A hole where a missile hit is seen above the destroyed window of the outpatient department at the MSF Trauma Centre in Kunduz, northern Afghanistan. Photo: Victor J. Blue
 
Dr Evangeline Cua is a surgeon from the Philippines. She was in MSF’s Kunduz Trauma Centre in Afghanistan when U.S. airstrikes destroyed the hospital on 3 October. Here she shares her story of surviving that horrific night when at least 42 people were killed and over 30 were injured.
 
It happened again last night
 
We were like two headless chickens running in total darkness – me and the surgeon who assisted me in an operation. The nurses who were with us a moment ago had run outside the building, braving the volley of gunshots coming from above. I was coughing, half-choked by dust swirling around the area. Behind my surgical mask, my mouth was gritty as if somebody forced me to eat sand.

I could hear my breath rasping in and out. Layers of smoke coming from a nearby room made it hard to see where we are.
 

 
Dr Evangeline Cua from the Philippines.  

Fire licked at the roof at one end of the building, dancing and sparkling in the dark, reaching towards the branches of the trees nearby. The ICU was burning. Outside, only the constant humming from above pointed to the presence of something. An aircraft? Airstrike? Why the hospital? Why us? Then, without warning, another tremendous, earsplitting blast shook the building. The ceiling came crashing down on us and the last remaining lights were turned off, sending us to total darkness.

I screamed in terror as wires pinned me to the ground. That was the last thing I could remember.
 
I woke up sobbing and disoriented. It had been months since I went home from Afghanistan and, except for a fading scar on my right knee, that awful incident at the Kunduz Trauma Center was almost forgotten, suppressed to memory. Debriefings, consultations with psychiatrists, meditation techniques, pages upon pages of journal entries to unload myself of the horror of that night...all of these were swept aside when memories came rushing in a nightmare triggered by a firework.
 

May 2015. A man injured in a traffic accident is treated at Médecins Sans Frontières (MSF) Kunduz Trauma Centre where free treatment is provided to patients regardless of their political affiliation (ie. the side on which the fight in the war between the armed opposition group and Government forces.) Photo: Andrew Quilty/Oculi

It was two weeks before the end of what had been my disappointingly quiet assignment in Afghanistan. Suddenly, all hell was let loose in fierce fighting between government troops and the opposition. The city of Kunduz, after 14 years, was once again back in the hands of the Taliban.
 
In the hospital, I lost track of time. Only the clock on the wall reminded me that it was already late afternoon. A barrage of gunfire and explosions continued in the far off distance. I just finished my 6th surgery and was slowly drying my hands with a piece of cloth near the wash area.
 
“Doctor, can you see the patients at the ER and tell us who’s going to surgery first?”  There was urgency in his voice.
 
“Now?”
 
“Yes, now.”

 
There were at least a dozen people on the floor. And more were lying on the stretchers parked on both sides of the ER lobby. There were women with blood-spattered, shalwar kameez, one of them pregnant, another staring blankly at the ceiling; men with tattered, bloody clothes and a little kid moaning in pain, blood pooling where his legs should have been. 
 
I was startled when an old wrinkled man with a full beard and kind eyes stopped me, and uncharacteristically for an Afghan man, tried to touch my arm. With a pleading voice, he asked me in halting English, “Doctor, please. My son is out there. Could you please take a look at him? He’s a nice man, doctor. My youngest son.” He was saying the words to me proudly, with a hint of smile on his face.
 
I managed to suppress a gasp when I saw him – the man on the stretcher near the wall. On his chest, a big gaping wound gave me a view to his partially exposed lung. He already had a glassy look in his eyes and had no palpable pulse. Trying to do something, anything, I adjusted his intravenous line. I gently covered his chest with hospital linen and, in a breaking voice, told the old man to excuse me and that I’ll ask one of the nurses to tend to his son. 
 
The grateful look in his eyes, as if I had given his son a second lease on life, would haunt me forever.

The remains of a bed frame in a room on eastern wing of the main Outpatient Department building.

The things that were constant in my nightmares were the roaring sound and panels of wood crashing down on us. And screams. Mine. Then me tripping down, landing on the floor.
 
“Get up! Come on.”
 
I slowly stood wincing in pain, trying to see him in the dark. Then I saw the unmistakable slanting roof. The basement! Thank God.
 
We ran and jumped into the hole. To our horror, and big disappointment, we found ourselves inside the exhaust of the basement window. Surrounded with thick cement wall, about 7 feet below the ground, it was covered only by a thin sheet of roof above. An abyss. A dead end. The basement proper is on the other side of the wall!

MSF staff in shock in one of the remaining parts of MSF's hospital in Kunduz, in the aftermath of sustained bombing 03 October 2015. Photo: ©MSF

We noticed fire darting in and out of the windows just above where we were hiding. Without any hesitation, he hoisted himself up the wall and successfully jumped out of that pit and ran into the open. I was left in the dark . . . alone.
 
I was already in panic. I was angry. I wanted to lash out at somebody, anybody. I wanted to punch someone in the face.  I hated both sides involved in this stupid war. I wanted them to see all the damage they have been causing to civilians and let them imagine that those are their families. Let us see then if they would still continue this senseless war.
 
I was also afraid. I don't want to be burned alive. The tears came in torrent, bringing all my frustrations into surface.

At the time of the airstrike, the operating theatres were in use – there were patients on the tables being attended to by surgeons and anaesthetists. In this operating theatre, you can see the hole in the back wall from a bomb and the shrapnel damage. Photo: Dan Sermand/MSF

Then, surprisingly, there was calm and clarity. I was back to being a surgeon again. I saw a small piece of steel jutting out from the right corner. It was hot but I didn’t let go and in a few minutes I was out of the hole. With a sigh of relief, I saw my colleague sprawled on the ground near the rose garden, waiting, a big grin on his face when he saw me.
 
When the volley of shots in the surroundings stopped, we started crawling towards a building, several meters from where we were. We were halfway there when a figure came out from the darkness. Fear gripped me. I did not survive the fire to just be kidnapped! No, please. 
 
Then, the man who was wearing traditional Afghan attire uttered the words that I would always remember, “Follow me, there’s a safe place here.” 


Waheedullah Sahel, MSF Kunduz staff member, walks through the destroyed hospital and describes the scene of the attack.

Find out more about MSF's work in Afghanistan