The international medical organization Doctors Without Borders condemns in the strongest possible terms the horrific aerial bombing of its hospital in Kunduz, Afghanistan. Twelve staff members and at least seven patients, including three children, were killed; 37 people were injured including 19 staff members. This attack constitutes a grave violation of International Humanitarian Law.
News reports now say up to 19 people are dead after the attack, and that U.S. warplanes were in the area. The Chicago Tribune reported that “a spokesman for American forces in Afghanistan said a U.S. airstrike ‘may have resulted in collateral damage to a nearby medical facility’ and that the incident was under investigation.”
All indications currently point to the bombing being carried out by international Coalition forces (U.S. and allies). MSF demands a full and transparent account from the Coalition regarding its aerial bombing activities over Kunduz on Saturday morning. MSF also calls for an independent investigation of the attack to ensure maximum transparency and accountability.
“This attack is abhorrent and a grave violation of International Humanitarian Law,” said Meinie Nicolai, MSF President. “We demand total transparency from Coalition forces. We cannot accept that this horrific loss of life will simply be dismissed as ‘collateral damage’.”
“The area has been the scene of intense fighting the last few days. U.S. forces in support of Afghan Security Forces were operating nearby, as were Taliban fighters,” said Secretary of Defense Ash Carter. “While we are still trying to determine exactly what happened, I want to extend my thoughts and prayers to everyone affected.”
From 2:08 AM until 3:15 AM local time today, MSF’s trauma hospital in Kunduz was hit by a series of aerial bombing raids at approximately 15 minute intervals. The main central hospital building, housing the intensive care unit, emergency rooms, and physiotherapy ward, was repeatedly hit very precisely during each aerial raid, while surrounding buildings were left mostly untouched.
“The bombs hit and then we heard the plane circle round,” said Heman Nagarathnam, MSF head of programs in northern Afghanistan. “There was a pause, and then more bombs hit. This happened again and again. When I made it out from the office, the main hospital building was engulfed in flames. Those people that could had moved quickly to the building’s two bunkers to seek safety. But patients who were unable to escape burned to death as they lay in their beds.”
The bombing took place despite the fact that MSF had provided the GPS coordinates of the trauma hospital to Coalition and Afghan military and civilian officials as recently as Tuesday, September 29, to avoid that the hospital be hit. As is routine practice for MSF in conflict areas, MSF had communicated the exact location of the hospital to all parties to the conflict.
In the aftermath of the attack, the MSF team desperately tried to save the lives of wounded colleagues and patients, setting up a makeshift operating theater in an undamaged room. Some of the most critically injured patients were transferred to a hospital in Puli Khumri, a two hour drive away.
“Besides resulting in the deaths of our colleagues and patients, this attack has cut off access to urgent trauma care for the population in Kunduz at a time when its services are most needed,” said Nicolai. “Once again, we call on all warring parties to respect civilians, health facilities, and medical staff, according to International Humanitarian Law.”
Since fighting broke out on Monday, MSF had treated 394 wounded. At the time of the aerial attack there were 105 patients and their caretakers in the hospital, alongside more than 80 international and national MSF staff. MSF expresses its sincere condolences to the families and friends of its staff members and patients who have tragically lost their lives in this attack.
MSF’s hospital is the only facility of its kind in the north-eastern region of Afghanistan. For four years it has been providing free high level life- and limb-saving trauma care. In 2014, more than 22,000 patients received care at the hospital and more than 5,900 surgeries were performed. MSF treats all people according to their medical needs and does not make any distinctions based on a patient’s ethnicity, religious beliefs or political affiliation.
MSF is an international medical organization and first worked in Afghanistan in 1980. MSF opened Kunduz Trauma Center in August 2011 to provide high quality, free medical and surgical care to victims of trauma such as traffic accidents, as well as those with conflict related injuries from bomb blasts or gunshots.
In Afghanistan, MSF supports the Ministry of Public Health in Ahmad Shah Baba hospital in eastern Kabul, Dasht-e-Barchi maternity in western Kabul and Boost hospital in Lashkar Gah, Helmand province. In Khost, in the east of the country, MSF runs a maternity hospital. MSF relies only on private funding for its work in Afghanistan and does not accept money from any government.
Doctors Without Borders/Médecins Sans Frontières (MSF) nurse Lajos Zoltan Jecs was in Kunduz trauma hospital when the facility was struck by a series of aerial bombing raids in the early hours of Saturday morning. He describes his experience:
“It was absolutely terrifying.
I was sleeping in our safe room in the hospital. At around 2am, I was woken up by the sound of a big explosion nearby. At first I didn’t know what was going on. Over the past week we’d heard bombings and explosions before, but always further away. This one was different, close and loud.
At first there was confusion, and dust settling. As we were trying to work out what was happening, there was more bombing.
After 20 or 30 minutes, I heard someone calling my name. It was one of the Emergency Room nurses. He staggered in with massive trauma to his arm. He was covered in blood, with wounds all over his body.
At that point my brain just couldn’t understand what was happening. For a second I was just stood still, shocked.
He was calling for help. In the safe room, we have a limited supply of basic medical essentials, but there was no morphine to stop his pain. We did what we could.
I don’t know exactly how long, but it was maybe half an hour afterwards that they stopped bombing. I went out with the project coordinator to see what had happened.
What we saw was the hospital destroyed, burning. I don’t know what I felt, just shock again.
We went to look for survivors. A few had already made it to one of the safe rooms. One by one, people started appearing, wounded, including some of our colleagues and caretakers of patients.
We tried to take a look into one of the burning buildings. I cannot describe what was inside. There are no words for how terrible it was. In the Intensive Care Unit six patients were burning in their beds.
We looked for some staff that were supposed to be in the operating theater. It was awful. A patient there on the operating table, dead, in the middle of the destruction. We couldn’t find our staff. Thankfully we later found that they had run out from the operating theater and had found a safe place.
Just nearby, we had a look in the inpatient department. Luckily untouched by the bombing. We quickly checked that everyone was OK. And in a safe bunker next door, also everyone inside was OK.
And then back to the office. Full, patients, wounded, crying out, everywhere.
It was crazy. We had to organize a mass casualty plan in the office, seeing which doctors were alive and available to help. We did an urgent surgery for one of our doctors. Unfortunately he died there on the office table. We did our best, but it wasn’t enough.
The whole situation was very hard. We saw our colleagues dying. Our pharmacist…I was just talking to him last night and planning the stocks, and then he died there in our office.
The first moments were just chaos. Enough staff had survived, so we could help all the wounded with treatable wounds. But there were too many that we couldn’t help. Somehow, everything was very clear. We just treated the people that needed treatment, and didn’t make decisions. How could we make decisions in that sort of fear and chaos?
Some of my colleagues were in too much shock, crying and crying. I tried to encourage some of the staff to help, to give them something to concentrate on, to take their minds off the horror. But some were just too shocked to do anything. Seeing adult men, your friends, crying uncontrollably—that is not easy.
I have been working here since May, and I have seen a lot of heavy medical situations. But it is a totally different story when they are your colleagues, your friends.
These are people who had been working hard for months, non-stop for the past week. They had not gone home, they had not seen their families, they had just been working in the hospital to help people… and now they are dead. These people are friends, close friends. I have no words to express this. It is unspeakable.
The hospital, it has been my workplace and home for several months. Yes, it is just a building. But it is so much more than that. It is healthcare for Kunduz. Now it is gone.
What is in my heart since this morning is that this is completely unacceptable. How can this happen? What is the benefit of this? Destroying a hospital and so many lives, for nothing. I cannot find words for this.”