In early October 2015, the hospital operated by the medical organisation Medecins Sans Frontieres (MSF – Doctors Without Borders) in Kunduz, Afghanistan, was attacked by an American air force gunship, the AC-130. At least 30 people were killed in the immediate attack, and another 30 were injured. The air raid on the MSF hospital last for at least one-and-a-half hours, with patients, doctors, medical staff and support workers killed and maimed. The MSF had provided the American and Afghan authorities with the precise coordinates of their facility, in order to avoid being hit.

The MSF issued a report earlier this month entitled the Kunduz Hospital Strike. It provides details of the gruesome nature of the attack, and the severity of the fatalities and casualties. The fact sheet accompanying the report states that:

From around 2:00-2:08am until 3:00-3:15am on Saturday, 3 October, MSF’s trauma hospital in Kunduz, Afghanistan came under precise and repeated airstrikes. The main hospital building, which housed the intensive care unit, emergency rooms, laboratory, x-ray, outpatient department, mental health and physiotherapy ward, was hit with precision, repeatedly, during each aerial raid, while surrounding buildings were left mostly untouched.

Patients burned alive in their beds, and some bodies are yet to be identified because the remains are unrecognisable. There were no armed combatants, or insurgents, or any fighting personnel in or around the vicinity of the hospital.  The American aircraft circled the hospital, with full cognisance of the attack and its effects. Multiple and rapid cannon fire hit the hospital and its wounded. The survivors were also targeted. The AC-130 is not just a small, reconnaissance aircraft, but a murderous airborne gunship, used in the commission of a war crime. Why was this lethal killing machine used to attack a hospital? The ability of such a gunship to spread death and destruction over a large swathe of territory is unmistakable.

The MSF fact sheet elaborated the tragic consequences of this air strike:

In the aftermath of the attack, the MSF team desperately tried to move wounded and ill patients out of harm’s way, and tried to save the lives of wounded colleagues and patients after setting up a makeshift operating theatre in an undamaged room.

MSF’s hospital was the only facility of its kind in northeastern Afghanistan, providing free high level life- and limb-saving trauma care. Since opening the hospital in 2011, more than 15,000 surgeries were conducted and more than 68,000 emergency patients were treated.

The MSF hospital in Kunduz has been substantially destroyed and is no longer operational. This leaves thousands of people without access to emergency medical care when they need it most.

The response of the US military authorities, and the Afghan government in Kabul, has been largely predictable – first claiming it was an accident, then shifting the story to one of blaming the other; there were insurgents holed up in the hospital – actually, the Afghan government gave us permission to go ahead with the strike. The New York Times, the loyal lapdog of the US empire, did its best to find excuses for the atrocity – the Afghan units in and around the area of Kunduz were new and inexperienced, lacking any familiarity with the area and its people, so you can understand why such an accident took place.

Glenn Greenwald has documented the constantly shifting rationales offered by the US military and political authorities for the attack, couched as they are in the standard obfuscation of ‘collateral damage’. This turn-of-phrase reduces flesh-and-blood fatalities and casualties into pure statistics and euphemism – now we can move on. Usually this standard tactic of stonewalling works; the victims are in faraway countries, speaking non-English languages that we cannot understand, and so the public’s conscience is salved. However, this time, the victims are not just the ordinary Afghans that we can ignore – or lock up in Australian detention centres when they arrive on our shores. MSF has a strong international presence, provide factual, up-t0-date documentation about their activities, and give articulate interviews to the media.

A few weeks after the original Kunduz attack, an American tank carrying US and Afghan military personnel crashed through the locked gates of the remains of the MSF hospital compound. Their unannounced and forced entry raises deep concerns about the intentions of such an incident – damaging not just the property, but also destroying crucial evidence, were among the concerns raised by MSF spokespeople, who have demanded an independent, impartial investigation of the Kunduz hospital attack.

The Obama administration has apologised for the air strike, sticking to the story of it being a tragic accident. So far, the United States has refused to agree to an independent investigation of this crime. Indeed, the response of the international community to appeals by the MSF for an exhaustive and independent investigation into the Kunduz attack has been lethargic, to say the least. The Common Dreams magazine quotes the following observation regarding the lack of response by governments around the world:

“The silence is embarrassing,” MSF executive director Joanne Liu told the Thomson Reuters Foundation in an interview on Monday. “We have seen an erosion over the years of international humanitarian law. Enough is enough. We cannot keep going like this.”

When hospital attacks like this occur, they are not simply war crimes, serious as they are. They affect the patients, medical staff, paramedics, the people in the vicinity who depend on the hospital for quality medical care. They cause lasting, perhaps irreparable damage, to the civilian population that relies on the medical facilities. These kind of strikes are not just crimes against the immediate patients and medical staff of the hospital – they signal a degree of psychopathic disregard for human life by the perpetrator. This is not the first time that US military authorities have bombed hospitals and civilian infrastructure. The Kunduz hospital bombing is just the latest in a long line of war crimes by the United States. While the specific chain of command needs to be traced back to determine who was responsible for giving the orders to launch the attack, it is not wholly surprising that a war crime of this kind has occurred, given that the US imperial adventure in Afghanistan is a criminal enterprise.

Since the October 2001, the United States has been bogged down in a quagmire of its own making. The war was launched not as a humanitarian enterprise to liberate the Afghan people groaning under a strict Islamist regime – the US has been financing and arming fundamentalist Islamist militias in Afghanistan for decades. The high-point of this venture being the 1980s, when the US engaged in a clandestine ideological insurgency to fight the former socialist and Soviet-supported Afghan government, sponsoring the former landlords and reactionary mullahs to topple the leftist regime.

Professor Mahmood Mamdani wrote an excellent account of this episode in his book “Good Muslim, Bad Muslim: America, the Cold War and the Roots of Terror.” He devotes an entire chapter to the Afghan anti-communist insurgency, and makes clear where the responsibility for that conflict lies. In the context of organising an ideological right-wing religious crusade against an “infidel’ enemy, right-wing Islamist groups were the front-line troops to be used, with Saudi Arabia, Pakistan and the Arab Gulf monarchies providing solid military-political support bases for such a crusade. Out of this enterprise, the Islamist groups that spawned the Taliban arose. The American effort in Afghanistan is hardly humanitarian, but aimed at restoring the privileges and power of a narrow financial elite, an elite class amenable to the interests of the dominant imperial power in the West.

American imperial power has always maintained a friendly, working sponsorship of right-wing Islamism – fractious at times, yes, turbulent in places, but the solid support of American financial and military power for fundamentalist groups in the Arab and Islamic world has never been broken. Not only must the Kunduz attack be investigated and its perpetrators punished. The predatory criminality of American imperial arrogance must also be questioned. After fourteen years of continual warfare in Afghanistan, it is high time to stop this utter disregard for international law.

Let us remember Kunduz, and not forget July 3 1988.