Ten years ago, in the early morning hours of October 3, 2015, the Kunduz trauma center run by Doctors Without Borders/Médecins Sans Frontières (MSF) in Afghanistan came under intense and prolonged US airstrikes. The hospital’s main building—which housed the intensive care unit, emergency rooms, laboratory, X-ray equipment, outpatient and mental health departments, and physiotherapy ward—was hit repeatedly and with precision for over an hour.
The attack killed 42 people, including 24 patients, 14 MSF staff members, and four patient caretakers. Patients burned in their beds, people were decapitated or lost limbs, and others were shot from the air while trying to escape the burning building. It remains the deadliest attack ever perpetrated against an MSF facility.
Destruction at the Kunduz Trauma Center after the aerial attack on October 3, 2015. Afghanistan 2015 © Andrew Quilty
A hospital on the front line
The MSF project in Kunduz started in August 2011 as a 55-bed hospital. We provided urgent surgical care and follow-up treatment for people with trauma injuries sustained in Afghanistan’s ongoing conflict: injuries from bomb blasts, shrapnel, and gunshots. Before the hospital opened, people in the region with severe injuries had no choice but to make long and dangerous journeys to Kabul or Pakistan or visit expensive private clinics. Once up and running, the MSF facility quickly grew to 70 beds, and by 2015 it had a 92-bed capacity. It was the only specialized trauma center in northern Afghanistan.
In September 2015, the fighting in Kunduz intensified as Taliban forces entered and eventually took control of the city, only to later lose it again a few weeks later. The hospital was on the front line of the conflict and was inundated with wounded patients. In response, we increased the number of beds to 110, and then 150. There were so many patients by the end of the month that they were being treated in offices and examination rooms and were being stabilized on mattresses on the floor. Throughout this time, the trauma center remained open, even as control of the city shifted.
“We were immensely proud to treat everyone—women, men, children—regardless of their ethnicity or political affiliations,” says Dr. Esmatullah Esmat, who survived the attack and today works as deputy project medical advisor for the Kunduz trauma center.
The attack left the hospital largely destroyed and no longer operational, reducing access to emergency health care for thousands of people at a time when they needed it most.
“Everything was burned,” said Dr. Sayed Hamed Hashemy, a surgeon who survived. He visited the hospital two weeks after the attack to see the wreckage: Paint blistered and peeled off the walls from the heat of the flames, warped pieces of metal and debris strewn across the grounds, and sections of roof blown open to the sky. “The operating theater where I had been working on the night of the attack had holes in its ceiling and walls. Oxygen bottles and the operating table were lying in pieces. Time had frozen: You could sense the moment when everyone stopped working.”
After the attack, MSF’s ceased medical activities in northeast Afghanistan.
It took more than a year for MSF to resume providing medical care in the city of Kunduz, and even longer to restart trauma care. In the intervening period, the Kunduz regional hospital worked hard to try to fill the gap.
MSF continued to support the district advanced post in the Chahardara district of Kunduz, which was in opposition-controlled territory. Nurses provided immediate care to patients who were wounded or injured, but it was no longer possible to refer them to Kunduz trauma center. Only basic care was available, and a lifeline was cut.
10 years since the deadliest attack on an MSF health facility
What happened next?
The deadly attack occurred despite MSF sharing the GPS coordinates of the hospital with the US Department of Defense, the Afghan Ministry of Interior and Defense, and the US Army in Kabul. In the aftermath, after discussions with US and Afghan authorities at all levels, MSF was not satisfied that an independent, impartial investigation could be carried out by the parties involved. We then asked for the International Humanitarian Fact-Finding Commission to undertake an independent investigation. However, without the agreement of the US and Afghan governments, it could not proceed. In November 2015, we released our own internal review.
In January 2017, because of the persistent needs, MSF decided to build a new trauma hospital at a different site in the city. Once the land was obtained and landmines were removed, construction started in late 2018. In parallel, in July 2017, MSF opened a small outpatient clinic in Kunduz for people with minor trauma-related wounds and injuries, but it unfortunately closed in April 2020 during the COVID-19 pandemic and did not reopen.
When fighting intensified in Kunduz in 2021 while the new facility was still under construction, MSF set up a temporary 25-bed trauma unit in its office to treat war-wounded patients. On August 16, 2021, MSF moved all the patients from the makeshift trauma unit to the new Kunduz trauma center. “We’re doing our medical work while the construction is still going on,” said a medic working there at the time. “But the speed at which all the construction team and others are fixing things is quite amazing.”
When the fighting in the region ended, the Kunduz trauma center adapted to meet the changing needs of the community. Instead of gunshot wounds and bomb blasts, the team cared for people injured in road traffic accidents as people felt safer to move around. In 2023 an antimicrobial resistance stewardship program started and burn care activities were introduced in 2025.
Kunduz trauma center today
The new Kunduz trauma center exists today in a country no longer at war but still struggling with myriad challenges. The facility boasts an emergency room, an intensive care unit, inpatient and outpatient departments, operating theaters, and a space for physiotherapy. It has 79 beds and provides comprehensive care for patients with trauma injuries from falls, traffic accidents, unexploded ordnance, and more. From January to June 2025 MSF cared for 10,253 patients in the facility’s emergency room and performed 3,197 surgical interventions.
“Kunduz city today is different from Kunduz city in 2015, just as the nature of the trauma injuries has changed,” said Emilie Buyle, MSF project coordinator in Kunduz. “But one thing that will never change is that MSF treats everyone according to their medical needs. We do not distinguish based on a patient’s race, gender, ethnicity, religious beliefs, or political affiliation.”
May our colleagues lost on that tragic day live on in our memories: Abdul Maqsood, Abdul Salam, Mohibullah, Naseer Ahmad, Mohammad Ehsan Osmani, Lal Mohammad, Najibullah, Shafiqullah, Aminullah Bajawri, Abdul Satar Zaheer, Ziaurahman, Abdul Nasir, Zabiullah, and Tahseel.
