If you continue without changing your settings, we’ll assume you’re happy to receive all cookies from the BMA website. Find out more about cookies
When you visit any web site, it may store or retrieve information on your browser, mostly in the form of cookies. This information might be about you, your preferences or your device and is mostly used to make the site work as you expect it to. The information does not usually directly identify you, but it can give you a more personalised web experience.
Because we respect your right to privacy, you can choose not to allow some types of cookies. Click on the different category headings to find out more and change our default settings. However, blocking some types of cookies may impact your experience of the site and the services we are able to offer.
These cookies are necessary for the website to function and cannot be switched off in our systems. They are usually only set in response to actions made by you which amount to a request for services, such as setting your privacy preferences, logging in or filling in forms.
You can set your browser to block or alert you about these cookies, but some parts of the site will not then work. These cookies do not store any personally identifiable information.
These cookies are required
These cookies allow us to know which pages are the most and least popular and see how visitors move around the site. All information we collect is anonymous unless you actively provide personal information to us.
If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance.
These cookies allow a website to remember choices you make (such as your user name, language or the region you're in) and tailor the website to provide enhanced features and content for you.
For example, they can be used to remember certain log-in details, changes you've made to text size, font and other parts of pages that you can customise. They may also be used to provide services you've asked for such as watching a video or commenting on a blog. These cookies may be used to ensure that all our services and communications are relevant to you. The information these cookies collect cannot track your browsing activity on other websites.
Without these cookies, a website cannot remember choices you've previously made or personalise your browsing experience meaning you would have to reset these for every visit. In addition, some functionality may not be available if this category is switched off.
Our websites sometimes integrate with other companies’ sites. For example, we integrate with social networking sites such as Twitter and Facebook, to make it easier for you to share what you have read. These sites place their own cookies on your browser as a result of us including their icons and ‘like’ or ‘share’ buttons on our sites.
The attack on a Médecins Sans Frontières (MSF) hospital in Kunduz Afghanistan last year led to the deaths of 42 patients and staff.
In the run up to a memorial event commemorating one year since the attack, the BMA is reproducing an account of the bombing written by Australian intensive care specialist Dr Kathleen Thomas, who witnessed the attack.
The names of patients and some staff have been changed to protect their privacy.
Click here to read Part one
Part two: The attack on Kunduz Trauma Centre
During the week leading up to the attack, the expats had set up camp in the hospital meeting room. This room was located in the office complex about 50 metres from the main building which housed the ICU, ER, OT and outpatient departments (OPD).
This is where I was when, as I slept, on 3 October at 2.08am, I was ripped awake by the first explosion. I could feel the vibrations in my chest and I instinctively covered my ears to protect my eardrums from rupture.
This was a totally different type of sound to anything previous and much, much closer. I had hardly managed to sit upright before the next explosion. I felt adrenaline pumping through my body – my legs tingled, my mouth was so dry, my hands shook.
I scrambled to put on my jacket and headscarf while looking at the terrified expressions of the three expat nurses with whom I shared the room. ‘It sounds like they’re bombing the hospital.’
More explosions followed in quick succession. We had no idea what was going on. It was dark in the room but we didn’t dare turn on any lights.
One of the nurses tried to look outside on several occasions, but every time he opened the door, heavy debris would hit the walls. I tried phoning everyone that wasn’t in the room with us, unsuccessfully – the ICU and ER staff and all of the other expats.
We scurried around the room like rats in a cage trying to figure out the safest place to be in case we took a direct hit. But we knew by the magnitude of the sounds - in a direct hit, there was no safe place. We were overwhelmed with this gripping fear.
The explosions continued, one after the other, separated every now and again with a short pause, presumably while the AC130 Gunship circled around. Every now and then we also heard heavy machine gun fire.
The message, as to what was going on, was delivered with our first patient. We heard a voice outside calling for help. Jecs, one of my colleagues with me in the room, opened the door to the sight of one of our ER nurses. All four of us froze as we absorbed a scene from a horror film.
He looked like a zombie; backlit, his left arm hanging by a small piece of skin and coated in thick grey dust. His bloody clothes were shredded. Several large wounds gaped and a piece of metal stuck out of his back. His right eye streamed blood. Then he collapsed.
We pulled him inside by his feet. Panic welled up inside me as I leant over to ask: ‘Where were you when you were hit?’
‘I was in ER.’
I was struck with disbelief. Did he misunderstand my question? He couldn’t have been inside the ER. ‘No, no, no. You must have been outside ER!’
‘No. I was inside the ER. Inside.’
This was the moment reality hit. It really was the worst case scenario. They really are bombing the hospital.
Soon after, our meeting room and the three surrounding rooms filled with injured people bringing absolute chaos. Most of them colleagues, friends and some patients, all covered in the same thick dust.
The injuries were the same as what we had been treating in patients all week – penetrating chest wounds, open fractures with extensive soft tissue wounds, traumatic amputations.
At first there was just me, three nurses, and a basic first aid kit. It’s hard to describe being surrounded by friends and colleagues, with life threatening injuries, calling out your name begging for help that you have no capacity to give them. It was horrendous.
Dr Osmani, Dr Ramakee, a training ICU Doctor, and two cleaners, were all in the ICU isolation room. Dr Osmani and one of the cleaners, Nasir, suffered devastating injuries and were killed.
Dr Ramakee, suffering blast injuries to the eyes and ears, managed to run out of the room literally dodging shells that rained down through the ceiling. One of those shells landed right in the middle of the ICU hitting and killing two of our nurses instantly.
He then hid in the laboratory until it caught on fire then escaped through a window. He recalls hearing Dr Osmani's cries for help fade into silence over about 20 mins, but was unable to get back to him.
We had seven patients in ICU at the time of the attack. Three were on ventilators. One was our injured Head ER nurse Lal Mohammed, the other two were chest and spinal cord injured patients.
I hope with all my might that Lal Mohammed was sedated enough to be unaware of the situation, but I know the other two were awake. Even if they’d been able to rip themselves off the ventilators, their paralysis would have prevented escape.
When the shells ripped through the ceiling in ICU, and the whole unit went up in flames, all those patients were killed, witnessed burning in their beds.
Our final intubated ICU patient was in theatre at the time of the attack, found dead on the operating table.
The only surviving patient in ICU was a three-year-old girl named Shaesta who had suffered horrific blast injuries yet was recovering in ICU.
The rest of the main building suffered the same fate including the ER, theatres, OPD where many staff were sleeping that night.
People fleeing the main building, like Tahseel, were picked off by machine gun fire. Forty-two people were killed, 14 of them were our staff. Countless others were injured, many suffering injuries making them unemployable in Afghanistan.