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In two different wars, two different hospitals were destroyed in strikingly similar ways. In Afghanistan, a hospital in Kunduz was attacked from above, without warning, and in the middle of the night. When it was over, 42 doctors, nurses, and patients were dead.

In Syria, the Al Quds hospital was also hit by aircraft, in four separate strikes that began just before midnight. In spite of the frantic efforts of rescuers, 55 died, including one of the last pediatricians in the city.

Both hospitals were supported by the international medical charity Doctors Without Borders and provided badly needed help to civilians trapped in war zones. Both were well marked, and their locations were known to combatants on both sides. In both cases, there were accusations that the attack was a war crime.


The only tangible difference between these tragedies is who attacked. In Kunduz, it was the United States Air Force. In Aleppo, it was the Syrian government and possibly their Russian allies.

Comparisons like this make many of us uncomfortable. We say to ourselves, "Surely, we're the good guys, accidents happen. What matters is intent and how we respond."

When the bombs first fell on the hospital in Kunduz, Doctors Without Borders immediately alerted US military personnel, who responded by calling the attack off, eventually. President Obama promised a full investigation and later offered an apology. Seven months later, 16 service members were given administrative punishment as a result.

In contrast, the Syrian military responded by immediately denying responsibility and suggesting media reports were "an attempt to cover the crimes which terrorists are committing against civilians in Aleppo." Later, they said the hospital didn't even exist. And the Russian Defense Ministry rebuffed any suggestions the Russians were to blame, arguing the only aircraft over Aleppo that night were from the Western coalition.


It seems clear that US forces never intended to attack that hospital. General Joseph Votel, the head of US Central Command, issued a 3,000-page report which "found that the incident resulted from a combination of unintentional human errors, process errors, and equipment failures, and that none of the personnel knew they were striking a hospital." Only the most energetic conspiracy theorists would think the United States wanted to kill those doctors and their patients.

Determining Russian and Syrian intent is more difficult. Both countries denied involvement, but their histories of attacking civilian targets is difficult to ignore. Many observers, including the United Nations and Amnesty International, have repeatedly condemned the Syrian government for attacking noncombatants. The organization Physicians for Human Rights has tracked 326 separate attacks by Russian and Syrian forces on medical facilities, killing 688 personnel. (By contrast, coalition and antigovernment rebels and have hit 22 facilities, killing 11.)

So, intentions and responses appear to have been very different. For most of the American public, that is good enough. And, even though General Votel himself conceded that personnel did not "comply with the rules of engagement in the law of armed conflict," the US military does not see a war crime either. Understandably, American political leadership is happy to accept both verdicts and move on.

But that neglects to consider the court of global opinion. There the verdict was different. Doctors Without Borders said the US report "amounts to an admission of an uncontrolled military operation in a densely populated urban area, during which US forces failed to follow the basic laws of war." Many other voices were similarly critical.


When the United States is seen to be on the side of the angels, as it so obviously is in Syria, American diplomacy is given much more heft. In this regard, the Kunduz attack undermined the America's place in the world. And it was added to 15 years of other mistakes, of countless incidents of "collateral damage" that have incrementally washed away a lot of good will.

According to the Pew Research Center, among key allies like France, Australia, and the United Kingdom, more than a quarter of the population see the United States in an unfavorable light. In Germany, it is a stunning 45 percent. Increasingly, the world does not see the United States as the "indispensable nation."

Rebuilding that global trust, after Iraq and Afghanistan, will take time, and it will require a new attitude. We have grown too accustomed to reports of bombs missing their targets. Accidents like Kunduz should not be shrugged off. We need to be horrified. American forces killed doctors and patients. That sentence should shock us like it would have 50 years ago. And, once shocked, we need to respond with more than reports and regrets. Independent investigators should be appointed. People should be held accountable.

If we want the world to see America the way America sees itself, we must take incidents like Kunduz more seriously. Because the rest of the world does.


Scott Gilmore is a senior fellow at the Munk School of Global Affairs, the founder of the nonprofit Building Market, and a former diplomat.