GENEVA — The aid organization Doctors Without Borders called Wednesday for a little-known international agency to carry out an independent investigation of the attack by a U.S. aircraft on its hospital in northern Afghanistan.
Joanne Liu, international president of Doctors Without Borders, said the International Humanitarian Fact-Finding Commission, a body set up under the Geneva Conventions, should investigate the attack that destroyed the aid group's hospital in Kunduz, killing 12 members of its medical staff and 10 patients, including three children.
"It is unacceptable that the bombing of a hospital and the killing of staff and patients can be dismissed as collateral damage or brushed aside as a mistake," Liu said at a news conference in Geneva.
"This was not just an attack on our hospital," she said. "It was an attack on the Geneva Conventions. This cannot be tolerated."
She added: "If we let this go as if it were a nonevent, we are basically giving a blank check to any country" involved in an armed conflict.
Gen. John F. Campbell, commander of the U.S. forces in Afghanistan, told a Senate panel Tuesday that the hospital was "mistakenly struck" as a result of a decision "within the U.S. chain of command."
Doctors Without Borders, which has likened the bombing to a war crime, said the purpose of the investigation would not be to establish criminal liability, but rather to clarify the laws of war and the conditions under which medical teams can operate in situations of armed conflict.
"We need to safeguard that space to allow access to health care in conflicts, that's the essential message," Liu said, emphasizing that without such safeguards, it would be impossible to continue operating in other conflict zones, like Syria, Ukraine and Yemen. "It's about being able to care for populations in conflict areas."
Liu said that patients burned in their beds, and that doctors, nurses and other staff members were killed as they worked.
"Our colleagues had to operate on each other," she said. "One of our doctors died on an improvised operating table — an office desk — while his colleagues tried to save his life."
The 15-person commission, established in 1991 to investigate breaches of international humanitarian law, has never been activated to conduct such an investigation, and doing so would require the consent of the United States and Afghanistan, said Françoise Saulnier, the charity's chief legal counsel.
Doctors Without Borders sent letters Tuesday asking the 76 nations that supported the formation of the commission to endorse their call for an investigation.
The commission's investigation would only be a first step, and Doctors Without Borders would determine its next moves on the basis of the panel's findings, Saulnier said, but she added, "We work on the assumption of a war crime."
The U.S. military, NATO and the Afghan authorities have opened inquiries into the bombing, but Liu said that was insufficient. "We cannot rely on only internal military investigations," she said.
The hospital, a major site with 13 doctors and surgeons that opened four years ago, conducted 6,000 surgical procedures and more than 20,000 consultations in 2014.
"This was high-tech medicine," Liu said. "This was not a little bush hospital, you could not miss it."
The charity reported that its hospital building — housing an intensive care unit, emergency rooms and physiotherapy unit — was hit four or five times at intervals of about 15 minutes. No other building was hit, "so we do not have doubts this building was targeted," said Bruno Jochum, general director of the charity's Swiss branch.
Doctors Without Borders said it had notified the armed forces from Afghanistan and its allies of the coordinates of the hospital as recently as Sept. 29, and that the bombing continued for 30 minutes after the aid group called military officials in Kabul and Washington to tell them they were striking a hospital.
The 12 medical staff members killed in the attack were all Afghan, the charity said. Three of the charity's international staff members who were in the hospital at the time survived.
Campbell said the military had received a request for air support from Afghan troops, but reports from hospital staff members said "there was simply no account" of the presence of armed fighters on the premises, Jochum said. "We want to be extremely strong and clear on this."