US strike on Afghan hospital 'not a mistake'

International medical Charity Medecins Sans Frontieres/Doctors Without Borders (MSF) released to the public an internal document that reviews the 3 October airstrikes by US forces on its hospital in northern Afghanistan.

The deadly US airstrike on the hospital triggered an international outcry and investigations by the Pentagon and NATO.

The group's international president Dr. Joanne Liu said that the organisation released the report to "counter speculation and to be transparent".

In Kabul, MSF General Director Christopher Stokes said Thursday: "The hospital was razed to the ground after a wave of attack from the air."

"We lost our ability to treat patients at a time when we were needed the most," he added.

"Thirty of our patients and medical staff died. Some of them lost their limbs and were decapitated in the explosions.

"Others were shot by the circling gunship while fleeing the burning building. We were forced to leave patients to die on the operating table and others burning in their ICU beds."

The view from inside the hospital is that this attack was conducted with a purpose to kill and destroy, according to MSF's statement.

"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," said Stokes.

"There were no armed combatants or fighting on or from the hospital grounds."

	Pictures of the bombing aftermath released by MSF

Patients burned in their beds

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 30 people were killed, including 13 staff members, 10 patients and seven unrecognisable bodies yet to be identified.

MSF said the initial findings of the MSF review "firmly establish the facts from inside the hospital in the days leading up to and during the attack".

The review includes the details of the provision of the GPS coordinates and the log of phone calls from MSF to military authorities in attempts to stop the airstrikes.

MSF said it had previously reached an agreement with all parties to the conflict to respect the neutrality of the hospital, based on international humanitarian law.

"We held up our end of the agreement - the MSF trauma centre in Kunduz was fully functioning as a hospital with surgeries ongoing at the time of the US airstrikes," said Dr Joanne Liu.

"MSF's no-weapons policy was respected and hospital staff were in full control of the facility prior to and at the time of the airstrikes."

Unjustified attack

Among the 105 patients at the time of the airstrikes, MSF said it was treating wounded combatants from both sides of the conflict in Kunduz, as well as women and children.

"Some public reports are circulating that the attack on our hospital could be justified because we were treating Taliban," said Stokes.

"Wounded combatants are patients under international law, and must be free from attack and treated without discrimination.

"Medical staff should never be punished or attacked for providing treatment to wounded combatants."

'A mistake'

Last month, the United States claimed the airstrike was a mistake, but MSF has since called it a war crime and demanded a humanitarian investigation.

"The question remains as to whether our hospital lost its protected status in the eyes of the military forces engaged in this attack – and if so, why," MSF said. "Those responsible for requesting, ordering and approving the airstrikes hold these answers."

Explosions from the attack rocked the northeastern Afghan city in the middle of the night on October 3. It was the 12th US airstrike in the area in a five-day period.

A week before the bombing, the Taliban had captured Kunduz – the first time the group had taken a major urban center in almost 15 years.

The US government has yet to comment on the new revelations.

MSF hospitals targeted in Syria and Yemen

Last week, MSF said a "significant increase" of airstrikes on Syrian hospitals recently had killed at least 35 patients and medical staff and wounded 72.

The group said the escalating attacks began in late September, coinciding with the Russian intervention in Syria though it did not specify this.

MSF pointed out that 12 hospitals had been hit in Idlib, Aleppo and Hama provinces, including six supported by MSF.

A Yemeni hospital run by MSF was also hit by a Saudi-led air strike last week.

The MSF facility in Saada, northern Yemen, was hit by several airstrikes with patients and staff inside the facility, according to MSF.

No casualties were reported in the attack.