US repeatedly bombs hospital in Kunduz, Afghanistan

A protracted series of precisely targeted US airstrikes ripped through a Doctors Without Borders/Médecins Sans Frontières (MSF) medical center in Kunduz, Afghanistan on Saturday, killing at least 22 and wounding at least 37. The dead included 10 patients, including three children, and 12 members of the MSF staff.

The medical facility was hit repeatedly over a period of nearly 90 minutes, despite desperate phone calls placed by hospital staff to US and NATO offices in Washington and Europe, begging for a cessation of the firing, according to testimony from surviving MSF personnel.

The central structure of the medical center was “completely gutted” by the inferno produced by the attacks, and bodies inside were “charred beyond recognition,” according to an eyewitness who spoke to the Guardian.

An MSF nurse, Lajos Zoltan Jecs, described the aftermath of the US bombing: “We tried to take a look into one of the burning buildings. I cannot describe what was inside. There are no words for how terrible it was. In the Intensive Care Unit six patients were burning in their beds.”

She told MSF: “What is in my heart since this morning is that this is completely unacceptable. How can this happen? What is the benefit of this? Destroying a hospital and so many lives, for nothing. I cannot find words for this.”

In a statement issued Sunday, MSF demanded an independent inquiry into the bombing of the hospital “under the clear presumption that a war crime has been committed.”

“Not a single member of our staff reported any fighting inside the hospital compound prior to the US airstrike on Saturday morning,” it said. “The hospital was repeatedly & precisely hit during each aerial raid, while the rest of the compound was left mostly untouched.”

The hospital, the only major trauma center in northern Afghanistan, was filled to well over capacity at the time of the attack, with at least 105 patients undergoing treatment. The center has now shut down medical activities altogether, and the remaining patients have been relocated to a town several hours outside of Kunduz. MSF said Sunday that it had been forced to abandon its work in Kunduz “at a time when the medical needs are immense.”

Afghanistan’s Pajhwok news agency reported that doctors are fleeing northern Kunduz province, believing that they are being deliberately targeted. The agency cited the Public Health Department as reporting that over 500 people wounded in the US airstrikes and other violence had been brought to the city hospital, where only a group of nurses was left to provide care.

In an official statement issued Saturday night, US President Barack Obama did not even pretend that his office is considering any form of punishment against the officers and units involved, nor any changes in military regulations. Instead, Obama called the event a “tragedy” and made clear that he would defer to the US military’s own internal investigation.

“The Department of Defense has launched a full investigation, and we will await the results of that inquiry before making a definitive judgment as to the circumstances of this tragedy,” Obama said, after cynically offering his “thoughts and prayers” to the victim’s families.

Officers of the US-backed Afghan government defended the US airstrikes on Sunday, claiming that the hospital was used by the Taliban as a “human shield,” and that Afghan forces received fire from the area surrounding the hospital.

A spokesman for US-led occupation forces Colonel Brian Tribus similarly claimed on Saturday that the attacks were launched “against individuals threatening the force.”

“The strike may have resulted in collateral damage to a nearby medical facility. This incident is under investigation,” Tribus said.

US officials have acknowledged that a US C-130 gunship opened fire “in the vicinity of the hospital” after receiving a request for air support from US Special Forces ground units that were maneuvering alongside Afghan government troops near the hospital as part of operations aimed at driving out Taliban insurgents who captured portions of the strategic northern city on September 28.

The call for air support and the C-130 attacks came during the same time period when the attacks took place, yet the US government has refused to officially acknowledge responsibility for the series of direct hits against the medical center.

In the latest in a series of tight-lipped statements from US officials, Defense Secretary Ashton Carter refused to confirm any concrete information or even offer a coherent general assessment of the incident. The circumstances surrounding the attacks are “confused and complicated,” and the US military is still uncertain about the details, Carter claimed.

“While we are still trying to determine exactly what happened, I want to extend my thoughts and prayers to everyone affected. A full investigation into the tragic incident is under way in coordination with the Afghan government,” Carter said.

While US military officials have tried to excuse the atrocity against the MSF hospital as “collateral damage” resulting from the targeting of Taliban fighters allegedly occupying buildings that were part of the same compound as the medical center, both MSF staff members and other witnesses have reported that there was no fighting in the hospital compound.

It appears far more likely that the attacks were intentionally ordered by officers with the US-led force, in order to send the message that medical personnel suspected of giving treatment to anyone opposing the US military are acceptable “collateral damage” or even legitimate targets.

US authorities have been aware of the exact location of the facility for years, MSF operations chief Bart Janssens told Al Jazeera. The precise coordinates of the hospital were re-confirmed with US military representatives as recently as September 29, according to MSF spokesperson Vickie Hawkins.

It cannot be ruled out that the hospital was destroyed deliberately by officers emboldened by aggressive new rules of engagement laid out in the 1,000-plus page US Defense Department Law of War Manual (LOWM) released by the Pentagon earlier this year, which authorize US commanders to attack civilian infrastructure and populations based on their own calculations of “military necessity.”

Among countless sweeping authorizations for use of military force, the LOWM contains expanded authority for US commanders to attack targets despite the presence of “human shields.”

So broad are the LOWM’s authorizations for “Conduct of Hostilities” that, even if it were conclusively shown that US commanders deliberately targeted the hospital, the US military could easily interpret the intentional destruction of the Kunduz hospital as “legal,” so long as the responsible commanders testify that they assessed the operations to be “militarily necessary” at the time.

The fact remains that the deliberate bombing of medical facilities, whether carried out in order to destroy enemy forces or to finish off wounded Taliban soldiers and to terrorize medical personnel who treat them is, as Doctors Without Borders representatives have correctly declared, “a war crime,” for which leading members of the Obama administration and US military must be held to account.