AMY GOODMAN: Doctors Without Borders continues to demand an independent war crimes probe of the U.S. bombing of its hospital in Kunduz, Afghanistan, after releasing its own preliminary investigation. The U.S. airstrike on October 3rd killed at least 30 people, including 13 medical staff, 10 patients and seven unrecognizable victims yet to be identified. In a new report, Doctors Without Borders describes patients burning in their beds, medical staff who were decapitated and lost limbs, and staff members shot from the air while they fled the burning building. The report describes doctors and other medical staff being shot while running to reach safety in a different part of the compound. Doctors Without Borders says it provided the GPS coordinates to U.S. and Afghan officials weeks before and that the strikes continued for half an hour after U.S. and Afghan authorities were told the hospital was being bombed. The group’s president, Meinie Nicolai, described the attack.

MEINIE NICOLAI: So there have been several rounds of very targeted and very precise bombing of that hospital. The hospital went in flames. Patients that couldn’t move burned in their beds. The shrapnel bombs that they used amputated the legs of doctors and nurses, and even one of our staff was decapitated. And on top of that, what we’ve heard from our staff is that from the plane, people who were fleeing the building were shot at.

AMY GOODMAN: U.S. officials have said they bombed the hospital in part because they thought it was under Taliban control. Doctors Without Borders General Director Christopher Stokes rejected that claim, saying there were no armed combatants on hospital grounds. Wounded combatants from both sides of the Afghan conflict were being treated inside.

CHRISTOPHER STOKES: Let me be clear: We were absolutely treating wounded combatants, and we were treating wounded combatants that were both government and opposition. And a patient is a patient. We don’t choose our patients. If they’re presented to hospital, they’ll be treated. And treating wounded combatants is not a crime. Being a doctor in a war zone cannot be punishable by airstrike.

AMY GOODMAN: For more on Doctors Without Borders’ internal report and its demand for an independent probe, we’re joined by Jason Cone, executive director of Doctors Without Borders here in the United States.

Welcome to Democracy Now! Our condolences on this catastrophe that has taken place at your hospital in Kunduz, Afghanistan. Can you tell us about this report and what you found?

JASON CONE: Yes, so this report is really based on about 60 interviews with our staff who were in the hospital at the time of the attack. We wanted to convey as transparently as possible everything we knew about what happened inside the hospital in the days leading up to the attack, during it and the immediate hours afterwards. And so, that’s what this report really covers, covers our communication with the various armed groups, including the U.S. government, and the days before the attack. And I think as the report illustrates, we did everything that we possibly thought we could to make clear that this was a civilian hospital treating wounded from all sides, which is the main focus of any medical facility in a war zone. And that’s what we do around the world. And we really wanted to share what we knew at this point, a little over 30 days after the bombing. And we shared this document with the U.S. government, with NATO and Afghan officials a day before the public release. It’s part of our efforts to cooperate with the investigation, but we still remain feeling that there needs to be an independent and impartial investigation conducted into the bombing.

AMY GOODMAN: So tell us what you understand took place on October 3rd.

JASON CONE: Well, our review essentially confirms what we said even in the first few days after the attack, which was—which is that the hospital always was under our control, that we were treating people from all sides of the conflict, that at no time—in fact, that night was very—the night of the attack and those early hours in the morning of Saturday, October 3rd, was really the first calm day that we had experienced that week. We had treated about 376 wounded during the week. That Friday night, in fact, the medical team had planned surgeries they had not been able to do and were in the midst of actually putting people under anesthesia when the attack unfolded. And so, in spite of the unnamed sources that have said otherwise, the hospital, from our perspective, remained in our control, and it was still in the same location, obviously, that the GPS coordiates we had shared days before at the same time.

AMY GOODMAN: So, explain what you understand happened in this attack.

JASON CONE: Well, what we know is that around between 2:00 a.m. and 2:10 a.m. on Saturday, October 3rd, our hospital, while patients were being treated, was struck from the air. It continued to be hit from the air—from what we know, it was an AC-130 gunship—repeatedly. When our staff tried to flee the hospital, they were also, from what our witnesses can tell, were shot with machine gun fire, we believe from the plane.

AMY GOODMAN: From the U.S. military plane.

JASON CONE: That’s what we understand. That’s the only sort of information that we have. We only really know what happened inside the hospital. And we know the people we lost, the incredible injuries, as your report sort of outlines, the fact that we had patients killed in our intensive care unit, which was the first part of the hospital that was struck from the—during the bombing. You know, it’s the worst attack that we’ve experienced in a single incident, clearly.

This hospital was a place that had been open for four years. In fact, that night even, it was the—probably the most well-lit structure in the entire city of Kunduz, which has about 300,000 people in it, because we were running generators that night. And so it was well lit, easily visible from the sky. And it was one of the most well-known facilities in the area.

AMY GOODMAN: So, you believe that people were running out of the hospital, and they were shot by—with automatic weapons from the plane as they were fleeing?

JASON CONE: Yeah. Some of—

AMY GOODMAN: And then—go ahead.

JASON CONE: Yeah, that’s correct. Yeah, some of our staff were shot. Others were killed by shrapnel from the blasts, from the shelling that came from the plane.

AMY GOODMAN: And there were others killed as they were seeking safety in another part of the compound?

JASON CONE: That’s correct, yes. And we had two of our unarmed guards who were also killed, unfortunately, by shrapnel in the post that they were manning at the time.

AMY GOODMAN: And so, the casualty list, as you understand it now, can you talk about the number of doctors, nurses, patients, children who were killed?

JASON CONE: Well, we know that at least 13 of our staff were killed. There’s an additional 10 patients that we’ve definitely confirmed. As you mentioned, there are seven unidentified, as yet, bodies. There may be more. These weapons do incredible damage, so there are still remains that we are trying to identify through DNA analysis. That may take some additional time. We’re not sure how long it will take.

So, I mean, this report is really to share what we know up until this point. It’s really based on a comprehensive review of all the information we could have from those debriefings of our staff, as well as some of the patients that we were able to talk to. And it’s—for us, it’s a comprehensive timeline from what happened inside the hospital in the five days before and during and after the attack.

What remains to be seen is what the U.S. government and others will report happened and led to essentially them deciding to target which was a well-functioning, well-known hospital, full of patients and staff—up to 200 patients and staff at the time of our attack. And our main question is: How is it that so clearly a civilian structure like that could lose, at least potentially in the eyes of combatants, its status as a protected facility?

AMY GOODMAN: At a press briefing on Thursday, White House spokesperson Josh Earnest was asked about the latest regarding the investigation into the bombing of the Médecins Sans Frontières, the Doctors Without Borders, hospital in Kunduz.

PRESS SECRETARY JOSH EARNEST: I don’t have an update at this point on the timing of when that investigation will be completed, but the commander-in-chief has indicated that he expects a full accounting of what exactly occurred, and he’s got a high degree of confidence that that’s what he’ll receive. The other thing that the Department of Defense has made clear about this investigation is that it will consider a series of potential human errors, failures of process and technical malfunctions that may have contributed to the mistaken strike. And I think that’s an indication from the Department of Defense that they take very seriously their responsibility to conduct this thorough investigation. And so, while we certainly are eager to understand all of the facts, I also don’t want to be in a position of rushing the investigators who are taking their jobs very seriously.

AMY GOODMAN: That’s White House spokesperson Josh Earnest. Are you satisfied with the U.S. response, Jason Cone?

JASON CONE: Well, they’re supposed to conduct this investigation. This is standard protocol any time civilians are killed in a war zone like Afghanistan. So, they’re doing everything we would expect them to do. And I think what we’d like is for an independent and impartial group—in this case, we called for the International Humanitarian Fact-Finding Commission to do this work—to conduct an investigation. We want to look at this through the lens of international humanitarian law. As a humanitarian organization, we work in places like Afghanistan and Syria and Yemen and other places with the understanding that the facilities that we run should be protected places, as long as we hold up our end of the bargain, which is treating everyone who comes and making sure that weapons are left at the door of our hospitals. And that’s what we do consistently—it’s what we did in Kunduz—and what we expect. And we asked—that’s why we’re looking for the U.S. government to essentially accept another investigation into this and to be recognized that the laws of war are important, they should be respected, and no one is above them.

AMY GOODMAN: And who are you demanding should investigate?

JASON CONE: So what we’ve asked, originally, several days after the bombing, was this International Humanitarian Fact-Finding Commission. It’s based in Bern, Switzerland. It was created out of additional protocols to the Geneva Conventions. It’s existed for about 24 years. Unfortunately, it has not—has not been used yet. Its main role is to—and it’s been empowered under the Geneva Conventions—to look at breaches of international humanitarian law. That’s why we went to this body. We felt that it was the most appropriate at the time. We’ve asked all 76 countries that are signatories to that convention to sponsor our—to sponsor our call for this investigation. We’ve also had about nearly half a million people who have signed petitions supporting that same call around the world. So, we feel like there’s a strong reason for this commission to be allowed to do its work. Now it really rests on the consent of the U.S. and the Afghan officials to allow that to happen.

AMY GOODMAN: Jason Cone, do you believe the U.S. military attack on the—your hospital, the MSF hospital in Kunduz, is a war crime?

JASON CONE: It’s going to be a war crime if it—you know, knowing that our hospital was a civilian structure. It should have never lost that status. We were always communicating its location. It’s a responsibility of the warring parties to be able to distinguish between civilian and military targets. From our perspective, they failed to do so. We were given no warning before the attack—that’s also a precondition. This isn’t about intent. There’s been a lot of discussion about whether or not this was a mistake. This is not necessarily the threshold that has to be crossed for this to constitute a grave breach of international humanitarian law. If the military fails to distinguish between military and civilian targets, as is in this case, from our standpoint, from everything we know, then they’re guilty of breaching IHL, humanitarian law. And that’s something that needs to be looked at and needs to be questioned by an international independent commission.

AMY GOODMAN: Who did your group, Doctors Without Borders, give the GPS coordinates to? And how often did they give those coordinates?

JASON CONE: We’ve frequently shared them. And keep in mind, this hospital has not moved its position in four years. As a precondition of opening the hospital, we negotiated with both the U.S., Afghan, NATO, as well as opposition forces, with the Taliban. We received the support of all of those groups to operate this hospital. And part of that was sharing our GPS coordinates with the various parties. We shared them as recently as September 29th. That was to reinforce the fact that we knew that things were happening. There were additional bombings that were starting to take place, and we were told that that was the best way to ensure the protection of our facility. We reaffirmed to U.S. officials both in Washington and in Kabul that we were continuing to operate, that we were continuing—we did not—we had nothing to hide. We were treating people on all sides, including women and children, not just combatants. And that’s what we’re supposed to do. We kept up our end of the bargain, and we were very transparent about what we were doing there in Kunduz.

AMY GOODMAN: The Afghan government’s responsibility here, you feel?

JASON CONE: Of course. They’re—this is their country. They have to be responsible, as well. And we’ve had a dialogue with them. When we released—when we shared the report beforehand, we shared it also with the Afghan government. We had—my colleague, Christopher Stokes, he had meetings with the Afghan president, as well as other officials, explaining what’s the content of the report. We shared it openly with them. We expect that they would hope to continue to do that with us, as well. Their key will—we hope to be in Afghanistan for a long time. We still operate a number of hospitals in other very contentious parts of the country. And how they react to this report and how they share their own findings is really key to us to be able to stay in the country.

AMY GOODMAN: Do you feel that this hospital was deliberately targeted by the U.S. government?

JASON CONE: We’re having a hard time believing in this point that it was—that it was just a mistake. It’s very difficult for us, but we want to be confronted with facts that would tell us otherwise. We’ve done—we’ve shared everything we can to know up to the point of when the bombs started to fall.

AMY GOODMAN: What do you think could be their reason?

JASON CONE: Honestly, we have no idea. I mean, it’s very difficult to anticipate how they could justify bombing a structure that had 200 people inside of it, many patients. Two of the children who burned to death were in our ICU. They were being treated. It’s just an egregious attack. We want answers. We’re still asking for them. We’re still hoping that the Obama administration will allow an independent probe, because we think it’s key to the credibility of the U.S. government in these matters.

AMY GOODMAN: Have you spoken to President Obama?

JASON CONE: President Obama did apologize directly to our international president, Dr. Joanne Liu. Other than that, we have had very little dialogue or response to our official letters. The day before we called for this commission, we sent a letter informing the U.S. government we were going to do so. We haven’t had an official response. All we continue to hear are statements like you showed from the press secretary. We had a meeting with General Campbell, who’s in charge of the U.S. forces in Afghanistan. My colleague Christopher met with him the day before the report, our initial review, was released, and we had dialogue. And we’re waiting to see what happens in terms of what’s shared with us.

AMY GOODMAN: Three weeks after the U.S. bombed the Doctors Without Borders hospital in Afghanistan, another one of the group’s hospitals was attacked October 26, this time in Yemen by the U.S.-backed, Saudi-led coalition. Doctors Without Borders, Médecins Sans Frontières, MSF, said hospital staff and two patients managed to escape as the hospital was hit multiple times over a two-hour period Monday night. The hospital’s roof was marked with the Doctors Without Borders logo, and the GPS coordinates had been shared multiple times with the Saudi-led coalition, most recently just two weeks ago. Doctors Without Borders’ Meguerditch Terzian described the damage.

DR. MEGUERDITCH TERZIAN: Since the beginning of the last conflict, only coalition forces’ planes are capable to organize strikes, military strikes, in the country. The other belligerents, they don’t have planes circulating in Yemen. So we have no doubt that the coalition forces bombed Heedan district, and they bombed, as well, our hospital.

AMY GOODMAN: So, this is three weeks later, another country, Yemen. Talk about what happened to this hospital and where in Yemen it happened.

JASON CONE: Well, it happened in Heedan, which is in Saada area. It’s like many hospitals. We’ve treated about 15,000 wounded in Yemen since the start of fighting, heavy fighting, back in March. Some of the difference between what happened in Kunduz and what happened in Heedan is the fact that really there’s been no limits on the war in Yemen. Schools have been bombed, gas stations. You know, everything has really been within the remit of the coalition bombing. Some of that has essentially been rubber-stamped because of a U.N. security resolution that was passed a number of months ago, which really gave sort of carte blanche for the coalition to do as they will. There’s the problem of the bombing, but there’s also the blockade that’s happening, which is preventing enough goods from getting into the country. The country is very dependent on imports for everything from food, even just the gas to pump the—run the wells that are needed to get the water. So, what happened, obviously, it’s a very different situation in the sense of—in the sense that the loss of life, obviously, there was—we didn’t have the same level of casualties like we had in Afghanistan. This was certainly in an area where really nothing is off-limits in terms of from an aerial bombing campaign.

That said, it certainly is a breach of humanitarian law, and we have been in direct dialogue with the Saudi officials in regards to that. They’ve unfortunately changed their story several times, as we saw, actually, in the case of Kunduz the very first few days after the bombing. For us, this is about just reinforcing the fact that there are the Geneva Conventions that govern the laws of war. We are not naive. We know the risks of working in war zones. We’ve been working in them for 40-plus years. That said, we need to understand that governments still respect these rules, because it’s the rules that allow us to send people into these war zones and treat the victims of them.

AMY GOODMAN: Jason Cone, back on Afghanistan, the longest war in U.S. history, MSF prides itself on not just talking about medical needs in a nation, but also political issues. Do you think this war should continue?

JASON CONE: That’s not for us to decide. That’s really for the parties to figure out and answer that. We’re not a peacemaking organization. We’re here to treat the victims. We’re doing that in a number of countries, in a number of parts of the countries, as are many other humanitarian groups. We know the needs are quite huge. Not that long ago, even before this incident, we had issued a report showing the real lack of access to healthcare, particularly for people who are far away from some of the main provincial capitals, the difficulties that people in day-to-day find to get basic access to healthcare. One of the hospitals we run in Khost is a maternal health program. We deliver dozens of children every day in that hospital. There’s an incredible need for emergency obstetrical care, incredible need for pediatric care. We see just a vast amount of needs in Afghanistan for women and children across the country.

AMY GOODMAN: Well, I want to thank you for being with us. Of course, we’ll continue to follow this story and the investigations—

JASON CONE: Thank you, Amy.

AMY GOODMAN: —that are expected to take place. Jason Cone is executive director for Doctors Without Borders USA.

This is Democracy Now! When we come back, Keystone is dead. President Obama has announced that the U.S. has rejected the Keystone XL pipeline. We’ll speak with one of the environmental leaders in Nebraska, and across the border, we’ll go to Ottawa to speak with a First Nations environmental activist, Clayton Thomas-Muller. Stay with us.