The Pulse | Security | South Asia

In Afghanistan, Healthcare Services Targeted for Attacks

In just over 10 weeks, amid a pandemic, a dozen attacks deliberately targeted healthcare workers or services in Afghanistan. 

Catherine Putz
In Afghanistan, Healthcare Services Targeted for Attacks
Credit: U.S. Army photo by Cpl. Matthew DeVirgilio

As Afghanistan grapples with an unsteady peace process, messy politics, and a deadly virus, violence has continued. Most egregiously, as a recent report from the UN Assistance Mission in Afghanistan (UNAMA) highlights, more than a dozen attacks this spring have targeted healthcare facilities.

Between March 11, when the World Health Organization declared the COVID-19 outbreak a pandemic, and May 23, when a three-day ceasefire in conjunction with the end of Ramadan temporarily slowed the violence in Afghanistan, there were 15 incidents documented by UNAMA that affected the provision of healthcare. A dozen of the documented incidents were deliberate attacks; the remaining three occurred alongside violence not necessarily aimed at healthcare services.

The majority — eight of the targeted attacks and two of the other incidents — have been attributed to the Taliban. Afghan forces were responsible for three targeted attacks and one incidental attack occurred in the context of a battle between Afghan and Taliban forces.

The most horrific attack in the 73-day period reviewed remains unattributed. On May 12 at around 10 a.m. three men wearing Afghan security forces uniforms attacked the maternity ward of a hospital in Kabul’s Dash-e Barchi neighborhood operated with the assistance of Doctors Without Borders (MSF). Two dozen were killed in the attack, including 19 women and three children. After shooting a security guard at the hospital entrance, the gunmen walked past other parts of the hospital to reach the maternity ward. The head of MSF programs in Afghanistan,  Frederic Bonnot, told VOA, “They came to kill the mothers.”

On June 15, MSF announced it would withdraw from the Dash-e Barchi hospital where it had worked since 2014.

Enjoying this article? Click here to subscribe for full access. Just $5 a month.

With the gunmen killed by Afghan forces, attribution has been murky. In the aftermath, the Afghan government blamed the Taliban; the Taliban denied responsibility and blamed the Islamic State. The United States blamed the Islamic State, too.

As the UNAMA report emphasizes, “deliberate acts of violence against healthcare facilities, including hospitals and related personnel, are prohibited under international humanitarian law and constitute war crimes.” Also treading into war crime territory are attacks against sick and wounded combatants, regardless of which side of the conflict they stand on. 

The Taliban’s attacks include the abduction of healthcare workers: 23 in seven different incidents across six provinces. Interestingly, while the motivation for some of the abductions is unclear, in other cases the intent seems to have been to either pressure the workers or their organizations to provide better services or, as was the case in the May 12 abduction of three healthcare workers in Khwaja Ghar district: “Taliban members abducted three healthcare workers from an organization accused of failing to pay the salaries of their workers.”

Of course, abducting a healthcare worker guarantees that even fewer services reach Afghan citizens directly, and indirectly undermines healthcare by contributing to the perceived risk of operating in certain areas. 

Another Taliban attack targeted a pharmacy in Nangarhar province, reportedly because the owners refused to pay the Taliban a set sum of money. 

The incidents UNAMA attributed to Afghan forces include a May 19 airstrike on wounded Taliban at a clinic in Kunduz and allegations that Afghan security forces interfered with healthcare services by way of threats and theft of medical supplies. 

UNAMA Chief of Human Rights Fiona Frazer said in the body’s press release about the report, “Perpetrating targeted attacks on healthcare during the COVID-19 pandemic, a time when health resources are already stretched and of critical importance to the civilian population, is particularly reprehensible.”