MSF staff inside destroyed hospital in Kunduz where 22 patients and staff were killed in a US bombing raid on October 3, 2015. Demotix/ Wakif Nasirahmad. All rights reserved.Out of the darkness of the Afghan night, in the skies over the Kunduz Trauma Centre, the faint drone of propellers could be heard. Then, the bombing began.
The intensive care unit (ICU), where the most critically ill adults and children silently lay, kept alive only by ventilators, was first to be hit. For the next hour the American AC-130 gunship circled its target, unleashing “concentrated volleys” of rockets on the medical centre. As staff escaped the building and fled, they were cut down by machine gun fire from above.
What they saw in that terrible hour on October 3, and in the grim aftermath, was enough to test the most conflict-hardened medic. Patients burning to death in their beds in ICU; two killed while lying on the operating table; the decapitated body of a colleague; the charred remains of children lying in the blood and the dust.
Frantic efforts to temper the chaos followed: a desk in the undamaged administrative building was converted into an operating theatre to perform emergency operations on staff and patients left dismembered, with open chest wounds, ruptured abdominal blood vessels and severe shock.
While the sun came up, the hell continued. As the wounded were rushed out to ambulances dispatched by the Ministry of Public Health to take them to hospital, fresh clashes erupted outside the compound leaving one ambulance riddled with bullet holes as it took patients away.
What isn’t up for question is that US and Afghan forces knew that the site was a hospital.
Hours later the world would wake in horror to the news; later it would emerge that 30 people, including 13 staff from Médecins Sans Frontières which ran the centre, had been killed. Very soon shock turned to anger, and demands for answers. How could this happen? Was the airstrike just a dreadful mistake, or had the US targeted the centre deliberately?
In the days that followed there were no answers, only confusion. The first statement from the US military HQ in Afghanistan said that it had attacked “insurgents who were directly firing upon US service members”; later it claimed the attack was “collateral damage”.
The acting governor of Kunduz, Hamdullah Danishi, said the compound was “100 percent used by the Taliban”; MSF vehemently hit back, saying it was “disgusted” at the “spurious” claims, and that both statements together amounted to “an admission of a war crime”.
Widney Brown, director of programmes at Physicians for Human Rights (PHR) says the initial explanations changed “almost hourly”. “The most telling part of the US's response was its attempts to cover up and excuse the attack rather than try to gather the facts,” she says. Medical staff clambered in the darkness frantically sending text messages of distress.
In this turbid atmosphere, and with the trauma of the attack still raw in the mind, MSF decided to conduct its own investigation. MSF general director Christopher Stokes tells me that the charity had to act, for fear of politics taking over.
He says: “For the first week there were different versions of events coming out. Certain parts of the local government have been speculating that this was a Taliban base, but this just doesn't match up to the facts”.
What isn’t up for question is that US and Afghan forces knew that the site was a hospital. MSF had repeatedly sent the GPS coordinates of the main hospital building to the US Department of Defense, the Afghan Ministry of Interior and Defense, and the Kabul HQ of Operation Resolute Support, the NATO mission in Afghanistan.
And once the attack began medical staff clambered in the darkness frantically making calls and sending text messages of distress. A desperate chain of communications was set in motion: to MSF representatives in Kabul; to Operation Resolute Support officials; to the International Committee of the Red Cross; from MSF in New York to the US Department of Defense.
It was a full hour before the attack could be stopped.
Stokes says it’s essential that answers are found as to how this happened, not least because there are bigger issues at stake than Kunduz. The whole legal basis for organisations like MSF working in conflict zones has been thrown into doubt by this ‘mistake’.
“What does the word mistake cover?” he says. “Was it a mistake because they shouldn't have bombed a hospital, or did they not know that it was a hospital? It doesn't tell us much about what happened that night and it doesn't tell us that it couldn't happen again.
“What we want to know now is, are we still operating under International Humanitarian Law (IHL) or is it now anti-terror legislation? We want reaffirmation of that and we want a much broader debate on our ability to work in these situations because we are having more and more of these mistakes occur”.
Mistakes by no means confined to the Afghan conflict. PHR says that in Syria 313 separate attacks on medical facilities have been carried out since the present conflict began in 2011. These, the organisation says, are mainly at the hands of government forces but, as Brown ominously warned in October, “the Russian government is now following in their footsteps”. In Syria 313 separate attacks on medical facilities have been carried out since the present conflict began in 2011.
And Brown is crystal clear that these are not isolated examples, nor where the responsibility lies. She says: “The Russian government in alliance with the Chinese has shielded Syria in the UN Security Council. Russia is also a major supplier of arms to Syria. As long as members of the UN Security Council send the message that upholding IHL standards is optional they are responsible for undoing decades of work aimed at making war a little less hellish for civilians”.
Two investigations into the Kunduz attack are under way by the US, as well as one by NATO and one by the Afghan government. Of these the key report is that of the AR 15–6 internal army investigation team, which will be privy to vital information such as cockpit recordings from the night, and all the details of the chain-of-command and communications between the US and Afghan government forces.
But will this be enough? Stokes isn’t convinced. MSF is pressing for a full independent investigation by the International Humanitarian Fact-Finding Committee (IHFFC), and is being supported by a number of signatory states. But without the consent of the US and Afghan governments the investigation won’t go ahead.
The international community must act with urgency to restore these hard-won standards... They are waiting to see what the US is going to do.
“At the moment the door isn't opening from their side,” says Stokes. “We are also disappointed that out of the 70 signatory states to the IHFFC there aren't more calling on this; they are waiting to see what the US is going to do. If there were more governments behind this then pressure on the US would be greater”.
MSF is appealing to the world for help. A petition to urge President Obama to consent to a full IHFFC investigation has been launched, and is gaining traction and international attention.
And as Brown tells me, in the wake of Kunduz, there is much at stake. “If medical workers and other humanitarian aid workers continue to be targeted,” she says, “more civilians will suffer and more will die. The international community must act with urgency to restore these hard-won standards.
“Part of doing that means ensuring justice for victims and accountability of perpetrators including those who gave superior orders or who had command responsibility for these war crimes”.
Whether or not the US bows to this pressure, and regardless of the outcome of the US army’s own internal investigation, these are parlous times for aid workers in conflict zones.
As the Middle East descends further into chaos, the implications of Kunduz - that even International Humanitarian Laws protecting aid workers are in doubt – couldn’t be more serious. This horrific moment must not be left to fade away, into the darkness of the Afghan night.
There is an acute and growing tension between the concern for safety and the protection of our freedoms. How do we handle this? Read more from the World Forum for Democracy partnership.