Sixteen U.S. military personnel, including a general, were disciplined but not charged with war crimes for the deadly strike against a Doctors Without Borders hospital in Afghanistan last year that killed 42 civilians, the Pentagon announced Friday.
Doctors Without Borders, also known as Médecins Sans Frontières (MSF), has called the attack on the hospital a “war crime” and demanded an independent investigation. But investigators concluded that U.S. personnel did not know they were targeting a medical facility. Instead, the report cited a combination of "human errors, compounded by process and equipment failures."
Fatigue, "high operational tempo," and "the fog of war" were also contributing factors, the report stated.
"This report provides important and painful lessons, and as I have directed senior leaders across the Department, we will now act upon them," Defense Secretary Ash Carter said in a statement.
"When we make mistakes we must own up to them and hold individuals accountable as necessary," he said. "Learning from the past and applying that knowledge to improve how we operate in the future is also a core value of the Department of Defense."
On Oct. 3, 2015, an Air Force gunship attacked a Kunduz hospital opened by Doctors Without Borders, killing 42 and injuring at least 30. The Intensive Care Unit was the first to be hit.
The disciplinary actions for 12 of the service members included suspension and
removal from command, letters of reprimand, formal counseling, and extensive
retraining, according to the report. Five personnel "were directed out of theater." None of them were identified in the report.
Responding to the report Friday, MSF acknowledged the military's effort to investigate the incident, but said that the administrative punishments "are out of proportion to the destruction of a protected medical facility, the deaths of 42 people, the wounding of dozens of others, and the total loss of vital medical services to hundreds of thousands of people."
"Today’s briefing amounts to an admission of an uncontrolled military operation in a densely populated urban area, during which U.S. forces failed to follow the basic laws of war,” MSF President Meinie Nicolai said in a statement. "It is incomprehensible that, under the circumstances described by the U.S., the attack was not called off."
The U.S. military initially said the strike was carried out to defend ground troops under fire by the Taliban.
Three days later, the United States commander in Afghanistan, General John F. Campbell, said that it was in fact Afghan forces who were under attack and requested the strike.
“To be clear, the decision to provide aerial fire was a U.S. decision made within the U.S. chain of command,” Campbell said during his testimony to the Senate Armed Services Committee, calling the strikes “a mistake.”
“We would never intentionally target a protected medical facility,” Campbell said.
A Department of Defense investigation found the aircraft fired 211 shells at the hospital over a 29-minute period before anyone realized they had made a mistake.
Investigators found that the intended target of the attack — an insurgent-controlled site — was 400 meters away from the trauma center and that the U.S. ground force and aircrew "misidentified" and the MSF center.
Both forces were "unaware the aircrew was firing on a medical facility throughout the engagement," according to the report.
The "lethal effects" of the strike lasted for 30 minutes, Gen. Joseph L. Votel, U.S. Central Command commander, said at a news conference Friday.
When the Doctors Without Borders staff contacted the command center 10 minutes into the attack, the information "went through a series of layers to get to people on the ground," Votel added.
Since the ground force commander was not tracking the medical facility, "it took a few moments" for him to register that they were striking the hospital. Once they processed the information they stopped firing, Votel said.
He attributed the deadly attack to the lack of communication between the air and ground crew, saying, "in a confusing situation like this, it merited more discussion of what was going on."
"We have young people, young leaders trying to make the right decision in the heat of the moment," Votel said. "Unfortunately, sometimes it comes up wrong."