US bombing of Doctors Without Borders hospital sparks international outrage: 7 things to know

President Barack Obama delivered a personal apology Wednesday to the head of Doctors Without Borders for what he described as the mistaken bombing of its field hospital in Kunduz, Afghanistan, which killed nearly two dozen physicians and patients, according to the New York Times. President Obama also promised a full investigation into the bombing.

However, the president's apology, which came five days after an American AC-130 gunship devastated the hospital, did little to satisfy the global physician group's leaders, who stated only that his apology had been "received," according to the report.

Here are seven things to know about the bombing.

1. Twelve staff members and 10 patients, including three children, were killed in the hospital during the bombing, and at least 37 were wounded. However, the death toll may increase significantly as a search for 24 missing staff members continues, many of them feared to be dead, Doctors Without Borders officials said Thursday.

The organization has not located the missing staff, despite having created a hotline for them to call. Guilhem Molinie, the group's representative in Afghanistan, said there might be more bodies buried in the debris of main building of the hospital, but they have not been able to inspect it because of security concerns.

2. The U.S. military confirmed the airstrike early in the morning Oct. 3, saying it had been targeting individuals "who were threatening the force" and that "there may have been collateral damage to the nearby medical facility," according to NYT.

3. The American warplane made five bombing runs, spaced about 15 minutes apart, beginning at 2:08 a.m. Oct. 3. Each of the attacks, in which the aircraft fired munitions that caused explosions inside the medical facility, targeted the main hospital building, which contained the emergency room, intensive care unit, blood lab and X-ray area, according to NYT.

"It was hit with precision repeatedly while surrounding buildings were left untouched," Mr. Molinie said, according to the report. There was no active ground combat in the area surrounding the hospital at the time of the attack, as far as Doctors Without Borders officials inside the hospital could tell.

4. Afghan government fighters and Taliban fighters were being treated in the hospital, which contained a fully equipped trauma center, 150 beds and a staff of more than 400. Doctors Without Borders officials insisted there were no weapons or explosives anywhere inside the hospital compound, per its longstanding policy, according to the report.

5. President Obama first reacted to the bombing two days after it happened by expressing his "deepest condolences" to families of the victims, calling it a "tragic accident." He and other White House officials declined to comment further, citing the need to let the investigation develop. However, that changed after Gen. John F. Campbell, the American commander in Afghanistan, told lawmakers Wednesday the attack was "a U.S. decision made within the U.S. chain of command."

6. Josh Earnest, White House press secretary, said President Obama had decided "he learned enough about this matter to conclude it was appropriate for him to offer an apology," according to NYT. President Obama told Joanne Liu, MD, the international president of Doctors Without Borders, he would make all necessary changes to ensure incidents such as this are less likely to occur in the future. He also promised a "full accounting" of who is to blame for the attack, and whether the military's rules of engagement need alteration, White House officials said.

7. Doctors Without Borders has said it does not believe the three investigations currently looking into the bombings — including those by NATO, a joint United States-Afghan group and the Defense Department — are independent enough to uncover exactly what happened and why. Dr. Liu has repeatedly called for the U.S. to "consent to an independent investigation led by the International Humanitarian Fact-Finding Commission." The IHFFC, a body created under the Geneva Conventions, can only investigate violations of international humanitarian law if the countries involved give permission. In this case, both the U.S. and Afghanistan would need to consent.

Targeting a medical facility is considered a war crime, but only if it is proved to be deliberate, according to the report.

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