‘Unlawful attack’: HRW slams Pakistan over deadly Kabul airstrike

International agencies reported that at least 143 people were killed and more than 250 injured, most of them patients.

"Pakistani authorities should promptly and impartially investigate the incident and hold all those responsible for wrongdoing to account," HRW said in a statement.

The Pakistan air force attack struck the Omid Drug Rehabilitation Center, a 2,000-bed treatment complex in eastern Kabul that has operated since 2016 on the premises of a former NATO base known as Camp Phoenix.

A center employee told Human Rights Watch that three buildings were hit: a large building used as a dining area, a building that accommodates 450 patients, and a guard room where eight men were working.

On March 17, Pakistan’s federal minister of information and broadcasting, Attaullah Tarar, posted on X that Pakistan had carried out “precision airstrikes” on “technical support infrastructure and ammunition storage facilities,” but did not mention the Omid facility.

“The available evidence indicates that the Pakistani airstrike against a well-known Kabul medical facility killing dozens of patients was unlawful,” said Patricia Gossman, senior associate Asia director at Human Rights Watch. “Pakistani authorities need to carry out an impartial investigation to determine why it hit a drug treatment center filled with civilians and who should be held to account.”

The center employee said that over 1,000 patients were at the facility at the time of the attack, but the actual number is uncertain. An official with an international agency said that many patients were in the dining area to break the Ramadan fast. The United Nations describedthe “complete destruction of one block that housed adolescents receiving drug treatment.”

Afghanistan’s poor health infrastructure and lack of DNA testing capacity have hampered identification of the dead. An Afghan forensic doctor at the Public Health Ministry said that medical personnel could not identify some bodies. The father of one victim said: “We searched all hospitals in Kabul…[but] we couldn’t find him. Then we went to forensic medicine, and his body was there. … They showed us many bodies before we could identify him.”

Afghan officials have read out their names to families searching for their relatives. Omid center patients also included detainees and prisoners from Pul-e Charkhi prison, 16 kilometers east, and people picked up during anti-drug sweeps in Kabul. Former employees and aid officials said that the missing may include prisoners and other patients who escaped in the chaos.

Satellite imagery from March 23, analyzed by Human Rights Watch, shows widespread destruction across the Omid center. The largest building in the compound and two smaller buildings are destroyed. Other buildings around the main building sustained heavy damage, as well as a group of buildings in a corner of the compound that appear completely burned.

Human Rights Watch verified a video that the Pakistan information minister posted on social media on March 17 showing a missile hitting the largest building in the compound, closely followed by explosions at two other buildings.

Humanitarian agency officials told researchers that the large building was used as a dining area and for accommodation, which Human Rights Watch corroborated by matching earlier photographs and video of the building’s interior.

"A 2023 Al Jazeera documentary about the Omid center shows dozens of patients gathering in the courtyard outside the building. Humanitarian agency officials said the other two buildings were living facilities and a guard room that a center employee said was used to store food and cooking oil," HRW said.

Human Rights Watch verified three videos posted on social media showing the immediate aftermath of the attack and photographs from search-and-rescue operations showing destruction across the camp.

Videos show the group of buildings in the center’s corner engulfed in flames. In a verified video, a sign on a burning building reads “Directorate of 2000-bed Support and Treatment Center (2000), Omid.” A photograph of the same building’s destroyed interior posted online on March 17 shows charred remains of a bunk bed.

The former NATO complex also houses the 1,000-bed Ibn Sina Addiction Treatment Hospital, run by the Public Health Ministry. The two medical facilities occupied only part of the former military base, and the purpose of other structures in the complex is unclear.

However, in the videos reviewed, Human Rights Watch saw no indication of secondary detonations caused by bulk explosives, propellants, or ammunition with tracer elements typically associated with ammunition depots. In addition, the facility had insufficient space to safely segregate and store bulk ammunition or propellants given the quantity and distance needed.

International humanitarian law applicable to the armed conflict between Pakistan and Afghanistan obligates all warring parties to take “constant care” to protect civilians during military operations. This includes taking all feasible precautions to avoid locating military objectives near densely populated areas and doing everything feasible to ensure that targets of attack are lawful military objectives.

Hospitals and clinics have special protections under the laws of war. While other presumptively civilian structures become military objectives when being used for a military purpose, medical facilities lose their protection from attack only if being used to commit “acts harmful to the enemy.” Even then, a warning with a reasonable time limit is required. The laws of war also prohibit attacks on military objectives if the anticipated harm to civilians is disproportionate compared to the expected military gain.

On the basis of available information, Human Rights Watch found no evidence that the Omid center was being used for military purposes, making the attack unlawfully indiscriminate. In any case, the attack would appear to violate the prohibition against disproportionate attacks. Serious violations of the laws of war committed with criminal intent—that is, deliberately or recklessly—are war crimes. Pakistan has an obligation under international law to investigate alleged war crimes by its forces and bring those responsible for serious abuses to account.

The Pakistani government in recent years has accused Taliban authorities in Afghanistan of harboring and providing material support to the Tehrik-i-Taliban Pakistan.

The Islamist armed group’s attacks in Pakistan killed over 600 Pakistani security force personnel and over 500 civilians in 2024 and prompted a surge in cross-border attacks between Afghan and Pakistani forces.

In February, the UN documented at least 76 civilian deaths and 213 injuries from Pakistani airstrikes across Afghanistan. On March 13, Pakistan’s president said that Afghanistan “had crossed a red line” after a spate of drone attacks on Pakistani cities injured civilians.

“Concerned countries should press Pakistan to provide genuine accountability and ensure that failures in intelligence, target verification, and decision-making are identified and fixed so such strikes never happen again,” Gossman said.