KABUL — Gunmen disguised as doctors and medics drove an ambulance into Kabul's main military hospital Wednesday morning, then opened fire on patients and staff members and battled Afghan security forces for hours. At least 30 people, most of them civilians, were killed and twice as many wounded, officials said.
“This attack marks an abhorrent new low. Dressing in disguise to shoot at the sick and wounded is a cowardly, wicked act,” Hamdullah Mohib, the Afghan ambassador in Washington, said in a statement. “These are forces of evil the world must work together to defeat.”
It also highlighted the threat of terrorist violence that continues to plague even the most secure areas of the Afghan capital, as well as other regions, after 16 years of conflict with Taliban insurgents and other armed groups that has cost tens of thousands of lives and involved more than 100,000 American troops at its peak.
Currently 8,400 U.S. troops are in the country, and U.S. military officials have said more are needed to prevent further insurgent gains and to keep the Western-backed government afloat.
As the Trump administration weighs its policy options here, experts have warned that 2017 is likely to be as grueling and deadly as 2016, which had a record number of civilian casualties and left Taliban forces in control of more than one-third of the country. The increasing threat from the Islamic State, known here as Daesh, is especially worrisome.
“We are on the front lines of a fight that can affect the world, and we can’t let Afghanistan become a global terrorist center,” Siddiq Siddiqi, the chief spokesman for Afghanistan’s Interior Ministry, said this week. “We have made a lot of sacrifices, but we need more help, especially in counterterrorism.”
The assault Wednesday began when a vehicle bomb detonated outside the front gates of the Sardar Daud Khan medical complex, a large and heavily guarded compound that is near the U.S. and European embassies, the headquarters of the U.S.-led military coalition, and Afghan government buildings in central Kabul.
Almost immediately afterward, witnesses and officials said, gunmen already inside the hospital, wearing white medical coats, pulled out concealed assault rifles and began shooting. At least four attackers were involved, some of whom took cover on the second floor. Grenade explosions were also heard inside the compound.
“Suddenly gunfire broke out and a gunman was shooting at everyone, he was shooting at doctors, patients and visitors,” a witness identified as Zahir Khan told news agencies. He said he had hidden under a table in the hospital and later escaped. Some patients and staff members were seen climbing out hospital windows and crouching on ledges.
The attackers fought off Afghan guards, police and special forces for hours before all of the assailants were finally killed, officials said. Sporadic gunfire was heard well into the afternoon. Military helicopters were seen landing on the hospital roof, and commandos scrambled out to join the fight.
"I saw a man in a white shirt with a gun in his hand, firing," a military doctor who gave her name as Zainab said in a brief online conversation Wednesday night. She said she and her colleagues took refuge in the hospital basement for four hours before the siege ended. "Everybody was so frightened," she said. "I don't want to go back there."
A security official said late Wednesday that the gunmen sneaked inside by using an ambulance to pretend to bring patients for treatment. The hospital treats sick and wounded Afghan military personnel and their families. Officials said that doctors and patients were among the casualties and that more than 66 wounded victims were taken to two civilian hospitals.
The incident followed a pair of similar attacks March 1 on a police station and an intelligence police facility in the Afghan capital, which left 23 people dead. Those attacks were claimed by the Taliban, which denied any role in the new assault.
The the Islamic State asserted responsibility through its online Amaq News Agency. Regional militias pledging allegiance to the Islamic State, based near the border with Pakistan, have said they were responsible for numerous bombings in Kabul in the past year, including one that killed 80 people during a peaceful protest, another that killed 22 people outside the Supreme Court, and several at Shiite mosques.
The capital was clogged and chaotic Wednesday morning, and many streets were already closed because of a large ceremony marking the third anniversary of the death of Marshal Mohammed Fahim, a former Afghan army chief and anti-Soviet militia leader.
Many government officials and Afghan leaders attended the all-day ceremony across the city, accompanied by large numbers of government and private armed guards, leaving the area near the military hospital quiet and deserted just before the blast.
President Ashraf Ghani, who was speaking at a ceremony honoring International Women’s Day when he learned of the assault, condemned it as “an attack against the entire people of Afghanistan. A hospital is considered immune in any law, any religion and sect,” he said.
The attack came just days after Ghani replaced Kabul’s longtime police chief for not curbing terrorist actions as well as rising criminal activity in the capital.
The government's chief executive, Abdullah Abdullah, addressing the ceremony for Fahim, called the attack a "crime against humanity," adding: "The only solution is to keep unity. Our enemies are only able to carry out their goals when there is political discord." Disputes between Abdullah and Ghani have left the government divided and weakened.
A statement from the U.N. assistance mission called the attack “egregious and morally reprehensible” and said it may “amount to a war crime” because it targeted people “at their most vulnerable” and those caring for them. “Without question, it amounts to an atrocity, and the perpetrators must be held accountable,” the statement said.