When the Medicins Sans Frontieres (MSF) hospital in Kunduz, Afghanistan, came under fire by an AC-130 gunship at the beginning of October, there was a swift and sharp media reaction. Human rights activists, lead by UN high commissioner for human rights Zeid Ra’ad Al Hussein immediately accused the U.S. military of committing a war crime, and MSF has said they will consider it a war crime until proven otherwise. The media coverage of the strike amplified that charge for weeks afterward.
There remain many unanswered questions about the Kunduz strike, including how and when the U.S. forces involved in the strike actually learned about the hospital and how they reacted after learning. But in the meantime, it is interesting to compare how both MSF and the international community has responded to this strike, versus other strikes against MSF aid workers. It reveals a troubling double standard about American conduct that policymakers need to learn how to manage.
The closest analogy to the Kunduz strike happened just this week, when the Saudi air force destroyed an MSF hospital in Saada, Yemen. Unlike in Afghanistan, MSF has not called the strike a war crime and the UN has not led the charge to investigate the strike with an independent team (UPDATE: while MSF still does not refer to the strike as a war crime, after I wrote this the Yemen country director did so in a statement to Reuters; however, since many falsely believe the Saudis to be acting on behalf of American interests, the larger point here still applies I think). Saudi officials have admitted to Vice News that they targeted the hospital deliberately, and have accused MSF of not submitting sufficient notification of the hospital’s location to their military. And yet, MSF remains mute about the strike, criticizing it (no one wants to lose a hospital) but not using the same heightened language. And no one has called for a war crimes probe.
The two strikes are similar in a lot of ways: both involve humanitarian workers providing medical care in areas controlled by insurgents (at the time, Kunduz was occupied by the Taliban and Saada is a stronghold of the Houthi insurgency). In both cases, MSF had at some point registered the hospital’s location with the attacking forces, and the attacking forces both believed the hospital had either been overrun or used as a base for engaging in combat. Both strikes could, conceivably, be war crimes if investigations reveal the violated the Law of Armed Conflict governing medical facilities.
Other attacks on MSF workers reveal the same troubling tendency to only call incidents involving Americans a war crime. In August of this year, two MSF doctors in South Sudan were killed during a battle between government forces and rebels in the town of Leer. Despite photographic evidence that the hospital was the site of violence, including defamatory graffiti on its walls, MSF has not called the incident a war crime and it has not called for any party to the conflict to be investigated for war crimes (more than 30 aid workers have died in South Sudan).
The pattern repeats elsewhere: in 2014, in the Central Africa Republic three MSF workers were killed in the capital, Bangui. The attack by the mostly-Muslim Seleka rebels targeted the MSF clinic and killed more than a dozen other civilians. MSF did not call the attack a war crime, and UN did not issue a demand for a full investigation into the incident to see if any war crimes were committed. In 2008, a bomb blast at an MSF hospital in Kismayo, Somalia, killed four volunteers. Same pattern: no media campaign to call it a war crime, no UN demand for an independent investigation, no media campaign against the bombers.
So why is there unique, immediate, and aggressive public outcry when the U.S. is involved in a tragic incident like Kunduz? At least for MSF, the United States is held to a high standard the group simply does not reserve for other parties to conflicts, whether states or non-states. When the Taliban killed five MSF workers in Badghis province, Afghanistan in 2004, the group decided to blame the United States instead of the killers. In MSF’s view, when the U.S. military began providing medical services and humanitarian aid in Afghanistan, it put humanitarian workers in danger. Elsewhere, they chalk up even deliberate attacks against their facilities that kill their volunteers as the tragic and horrible consequence of random violence in a conflict zone. But for the U.S., their only explanation is a deliberate strike.
There is a reflexive, open anti-Americanism from the aid group. The group proudly says it treats everyone at their hospitals, regardless of affiliation: Taliban, Boko Haram, civilian. They find moral courage in treating even “bad” people because of their belief in the humanitarian principle of treating all people equally… unless the U.S. is involved. One soldier who deployed to Afghanistan in 2002 has told me that one MSF facility refused to treat an injured child because she was brought to the hospital by U.S. troops. Their laudable commitment to medical ethics and political neutrality in war seems to falter when Americans get involved.
But reflexive anti-Americanism probably does not tell the whole story: plenty of aid groups are deeply skeptical, even mistrustful, of the U.S. military without displaying MSF’s double standards. Globally, the U.S. is held to a higher standard than any other party to conflict, partly as a consequence of America’s unmatched military power, partly because of American global economic and cultural dominance, and partly because of a general sense of anti-imperialism that influences many internationalists.
This double standard creates a dilemma for policymakers. In war, mistakes happen, people get coordinates confused, and sometimes the wrong target gets struck and innocent people die. The U.S. military, however, is expected to operate with zero mistakes, or at least a zero tolerance for mistakes: collateral damage, targeting mix ups, and acting on flawed intelligence are simply not acceptable to a broad swath of the international community. It can put U.S. troops at greater risk when restrictive ROEs (and rhetoric aside American ROEs exceed the minimum standards required by international law) limit how they can respond to attacks — such as if some Taliban militants set up a firing position from a hospital and Americans cannot respond in kind.
The politics of America’s wars have not caught up to the political reality of American force around the world. Within Congress, and among candidates for President, there is a broad agreement that American military force can and should be used for good around the world — that American forces should directly intervene in conflicts from Libya to Syria to Afghanistan — but do not account for either domestic or international reactions to how they operate. You see the same push from policymakers and working-level analysts: a demand for force to address crises, but little desire to handle the political aftereffects.
In Afghanistan, the result has been a muddling defensive action as the Taliban advance across the country and American troops have fewer and fewer options available to them for defense or counterattack. In Iraq, it limits the U.S. to limited air strikes, which have had few consequences for the ISIS militants they target. A zero-risk approach to war, where troops are kept out of harm’s way but civilians are somehow protected, is not possible. What is possible, however, in a world where American troops are subjected to a double standard no one else is, remains unclear. Policymakers need to start addressing how to respond to this impossible standard in a proactive and deliberate way.