Kabul – Médecins Sans Frontières (MSF) has announced our decision to end activities and withdraw from Dasht-e-Barchi in Kabul, Afghanistan, following the brutal attack on our maternity wing on 12 May, in which 16 mothers were systematically shot dead. An MSF midwife, two children aged 7 and 8, and six other people present at the time of the attack were also killed.

The decision comes with the understanding that while no information has emerged about the perpetrators or motive of the assault, mothers, babies and health staff were the deliberate targets of the attack, and that similar attacks may occur in the future.

A month after the horrifying event, we know very little; the attack remains unclaimed. Afghan authorities blamed the Taliban – or Islamic Emirate of Afghanistan – who refuted and condemned the accusation, while representatives of foreign governments publicly pointed their finger at radical groups as perpetrators, namely Islamic State Khorasan province.

While we don’t know who was responsible, we know enough to realise that the maternity wing was targeted by an act of unconscionable violence aimed at its patients, health workers and humanitarian activity. This attack cannot be left behind as a tragic, isolated incident: the Hazara people living in the area have been subject to a series of attacks, as have various aid organisations.

“We were aware that our presence in Dasht-e-Barchi carried risks, but we just couldn't believe that someone would take advantage of the absolute vulnerability of women about to give birth to murder them and their babies,” says Thierry Allafort-Duverger, MSF General Director. “But it did happen.”

“Today, we have to accept reality: higher walls and thicker security doors won’t prevent such horrific assaults from happening again,” says Allafort-Duverger. “To remain would mean to factor in such loss of human lives as a parameter of our activity, and this is unthinkable.”

The decision has been communicated to our staff, the national health authorities and other partners. Our concern is to continue to provide the necessary support to our staff, including psychological assistance. MSF is also looking into ways to provide appropriate support to the families of the patients killed in the maternity wing. While the security conditions have forced our withdrawal from Dasht-e-Barchi, we are looking into ways to support local initiatives aimed at improving access to healthcare.

The end of MSF’s activities in the maternity wing of Dasht-e-Barchi hospital is a necessary but painful decision, fraught with consequences for more than one million people who live in the area. Most of them are from the Hazara community, a historically marginalised and poor population, many of whom were displaced by decades of conflict.

With almost 16,000 deliveries in 2019, the Dasht-e-Barchi maternity wing was one of MSF’s biggest such projects worldwide. By pushing us to close our activity in the hospital, the assailants have also left women and babies without access to essential medical care, in a country where maternal and neo-natal mortality remain high.

More than 70 MSF staff and patients in MSF healthcare programmes have been killed in Afghanistan over the past 16 years. Such tragic instances include the murder of five employees in Badghis province in 2004, and the destruction of our hospital in Kunduz by the US air force in October 2015, when 42 people died.