On May 12, 2020, armed men attacked the Doctors Without Borders/Médecins Sans Frontières (MSF)’s maternity wing in Dasht-e- Barchi hospital in Kabul, Afghanistan, killing 24 people, including 16 mothers, an MSF midwife and two young children.

Fearing our patients and staff would be targeted again, we made the painful decision to withdraw from the hospital in mid-June. The assailants, whose brutal attack forced us to close our maternity and neonatology departments, have left women and babies without essential medical care in a country that has some of the worst maternal and neonatal death rates in the world. In 2019 alone, MSF teams assisted 16,000 births in Dasht-e-Barchi, making it one of our biggest maternal care projects to date.

Aquila is a midwife from Afghanistan who was working at Dasht-e-Barchi hospital at the time of the attack:

“When MSF opened the Dasht-e-Barchi project in November 2014, I was one of the first to start working there, as a midwife to begin with, then as midwife supervisor in the admission, labour and delivery rooms. After that, I became a midwife trainer – which I remained until the day of the attack.

Dasht-e-Barchi is an area with a large population. Most of the people living here are among the poorest of Afghan society.

The maternity department offered good services for pregnant women, including labour, delivery and postnatal rooms, a neonatal unit, a blood bank, a laboratory and an operating theatre, as well as health education and family planning. It was one of the few places providing free, high quality healthcare regardless of ethnicity, religion and nationality, and we looked after patients very well. For this reason, many women chose to come to the hospital to give birth. On average we’d assist 45 to 50 births every day, some of which would be complicated deliveries.

The day of the attack started like any other. At 9 a.m., I went to the gate to collect the night report. I realized that there was no registration book and headed to the office to get a new one. Suddenly, I heard gunfire. At first, I thought it might be coming from the street outside. I met my colleagues on
the way, and we all looked at each other questioningly. Just then, the alarm bell rang, and we all headed to a safe room. We closed the door, after making sure most of our colleagues were inside.

The sound of gunfire was getting closer and louder. We asked each other why the hospital would be attacked when we were there to bring new life into the world, when most of the employees were female and the patients were pregnant women and newborns.

The attack started at about 9:50 a.m. and lasted for around four hours. We stayed inside the safe room for five hours. I was thinking about my patients and colleagues, the poor patients who were in labour and the innocent children who could not defend themselves. Because my work took me to each part of the hospital every day, I could imagine the patients in the delivery room and the labour room – each of them flashed before my eyes. After the shooting ended, we learned that we had lost one of our midwives, Maryam, as well as children and mothers who had come here hoping for a safe delivery. A number of colleagues, patients and carers had been injured. Every time I think about it, I get angry and upset.

MSF’s decision to leave the hospital was almost as shocking as the attack. I cannot judge this decision, but I know that it will take a heavy toll on the people of Dasht-e-Barchi, because, every day, MSF’s services saved the lives of many mothers who were at risk of dying. MSF’s departure from the area not only affected patients, but also the hospital staff, many of whom are still unemployed. For me, my colleagues and the people of Dasht-e-Barchi, this was a black day that will not be forgotten.”

MSF’s decision to leave Dasht-e-Barchi was a difficult and painful one. In many conflict zones, including those in Yemen, Syria, Democratic Republic of Congo and Central African Republic, medical facilities continue to be attacked. MSF calls again for all parties to conflict to stop attacks on healthcare workers, facilities and patients. Violence has taken a heavy toll on civilians in many places where we work and each attack on medical facilities or health workers deprives communities of much needed, often lifesaving care.