As an American gunship unleashed burst after burst of cannon fire on Doctors Without Borders’ (MSF) hospital in Kunduz, medical staff inside the building frantically tried to alert military headquarters in Kabul and Washington DC.

When they finally received a reply, a massacre had already happened.

At 2.52am – at least 45 minutes into the attack and 30 minutes after MSF’s first call – a text message arrived from Nato’s Afghanistan mission: “I’m sorry to hear that, I still do not know what happened.”



When MSF personnel demanded an end to the attack, and warned that heavy casualties were feared, the Nato officer texted back, at 2.59am: “I’ll do my best, praying for you all.”

It took another 15 minutes before the airstrike stopped. By that time at least 22 people in the facility were dead or mortally wounded.

New details of the deadly 3 October airstrike emerged on Thursday as MSF published the results of an internal investigation.

The report gives a graphic description of the carnage, and concludes that although wounded Taliban fighters were being treated at the hospital, there were no armed men or nearby fighting before the US attack.

Amid “concentrated volleys” of explosions, staff members died on makeshift operating tables and people were burned alive running for safety, the report says.



One nurse was “covered from head to toe in debris and blood with his left arm hanging from a small piece of tissue after having suffered a traumatic amputation in the blast”. Another staff member was decapitated by a piece of shrapnel.

Using before-and-after satellite photos, the report reiterates MSF’s claim that the hospital was targeted deliberately and with precision. It also quotes staff saying the plane shot people trying to escape.

The report increases pressure on the ongoing US investigation to explain how a manned gunship could for over an hour strafe a marked hospital, whose GPS coordinates were known.

“We want them to tell us the truth and be as honest and detailed as possible,” MSF’s general director, Christopher Stokes, told the Guardian.

According to MSF, the day before the attack a US government official asked the charity if its staff were safe, and if Taliban fighters were “holed up”, in any of its facilities in Afghanistan. MSF replied that some of their patients were wounded Taliban combatants, but implored that the obligation to respect medical facilities be honored.

In the early morning hours after the attack, an ambulance from Kunduz public hospital arrived to transfer some of the wounded, together with an MSF ambulance. At the same time, MSF says, Afghan special forces arrived and began searching the ambulances for wounded Taliban.

Between 7.30 and 8am, some MSF staff evacuated to Kunduz airport. Shortly thereafter, fighting broke out again in front of the hospital, forcing the remaining personnel to stay in the hospital basement for another hour.

The report also seeks to debunk persistent claims from Afghan officials that Taliban were fighting inside the hospital at the time of the attack.

“This portrayal of the hospital as a base with 300 Taliban fighters inside is not true,” Stokes said. “President Ghani has said MSF should return to Kunduz. But we need some people in the Afghan government, who want to portray the hospital as a Taliban base, to stop, because it’s putting us and our Afghan colleagues in danger.”