Kunduz hospital bombing: “This is NOT collateral damage” (MSF)

The international medical organisation Médecins Sans Frontières/Doctors Without Borders (MSF) has condemned in the strongest possible terms the horrific aerial bombing of its hospital in Kunduz, Afghanistan. Twelve MSF staff members and at least seven patients, including three children, were killed; 37 people were injured including 19 staff members. In a statement just issued MSF said: “This attack constitutes a grave violation of International Humanitarian Law”.

UPDATE: MSF have evidence that bombing was deliberate and targetted and therefore constitutes a war crime. This evidence is based on a statement issued by the Government of Afghanistan – for more details click here.

All indications currently point to the bombing being carried out by international Coalition forces. MSF has demanded a full and transparent account from the Coalition regarding its aerial bombing activities over Kunduz on Saturday morning. MSF has also called for an independent investigation of the attack to ensure maximum transparency and accountability.

Horrific loss of life

“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’.”

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.

Patients burned to death in their beds

“The bombs hit and then we heard the plane circle round,” said Heman Nagarathnam, MSF Head of Programmes 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.”

Coalition knew hospital location

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 29 September, 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 theatre in an undamaged room.

Respect health facilities

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 5900 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.

Note 1: The new MSF hospital, which opened August 29, 2011, provided urgent surgical care and follow-up treatment for people suffering life-threatening injuries. The MSF Kunduz Surgical Hospital, the only trauma centre of its kind in northern Afghanistan, was equipped with an emergency room, two operating theatres, an intensive care ward, and X-ray and laboratory facilities. There are separate male and female inpatient wards. SF services are completely free of charge and available to anyone meeting the admission criteria – which includes anyone that is either violently or accidently injured. “The only label we use is ‘patient,’” said Dr. Dorian Job, MSF medical coordinator in Afghanistan. “Every injured person has the right to receive medical treatment, and we make no distinction between civilian and combatant.” In all locations where MSF is working in Afghanistan, a strict no-weapons policy is implemented to ensure patient safety and security. It is imperative that no armed people are present in medical structures. Such a presence could make the facilities targets of attack.

Note 2: “This deeply shocking event should be promptly, thoroughly and independently investigated and the results should be made public,” Zeid Ra’ad al-Hussein, the UN High Commissioner for Human Rights said in a statement on Saturday. “The seriousness of the incident is underlined by the fact that, if established as deliberate in a court of law, an airstrike on a hospital may amount to a war crime.” He described the bombing as “utterly tragic, inexcusable, and possibly even criminal.” “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.”