“They were trying to do the right thing. They were trying to support our Afghan partners,” said Votel. “Unfortunately, they made a wrong judgment in this particular case and ended up targeting this Doctors Without Borders facility.”

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Five service members, including a general officer, were removed from Afghanistan. None of the 16 service members have faced court-martial.

The Oct. 3 incident, which Votel called a “tragedy,” illuminates the downsides of the U.S. strategy of fighting at arm’s length, rather than committing a large ground presence. Teaming up with local counterparts, backed by U.S. air power and Special Operations troops, still presents pitfalls.

In this case, the Pentagon investigation showed there was a widespread breakdown in procedures and communication. And according to the investigation, in the days leading up to the attack, some Special Operations troops felt they had no sense of what they were trying to accomplish as they fought to retake the northern Afghanistan city of Kunduz, which had been unexpectedly seized by the Taliban.

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One officer, whose name, rank and unit were redacted from his witness statement, blamed senior leaders for the fiasco, saying there was a “profound lack of strategy” during the multi-day battle.

Army Green Berets on the ground in the city at the time asked for guidance “no fewer than three times” during the battle and heard nothing but crickets — “though those were hard to hear over the gunfire,” he alleged.

The officer also questioned the U.S. strategy of pulling most U.S. troops back almost entirely onto large bases that they rarely leave, rather than taking a more active approach as in years past.

“If someone must be held accountable,” he concluded, “let it not be the man who was ordered to sky-dive without being given a parachute.”

According to investigation documents released Friday, the Oct. 3 attack on the hospital was the final event in a breakdown of communication among a number of units on the ground and in the sky. These failures led to the hospital being misidentified as a Taliban command center, the report said.

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U.S. Special Forces had requested an AC-130, a lumbering four-engine aircraft armed with a 40mm and 20mm cannon, along with a 105 mm howitzer, to support Afghan forces as they attacked a Taliban compound in the dark of night.

As the AC-130 headed toward its intended target, another issue quickly surfaced. A key piece of equipment — a device that transmitted secure video footage from the aircraft to a Special Forces soldier on the ground guiding the aircraft and talking to the pilot — failed.

With this device not working, the soldier was not able to see what the aircrew was looking at on the ground, removing a key link between the ground and the air.

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To make things even more confusing, the Special Forces soldier was at a nearby headquarters, miles from the site of the attack, according to Votel. There were no American forces with their Afghan counterparts.

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As the AC-130 arrived over Kunduz it was targeted by a Taliban surface-to-air missile, according to Votel, forcing the aircraft to alter its course. The Special Forces soldier then proceeded to direct the aircraft to its target using verbal commands to verify that the crew was looking at the intended Taliban command center. Records of conversations show that there was some hesi­ta­tion among the aircrew about the information being transmitted to them, the investigation found.

After a series of miscommunications, the soldier thought he had directed the AC-130 to the Taliban compound. In reality, however, the soldier had the aircraft’s crew pointing their cannons at the Doctors Without Borders hospital, a quarter-mile from the Taliban’s facility.

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At this point, there still needed to be an authorization by the American ground commander to fire. Under the rules of engagement, an airstrike is authorized only if it’s meant to protect U.S. forces and their allies. The commander said he heard machine-gun fire in the area, so he authorized the strike. In fact, the compound showed no signs of hostile acts or intent that would justify a strike, and so the commander violated the rules of engagement, according to the investigation.

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At approximately 2:08 a.m., the AC-130 began firing, using a mixture of its weapon systems.

At the time, Afghan forces were more than five miles from their intended target, according to the report. So there were no forces on the ground to determine whether the gunship was hitting the right building.

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Doctors Without Borders staff began frantically trying to reach U.S. commanders to tell them to stop the attack.

Exactly 30 minutes after the strike began, the AC-130 ceased firing, after the U.S. ground commander was informed through “multiple echelons of command” that the aircraft was targeting the hospital.

Doctors Without Borders says at least 42 people were killed, though the Pentagon’s report notes that the number has not been independently verified.

Following the attack, the United States has provided more than 170 individuals and families with condolence payments, including $6,000 to family members of those killed. U.S. forces have also revised their target procedures, according to Votel, and have ensured that facilities like hospitals are included on a “no strike list” loaded onto aircraft systems.

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John Sifton, Asia advocacy director for Human Rights Watch, called the punishments announced Friday an “insult to the dead.”

“The Pentagon public affairs office can try to spin ‘counseling’ and ‘letters of reprimand’ as devastating and career-ending for implicated personnel,” Sifton said. “But the attack ended people’s very lives, and devastated the families and survivors of those who were killed.”

The president of Doctors Without Borders, Meinie Nicolai, said in a statement that “today’s briefing amounts to an admission of an uncontrolled military operation in a densely populated urban area, during which US forces failed to follow the basic laws of war. It is incomprehensible that, under the circumstances described by the US, the attack was not called off.”