Six-year-old Shaista, here shown with her father, was the only patient in the Intensive Care Unit to survive the bombing. PHOTO: Aurelie Baumel/MSF
On October 3, 2015, a hospital run by Medecins Sans Frontieres (Doctors without Borders, or MSF) in Kunduz, Afghanistan was struck repeatedly by US military aircraft; 42 lives were lost in the mistaken dawn assault. Dr. Evangeline Cua, a Filipino field surgeon with MSF, survived the horrifying ordeal. This is her story.
PART 3
The things that were constant in my nightmares were the roaring sound and the panels of wood crashing down on us. And screams. Mine. Then me tripping down, landing on the floor.
I can vividly remember the exact moment. My ears rang and the wind was knocked out of me after the explosion. My heart was slamming loudly in my chest. I was too stunned to move. Lying there stiffly, I became aware of a hand still holding me, tugging at me.
“Get up! Come on.”
I slowly stood wincing in pain, trying to see him in the dark. “Stop pulling me!” I shouted. A thick cable was on my chest, restricting my movement. My body hurt, like somebody had hit me with a lead pipe, yet I knew we had to get out of there. There’s just no time to waste. I clumsily tried to free myself from the tangle of wires and cables, wondering where the others went. A moment ago, while we were crouching near the wall waiting for the bombing to stop, a group of five kids and two women each holding an infant in their arms joined us. A hair-raising scream – a young voice – shattered the stillness and my train of thought. Then there was another scream, of anguish this time. Running steps followed. Then, as if nothing happened, it was quiet once again. Oh, God, I said with dread. It’s them. Somebody just got hit.
Successfully freeing myself, my colleague and I starting running out of the building. It was still dark outside. The outlying buildings were meters away and it was too dangerous to run in the open field and go there.
Where? Where? He seemed to be saying. He was looking at me, asking me which direction we should run in. Doing a quick assessment, I realized that running toward the gate of the hospital, toward the streets, would be an unwise choice. We had no idea what was going on beyond the gates. Then I saw the unmistakable slanting roof. The basement! Thank God.
“Left side. Going to the basement!,” I shouted. We ran and jumped into the hole. To our horror, and big disappointment, we found ourselves inside the exhaust of the basement window. Surrounded with thick cement walls, about seven feet below the ground, it was covered only by a thin sheet of roof above. An abyss. A dark space. Dead end. The basement proper was on the other side of the wall! Rattling the steel bar-covered window in panic, unable to remove it and without access to the basement, we were like two mice who ran into a trap. Resigned to our fate, I silently reminded myself that we had done everything. If this was where we were going to die, then so be it. Settling down beside him, I closed my eyes, hopeless, worn out, but feeling oddly safe and comfortable. Absent, dreamy. Must be hypoglycemia.
“It’s going to be all right. We will get out of here.” He was trying to reassure me but there was a hint of fear in his voice. I could hear his heart beating loudly. His breathing was fast. “Yeah, maybe,” I answered, trying to convince myself, too.
The wind was blowing in our direction, fanning the smoke to where we were. Coughing and tears streaming from our eyes, we struggled with great difficulty not to inhale the smoke. The sound of crackling wood and leaves were the only other indication that there was a fire nearby. Bombs continued dropping on the hospital. At one point, the ground shook so hard we thought it was the end for us.
“Pray with me,” I heard him saying with terror in his voice. “Allah…….”
I only heard the first word of what he said.
“What? Say it again. Slowly.”
Patiently, like a teacher, he guided me through the prayer.
La … La, I repeated.
Ilaha … ilaha
Illa … illa
Allah … allah.
“La ilaha illa allah””
I barely heard him from the cacophony of noise above us. In all honesty, I did not understand what I had just recited but I prayed it with all my heart, holding on to any hope I was being offered. Maybe Allah, in his goodness and mercy, would keep us safe. “I am not Muslim but I pray for your protection. Keep us safe.” I silently begged Him.
At the same time, I was thinking of my mom. What would she feel if I was returned home in an urn, just a mound of ash? Worst, if I would burn to death here and nobody would recognize my remains. Unidentified. Missing for eternity. I shuddered at the thought. I wanted to spare her from that agony. But how? How?
There was silence between us, occasionally interrupted by a burst of gunfire or a big explosion that seemed far away. I could see only his outline in the dark but I knew he was deep in thought too. I was drifting in and out of consciousness. Dog-tired and hungry, all I wanted was to sleep.
My mind wandered to the five days when the conflict started. We had non-stop surgeries; from morning to night, sometimes staying at the operating theater for 16 hours straight. My arms were red and raw from constant scrubbing and I would wince in pain whenever I prepared for surgery. “You’re losing weight,” one of the local surgeons told me. I did. I lost appetite from seeing all the wounded day in and day out. And sleep was a luxury. I tried sleeping in the dressing room whenever I could – on the narrow bench, even on the cold floor when I felt so exhausted and I didn’t want to walk back to where we usually slept. There was no stopping the flow of injured people seeking treatment at our hospital. There was just too much to do and I felt like we were not doing enough. But the anguish on the faces of parents with injured children was enough to keep me going. I was functioning like a robot on those days – emotions off, just concentrating on the task at hand and doing as much as I could to save lives. There was no time to get emotional even if I wanted to cry; always bad for the morale of the team.
Then my thoughts shifted to the day just before the bombing. It was quiet at the hospital the whole day. We were woken up — the other surgeons, the anaesthesist, and me — from deep slumber. “Morning meeting guys, it’s already 8 a.m.!” I woke up refreshed; eight hours of sleep, that was good! Things were going back to normal. We could now walk across the open field going to the hospital without fear of getting hit by a stray bullet. And the whiteboard outside the OR was the silent witness of how small the schedule of patients had become. I ended up going to the outpatient department to do rounds, something which we had missed doing for almost a week.
A hole carved by a missile strike, on the wall of the outpatient department of the Kunduz Trauma Center in Afghanistan. PHOTO Victor J. Blue
Life is good in Kunduz, again!
We scheduled a young man at the ICU for a definitive surgery. Two more of my patients at the ICU also needed repeat surgery after undergoing damage control. We wanted to finish all the cases scheduled on the board that night. We’ve been doing the first surgery for almost three hours and we were exchanging jokes and stories to break the monotony of the activity. It was already 2 a.m. when I glanced at the clock. I scrubbed out, asking the local surgeon to finish the operation while I wrote the operative technique. “Let’s eat after you finish. I have some food in my locker,” I said.
Then the bombing started. IDL
To be concluded
READ: Part 1 ‘I screamed in terror’ when US bombs fell on my hospital
READ: Part 2 ‘The city was once again back in the hands of the Taliban’
Factsheet: Kunduz Hospital Attack
Dr. Evangeline Cua is a surgeon from Iloilo, Philippines. She works for Doctors Without Borders (MSF) and was at the scene during the October 2015 Kunduz Trauma Hospital bombing. Dr. Cua is due to return to Afghanistan to work in a maternal health care project of the MSF.