemned the attack saying it was “devastating” and “a violation of international humanitarian law.”

The United States Embassy in Kabul also released a statement. “The U.S. Embassy mourns for the individuals and families affected by the tragic incident at the Doctors without Borders hospital, and for all those suffering from the violence in Kunduz,” it said. The statement praised the group. “Doctors without Borders performs heroic work throughout the world, including Afghanistan, and our thoughts and prayers are with their team at this difficult time.”

Kunduz has been the scene of heavy fighting since Thursday, when Afghan government security forces began a counterattack on the Taliban, which captured the city on Monday.

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How the Taliban Are Advancing in Afghanistan

The Taliban seized the provincial capital of Kunduz, the first major city they have won since 2001, more than a year after local Afghan officials began warning about the insurgents’ advances toward the city.


A resident who lives near the hospital, and who spoke to staff members there, said that smoke was still rising from the wreckage hours after the strike. He said the bombing had been heavy, and that it was possible that more than one bomb had been dropped.

Among the dead was the Afghan head of the hospital, Abdul Sattar, said several of the residents. Both foreign and Afghan employees worked there.

Although the hospital was overwhelmed in recent days by civilians wounded in the fighting, and was running short of supplies, staff members continued to work. Early on, the Taliban had respected the hospital’s request not to bring weapons inside, according to staff members, and the hospital had been a refuge in the shattered city.

The United States began dropping bombs on the Kunduz area on Tuesday in an effort to aid Afghan forces fighting the Taliban.

The civilian deaths in the Saturday airstrike, and the discrepancies in the accounts of what led to the bombing, were a painful reminder of scores of earlier mistakes by American forces as they mistakenly hit civilians including women, children and the elderly at weddings, on roads, in villages and even on hillsides as they gathered firewood.

Although such mistakes have accounted for an ever smaller fraction of civilian deaths in the war, each one has taken on magnified significance in the eyes of many Afghans, because it is the fault of a foreign power. That has done much to alienate the Afghan population, which in turn has hurt the United States-led forces and their Afghan government allies.

The most recent report from the United Nations found that the United States was responsible for just 1 percent of civilian casualties.

Civilian casualties from coalition airstrikes have also engendered support for the insurgency. Whatever the Taliban’s atrocities, and there certainly have been many of them, the insurgents do not have aircraft and the devastating capability to kill from above. Nonetheless, in the first half of 2015, the Taliban and other antigovernment forces were responsible for 70 percent of civilian casualties.

In 2012, after years of botched American strikes that hit wedding parties, villages filled with women and children, and even, in 2011, nine young boys gathering firewood on a mountainside in Kunduz Province, the United States military reached an agreement with then-President Hamid Karzai to sharply limit the circumstances in which air support was used, and to avoid population centers and Afghan homes almost entirely.

At the time, exceptions were allowed for extraordinary circumstances, for instance, when Afghan government forces requested help. It was unclear whether those rules remained in place.

However, the United States military was careful to note today that it has dropped only two bombs in Kunduz City since it fell to the Taliban: one airstrike took place earlier this week, and the second apparently struck the hospital Saturday.

The United Nations says that 19,368 civilians have been killed in fighting in Afghanistan since 2009, when the world body began to keep detailed statistics. Nearly 33,300 have been wounded.

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