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"Nothing can explain it": Attack on maternity ward in Afghanistan

20 May 2020

On Tuesday 12 May, 24 people were killed in an attack on MSF’s maternity ward in Dasht-e-Barchi hospital in Kabul, Afghanistan. Filipe Ribeiro, MSF Country Representative for Afghanistan, spoke with Cathy Van Extel for ABC Radio National Breakfast about the attack.

Dasht-e-Barchi hospital in Kabul, Afghanistan, in the aftermath of the attack. © Frederic Bonnot/MSF
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Fran Kelly: Médecins Sans Frontières is considering its future in Afghanistan following last week’s horrendous attack on its specialist maternity hospital in Kabul. In an horrific attack, militants targeted the maternity ward and delivery rooms – shooting and killing women and their unborn babies as well as very young children. In all, 24 people were killed including 11 new mothers. At least 20 people including newborns were badly injured; several babies were orphaned. Filipe Ribeiro is the Afghanistan country representative for Médecins Sans Frontières, he’s speaking here with Cathy Van Extel.

Filipe Ribeiro: Hello, good morning. 

Cathy Van Extel: Now you've just visited the hospital today, it's still shut down, but can you give us an update on how those who are injured are getting on? Are they getting the treatment that they need?

Filipe Ribeiro: Yes, the hospital is still closed down of course for obvious reasons, as we have to deal with a lot of things including cleaning the place, which is not a very pleasant task to be done. With regards to the wounded and injured people as you may know almost 20 people were injured during the attack, some of them are still in the hospitals and we are of course taking care of them. Most of them have come back home and we are following them both for medical treatment but also for psychological support. And to our colleagues – two MSF members were wounded during the attack. 

Cathy Van Extel: There was a four hour siege ultimately and a number of patients and hospital workers hid in a safe room while that played out. There was a woman who actually had to give birth in silence with no medical equipment; by all accounts this was a terrifying ordeal…

Filipe Ribeiro: There is no words to describe it, I mean, basically it was just awful. If I have to put a category – I will say that this was pure barbarism. Nothing can explain it. Well just as you can imagine it’s very emotional for all of us. It’s just awful and there are no words. Fortunately, we had safe rooms – and enough safe rooms – which allowed us to protect almost 100 people that could make it to the safe rooms. Unfortunately not all of them were able to reach the safe rooms and those who were not able to reach the safe rooms had to face those guys who came to just kill infinitely. 

Cathy Van Extel: Médecins Sans Frontières says that this was a deliberate targeting of women and babies. What makes you believe that?

Filipe Ribeiro: It seems pretty clear that the attackers came into the hospital, went room after room looking after people and shooting people in the beds. No one escaped actually from the rooms. That's why we do think that the attackers came with this main objective to kill as much as possible people inside the maternity. 

Cathy Van Extel: Has this ever happened before? Has any group claimed responsibility?

Filipe Ribeiro: So far no group claimed responsibility and even some of groups have released a disclaimer saying they were not behind it. Of course hospitals were already targeted several times in Afghanistan and elsewhere – it’s not the first time a hospital has been attacked. But as far as I know, it's the first time that a hospital and a maternity is attacked that way. It's never happened before. Unfortunately we have a record of hospitals being attacked not long ago – five years ago in Kunduz where the US army bombed one of hospitals – that was bombed if I can say so. 

Cathy Van Extel: There have been shockwaves globally about this particular attack. What's been the effect of it within Afghanistan?

Filipe Ribeiro: International drama as you can imagine. Everybody is shocked. No-one understands what is happening – let’s say it's a national event. 

Cathy Van Extel: As we talk about no group has claimed responsibility but there’s certainly a concern that this will derail the prospect of peace talks with the Taliban. How worried or what does that mean for MSF?

Filipe Ribeiro: I'm not sure that it will have an impact on the peace deal between the US and the Taliban. Of course it will have an impact in the political landscape in the country, that is for sure. Then coming to us of course he would also have an impact on the way we look and run our operations. For now, we have to assess and to analyse and try to understand what happened to us – and why it happened and then we review our way of working in Afghanistan depending on the findings of this. It’s going to take some time to try to figure out who was behind it, what was the purpose of it and the general objective. It's already quite difficult and it’s going to be a really tough time for us to figure out exactly what happened to us.

Cathy Van Extel: What decisions is MSF making then about your future in Afghanistan? Will it change your work? Is there a risk that you will withdraw?

Filipe Ribeiro: No decision has been made yet with regards to MSF presence in Dasht-e-Barchi. Of course we will have to reconsider the way of working in Kabul at first and maybe in Afghanistan, taking into account what happened to us in Dasht-e-Barchi, in Kabul itself. For the time being, we remain committed. We remain in the country and we stand by the Afghan population.

Cathy Van Extel: You indicated that at this stage no group has taken responsibility for this attack. The indication from the US is that it is ISIS. Do you share that view? 

Filipe Ribeiro: It's too early to say who is behind and I’m sure one day there have been a lot of attacks in Afghanistan are still unclaimed. At the end of the day what is important for us is to know – are we going to be able to provide medical care to the population within this context? That is our main concern nowadays. 

Cathy Van Extel: This hospital is in one of Kabul's poorest areas and it specialised in care for newborns and premature babies and their mothers. When would you expect to be in a position to make that decision about whether it could reopen?

Filipe Ribeiro: I guess a couple of weeks – the sooner the better and we are working very hard to find out what happened to us in order to be able to take a decision very quickly. But just to give you an idea of what such a maternity means in this neighbourhood of Kabul – it's more than 1,000 deliveries per month – that’s huge, that’s 60 per day. 

Cathy Van Extel: And is their capacity at all in the other hospitals to take on those numbers? What happens?

Filipe Ribeiro: No, unfortunately there is no local capacity to take that in charge. We are reinforcing with material, for some of the local facilities to cope with the demand. We are working with the Ministry of Health to see how we can best respond to the needs – maybe putting in place some kind of evacuation processes for the patients. But surely the local health system is not able to respond to the needs and the absence of MSF will be a great loss for the population. 

Fran Kelly: That’s Filipe Ribeiro, Médecins Sans Frontières Afghanistan’s country representative speaking with Cathy Van Extel.