President Barack Obama apologized to Médecins Sans Frontières/Doctors Without Borders (MSF) on Wednesday for an airstrike on a hospital the organization ran in Kunduz, Afghanistan. Twenty-two patients and hospital staff members were killed when American bombs hit the hospital late Saturday night.
MSF President Joanne Liu acknowledged in a statement emailed to ThinkProgress that she received an apology from the president but reiterated demands for an independent investigation into the bombing. MSF previously stated that if Afghan and U.S. forced “decided to raze to the ground a fully functioning hospital” the action would be considered a war crime.
According to the Geneva Conventions, which the U.S. ratified in 1955, “Civilian hospitals organized to give care to the wounded and sick, the infirm and maternity cases, may in no circumstances be the object of attack but shall at all times be respected and protected by the Parties to the conflict.”
U.S. military officials said they bombed the hospital after Afghan forces said they were taking fire from the building. Hospitals are sometimes targeted for attack if they are used by enemy forces. In other instances, military forces have drawn scrutiny for accidentally hitting hospitals by unleashing massive bombs on congested urban areas.
Despite formally recognizing that a great deal of care to avoid attacking hospitals is mandated by international humanitarian law, the U.S. and some of the international organizations that it’s a part of have attacked hospitals in recent years. Five such instances are listed below.
U.S. aircraft bombed a maternity hospital run by the International Red Crescent on April 2, 2003. Several people were killed and 27 injured, including some medical personnel.
“It was not a direct hit and, mercifully, there were no staff members indoors when it happened, so there are no casualties,” Roland Huguenin-Benjamin, a spokesperson for the International Red Cross, said at the time.
“Coalition forces target only legitimate military targets and go to great lengths to minimize civilian casualties and damage to civilian facilities,” U.S. Central Command responded in a statement.
Hundreds of American troops stormed into the largest hospital in Western Iraq on July 5, 2006. The Marines took control of Ramadi General Hospital, which they said was being used by Al Qaeda to fire on American forces and to treat injured militants.
While attacking hospitals is generally considered to be outside the confines of the rules of war as outlined by the Geneva Conventions, they can become targets if used by enemy forces.
“They don’t play by the same rules that we do,” Pfc. Gilberto Rodriguez, 20, said in an interview at the hospital. “Insurgents have free rein here. They can do whatever they want. They use whatever tactics are most effective.”
But some medical professionals at the hospital were unhappy with the American takeover of their facilities.
One young physician pointed to bottles of medicine that had been thrown onto the floor by Marines who searched the hospital for weapons. Given the dearth of medical supplies in the area at the time, he told a Washington Post reporter that he wished the Marines had never come to the hospital.
“Why is all this damaged?” the doctor asked a Marine. “The next time you visit the hospital, please try not to intimidate the patients.”
After accidentally bombing the Chinese Embassy that killed three Chinese journalists, NATO warplanes bombed a hospital in Belgrade on May 21, 1999. The hospital bombing left four people dead and damaged nearby residences for three European ambassadors along with the Libyan Embassy.
“[O]ne of the bombs was misdirected for technical reasons,” NATO spokesman Jamie Shea said. While he admitted that one of eight laser-guided bombs overshot its target by 500 yards, according to the Washington Post, he declined to give further details or acknowledge that a hospital had been hit.
“We believe there should be great care to avoid the errors that would increase the sense of unease among our voters,” Italian Prime Minister Massimo D’Alema said at the time, as his country along with fellow NATO countries Germany and Greece began to question the war.
“For sure I can tell you we did not target civilian hospitals.”
NATO dropped cluster bombs on a crowded outdoor market and a hospital in the Serbian city of Nis on May 7, 1999. At least 15 people died in the attack, three of whom were killed in the hospital. Many more were injured.
“Cluster bombs hit the market, nearby buildings look like Swiss cheese…missiles hit a pathology ward, a parking lot and nearby buildings,” Nis’ mayor Zoran Zivkovic said at the time. “I saw a dead man with a carrier bag with onions in it.”
NATO denied that collateral damage resulted from the bombing and also refuted the notion that the hospital had been targeted.
“For sure I can tell you we did not target civilian hospitals,” NATO military spokesman General Walter Jertz said. “We do not target any civilian targets whatsoever. We will be very honest. If anything has gone wrong we will address it.”
On July 20, 1993, Turkish and American forces involved in a United Nations’ peacekeeping mission in Somalia bombed a Digfer Hospital, where MSF was operating.
Three patients were killed, and the hospital was badly damaged.
“There is a gaping hole in the wall of the recovery room, where three anesthetized patients had been lying when a projectile struck,” Liz Sly reported at the time. “The ground floor main reception area is a jumble of glass shards and twisted shrapnel from another bomb.”
A U.N. official said that the hospital was targeted because gunmen loyal to Gen. Mohammad Farah Aidid, the warlord who had taken power in a coup, were hiding there.
MSF protested the attack on the hospital, which was the largest medical facility in the Somali capital.
“We had clearly indicated ourselves to the U.N.,” Francoise Bouchet-Saulnier, legal advisor to MSF wrote of the attack. “[T]here were big red crosses on the roof of the hospital.”
“The [U.N.] coordinator said to the American general: ‘[Y]ou’ve attacked a hospital, our house, which are protected by the Geneva Conventions.’ He replied that in a peacekeeping operation, there is no limit on the force that can be deployed: ‘[T]his hospital was a military target because there were soldiers in it. The use of force by peacekeeping forces is not regulated by the Geneva Conventions. We’re here to restore peace so there is no restriction on the amount of force we use.’”