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Kunduz hospital: Interview with Dr Declan Barry
Dr Declan Barry from County Longford was Medical Director at Kunduz hospital, Afghanistan for six months in 2015, leaving just two weeks before it was destroyed in a US airstrike on 3 October. The MSF trauma centre treated over 20,000 people per year and was the only facility of its kind in northeastern Afghanistan.
"I arrived in Kunduz in early March to work as the Medical Director at the MSF hospital. I’d been to Afghanistan with MSF in 2012 and it’s such a magnificent country.
The project was so impressive I wondered whether I would have anything to contribute. When I arrived we were already incredibly busy and I was managing a team of 16 people.
The hospital in Kunduz was three and a half years old and very ambitious. It was the only trauma centre in the northern part of the country. I’ve worked for MSF since 2010 and been on nine missions.
The sheer size, scale and level of care provided was incredible. We’re talking about a fully functioning hospital – ER, Intensive Care Units, Out-Patient and In-Patient departments, everything.
We were dealing with all levels of trauma - from bombardments, gunshot wounds and shrapnel - typical war injuries - to everyday trauma like car accidents. Our teams were providing highly specialised care.
Working at capacity
A very significant amount of our patients were accidental traumas, we treated a large amount of children.
Often we had to make a lot of tough choices about care, because we were always at capacity. Sometimes we had to make hard decisions like who would have a ventilator, and who would have to go without.
We should be immensely proud of Kunduz. Our results were great and we were lucky to have a really strong team there. I was so proud of my colleagues, especially when the attack happened. They just kept going.
Nearly 400 people came into the hospital in the week leading up to the attack.
We had extended to 140 beds. Bombardment from above by the US government is not something you are prepared for. This kind of attack was nowhere on the radar for us. We never, ever thought this could happen.
The hardest moment during my mission was the night when ten boys were brought in.
A mortar had landed outside their madrasa earlier in the evening.
Maybe it was on my 2nd or 3rd day. They were all children.
That upset us the most.
Protection of hospitals
International humanitarian law needs to be upheld. We repeatedly gave GPS coordinates of the hospital to all parties to the conflict.
Kunduz hospital should have been protected. Our patients should have been protected. My colleagues should have been protected.
A hospital is not a battlefield and there were no weapons inside our hospital.
We were able to provide healthcare in a safe place. That’s why people keep coming to us.
The bombing in Kunduz really challenges how safe it is to work in these contexts. We need to know that a fully functioning hospital is a protected space for our patients and for ourselves.
So if that has changed somehow, we need to know. That’s why we’re demanding an independent investigation.
We need clarification. If this does threaten a hospital’s protected status, then that has huge implications for humanitarian work throughout the world.
Commitment to healthcare
It’s a project I so believe in and I will miss it so very much.
I will miss the national staff I worked so closely with. They were a truly great team. They came up with some brilliant ideas. These are the most committed people I’ve ever seen.
Our hospital was the only trauma facility of its kind in North-Eastern Afghanistan and treated more than 20,000 people per year. Now there is no trauma surgical specialist hospital in this region.
Until MSF understands what happened on the night of the attack and has strong assurances that it cannot happen again, the Kunduz trauma centre cannot be reopened. Our staff and patients must be safe.
We need to understand what happened and why for the safety of our teams in Afghanistan, and in all conflicts.