With the government hospital shut down, a facility run by Médecins Sans Frontières is now the only place for people needing urgent trauma care to be treated in Kunduz, which was taken by the Taliban on Monday. Afghan forces have been battling the insurgents to regain control of the northern city of about 300,000 people, and residents are caught in the middle.
Doctors are already struggling to treat an influx of wounded civilians while casualties are expected to rise as fighting continues between Afghan government forces and the Taliban in Kunduz, which is the first provincial capital to fall to the insurgent group since it was ousted from power in 2001.
"The MSF hospital is completely overwhelmed and wounded continue to arrive,” said the charity's operational coordinator, Renzo Fricke. “With the hospital reaching its limit and fighting continuing, we are worried about being able to cope with any new influxes of wounded.”
Fricke told IRIN that MSF had treated more than 250 patients since Monday morning, including 53 children. Most patients suffered gunshot wounds and 66 arrived in critical condition.
Two medical staff with the International Committee of the Red Cross have been working “around the clock” at the MSF hospital, which is running low on medical supplies, ICRC spokeswoman Neha Thakkar told IRIN.
“As the ICRC endeavours to deliver those medical supplies, we urge all parties to the conflict to respect international humanitarian law that requires them to not target civilian lives and property,” she said.
Civilians in the crossfire
So far, the Taliban fighters have not “demonstrated violence against civilians”, said Lola Cecchinel, head of research at ATR, a Kabul-based consulting company. They have put civilians in danger, however, by hiding in people’s houses “to blend in with the civilian population”, Amnesty International said in a statement citing reports from local residents.
Casualties are likely to increase as Afghan and foreign forces launch an assault to take back the city, Cecchinel told IRIN. She said the Taliban are likely to be driven from Kunduz, but their successful offensive has been “a major blow for the central state”.
The Taliban took control of Kunduz as President Ashraf Ghani marked his first year in office yesterday, and he has come under fire from MPs who called for his resignation in a televised session of parliament today. They accused him of mishandling the battle for control over the city.
In a statement released Tuesday, Ghani accused the Taliban of using civilians as human shields and said his government “does not want the clearing operations to cause any civilian casualties in Kunduz city”. Ghani said he had dispatched reinforcements to Kunduz, including special forces.
Too little, too late?
Those measures have come too late, according to some analysts. They argue that Ghani failed to implement an effective strategy to take back parts of Kunduz Province that were controlled by the Taliban and provide enough security to protect the provincial capital.
“Although Kunduz was among the priority provinces he listed when he arrived in office, there has been little effort to tackle the most pressing issues there: lack of leadership, poor governance structures, and power in the hands of warlords,” said Cecchinel.
Many have criticised Ghani for activating militia groups this year in an attempt to impose government authority in the province. Residents have told IRIN that militia members committed abuses including assaulting and extorting civilians, and stealing their property.
“Instead of investing in the state forces in times of crisis, the government keeps on supporting armed groups with little or no loyalty to the state, who abuse the population with impunity and further disintegrate the authority of the state,” said Cecchinel.
In addition to creating problems for Ghani, the takeover of Kunduz poses a problem for the United States, which led an invasion in 2001 that pushed the Taliban from power. Kunduz was one of the last cities to fall to US and Afghan fighters in 2001, and the US has now been drawn into battle there again despite having scaled back its military presence in Afghanistan as part of a plan to withdraw almost all of its troops by next year.
The Pentagon said it had carried out an airstrike Tuesday on Taliban fighters who were moving towards the airport where Afghan and US soldiers were stationed.
The fall of Kunduz raises questions about the ability of Afghan security forces to fight the Taliban without heavy US backing.
“The situation is a setback for Afghan forces,” said Pentagon press secretary Peter Cook in a statement, but he added that the US “has confidence” in Afghanistan’s military.
That confidence will be put to the test in the coming days, as the Taliban appear determined to hold on to Kunduz for as long as they can – which is bad news for the city’s residents, many of whom are likely to fall victim to the violence.