PARWAN, Afghanistan -- A bullet through the head didn’t kill 9-year-old Amina. Her father, Abdel Qadir, had managed to carry her limp body to the trauma hospital in Kunduz, praying that she would live.
But on Oct. 3, less than a week after surviving a firefight between Afghan forces and Taliban insurgents that had surrounded her home, Amina burned to death in a hospital bed as her father watched helplessly. Her last words were screamed in terrified pain.
“Father! Father!” she wailed as flames consumed her body, Abdel Qadir recalled, weeping.
It's been nearly six months since a U.S. attack aircraft bombed the Médecins Sans Frontières trauma clinic where Amina was staying. Time has not yielded clarity -- there still seem to be more questions than answers. And the U.S. military’s lack of transparency has only compounded people's mistrust.
According to Gen. John Campbell, the top U.S. general in Afghanistan at the time, what happened in Kunduz was a “tragic but avoidable accident.” MSF, the international medical aid organization that ran the hospital, has described the assault as a potential war crime.
Amina and at least 41 other men, women and children perished in the attack on the clinic, which had been the only hospital of its kind providing free trauma care in northern Afghanistan. And while the bombing happened six months ago, the murky circumstances under which it occurred are still having a chilling effect on medical care in the area.
MSF has said it cannot make a decision about re-opening the trauma hospital until all parties to the conflict can ensure the safety of MSF staff, patients and medical facilities.
"We need assurances that we can work according to our core principles and to international law," an MSF spokesperson told The WorldPost on Thursday. "Namely, that we can safely treat all people in need, no matter who they are, or for which side they fight."
As of now, the clinic can only treat a small number of patients, many of them victims wounded in the Kunduz attack. This leaves many Afghans with no choice but to travel to the capital -- a trip that can take hours, often via dangerous roads -- to find free, high-quality emergency medical care.
Survivors of the Oct. 3 bombing describe a nightmarish scene. The first strike hit the intensive care unit. Doctors, some with severed limbs, bled out in front of colleagues. Others were gunned down as they ran for their lives. Patients died on the operating table mid-surgery. Those who were unable to run -- like young Amina, a clever girl who loved computers -- were incinerated.
The U.S. military has reportedly responded by reviewing its targeting process, re-training its forces on rules of engagement and disciplining more than a dozen service members -- including officers and enlisted personnel, but not generals -- who took part in the attack. The service members will not, however, face any criminal charges.
U.S. Central Command has not yet published its investigation into the attack, which is reported to be 3,000 pages or more. The investigation cannot go public until certain material has been redacted, according to Brig. Gen. Wilson Shoffner, chief spokesman for U.S. forces in Afghanistan, who spoke to The WorldPost in Kabul in late January.
The military has ignored multiple calls by MSF and other parties for a truly independent investigation by an outside group, arguing instead that fact-finding efforts carried out by military officers outside the chain of command in Afghanistan would be "thorough and unbiased."
Basic details are still up for debate. The U.S. military insists the strikes went on for 29 minutes. MSF and survivors say the targeted assault dragged on for at least an hour.
And larger questions remain.
In the days leading up to the Oct. 3 attack, Taliban insurgents had caught Afghan forces off guard and took control of Kunduz, including the area surrounding the MSF hospital.
They quickly established their infamous brand of terror, looting buildings, freeing prisoners, taking over homes and hunting down women's rights activists who dared defy their violent ideology. It was the first time the extremists had taken over a major Afghan city in 14 years. Afghan and U.S. forces alike were desperate to push them out.
According to U.S. military statements on the incident, a U.S. Special Forces commander called in the strike, carried out by a powerful AC-130 gunship, at the request of Afghan forces on the ground. U.S. forces did not have eyes on the target before calling in the strikes, the Associated Press reported in November.
They instead placed trust in their Afghan allies who had, just three months earlier, violated international law by raiding that same clinic, shooting in the air and attacking three staff members while allegedly searching for an unarmed, highly ranked al Qaeda patient.
The U.S. military has repeatedly insisted it would not knowingly target the MSF's clinic, and has said it did not know it was shelling a hospital, even though the trauma center was on the military’s no-strike list and its exact coordinates were no mystery. MSF had sent the coordinates to U.S. forces and NATO allies as recently as Sept. 29 -- four days before the bombing.
Frantic calls and texts during the attack from MSF to the Operation Resolute Support headquarters in Kabul proved futile. Thirty minutes after MSF’s initial call for help, at 2:19 a.m., someone at the NATO mission texted back, saying: "I’m sorry to hear that, I still do not know what happened." When MSF warned that the death toll was growing, the person responded: “I’ll do my best, praying for you all.”
Campbell, the army general, has blamed a deadly combination of unfortunate events for the strike. U.S. forces misidentified the target and launched 69 minutes early without verifying whether the target was on a no-strike list. Technical glitches onboard the AC-130 meant troops could not send or receive electronic messages or video. The aircraft, forced beyond its normal orbit by a missile, could not accurately strike a target.
"Why did nobody take the decision to hold off and say that they weren't sure?” said Guilhem Molinie, MSF's representative in Afghanistan. "It questions the capacity of NATO in this country and many other armies to be indiscriminate in the way they conduct warfare and respect the Geneva Conventions."
Afghan officials, including the acting governor of Kunduz, Hamdullah Danishi, insisted in the days after the bombing that the Taliban had used the compound to launch attacks on Afghan forces, a claim MSF fiercely rejects.
“That was a time of fighting -- some things happen,” Danishi told The WorldPost in early February. “I know the Taliban. They are using everywhere as bases. I cannot say if [the hospital] was a military base or not. But they were there, 100 percent.”
A dozen MSF staff, surviving civilians, Kunduz residents and family members of patients told The WorldPost they saw no armed gunmen on the hospital grounds at any time before or during the strikes. The clinic had a strict no-weapons policy.
“It’s completely untrue that there were Taliban inside the hospital,” said Dr. Mohammad Omar, an MSF emergency room supervisor who survived the attack.
Just two days before the strikes, Carter Malkasian, a top adviser to the chairman of the Joint Chiefs of Staff, reached out to MSF, asking whether there were Taliban “holed up” in the hospital. He was told that while there were no armed combatants inside the compound, there were indeed Taliban patients being treated. Malkasian declined a request by The WorldPost for more information.
MSF staff have, for years, treated people on all sides of the conflict, including patients believed to be high-ranking insurgents.
That leaves many Afghans and medical professionals wondering whether the presence of wounded but unarmed Taliban patients inside the clinic may have prompted the Oct. 3 strike.
The attack has raised concerns over the current U.S. role in Afghanistan, and questions about the presence of special forces now that the United States’ combat mission is formally over. American forces are primary in a “train, advise and assist” capacity, though it seems troops are still finding themselves in active combat situations.
The Kunduz attack is also yet another stain on the U.S. military’s reputation in Afghanistan. Survivors and family of people killed in the bombing still have no closure, no real explanation as to why the attack occurred. And there's very little confidence among Afghans that such an “accident” won’t happen again.
“The Americans have access to good information,” Abdel Qadir said, sitting cross-legged on the floor of a guesthouse in Parwan, an Afghan city between Kabul and Kunduz, as rain pitter-pattered outside. “Why would they make this mistake?”
As with past combat incidents in Afghanistan and Iraq that led to civilian deaths, the U.S. military has made more than 100 condolence payments to family members of Kunduz victims, according to Shoffner. Some recipients say they've received around $6,000 or $7,000 each -- the U.S.-determined price of life for a daughter, brother or father wrongfully killed.
A brother of one of the slain MSF doctors told The WorldPost that he refused the money, instead giving it to other families who needed it more. He said he learned of his brother’s death via Facebook, after someone posted a photo of ashes with the caption, “Here is the body of Dr. Osmani.”
Gen. John W. Nicholson, the new head of NATO and U.S. forces in Afghanistan, traveled to Kunduz on March 22 to personally apologize.
“I grieve with you for your loss and suffering,” he said. “And humbly and respectfully ask for your forgiveness.”
But despite the U.S. military’s efforts to remedy the horrific event, Afghans whose lives have been torn apart by the attack demand something far more difficult to come by than scripted apologies and condolence payments -- namely, the full truth.
“They killed so many civilians,” said one male Kunduz resident who lives close to the MSF compound. “Most of the people here, their ideas changed of the American people. The people are angry. The Americans have the technology and the information. They can see if there are armed people or not.”
“An apology is not enough,” continued the young man, who asked that his name not be published for security reasons. “I lost four friends -- two doctors, one nurse and one student.”
An apology also means nothing to Omar, the ER doctor, who now lives in terror that such an attack will happen again. He’s far from the only one. The Italian-run Emergency Hospital in Lashkar Gah responded to the attack by building a bunker large enough to accommodate staff and patients.
Omar said he remembers the Oct. 3 bombing like it was yesterday. As the attack aircraft unleashed hell outside, the experienced ER doctor thought there was no way he would survive. He called his wife to say goodbye.
“She was crying,” Omar said solemnly. “It was the hardest moment of my life.”
Omar survived because he was in the clinic's basement, where MSF staff had set up makeshift trauma stations in an attempt to save those they could.
When the sound of the attack aircraft finally died out, people scrambled out from the ruins of the hospital, plumes of smoke still rising as much of the compound burned.
Patients were loaded into ambulances that had come to collect the wounded. Some staff members, including foreigners, were whisked away to the airport. Many local staff had to fend for themselves, seeking shelter in nearby homes and hitching rides with helpful strangers.
But the dead remained. Amina’s body still lay in the ICU. Her parents weren't able to collect her remains until days later.
“I couldn’t save her,” cried Abdel Qadir, gasping for breath between sobs. “I took her ashes, her skeleton, and gave them to my wife."
Half a year after the fatal attack, Abdel Qadir is left with a wad of cash from the U.S. military. It does nothing to fix his broken heart. He remains haunted by a simple question: Why did his daughter have to die?
All he can do is pray for Amina, the daughter he couldn’t save twice.
Naiemullah Sangen contributed reporting from Parwan and Kabul.