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Bombing a hospital in Afghanistan is the modern American way of war

Doctors Without Borders staffers huddle in their Kunduz hospital after being hit by US airstrikes.
Doctors Without Borders staffers huddle in their Kunduz hospital after being hit by US airstrikes.
MSF/Pool/Anadolu Agency/Getty

Over the weekend, a United States AC-130 military aircraft targeted a Doctors Without Borders hospital in Afghanistan, killing 22 innocent people and forcing the humanitarian group to withdraw from the city.

The incident, on its face, was surely the result of some terrible human error, whether it was the Americans who launched the strike, the Afghans who reportedly called it in, or the many people involved who did not realize what they were doing, though Doctors Without Borders had alerted the US to their presence.

But regardless of any human error, there is a deeper and not-at-all accidental cause to blame, and it is the same thing that has contributed to the American bombing of so many wedding parties and innocent villages before: This is how a bombing war works. This is what a bombing war does. It is the war we've chosen in Afghanistan, the war we've chosen in Syria and Iraq, and the war that, if history is any guide, the United States will continue to choose over and over. When we treat it as mainly an accident or an aberration, we obfuscate that fact and ignore what makes this incident truly terrible.

What happened in Kunduz

In the twilight between Friday night and Saturday morning, in the northern Afghan town of Kunduz, Lajos Zoltan Jecs, a nurse with Doctors Without Borders, was shaken awake by an explosion. At first, as he wrote on his NGO's website, all he knew was that the blast had been very close — much closer than the usual background noise of war.

Jecs stumbled into the hospital to look for survivors. He found one patient killed on the operating table and another six "burning in their beds" in the intensive care unit. "I cannot describe what was inside. There are no words for how terrible it was," he wrote. The bombing continued for half an hour. By the end, at least 22 people were dead: 12 Doctors Without Borders staffers and 10 patients, three of them children.

The town of Kunduz had, just a few days earlier, been overrun by the Taliban. It was the group's biggest military victory in 14 years and the beginning of what many Afghans fear will be the Taliban's reconquest of their country, now that the American-led force is leaving. But this was not Doctors Without Borders' first war, and the group had made sure all parties in the war knew their facility's precise location.

Jecs could not know it at the time, but he and his colleagues were being bombed not by the Taliban or the Afghan military, but by the United States government. An American AC-130 ground-attack aircraft, which can function as a kind of flying artillery platform, had pounded the hospital from above.

The US-led NATO forces in Afghanistan at first said they were only returning fire against militants who'd shot at them first. When it became clear they had in fact destroyed a hospital, Afghan authorities insisted militants had been hiding out in the facility. On Monday, the top US commander in Afghanistan walked back the claim that Americans had been under fire, and said the strike had in fact been called in by Afghan forces. He did not apologize.

Kunduz isn't an aberration: this is the war we've chosen in Afghanistan

What happened in Kunduz was, by all appearances, a terrible accident. But it is a kind of accident that, all the same, is an inevitable and entirely foreseeable consequence of America's role in Afghanistan.

This is just what happens when you lead an air war against irregular forces like the Taliban: You bomb hospitals into dust, you burn patients in their beds, you kill 22 innocent people for nothing.

And indeed, such accidents have been happening for some time. The UN has documented 1,700 Afghan civilians killed by airstrikes just since 2008. While it does not differentiate based on who launched the strike, the US has dominated the air campaign in Afghanistan since 2002, and the stories of bombed civilians and wedding parties have been around just as long.

In July 2002, the US bombed a wedding party outside of Kandahar in error, killing at least 30. In July 2008, in Nangarhar province, as a group of mostly women and children escorted a bride to her wedding, US-led airstrikes rained down on them, killing 47. That November, another US-led airstrike on a wedding party killed 37. In May 2009, an American B-1 bomber leveled the village of Granai, just south of Herat, killing somewhere between 80 and 120-some people in what became known as the Granai massacre. On and on.

This is simply how these sorts of wars work. Whether American intentions are noble or cynical, whether the president is Barack Obama or George W. Bush, the Kunduz hospital bombing, or something like it, is going to happen.

That is not a case for shrugging it off, for obviating the United States of responsibility or guilt. Quite the opposite: It is a reminder that Kunduz is the war we've chosen, not just in Afghanistan, and that we go into this and other bombing campaigns knowing full well the consequences.

Kunduz will always happen in a bombing campaign

For all America's advances in accuracy when it comes to airstrikes, there is one problem it cannot solve with technology: You need someone on the ground calling the targets. That invites human error when you have it. In its absence, it forces you to pick your targets based on some combination of guesswork (e.g., US "signature strikes" on armed young men standing around in militant-held areas) and local proxies, who may or may not be honest or even minimally competent.

As the US and its allies withdraw their ground troops but keep up the air campaign, they will be launching more airstrikes based on reports called in from Afghan proxies on the ground. There will be more accidents like Kunduz, more senseless death for which America is rightly seen as culpable.

War is never clean, never more than a menu of bad options. In Afghanistan, our choices, broadly, were to keep a ground force that had not won in a decade-plus of fighting, scale back to an air campaign that has a long record of killing civilians, or withdraw entirely and watch as the Taliban regains power. We chose the second bad option. We chose Kunduz.

It's the same choice we've made many times before and will surely continue to make. The United States often seeks to use military force in faraway conflicts but is neither able nor willing to use ground troops in most cases, and so falls back to airstrikes.

That is not to say that this is a good choice, or even a defensible choice. But it is a reminder of a truth that Americans don't like to acknowledge: This is what we resign ourselves to when we launch an air war, whether in Afghanistan or Iraq or Syria. No matter how evil the foe or how necessary the fight, on the red side of the pro-con ledger there will always be Kunduz and its victims, whether we admit it to ourselves or not.

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