Why do combatants bomb hospitals?

Kunduz Hospital: The aim was to kill and destroy

"Doctors Without Borders" presents the results of the internal investigation into the air strike on the hospital in Kunduz

Doctors Without Borders (Médecins Sans Frontières, MSF) have presented the first results of their internal investigation into the air strike of October 3 by US special forces in Kunduz (Afghanistan: war target hospital) in Kabul. Accordingly, the aim of the airstrike, in which 30 people were killed and 37 injured, was clearly to kill and destroy.

The hospital was razed to the ground by the air raids. "30 of our patients and staff were killed. Some of them lost their limbs and were beheaded in the explosions," reports MSF. People who tried to escape from the burning building were shot at by the flying "gunboat" AC-130U. Some eyewitnesses report that the shots followed the movements of the fleeing people.

The situation after the Taliban offensive

For the preliminary internal investigation report, which is currently in the process, MSF evaluated around 60 testimony from Afghan and international employees, internal and public reports, email and telephone communications, as well as photos and satellite images. This gives an internal perspective of how the events in the hospital played out.

Due to the increasing intensity of the fighting after the Taliban offensive, MSF transmitted the exact geospatial data to the Pentagon, the Afghan Ministry of the Interior and Defense and the US Army in Kabul on September 29.

Both the US Department of Defense and the US Army confirmed receipt of the data and assured that they would be passed on to the appropriate agencies. The Afghan interior minister also gave an oral commitment. The GPS data were also communicated to a UN mediator, who confirmed that they would be forwarded to the responsible bodies of Operation Resolute Support.

On Wednesday September 30, MSF was treating 130 wounded, including 65 Taliban. Two of the wounded insurgents were of higher rank. One day later, MSF received a request from the US government as to whether large numbers of Taliban were hiding in the hospital and what was the situation for the safety of the employees.

When the fighting in Kunduz subsided on Friday October 2 for the first time since the Taliban's offensive, members of MSF climbed onto the roof of the hospital to hang up two flags. The bombing of Kunduz by US forces over the past few days made this precautionary measure seem sensible. Christopher Stokes, Managing Director of MSF, confirmed at the press conference in Kabul that the flags were placed flat on the roof. The building was also painted completely in white and was one of the few buildings that had light at all. Accordingly, the building would have been clearly recognizable as a hospital.

Stokes pointed out, however, that all parties to the conflict had repeatedly assured that the central information was the GPS data. These data are crucial information for NATO and the USA so that nothing can happen.

A few hours before the airstrike, French and Australian diplomats informed MSF that international employees were in danger of being kidnapped. The MSF team included two French and one Australian. Thereupon MSF decided that the international staff, if they were not on duty, should stay in the security rooms in the basement or in the administration building.

At 10 p.m., around 100 employees were sleeping in the facility's security rooms. Those who were still awake reported how calm that night was compared to the intense firefights of the previous nights. There was no fighting in the immediate vicinity of the hospital. No planes, gunshots or explosions were heard. Some employees even dared to go outside for the first time since the Taliban offensive.

All employees gave assurances that the gate to the facility was locked and that MSF's unarmed security was on patrol.

The US air strike

When the attack began around 2:08 a.m., 105 patients were in the hospital. 3 or 4 patients were government soldiers, while about 20 wounded were from the Taliban. All parties had accepted the gun ban within the facility. Nine international and 140 Afghan MSF employees as well as a delegate from the International Committee of the Red Cross (ICRC) were also present.

At 2:19 a.m., just 10 minutes after the hospital was first shot at, MSF informed the officials of Operation Resolute Support. The ICRC was informed a minute later. After the attacks continued at 15-minute intervals, the UN Office for Coordination of Humanitarian Affairs Civil Military (OCHA CivMil), the US Department of Defense and the Afghan Ministry of the Interior were informed.

At 2.52 am, Resolute Support replied, "I'm sorry to hear that. I still don't know what's going on." MSF continued to insist that the attacks must be stopped immediately and that serious losses can already be expected. Resolute Support responded by text message, "I will try my best and pray for all of you."

At 3:09 a.m. OCHA asked CivMil whether the air strikes had stopped. At 3.13 am, MSF confirms this via SMS.

Accordingly, Resolute Support, the responsible NATO mission, was not informed for 50 minutes about what US American special forces, to which the AC-130 Special Operations Command Gunship belongs, were doing in Kunduz. And they were unable to stop the attack. The question arises as to what role NATO, and thus at least to a certain extent also the Bundeswehr, actually play in Afghanistan.

The first impact occurred in the intensive care unit, which contained numerous immobile patients, some of whom were attached to ventilators. The MSF personnel were killed directly when the grenades hit, and others were burned to death like the motionless patients in their beds by the fire that started immediately.

The hospital was then systematically shot to rubble from east to west. A procedure that has a considerable need for explanation on the part of the US authorities.

Eyewitnesses reported massive explosions that shook the ground. These larger explosions are said to have come in volleys. That would speak for the fire with the 40mm automatic cannon of the AC-130. Doctors and employees who tried to escape from the burning building were specifically shot at from the plane.

A wheelchair user trying to save himself from the explosions was killed by shrapnel. A doctor had part of his leg torn off. Some people ran around burning until they fell dead to the ground. An MSF employee was beheaded by a flying bullet.

Given the precise and concentrated destruction of the main building, there is no doubt, according to MSF, that the hospital was the target of the attack. The attack had only one purpose, according to the internal perspective from the hospital, namely to kill and destroy: "We don't know why. We neither have a view from the cockpit, nor do we know what is going on in the Afghan military chains of command or Americans happened, "said Stokes.

New narratives

Meanwhile, the reports about the night of the air raid are getting more and more grotesque. Hours before the hospital was bombed, US warplanes had carried out two more attacks. A villa and a warehouse in densely built-up residential areas were destroyed. In both cases, the Afghan army asked for help because their soldiers were under heavy fire.

However, local residents reported that there were no Taliban fighters present at the time of the air strikes. In all three cases, the bombings appear to have been carried out on demand. This would clearly contradict the rules of engagement, according to which those responsible should have checked the information from the Afghan army.

Meanwhile, Afghan Defense Ministry spokesman Dawlat Waziri has contradicted American officials. The Afghan special forces did not request a bombing of the hospital on the night of October 3rd, but pointed out that the insurgents had positioned themselves near the hospital. Hamdullah Danishi, governor of Kunduz, on the other hand, has identified a very exclusive reality. 300 Taliban fighters are said to have stayed in the hospital and opened fire.

After the air raid

Immediately after the bombing, the MSF employees tried to take care of the survivors, to carry out emergency operations and to get a picture of the situation in the first place. At around 5:45 a.m., ambulances from the Ministry of Health arrived at the site. At the same time, Afghan special forces entered the property.

The Afghan special forces searched the ambulances for Taliban. A procedure that increasingly indicates that a high-value target was the target of the attack (compare also Afghanistan: war target hospital). In the meantime, there are also said to have been firefights in the vicinity, and an ambulance is said to have been shot at.

MSF left the facility that same morning. Since October 3rd, the hospital has been closed due to total destruction by US air strikes.

MSF makes it clear that the building was previously a fully functional hospital. All parties had ensured the neutrality of the medical facility. MSF's policy of "no arms" was recognized by all combatants. The hospital was under full control of MSF at all times. There were no armed fighters on the premises, nor was there any fighting from there. In short: Medical institutions were given special protection under international law at all times.

This leads to the question that the further investigations have to answer: Based on what assumption did the US soldiers target a hospital? What or who was the goal? So when will the US and the Afghan Army be ready to deliberately and specifically target a hospital with staff and patients?

Doctors Without Borders calls for an independent investigation into the events in Kunduz by the "International Humanitarian Investigation Commission" introduced in the Geneva Conventions.

Stokes sums up: "Nothing within the framework of international humanitarian law justifies bombing, leveling a hospital."

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