An armed group affiliated with the Islamic State (also known as ISIS) reportedly claimed responsibility for the day-long attack on the Sardar Mohammad Daud Khan hospital, the main treatment center for wounded Afghan soldiers. Following a suicide attack on the building, gun battles continued for several hours, and hospital staff trapped in the building reported that patients who could not escape remained in their beds. Some of the gunmen were dressed as doctors, according to reports. At least 30 people were killed and dozens wounded.

The International Committee of the Red Cross in Kabul denounced the attack as a “heinous crime” with “no justification possible.”

Attacks directly targeting health care in Afghanistan have increased sharply since 2014. A recent report by the organization Watchlist details some 240 attacks in 2015 and 2016 that killed or injured medical personnel and closed, damaged, or destroyed medical facilities, eroding the healthcare system in Afghanistan. The United Nations Assistance Mission in Afghanistan (UNAMA) documented 119 incidents where healthcare facilities were targeted in 2016. The Taliban and other insurgents were responsible for the vast majority of these incidents, though Afghan security forces have been responsible for raids on clinics, or have used medical facilities for military purposes.

International humanitarian law, or the laws of war, applicable to the armed conflict in Afghanistan protects patients, including wounded soldiers, and all medical personnel from attack. Hospitals and other medical facilities are also protected from attack unless they are being used for offensive military operations. Commanders and combatants who willfully violate these protections are responsible for war crimes. Fighters who may have dressed as doctors would be committing the war crime of perfidy – feigning civilian status to carry out an attack.

Those paying the price when warring parties reject the neutrality of medical facilities are not just the patients, doctors, nurses, and medical staff, but Afghan civilians, including alarming numbers of children, who are denied essential care when clinics and hospitals are forced to close.