Medical aid group Medicins Sans Frontieres (MSF) said on Thursday it was hard to believe a United States (US) airstrike on an Afghan hospital last month was a mistake, as it had reports of fleeing people being shot from an aircraft.
The following events were taken from a public release of MSF Kunduz.
On September 28 at 6pm, two Taliban combatants arrived at the hospital gates to inform MSF that they were in control of the area.
On September 29, MSF met with a Taliban representative to discuss the need to free beds for other critical patients due to the ongoing fighting, and therefore for some patients to be discharged and for those who required nursing follow-up to be referred to the MSF Chardara medical post.
Due to the increased intensity of fighting in Kunduz, MSF reaffirmed the well-known location of the Kunduz Trauma Centre (KTC) by once again emailing its GPS coordinates to US Department of Defence (DoD), Afghan Ministry of Interior and Defence and US Army in Kabul.
The GPS coordinates provided for the KTC were: 36°43’4.91″N 68°51’43.96″E for the main hospital building and 36°43’4.29″N 68°51’42.62″E for the administrative office building within KTC.
Confirmation of receipt was received from both US DoD and US Army representatives, both of whom assured us that the coordinates had been passed on to the appropriate parties. Oral confirmation was received from the Afghan Ministry of Interior.
On September 30, out of 130 patients in the KTC on Wednesday, there were approximately 65 wounded Taliban combatants that were being treated.
Starting this same day, a large number of patients discharged from the hospital, including some against medical advice. It is unclear whether some of these patients discharged themselves due to the discussion to free some beds between MSF and the Taliban representative or whether there were general concerns about security as rumours were circulating of a government counter-offensive to reclaim Kunduz city.
By Wednesday, MSF was aware of two wounded Taliban patients that appeared to have had higher rank.
This was assumed for multiple reasons: being brought in to the hospital by several combatants, and regular inquiries about their medical condition in order to accelerate treatment for rapid discharge.
On Thursday October 1, MSF received a question from a US Government official in Washington DC, asking whether the hospital or any other of MSF’s locations had a large number of Taliban “holed up” and enquired about the safety of our staff.
MSF replied that our staff were working at full capacity in Kunduz and that the hospital was full of patients including wounded Taliban combatants, some of whom had been referred to the MSF medical post in Chardara.
MSF also expressed that we were very clear with both sides to the conflict about the need to respect medical structures as a condition to our ability to continue working
On Friday October 2, two MSF flags were placed on the roof of the hospital, in addition to the existing flag that was being flown at the entrance to the Trauma Centre.
The KTC was also one of the only buildings in the city that had full electricity from generator power on the night of the airstrikes.
Throughout the night before the airstrikes began, all MSF staff confirm that it was very calm in the hospital and its close surroundings.
No fighting was taking place around the hospital, no planes were heard overhead, no gunshots were reported, nor explosions in the vicinity of the hospital.
Some staff mention that they were even able to stand in the open air of the hospital compound, which they had refrained from doing in the days prior, for fear of stray bullets from fighting in the neighbourhood around the hospital.
All staff confirm that the gate of the hospital was closed and that the MSF unarmed guards were on duty. From approximately 12:20 am to 1:10 am, the MSF coordinator conducted the nightly security round of the hospital compound.
The coordinator reported that the KTC was calm, with no armed combatants present, nor any fighting on the hospital grounds or within the audible vicinity.
All MSF guards were on duty and MSF was in complete control of the compound.
All of the MSF staff reported that the no weapons policy was respected in the Trauma Centre.
In the week prior to the airstrikes, the ban of weapons inside the MSF hospital Kunduz was strictly implemented and controlled at all times and all MSF staff positively reported in their debriefing on the Taliban and Afghan army compliance with the no-weapon policy.
On October 3, the US airstrikes started between 2:00 am and 2:08 am.
Despite it being in the middle of the night, the MSF hospital was busy and fully functional at the time of the airstrike.
Medical staff were making the most of the quiet night to catch up on the backlog of pending surgeries. When the aerial attack began, there were 105 patients in the hospital. MSF estimates that between three and four of the patients were wounded government combatants, and approximately 20 patients were wounded Taliban combatants.
One hundred and forty MSF national staff and nine MSF international staff were present in the hospital compound at the time of the attack, as well as one International Committee of Red Cross (ICRC) delegate.
