Obama apologizes to Doctors Without Borders for Kunduz hospital airstrike

President Barack Obama apologized to Doctors Without Borders on Wednesday for the U.S. air attack that killed at least 22 people at a medical clinic in Afghanistan, and said the U.S. would examine military procedures to look for better ways to prevent such incidents.

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Obama's telephone call to the group's international president, Joanne Liu, came a day after the White House had stopped short of an apology, waiting to learn more while acknowledging that the attack was a U.S. mistake. White House spokesman Josh Earnest said Obama offered condolences to the staff and pledged a "transparent, thorough and objective accounting of the facts."

Liu confirmed the apology and, in a written statement, reiterated her organization's call for the U.S. government to consent to an independent investigation "to establish what happened in Kunduz, how it happened, and why it happened."

"When the United States makes a mistake, we own up to it, we apologize where appropriate, and we are honest about what transpired," Earnest said. He described Obama's apology as "heartfelt."

Emerging details about the erroneous strike have only fuelled growing condemnation by Doctors Without Borders and other aid groups in the four days since the clinic in the northern city of Kunduz came under heavy fire that killed a dozen staffers and 10 patients.

After initial confusion, officials determined the U.S. had carried out the strike, an admission that complicates delicate U.S. efforts in Afghanistan as Obama weighs how many troops to leave there.

Obama told Liu that the U.S. would review the attack to determine whether changes to U.S. military procedures could reduce the chances of a similar incident.

Obama also spoke with Afghan President Ashraf Ghani to convey condolences and praise Afghan forces for securing Kunduz, the White House said. Taliban fighters had seized control of Kunduz for three days last week.

Investigations by the U.S., NATO and the Afghan government are underway, but the medical aid group has called them insufficient and has appealed to the U.S., Afghanistan and other countries to mobilize a commission to look into the tragedy. Without addressing that demand, the White House offered assurances that the Pentagon would dutifully carry out its internal probe.

'Attack on the Geneva Conventions'

Doctors Without Borders, known by its French language acronym MSF, has also said the strike may have been a war crime and has described it as an attack on the Geneva Conventions governing humanitarian treatment during war. The White House urged patience while the Pentagon works to establish what transpired.

Asked whether the apology signified U.S. culpability for loss of life, Earnest said individuals would be held accountable if necessary.

U.S. officials have declined to discuss most circumstances of the blunder, and it's unclear whether the strike exceeded the rules applying to American forces operating in Afghanistan.

But the top U.S. commander in Afghanistan, Gen. John F. Campbell, has said Afghan forces fighting to retake Kunduz from the Taliban had requested U.S. air power, and that a U.S. special operations unit in the "close vicinity" was communicating with the crew of the heavily armed AC-130 gunship that pummeled the hospital.

MSF wants to mobilize the International Humanitarian Fact-Finding Commission, based in the Swiss capital, Bern. It is made up of diplomats, legal experts, doctors and some former military officials from nine European countries, including Britain and Russia. Created after the Gulf War in 1991, the commission has never deployed a fact-finding mission.

Liu said MSF is "working on the assumption of a possible war crime," but said its real goal is to establish facts about the incident and the chain of command, and clear up the rules of operation for all humanitarian organizations in conflict zones.

The strike "was not just an attack on our hospital, it was an attack on the Geneva Conventions. This cannot be tolerated," she told reporters Wednesday.

The U.S. airstrikes have all but shattered the humanitarian aid response in Kunduz, causing MSF — whose hospital was the primary medical facility in the region — and other aid groups to suspend operations there.

Zafar Hashemi, deputy spokesman for the Afghan president, said his government was committed to a full, transparent investigation and "will fully co-operate with the investigation through appropriate channels agreed upon by our partners" in the NATO Resolute Support mission.

In Brussels, U.S. Ambassador to NATO Douglas Lute said the United States was open to working closely with MSF, but added: "I'm not sure where we'll go in terms of any further investigations."

U.S. officials in Washington have previously said they do not believe an international investigation is needed.