Afghanistan: Kunduz Hospital Attack

pdate: 12 December 2015:

 After two months of in-depth investigations following the US airstrikes that destroyed the MSFtrauma centre in Kunduz, Afghanistan, on 3 October, MSF today announces with great sadness that the death toll has been confirmed to be at least 42 people.

The revised figures include the 14 MSF staff members confirmed to have been killed, as well as 24 patients and four caretakers (relatives that provided additional nursing care for the patients in the hospital). 

09 December 2015:

MSF today delivered a petition signed by more than 547,000 people to the White House, calling for President Obama to consent to an independent investigation of the deadly U.S. airstrikes on MSF's trauma hospital in Kunduz, Afghanistan.

The MSF petition calls for President Obama to consent to an investigation by the International Humanitarian Fact-Finding Commission (IHFFC), the one body established specifically to investigate potential violations of international humanitarian law under the Geneva Conventions. 

30 November 2015:

October 3, 2015 will forever remain a black day in MSF’s history. In the early hours of the morning, MSF’s trauma hospital in Kunduz, Afghanistan came under precise and repeated airstrikes. Under attack, our colleagues fought for their lives and for the lives of their patients with extraordinary determination and courage.
 
Fourteen MSF colleagues lost their lives that tragic day. All of MSF grieves with the victims’ families.  They will be tremendously missed and never forgotten.
 
As our colleague Zabiullah wrote in one of his poems:
“Time will fly, but its memory will remain,
Wounds will heal, but its stain will remain.”

These are our colleagues who were killed and their obituaries provide some insight into their character and commitment to providing independent medical care to people in crisis. 

Abdul Maqsood was 22 years-old and worked as a patient information focal point. He began his career in the hospital as a daily worker, and was very proud when only a few months later he was recruited as a permanent member of the team.  Maqsood showed dedication to his job and felt that working in the hospital was a great honour.

22 years-old, Abdul Nasir was a hospital cleaner. He was born in Kunduz province where he had been working for MSF since July 2013 and was described by those who knew him as a good person and incredibly hard working. He was always ready to contribute and went above and beyond what his job demanded of him.
 
Friendly and easy going, 29 year-old Abdul Salam was a nurse in the operating theatre. He was one of the most passionate workers amongst the Kunduz Trauma Centre staff, and enjoyed every second of his life.  As well as being an experienced OT nurse, he also possessed a diploma in pharmacy.

Abdul Satar Zaheer, 47 years-old, was the Deputy Medical Director at MSF’s Kunduz Trauma Centre. He managed a large group of staff and was described by all who worked with him as conscientious, empathetic and respectful.  He was often working until the middle of the night.  He was known for his incredible patience and sense of humor. The night of the attack Dr. Satar decided to stay close to his patients instead of taking a rest, and was sharing jokes with the other staff on duty to try to lift their spirits. He was the proud father of eight children.
 
Dr Aminullah Bajawri was a 32 year-old father and emergency room doctor. Like so many others, when the fighting broke out in Kunduz he decided not to leave the city in search of safety, but stayed to help his people, friends and colleagues. Dr. Amin was someone that could always be relied on in the ER, with extensive medical knowledge, a willingness to learn new things and a kind approach to his patients.  It was his dream to become a neurosurgeon. He was also a teacher at the Kunduz University and was highly respected by his students.    
 
Born in Kunduz, Lal Mohammad was 28 years-old. He always had a smile on his face, and was like a mentor to the younger nurses. He was kind-natured and always ready to help people in need.  His dedication to his patients went beyond providing medical care; he would always try to give as much comfort and support to them as he could. We will always remember his smile, his eagerness to learn and his positive energy.  He leaves a wife and three children behind.

At 32 years-old, Dr Mohammad Ehsan Osmani was a young intensive care unit doctor with extraordinary enthusiasm and dedication to his patients. With an everlasting smile, he would never say no to any extra work or to covering an extra shift; he would often volunteer to stay and work in his free time when the hospital was overloaded with patients. Dr Osmani was always willing to help others and never turned down someone in need of help.  On the night of the airstrike, instead of taking a rest in the bunker with his colleagues, he continued to work and look after his patients who were in critical condition.  
 
Mohibullah, 38 years-old, was a dedicated father and an experienced emergency room nurse who joined the Kunduz Trauma Centre three years ago. He was the youngest of eight brothers, several of whom were also working in the medical field. He started working as a nurse in the outpatient department, but then decided to change to the emergency room. Whenever he had the time he would try to study or learn from books or from his colleagues. He would always stay late if needed.    

Najibullah, a 27-year old father, had been working for MSF since August 2011 as cleaner in the emergency room. He was well liked by everyone as he was always talkative, happy and kind.  To further his knowledge, he was studying in his free time. The ER was always clean and tidy when he was on shift. More than a cleaner, Najibullah was a caregiver to the patients in the ward

Naseer Ahmad was a 23 year-old intensive care unit nurse who began working with MSF in June 2014. He was gentle, quiet, and very eager to learn.  He loved to have many people around him, to share his happiness and thoughts with them. In the ICU he often wanted to take responsibility for the critical patients by himself; it was a sign of his great commitment to his job and the care of his patients. He always wanted to help the patients who didn’t have family to look after them. 

Shafiqullah was 39 years-old and had been working as a guard since February 2015. He was very quiet, but always had a big smile on his face. He treated everyone with kindness and was very committed to his job. Always friendly, he was much loved by his colleagues who miss him greatly. He leaves behind four children.

Tahseel, 35 years old, was a father and a much loved and valued member of the pharmacy team at the Kunduz Trauma Centre since the opening of the project. He was very hard-working; the pharmacy was well organized and he was prepared for any emergency in the hospital. He had a great sense of humour, and always wore a big smile on his face.  Proving how dedicated Tahseel was to helping others, he returned to the hospital in the last few days of his leave to assist the team when they needed him most.

Zabiullah was 29 years-old and married. He had been working as a guard in the hospital since February 2015. He was a poet and was working on Pashto language translations of several books. He was also writing a book about the famous Khan Abdul Ghafar Khan. While he started working with MSF less than a year ago, he had already made lots of friends due to his friendly and kind manner.

Ziaurahman was a 23 year-old intensive care unit nurse, who had been working for MSF since December 2013. He was known to be a talented nurse with a sharp mind. He always joined the training sessions and showed an incredible eagerness to learn. He was very interested in everything and everybody and had a very caring nature.

25 November 2015:

Today the top American commander in Afghanistan briefed the press on the U.S. military investigation into MSF’s trauma centre attack in Kunduz.
Attributed to Christopher Stokes, MSF General Director

The US version of events presented today leaves MSF with more questions than answers.

It is shocking that an attack can be carried out when US forces have neither eyes on a target nor access to a no-strike list, and have malfunctioning communications systems.

It appears that 30 people were killed and hundreds of thousands of people are denied life-saving care in Kunduz simply because the MSF hospital was the closest large building to an open field and “roughly matched” a description of an intended target.

The frightening catalogue of errors outlined today illustrates gross negligence on the part of US forces and violations of the rules of war.

The destruction of a protected facility without verifying the target – in this case a functioning hospital full of medical staff and patients -- cannot only be dismissed as individual human error or breaches of the US rules of engagement.

05 November 2015:

On 5 November 2015, MSF released to the public an internal document that reviews the 3 October airstrikes by US forces on its hospital in northern Afghanistan. The chronological review of the events leading up to, during, and immediately following the airstrikes shows no reason why the hospital should have come under attack. There were no armed combatants or fighting on or from the hospital grounds.
 
The MSF internal review describes patients burning in their beds, medical staff that were decapitated and lost limbs, and others who were shot from the air while they fled the burning building. At least thirty people were killed, including 13 staff members, 10 patients and 7 unrecognisable bodies yet to be identified.
 
“The view from inside the hospital is that this attack was conducted with a purpose to kill and destroy,” said Christopher Stokes, MSF General Director. “But we don’t know why. We don’t have the view from the cockpit, nor what happened within the US and Afghan military chains of command.”

READ THE INTERNAL REVIEW HERE

03 November 2015:

Today marks one month since the U.S. attack on MSF hospital in Kunduz, Afghanistan.

The MSF SA staff will be holding a memorial ceremony at Park Station, Braamfontein to remember our colleagues and patients who were killed.

This is part of a series of remembrance events we will be holding worldwide. Come join us to remind the world and insist that ‪#‎evenwarhasrules‬.

SAVE THE DATE

Join Doctors Without Borders (MSF) for a public memorial for 30 people killed in the Kunduz Hospital Attack in Afghanistan.
DATE:  Tuesday 3 November 2015
TIME: 16:30 to 18:00
VENUE: Park Station, Braamfontein (Wolmarans street, exit of Gautrain station)

EVENT INFORMATION

On 3 November MSF staff in 27 cities and 63 countries around world will gather to grieve for our colleagues and patients who were killed one month ago in a US airstrike on our hospital in Kunduz, Afghanistan. We want to raise concern for the 300,000 residents of Kunduz who are now left without to emergency medical care when they need it most.

The Kunduz attack lead to the single biggest loss of life of MSF personnel and patients in an airstrike during our 44 year history in providing independent, impartial and neutral medical care during conflicts and crises. This attack was grave violation of International Humanitarian Law.

On 3 November we call on South Africans to gather with MSF Southern Africa in Johannesburg in memory of the 30 staff and people killed in Kunduz one month ago. Join us to remind the world and insist that even wars have rules.

This was not just an attack on our hospital – it was an attack on the Geneva Conventions. These Conventions govern the rules of war and were established to protect civilians in conflicts – including patients, medical workers and facilities. They bring some humanity into what is otherwise an inhumane situation.

We need answers. By calling for an independent investigation MSF is fighting back for the respect of the Geneva Conventions. As an independent medical organisation we are fighting back for the sake of our patients. We need you, as members of the public, to stand with us.

We call on South Africans to sign a petition to President Obama and the US government to consent to an independent investigation by the International Humanitarian Fact Finding Commission. The IHHFC is the only permanent body set up specifically to investigate violations of international humanitarian law.

About MSF’s Kunduz Trauma Centre:

 

• MSF’s hospital was the only facility of its kind in northeastern Afghanistan, providing free high level life- and limb-saving trauma care.
• Operating since 2011 the MSF’ Kunduz Trauma Centre treated anyone according to their medical needs and did not make distinctions based on a patient’s ethnicity, religious beliefs or political affiliation. Since 2011 a total of 37 southern and east African fieldworkers have worked with MSF in Afghanistan – 13 of them in Kunduz.
• In 2014, more than 22,000 patients received care at the hospital and more than 5,900 surgeries were performed. In the days prior to the attack MSF teams in Kunduz had treated 394 wounded people in the hospital during major fighting in Kunduz.

Help MSF today. 

Spread the word about our petition on Facebook and Twitter by using the following hashtags:
#independentinvestigation | #evenwarshaverules | #kunduz | #SAforKunduz
ALSO READ: FACT SHEET ON THE KUNDUZ HOSPITAL AIRSTRIKE
 

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Update: 26 October

Nearly three weeks on from the US bombing of the MSF trauma centre in Kunduz, Afghanistan, on 3 October, MSF today announces with sadness that the death toll is still rising, with one more MSF staff member confirmed to have been killed.

The total number of dead is known to be at least 30, including: 10 known patients, 13 known staff, and 7 unrecognisable bodies that were in the wreck of the hospital and that have not been identified so far (these bodies are now duly buried). One MSF staff member and two patients who are missing and presumed dead may be among the seven unrecognisable bodies, but ongoing forensic examinations have not yet been concluded. These unfortunately may not be final numbers.

Update: 16 October 

MSF launches a petition urging citizens to call on President Obama and the United States to consent to an independent investigation into the bombing of MSF’s trauma hospital in Kunduz, Afghanistan, on October 3.

Update: 14 October

MSF Kunduz attack: IHFFC awaits agreement from US and Afghanistan to proceed with independent investigation
 
Doctors Without Borders (MSF) has been informed that the International Humanitarian Fact-Finding Commission (IHFFC) has been activated. This is the first step needed to undertake an independent investigation into the attack on MSF’s hospital in Kunduz, Afghanistan on 3 October. The IHFFC is now awaiting the agreement of the United States and Afghanistan governments to proceed.
 
“We have received apologies and condolences, but this is not enough. We are still in the dark about why a well-known hospital full of patients and medical staff was repeatedly bombarded for more than an hour,” said Dr Joanne Liu, MSF International President. “We need to understand what happened and why.”

MSF Factsheet – Kunduz Hospital Attack
 
As in all its projects, MSF doctors treat people according to their medical needs and do not make distinctions based on a patient’s ethnicity, religious beliefs or political affiliation. MSF relies only on private funding for its work in Afghanistan and does not accept money from any government.
 

• Find out more about MSF's work in Afghanistan

 

Update: 7 October

Speech delivered by Dr Joanne Liu, MSF International President. 7 October 2015, Palais des Nations, Geneva, Switzerland

The US attack on the MSF hospital in Kunduz was the biggest loss of life for our organisation in an airstrike. Tens of thousands of people in Kunduz can no longer receive medical care now when they need it most. Today we say: enough.  Even war has rules.  
 
This was not just an attack on our hospital – it was an attack on the Geneva Conventions. This cannot be tolerated. These Conventions govern the rules of war and were established to protect civilians in conflicts – including patients, medical workers and facilities.
 
It is precisely because attacking hospitals in war zones is prohibited that we expected to be protected.
 
The facts and circumstances of this attack must be investigated independently and impartially, particularly given the inconsistencies in the US and Afghan accounts of what happened over recent days. We cannot rely on only internal military investigations by the US, NATO and Afghan forces.
 
Today we announce that we are seeking an investigation into the Kunduz attack by the International Humanitarian Fact-Finding Commission.
 
We ask signatory States to activate the Commission to establish the truth and to reassert the protected status of hospitals in conflict.
 
It is unacceptable that the bombing of a hospital and the killing of staff and patients can be dismissed as collateral damage or brushed aside as a mistake.
 
Today we are fighting back for the respect of the Geneva Conventions. As doctors, we are fighting back for the sake of our patients. We need you, as members of the public, to stand with us to insist that even wars have rules.
 

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Update: 6 October

Statement by Dr Joanne Liu, President, MSF International
 

Geneva, 6 October 2015 

For four years, the Doctors Without Borders (MSF) trauma centre in Kunduz was the only facility of its kind in northeastern Afghanistan, offering essential medical and surgical care.
On Saturday 3 October this came to an end when the hospital was deliberately bombed.

Twelve MSF staff and 10 patients, including three children, were killed, and 37 people were injured, including 19 members of the MSF team. The attack was unacceptable.

Despite MSF alerting both the Afghan and Coalition military leadership, the airstrike continued for at least another 30 minutes.

The hospital was well-known and the GPS coordinates had been regularly shared with Coalition and Afghan military and civilian officials, as recently as Tuesday 29 September. This attack cannot be brushed aside as a mere mistake or an inevitable consequence of war.

We need answers, not just for us but for all medical and humanitarian staff assisting victims of conflict, anywhere in the world. The preserve of health facilities as neutral, protected spaces depends on the outcome of a transparent, independent investigation.

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On Saturday 3 October 2015 the MSF Trauma centre in Kunduz was hit several times during sustained bombing by coalition forces, and was very badly damaged.

Twelve staff members and at least 10 patients, including three children, were killed; 37 people were injured including 19 staff members.

Update: 5 October
 

US government admits their airstrike hit hospital

"Today the US government has admitted that it was their airstrike that hit our hospital in Kunduz and killed 22 patients and MSF staff. Their description of the attack keeps changing – from collateral damage, to a tragic incident, to now attempting to pass responsibility to the Afghanistan government.

The reality is the US dropped those bombs. The US hit a huge hospital full of wounded patients and MSF staff. The US military remains responsible for the targets it hits, even though it is part of a coalition.

There can be no justification for this horrible attack.

With such constant discrepancies in the US and Afghan accounts of what happened, the need for a full transparent independent investigation is ever more critical." 

- Christopher Stokes, General Director, Doctors Without Borders (MSF)
 

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Update: 4 October

MSF leaders demand answers

12 MSF staff and 10 patients, including three children are confirmed killed in the attack

“Under the clear presumption that a war crime has been committed, MSF demands that a full and transparent investigation into the event be conducted by an independent international body. Relying only on an internal investigation by a party to the conflict would be wholly insufficient.

"Not a single member of our staff reported any fighting inside the MSF hospital compound prior to the US airstrike on Saturday morning. The hospital was full of MSF staff, patients and their caretakers. It is 12 MSF staff members and 10 patients, including three children, who were killed in the attack.

"We reiterate that the main hospital building, where medical personnel were caring for patients, was repeatedly and very precisely hit during each aerial raid, while the rest of the compound was left mostly untouched. We condemn this attack, which constitutes a grave violation of International Humanitarian Law.”

- Christopher Stokes, General Director, Doctors Without Borders (MSF)
 

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Update: 4 October

Kunduz: MSF demands explanations after deadly airstrike

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.

All indications currently point to the bombing being carried out by international Coalition forces. MSF demands a full and transparent account from the Coalition regarding its aerial bombing activities over Kunduz on Saturday morning.

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Update: 3 October

MSF had informed all fighting parties of hospital GPS coordinates on several occasions

MSF condemns in the strongest possible terms the horrific bombing of its hospital in Kunduz full of staff and patients.

MSF wishes to clarify that 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 and an outreach stabilization unit in Chardara (to the north-west of Kunduz).

As MSF does in all conflict contexts, these precise locations were communicated to all parties on multiple occasions over the past months, including most recently on 29 September.

The bombing continued for more than 30 minutes after American and Afghan military officials in Kabul and Washington were first informed. MSF urgently seeks clarity on exactly what took place and how this terrible event could have happened.

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Update: 3 October

Hospital bombing casualties

It is with deep sadness that we confirm so far the death of nine MSF staff during the bombing last night of MSF’s hospital in Kunduz. Latest update is that 37 people were seriously wounded during the bombing, of whom 19 are MSF staff.

Some of the most critically injured are being transferred for stabilisation to a hospital in Puli Khumri, 2 hours’ drive away. There are many patients and staff who remain unaccounted for. The numbers keep growing as we develop a clearer picture of the aftermath of this horrific bombing.

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Update: 3 October

Kunduz: MSF trauma centre hit several times

KABUL – At 02h10am on Saturday 3 October the MSF Trauma centre in Kunduz was hit several times during sustained bombing and was very badly damaged.

MSF staff confirmed dead

Three MSF staff are confirmed dead and more than 30 are unaccounted for. The medical team is working around the clock to do everything possible for the safety of patients and hospital staff.

“We are deeply shocked by the attack, the killing of our staff and patients and the heavy toll it has inflicted on healthcare in Kunduz,” says Bart Janssens, MSF Director of Operations.

“We do not yet have the final casualty figures, but our medical team are providing first aid and treating the injured patients and MSF personnel and accounting for the deceased. We urge all parties to respect the safety of health facilities and staff.”

Treating 394 wounded

Since fighting broke out on Monday, MSF has treated 394 wounded. When the aerial attack occurred this morning we had 105 patients and their care-takers in the hospital and over 80 MSF international and national staff present.

MSF’s hospital is the only facility of its kind in the whole north-eastern region of Afghanistan, providing free life- and limb-saving trauma care. MSF doctors treat all people according to their medical needs and do not make distinctions based on a patient’s ethnicity, religious beliefs or political affiliation.

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MSF started working in Afghanistan in 1980. In Kunduz, just like in the rest of Afghanistan, both national and international staff work together to ensure the best quality of treatment. 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 operates a maternity hospital. MSF relies only on private funding for its work in Afghanistan and does not accept money from any government.

Find out more about our work in Afghanistan