U.S. airstrike on hos­pi­tal still un­ex­plained

Mil­i­tary leaves holes in nar­ra­tive of in­ci­dent in which U.S. gun­ship fired on Afghan hos­pi­tal, killing at least 22


The day af­ter Tal­iban fight­ers swept through Afghanistan’s north­ern city of Kun­duz, cap­tur­ing a ma­jor ur­ban area for the first time since 2001, six stray bul­lets crashed through the win­dows at the Doc­tors With­out Borders hos­pi­tal there.

The spillover from the mil­i­tant as­sault, which had over­whelmed lo­cal se­cu­rity forces, was an un­set­tling sign at the lightly guarded civil­ian fa­cil­ity, where doc­tors and nurses were tend­ing to a crush of pa­tients.

It was also a fore­shad­ow­ing of a far greater calamity that would de­scend on the hos­pi­tal four days later when, in the early hours of Oct. 3, nearby U.S. com­bat ad­vis­ers au­tho­rized a gun­ship to un­leash a pow­er­ful at­tack. The AC-130U plane, cir­cling above in the dark, raked the med­i­cal com­pound with bursts of cannon fire, po­ten­tially even us­ing high ex­plo­sive in­cen­di­ary mu­ni­tions, for more than an hour. The as­sault left at least 22 peo­ple dead, some of them burned to death.

The aid group, also known as Médecins Sans Frontières, has de­manded an in­ter­na­tional in­ves­ti­ga­tion of what it deems a pos­si­ble war crime.

The U.S. mil­i­tary, whose own ac­count of what took place changed in the ini­tial days af­ter the at­tack, has said that the hos­pi­tal was “mis­tak­enly struck” in an at­tempt to sup­port Afghan se­cu­rity forces. But the mil­i­tary has de­clined to pro­vide full de­tails of the in­ci­dent while its in­ves­ti­ga­tors ex­am­ine what oc­curred in the worst ex­am­ple of er­rant U.S. air power in re­cent years.

This ac­count of what took place is based on mul­ti­ple

in­ter­views in Afghanistan and the United States with U.S. and Afghan mil­i­tary of­fi­cials, Doc­tors With­out Borders per­son­nel and lo­cal Kun­duz res­i­dents; some of those in­ter­viewed spoke on the con­di­tion of anonymity be­cause of the on­go­ing in­ves­ti­ga­tion.

Although gov­ern­ment forces have re­cap­tured much of Kun­duz, the city’s col­lapse to a rel­a­tively small mil­i­tant force was a blow to the Afghan gov­ern­ment and its Western al­lies, il­lus­trat­ing the Tal­iban’s po­tency at a time when for­eign forces are wind­ing down their long mis­sion in the coun­try.

In the days af­ter the city’s Sept. 28 col­lapse, Tal­iban fight­ers con­sol­i­dated their con­trol of the neigh­bor­hood around the hos­pi­tal’s tree-lined com­pound, clamp­ing down on res­i­dents’ move­ment and im­pos­ing their harsh in­ter­pre­ta­tion of Is­lam.

For much of that week, the cen­tral Kun­duz neigh­bor­hood of Spin­zar, which was un­der the mil­i­tants’ con­trol, was rel­a­tively quiet, ac­cord­ing to res­i­dents and hos­pi­tal of­fi­cials.

In­side the hos­pi­tal, which the in­ter­na­tional re­lief agency in re­cent years had turned into the province’s most ad­vanced med­i­cal fa­cil­ity, doc­tors and nurses were busier than ever. Be­tween Sept. 28 and Oct. 3, ex­hausted hos­pi­tal staffers treated 394 peo­ple, many of whom had re­ceived gun­shot wounds dur­ing the bat­tle for the city.

All that week, a steady stream of Tal­iban fight­ers ap­peared at the hos­pi­tal seek­ing treat­ment, adding to the pa­tient load, ac­cord­ing to a hos­pi­tal se­cu­rity guard.

Be­fore fight­ers were ad­mit­ted onto hos­pi­tal grounds, the guard said, they were re­quired to hand over their as­sault weapons to fa­cil­ity guards. Once in­side, the Tal­iban fight­ers— many of whom had been shot— were treated like any other pa­tient.

The Tal­iban ap­peared to re­spect the neutrality of the char­ity op­er­a­tion, the only hos­pi­tal func­tion­ing in Kun­duz that week.

“Even the Tal­iban didn’t harm wounded Afghan se­cu­rity forces taken to the hos­pi­tal,” the guard said.

Doc­tors With­out Borders has de­clined to dis­cuss pa­tient iden­ti­ties, point­ing to rules un­der the Geneva Con­ven­tions that state wounded sol­diers or mil­i­tants must be treated like other non­com­bat­ants. “We don’t even want to know who is in­side be­cause that is a ba­sic pro­tec­tion, as a pa­tient,” said Guil­hem Molinie, di­rec­tor of the or­ga­ni­za­tion’s oper­a­tions in Afghanistan.

But or­ga­ni­za­tion of­fi­cials said that some Tal­iban fight­ers were treated.

Ac­cord­ing to the guard’s ac­count, not just wounded Tal­iban fight­ers were present at the hos­pi­tal that week. On Mon­day, Sept. 28, as the bat­tle for Kun­duz kicked off, Mul­lah Ab­dul Salam, the most se­nior Tal­iban com­man­der in Kun­duz province, vis­ited wounded fight­ers re­ceiv­ing treat­ment there, the guard said.

Some Afghan lead­ers have sug­gested that the Tal­iban had been us­ing the hos­pi­tal as a base. MSF of­fi­cials have strongly de­nied those claims, say­ing no Tal­iban com­man­ders and fight­ers had used hos­pi­tal grounds to plan or carry out at­tacks.

Shat­tered calm

Early on Satur­day, Oct. 3, a team of U.S. Spe­cial Oper­a­tions forces was track­ing the fight­ing across Kun­duz from a small U.S.-Afghan joint oper­a­tions cen­ter at the air­port, about five miles south of the city. The JOC, as it is called, has be­come a hall­mark of the long in­sur­gent wars in Iraq and Afghanistan, where U.S. forces li­aise closely with their lo­cal coun­ter­parts.

As part of the lim­ited U.S. mil­i­tary mis­sion in Afghanistan, that night the U.S. forces were sup­port­ing elite Afghan troops as they fought their way through the city, and helped co­or­di­nate U.S. air power to back their as­sault against the Tal­iban.

Gen. John F. Camp­bell, com­man­der of U.S. and al­lied forces in Afghanistan, told law­mak­ers in Washington on Thurs­day that his forces were pro­vid­ing plan­ning and “train­ing ad­vice” for lo­cal forces around Kun­duz, with a head­quar­ters sup­port group at the air­field.

In the days af­ter the city’s fall, Afghan se­cu­rity forces had ad­vanced into Kun­duz’s com­mer­cial dis­trict but were still locked in in­tense clashes with Tal­iban mil­i­tants holed up in gov­ern­ment build­ings, pri­vate homes and the aban­doned of­fices of in­ter­na­tional aid groups. That Afghan se­cu­rity forces had made it into the city at all was a re­sult of the airstrikes that the U.S. mil­i­tary be­gan to con­duct to sup­port their ad­vance.

The strikes ear­lier in the week were re­ported to have killed nearly 50 Tal­iban fight­ers who were at­tempt­ing to ad­vance on Afghan and coali­tion troops at the Kun­duz air­port.

In cen­tral Kun­duz on the night of Oct. 2, hos­pi­tal staffers were set­tling in. Five pa­tients — mem­bers of a fam­ily shot while try­ing to flee Kun­duz — had been brought in ear­lier that evening, around 6 p.m. The wards were mostly quiet af­ter that, and no fight­ing had been re­ported.

“It was the first time the team could rest and [the] first time we could plan some oper­a­tions that had been de­layed be­fore,” Molinie said.

Shortly be­fore mid­night, clashes erupted nearby be­tween Tal­iban and gov­ern­ment forces and quickly in­ten­si­fied, said Is­la­mud­din, a Kun­duz res­i­dent who lives about 50 yards from the hos­pi­tal gates and, like many Afghans, goes by one name. At the air­port, U.S. ad­vis­ers re­ceived a re­quest from Afghan spe­cial forces for ur­gent help in the vicin­ity of the hos­pi­tal, where they re­ported re­ceiv­ing Tal­iban fire.

Scram­bling to as­sist, Amer­i­can Spe­cial Oper­a­tions forces ad­vis­ers re­quested im­me­di­ate close air sup­port for the Afghan com­man­dos.

Soon af­ter, an AC-130U from the 4th Spe­cial Oper­a­tions Squadron — call sign “Ham­mer” — was lum­ber­ing through a mostly clear night sky to­ward the tar­get po­si­tion.

The AC-130U is one vari­ant of the AC-130 gun­ship. A holdover from the Viet­nam War, the plane is a con­verted trans­port air­craft loaded with 25mm and 40mm can­nons as well as a 105mm how­itzer. As its weapons jut from the left side the air­craft, the AC-130 en­gages tar­gets in a wide left turn. Crewed by a dozen air­men, in­clud­ing a Spe­cial Oper­a­tions Ground li­ai­son of­fi­cer re­spon­si­ble for co­or­di­nat­ing with ground forces, the AC-130 has low-light and ther­mal sen­sors that give it a “God’s eye” of the bat­tle­field in al­most all weather con­di­tions.

Ac­cord­ing to in­di­vid­u­als fa­mil­iar with the in­ci­dent, Amer­i­can forces from the JOC di­rected the air­craft over the Afghan spe­cial forces and sent up the ini­tial “call for fire” to the air­craft. The re­quest gave the air­craft the nec­es­sary tar­get­ing in­for­ma­tion as well as the lo­ca­tion of friendly forces.

Ac­cord­ing to an in­di­vid­ual fa­mil­iar with the air­craft’s oper­a­tions that night, the sen­sor op­er­a­tors iden­ti­fied fight­ers mov­ing into and fir­ing from one of the hos­pi­tal’s front por­ti­cos. The crew, pi­lot­ing an air­craft that rarely tar­gets build­ings, asked the JOC twice if they wanted the air­craft to en­gage, the in­di­vid­ual said. How close ac­tive Tal­iban forces may have been to the hos­pi­tal — a point where the ac­counts of the char­ity’s per­son­nel and Afghan se­cu­rity of­fi­cials di­verge — is now a cen­tral ques­tion for in­ves­ti­ga­tors. Even if Tal­iban mil­i­tants were fir­ing from the com­pound, U.S. rules of en­gage­ment would not have al­lowed an airstrike if the crew knew it was a pro­tected civil­ian fa­cil­ity.

On Satur­day, Pen­tagon press sec­re­tary Peter Cook said that the U.S. mil­i­tary was au­tho­rized to make “ap­pro­pri­ate” con­do­lence pay­ments to the fam­i­lies of civil­ians killed in the hos­pi­tal at­tack, and to pro­vide fund­ing for re­pair­ing the hos­pi­tal.

U.S. in­ves­ti­ga­tors are now try­ing to de­ter­mine whether the air crew knew that the tar­get was a hos­pi­tal.

While the Afghan gov­ern­ment has not said defini­tively whether it thinks that the Tal­iban forces were fir­ing from near or within the com­pound, lo­cal of­fi­cials have said that the group had set up a “com­mand cen­ter” at the fa­cil­ity — an as­ser­tion Doc­tors With­out Borders has strongly re­jected.

Who placed the call?

Another un­re­solved ques­tion is who placed the re­quest for the air sup­port. Ac­cord­ing to Brig. Gen. Dawlat Waziri, a spokesman for the Afghan Min­istry of De­fense, troops from the Afghan army’s 209th Corps were fight­ing on the ground in that area, but of­fi­cials in Kabul were un­sure whether they made the re­quest pro­cessed by U.S. ad­vis­ers at the Kun­duz air­port.

Waziri sus­pects that Afghan sol­diers were aware of the hos­pi­tal’s lo­ca­tion. Be­fore sol­diers be­gin com­bat, they re­ceive de­tailed maps from lo­cal po­lice out­lin­ing the lo­ca­tions of mosques, schools and hos­pi­tals, he said.

A few min­utes af­ter 2 a.m., fol­low­ing ap­proval from U.S. for cma­jor

the plane fired a mas­sive ini­tial burst at the main hos­pi­tal build­ing, which houses the fa­cil­ity’s emer­gency rooms and in­ten­sive care unit.

While it is un­clear what weapons were em­ployed, the AC130U’s 40mm round has a high ex­plo­sive in­cen­di­ary mu­ni­tion that is lined with zir­co­nium. The rounds are known for caus­ing fires.

One MSF physi­cian, who spoke on the con­di­tion of anonymity for se­cu­rity rea­sons, had fin­ished his shift and was drift­ing off to sleep in the hos­pi­tal’s break room when a gi­ant blast shook the build­ing. Light fix­tures and parts of the ceil­ing crashed down on him.

The ex­plo­sion, pos­si­bly from the plane’s 105mm gun, was so pow­er­ful that it shat­tered win­dows of nearby homes. “I saw the flame of fire rise from the hos­pi­tal,” Is­la­mud­din said.

The physi­cian and other staff mem­bers rushed to the hos­pi­tal’s base­ment, which was used as a makeshift bomb shel­ter.

Far above, the U.S. pilots banked the air­craft into a wide or­bit cir­cling the hos­pi­tal. Over the next 65 min­utes, the plane un­leashed ad­di­tional fire on each pass around the fa­cil­ity be­low, ev­ery 15 min­utes or so.

Some staff mem­bers and pa­tients may have died in­stantly; oth­ers died amid the rub­ble or as col­leagues tried fruit­lessly to ad­min­is­ter care. A phar­ma­cist died in the hos­pi­tal of­fice. As a fire en­gulfed the hos­pi­tal build­ing, at least six pa­tients burned to death in the in­ten­sive care unit.

Dur­ing the at­tack, staff memes, bers placed des­per­ate calls to col­leagues, who re­layed mes­sages to U.S. of­fi­cials in Kabul and Washington, in­clud­ing to the Pen­tagon’s Joint Staff in Washington, the or­ga­ni­za­tion said.

In the days be­fore the as­sault, Doc­tors With­out Borders said, it pro­vided the hos­pi­tal’s lo­ca­tion re­peat­edly to the same of­fi­cials. But the re­lief group has de­clined to pro­vide de­tails of ex­actly who it alerted. The of­fice of the Joint Staff says it has not yet lo­cated an in­di­vid­ual who re­ceived that in­for­ma­tion.

At about 3:30 a.m., staffers hud­dled in the base­ment bomb shel­ter heard the guns fall silent. It is not known why the air crew chose to halt the at­tack.

Many of those who had taken shel­ter be­low ground were too fright­ened to emerge and stayed there un­til dawn. “Then we heard this call­ing, ‘ Any­one alive? You can come out,’ ” the physi­cian re­called.

When he emerged into the rub­ble of the smol­der­ing hos­pi­tal, the doc­tor im­me­di­ately saw the bod­ies of pa­tients and col­leagues. Other staffers be­gan to make their way out into the open and rushed to treat those wounded in the at­tacks. Some could not be saved. One doc­tor died on a desk while another staff mem­ber tried to per­form emer­gency surgery to save him.

Mo­ham­mad Sharif in Kabul and Julie Tate and An­drew Katz in Washington con­trib­uted to this re­port.



TOP: Afghan guards stand at the gate of the Médecins Sans Frontières hos­pi­tal in Kun­duz, Afghanistan, af­ter the Oct. 3 airstrike by a U.S. gun­ship. ABOVE: Med­i­cal per­son­nel scram­ble to treat one of the wounded af­ter the at­tack. At least 22 peo­ple were killed, in­clud­ing 12 mem­bers of the hos­pi­tal’s staff and 10 pa­tients, three of whom were chil­dren. The U.S. mil­i­tary says the hos­pi­tal was “mis­tak­enly struck.”



Christo­pher Stokes, right, gen­eral di­rec­tor of Médecins Sans Frontières, and Guil­hemMolinie, the group’s Afghanistan di­rec­tor, at a news con­fer­ence. Out­raged MSF of­fi­cials have called for an in­ter­na­tional in­ves­ti­ga­tion into the U.S. airstrike on the Kun­duz hos­pi­tal, above, say­ing that it was a pos­si­ble war crime.


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