The United States has been condemned for launching an airstrike on a Médecins Sans Frontières (Doctors Without Borders) hospital in that is believed to have killed up to 20 people.
The hospital was hit during an aerial bombardment on Saturday morning in the besieged city of Kunduz, destroying a large portion of the facility.
An MSF source told the Guardian that up to 20 Afghan members of staff and patients were killed and dozens more injured, adding that the death toll could rise further. Among the killed were nine MSF staff and seven patients from the intensive care unit, including three children. None of the international doctors volunteering at the facility were hurt.
At the time of the bombing, 105 patients and their carers, and more than 80 MSF international and national staff were in the hospital.
The charity claimed the GPS coordinates of the hospital had been widely circulated to all parties fighting in the conflict and that the bombing continued for up to 30 minutes after it raised the alarm with US and Afghan officials.
The US, which has been involved in airstrikes in the country in an attempt to repel Taliban fighters, admitted a strike on Kunduz may have caused “collateral damage”.
“US forces conducted an airstrike in Kunduz city at 2:15am [local time] on 3 October against individuals threatening the force. The strike may have resulted in collateral damage to a nearby medical facility. This incident is under investigation,” said Col Brian Tribus, spokesman for international forces in Afghanistan.
According to reports, head of US-led forces in has since apologised to the country’s president. The office of the Afghan president reportedly said Army General John Campbell provided details of the incident to Ashraf Ghani and apologised.
A spokeswoman for the international coalition could not immediately confirm that Campbell phoned Ghani but said she was checking.
An MSF spokesman said the organisation condemned “in the strongest possible terms the horrific bombing of its hospital in Kunduz full of staff and patients”.
A statement added: “MSF wishes to clarify that all parties to the conflict, including in Kabul and Washington, were clearly informed of the precise location (GPS coordinates) of the MSF facilities – hospital, guesthouse, office and an outreach stabilisation unit in Chardara (to the north-west of Kunduz).
“As MSF does in all conflict contexts, these precise locations were communicated to all parties on multiple occasions over the past months, including most recently on 29 September.
“The bombing continued for more than 30 minutes after American and Afghan military officials in Kabul and Washington were first informed. MSF urgently seeks clarity on exactly what took place and how this terrible event could have happened.”
Human Rights Watch said it had “grave concerns about whether US forces took sufficient precautions to identify and avoid striking the facility”.
Patricia Gossman, a senior researcher at the NGO, said: “The bombing of the hospital is a shocking development for Kunduz, where civilians and aid workers are already at grave risk from the fighting. All forces are obligated to do their utmost to avoid causing civilian harm.”
The group called for an impartial investigation to establish the circumstances of the attack, and urged the US to review its targeting procedures to ensure such incidents do not reoccur.
The US airstrikes came after days of fighting over the town.
Sarwar Husaini, a spokesman for Kunduz police, claimed fighters had entered the hospital compound on Friday evening and were firing at security forces from inside. MSF has not responded to the allegation.
An MSF staff member, who was on duty at the time, told the Guardian: “I was inside my office. Around 2am, the plane started bombing the main building of MSF. It lasted one and a half hours. After 3.30am, I came out from my office and saw all of the hospital was on fire.”
Adil Akbar, a doctor at the trauma centre who was on duty at the time, told the Associated Press the operating theatre, emergency room and other parts of the hospital complex had been hit.
“I managed to escape after the attack but I know that most of the staff and even some of the patients are missing,” he said.
A relative of another doctor working at the hospital said his cousin had been killed in the strike.
Nasratullah, 22, told the Guardian that Akbar, a 25-year-old not thought to be related to Adil, was in the Kunduz facility at the time. “He had been working in the hospital for a long time. He was a famous doctor,” he said.
Afghan special forces have been battling to retake the city with the help of international special forces advising on the ground, as well as US airstrikes. Since fighting broke out on Monday, MSF had treated 394 wounded people in Kunduz.