Kunduz: One month since the US bombed our hospital

Today, Tuesday, one month has passed since airstrikes by US special forces devastated MSF's trauma hospital in Kunduz, Afghanistan.

This unprecedented attack on our organisation killed 30 people - 10 patients, 13 MSF staff members and seven others whose bodies have not yet been identified. Injuries included 37 other people - including 19 MSF staff.

Despite repeated requests by MSF to stop the bombing, the airstrikes continued for over an hour.

Medecins Sans Frontieres' hospital in Kunduz, open since 2011, is one of the very few trauma centres in northeastern Afghanistan. Thousands of surgeries are performed every year, and essential medical assistance is provided to anybody who needs it.

When MSF, known in English as Doctors Without Borders, runs a trauma centre in a conflict zone, we always begin with negotiations with all warring parties to ensure the possibility of treating all patients impartially - whether civilian or soldiers incapable of fighting - impartially and without distinction of origin, religion, or political affiliation, in accordance with the Geneva Conventions.

We had done so in the case of Kunduz as a precondition to working in such a volatile environment, and had full agreement from all warring parties that MSF could conduct its work in a fully impartial and humanitarian manner.

Despite repeated requests by MSF to stop the bombing, the airstrikes continued for over an hour

In the week before this terrible attack, 394 patients injured in the recent clashes in Kunduz had sought care at the hospital, and the status of the hospital as a protected space had been respected. When the airstrikes began, 105 patients and 80 staff members were inside.

We were outraged when, roughly three weeks later, in northern Yemen on 27 October, Haydan hospital - supported by MSF - was bombed by the Saudi-led coalition.

Luckily there was only one minor injury as the hospital had been evacuated in time before it was totally demolished. However, as it was the only private hospital in the area serving a population of 200,000 people, its destruction will have terrible and far-reaching consequences. It is the 20th hospital to be destroyed in this way, in a war where civil infrastructure, such as health facilities, schools, markets, is routinely targeted.

Beyond the pain we feel from losing colleagues and patients, we are struggling to find out why we were targeted.

This is why MSF has been calling for an independent investigation to clarify the circumstances surrounding the attack in Kunduz. Understanding the reasons for such deliberate targeting against a medical facility is essential in order to assess the risks for our teams who continue working in hostile environments across the world.

In times of war, hospitals and other healthcare facilities are where the most vulnerable - the sick and wounded - are to be found. They are places of hope and humanity amid violence and chaos.

Unfortunately, the events in Kunduz and Haydan are not isolated cases

The Geneva Conventions stipulate that functioning hospitals must not be bombed in any case and for any reason, particularly without prior warning while medical workers and patients are inside.

For people caught up in armed conflict, medical facilities provide reassurance that even in the middle of appalling violence, they can safely access treatment.

What are medical workers, from Afghanistan to Syria or Yemen and beyond, to do if their protection is stripped from them and their patients? What does it mean for patients if their ability to access medical care is destroyed?

Unfortunately, the events in Kunduz and Haydan are not isolated cases.

The protection of health facilities in conflict zones has been eroded. This tragic and wanton destruction not only affects MSF. It affects the millions of people who are caught up in conflict and all too often, it is patients, doctors, paramedics and support staff who pay the highest price.

Since 1949, the Geneva Conventions have obliged warring parties to protect the wounded and sick, without discrimination and in respect of the rules of medical ethics. They bring some humanity to the inhumane. Is there some concerted effort to rewrite these rules of war?

Today, as MSF staff gather across the Middle East and Europe to remember our fallen colleagues and patients, we say the targeting of medical facilities must end.

Dr Tammam Aloudat is the Deputy Medical Director of Medicins Sans Frontieres.  

Opinions expressed in this article remain those of the author and do not necessarily represent those of al-Araby al-Jadeed, its editorial board or staff.