The U.S. Gunship that Slaughtered Doctors and Patients in Kunduz

The crews of the AC-130, a low, slow plane bristling with guns, don’t have to follow the same rules as those in other U.S. warplanes

The American warplane that apparently struck a Doctors Without Borders clinic in the embattled city of Kunduz in northern Afghanistan on October 3, killing 22 people, was probably an AC-130 gunship — a lumbering, four-engine transport modified to carry a powerful arsenal of side-firing guns.

Maybe the gunship’s crew knew exactly where the clinic was in Kunduz, maybe it didn’t. Maybe there were Taliban fighters nearby, maybe there weren’t.

Regardless, the AC-130 blasted the vicinity of the clinic for more than an hour, repeatedly striking the medical facility. And the U.S. military’s lax rules allowed it to happen.

Packed floor to ceiling with high-tech sensors and radios and boasting a wide range of weaponry including 25-millimeter and 40-millimeter cannons plus a 105-millimeter howitzer, the AC-130 is supposed to be more accurate than other warplanes—and thus safer for innocent civilians in the line of fire.

But the Pentagon's rules for using the gunships actually make them less safe. Eager to take advantage of the AC-130’s firepower, the military actually requires relatively little scrutiny of the target area before a gunship crews opens fire, compared to the much greater restrictions the Defense Department imposes on the pilots of other aircraft types.

Owing to these loose procedures, the AC-130 could actually be one of the most dangerous U.S. warplanes for civilians caught in the crossfire. And yet it’s also the plane that American commanders sent into the chaotic combat in densely populated Kunduz, where U.S.-backed Afghan forces were locked in battle with Taliban fighters who captured the city in late September.

And where Doctors Without Border was working to save people, including children, who’d been injured in the fighting—unaware that their clinic was about to become a slaughterhouse.

Hundreds of Taliban fighters attacked Kunduz in the last week of September, quickly routing a much larger but poorly led Afghan National Army force. Encouraged by their American advisers and backed by U.S. warplanes, Afghan soldiers counter-attacked. Kunduz’s 300,000 residents were caught in the middle without adequate medical care.

Doctors Without Borders, a Paris-based humanitarian organization that’s also known by its French name Médicins Sans Frontières (MSF), sends medical personnel into even the most dangerous war zones. It has been at work in Kunduz for four years. The group said that on September 29 it relayed the exact location of its clinic in Kunduz to the U.S.-led coalition, in order to prevent the facility and its 180 staff and patients from coming under attack.

It’s not clear whether the military got the memo.

At 2:08 in the morning local time on October 3, the first munitions struck the clinic. The blasts continued at 15-minute intervals until 3:15, according to Doctors Without Borders. “The main central hospital building, housing the intensive care unit, emergency rooms and physiotherapy ward, was repeatedly hit very precisely during each aerial raid, while surrounding buildings were left mostly untouched,” the group stated.

“The bombs hit and then we heard the plane circle round,” Heman Nagarathnam, in charge of Doctors Without Borders’ programs in northern Afghanistan, said in the statement. “There was a pause, and then more bombs hit. This happened again and again.”

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“When I made it out from the office, the main hospital building was engulfed in flames,” Nagarathnam added. “Those people that could had moved quickly to the building’s two bunkers to seek safety. But patients who were unable to escape burned to death as they lay in their beds.”

Ten patients and 12 staff members died and 37 people were hurt, Doctors Without Borders stated. At least three of the dead patients were children, according to the group. The remaining medical personnel scrambled to get the surviving patients to hospitals in other Afghan cities, in some cases driving hours on rough roads.

On October 4, Doctors Without Borders said it was shutting down its Kunduz operation. “No medical activities are possible now in the ... hospital in Kunduz, at a time when the medical needs are immense,” spokesman Tim Shenk told The New York Times.

In the immediate aftermath of the attack, Doctors Without Borders said it suspected a coalition airstrike. Sure enough, the U.S. military’s headquarters in Afghanistan quickly released a statement confirming that its forces conducted an air raid at 2:15 AM local time on October 3, “against insurgents who were directly firing upon U.S. service members advising and assisting Afghan security forces in the city of Kunduz.”

The U.S. government implied that the attack was an accident.

“The strike was conducted in the vicinity of a Doctors Without Borders medical facility,” the headquarters admitted, adding that both NATO and the Pentagon would be conducting investigations. “On behalf of the American people, I extend my deepest condolences,” President Barack Obama said in a statement.

Hamdullah Danishi, the acting governor of Kunduz, told The Washington Post that Taliban fighters had taken up positions in the clinic’s expansive garden and were firing on coalition forces. Doctors Without Borders said in a statement that it was "disgusted" by Danishi’s claim.

In any event, a coalition warplane opened fire. An unnamed U.S. military official told CNN an AC-130 was involved in the Kunduz air raid. The clockwork timing of the attack matches the flight pattern of a gunship.

The side-firing transport typically “orbits” over a target for potentially hours at a time, its left wing dipping low to maintain a tight turn that brings the bank of guns protruding from its fuselage to bear on the ground below. Scanning with cameras and communicating with commanders and troops on the ground, the gunship crew selects targets, aims and fires, pausing each time the targets pass out of the plane’s line of sight.

In an official fact sheet the U.S. Air Force—which possesses 28 AC-130s and has deployed them all over the world—lauds the gunship’s “surgical firepower” and “sophisticated sensor, navigation and fire control systems.”

“These sensors allow the gunship to visually or electronically identify friendly ground forces and targets anytime, anywhere,” says the fact sheet.

The AC-130 might seem perfect for attacking Taliban insurgents hunkered down in close proximity to a medical facility.

And the fact that a gunship has so many different kinds of weapons means it can dial up, or down, its destructive power to just the right intensity for the situation, unleashing enough explosive power to kill the enemy without also endangering nearby civilians.

“The AC-130 gunship controls the destructiveness of its lethal weapons by highly accurate delivery means,” Air Force Major Justin Bobb wrote in a 2002 paper for the flying branch’s Air Command and Staff College. “Vast confidence in the precision, repeatable effectiveness, minimization of collateral damage and flexibility of gunships has been established over the years.”

But there’s a loophole in the Pentagon’s regulations governing airstrikes—one big enough for the AC-130 to fly right through. Although the giant plane is equipped for precise strikes, its crew is authorized to attack without thoroughly vetting the target area for innocent people who might be harmed by the gunship’s firepower.

Normally, U.S. troops must complete what’s called a “collateral damage estimation” before firing missiles or dropping bombs. A CDE is essentially a flowchart that requires an air controller to figure out where civilians are in proximity to enemy targets, and to ask whether an attack on the enemy using a particular weapon might also harm the civilians.

If the controller can’t answer “no” to a fairly length of questions about civilians’ safety, they’re not supposed to approve the attack.

But a 2009 edition of the CDE guidelines that the ACLU obtained via the Freedom of Information Act lists some weapons that are exempt from the guidelines. “CDE as specified in this instruction is not required for ... fixed-wing air-to-surface direct-fire weapon systems less than 105 millimeters ... due to operational practicality.”

The exemption applies to the 25-millimeter and 40-millimeter cannons on the AC-130, which spin up quickly, fire lots of deadly bullets very fast and are perfect weapons for quickly reacting to an enemy ambush. A flowchart would slow any attempt to use the weapons for the thing they’re best at.

A civilian Defense Department employee, who specializes in collateral-damage assessments for the air war over Iraq and Syria, confirmed that the current CDE guidelines are basically unchanged since 2009. A different, and vaguer, set of rules governs the gunship’s “direct-fire” weapons that aren’t covered by the normal guidelines. “Concepts of proportionality, necessity and reasonableness are considered for employment of direct-fire weapon systems,” the collateral-damage expert explained while asking not to be named.

In plain English, that means gunners in an AC-130 only need to feel that a burst of 25-millimeter or 40-millimeter gunfire is appropriate in order to justify squeezing the trigger. And when friendly troops on the ground are under attack, a gunship crew is more likely to decide to open fire, a former AC-130 pilot told The Daily Beast on condition of anonymity.

So the gunship crew over Kunduz, apparently believing insurgents were firing on U.S. advisers, skipped the normal procedures meant to protect civilians and blasted away on what turned out to be a medical facility—for more than an hour.

There was no requirement to second-guess. The normal checks on America's massive aerial firepower failed to prevent a tragedy because the regulations allow gunship crews to skip the checks so they can take advantage of their fearsome array of guns. Doomed by a loophole, staff and patients died instantly or burned to death as flames engulfed the ruined clinic.