Afghanistan: 9 MSF staff killed, 37 people injured (19 were staff) in hospital US airstrike in Kunduz – Published 03 Oct 2015 1000z (GMT/UTC)

UPDATED 03 Oct 2015 10:55 GMT

Air strike kills MSF medical staff in Afghanistan

Nine Doctors Without Borders staff killed in bombing of hospital in Kunduz, as NATO admits it may have been involved.

Surviving MSF staff were in shock after the clinic in Kunduz sustained heavy damage in the bombardment [MSF/Al Jazeera]

Surviving MSF staff were in shock after the clinic in Kunduz sustained heavy damage in the bombardment [MSF/Al Jazeera]

Doctors Without Borders (MSF) says at least nine of its staff have been killed in an overnight bombing of a hospital in the embattled Afghan city of Kunduz.

Another 37 people were wounded in the attack, including 19 MSF staff, the medical charity organisation told Al Jazeera.

NATO said on Friday that a US air strike “may have” hit the hospital, which is run by the medical charity, adding that the attack may have resulted in collateral damage.

An MSF spokesperson told Al Jazeera that the death toll is likely to rise, as the “fluid situation at the clinic hampered information gathering.

“The bombing struck the dormitories of the hospital, which explains why we – so far – have only seen deaths among our staff and not among patients,” MSF spokesperson Dalila Mahdawi said.

The MSF hospital is seen as a key medical lifeline in the region, which has been running “beyond capacity” in recent days of fighting which saw the Taliban seize control of the provincial capital for several days.

“At 2:10 am (20:40 GMT) local time … the MSF trauma centre in Kunduz was hit several times during sustained bombing and was very badly damaged,” MSF said in a statement on Friday.

At the time of the bombing, 105 patients and their caretakers and more than 80 MSF international and national staff were present in the hospital, the charity said.

NATO investigation

NATO said in a statement that US forces conducted an air strike in Kunduz at 2:15am local time “against individuals threatening the force”.

“The strike may have resulted in collateral damage to a nearby medical facility. This incident is under investigation,” the statement said.

MSF said it gave the coordinates of the hospital to Afghan and US forces several times to avoid being caught in crossfire.

“As MSF does in all conflict contexts, these precise locations were communicated to all parties on multiple occasions over the past months, including most recently on 29 September,” according to MSF Afghanistan representatives.

The bombing reportedly continued for more than 30 minutes after US and Afghan military offices in Kabul and Washington were first informed.


Residents tell of suffering as battle for Kunduz rages


“MSF urgently seeks clarity on exactly what took place and how this terrible event could have happened,” MSF said.

The MSF trauma centre in Kunduz is the only medical facility in the region that can deal with major injuries.

Following the attack, the medical charity urged all parties involved in the violence to respect the safety of health facilities, patients and staff.

Speaking to Al Jazeera after the attack, Taliban spokesperson Zabiullah Mujahid said that no Taliban fighters were present in the hospital at the time of the air strike.

“We condemn the bombing on the hospital. It was an attack carried out on innocent people.” Zabiullah told Al Jazeera.

“Our mujahedeen (fighters) were not treated at the MSF trauma center due to prevailing military conditions. Such attacks by the US forces have taken place in Afghanistan for years now. This very attack has once again exposed the ruthless colors of the invaders to the Afghans,” he added.

MSF’s hospital is the only facility of its kind in the whole north-eastern region of Afghanistan [MSF]

However, Sediq Sediqqi, an Afghan interior ministry spokesperson, claimed the fighters were attacking security forces with gunfire and grenades from an area near the hospital.

“According to our information, the Taliban were hiding in the hospital building and the area around it while attacking the forces,” Sediqqi said.

“We are assessing and evaluating the collateral damage to the medical facility. However, in any case, the safety of the civilians comes first,” he added.

A caretaker at the hospital, who was severely injured in the air strike, told Al Jazeera that clinic’s medical staff did not favour any side the conflict.

“We are here to help and treat civilians,” Abdul Manar said.

“Several women and children are also killed in the strike. I could hear them screaming for help inside the hospital while it was set ablaze by the bombing. We are terrified and speechless.”

Battle for Kunduz

The development came a day after the Afghan government claimed it had successfully retaken parts of Kunduz from Taliban fighters who had controlled the strategic city since Monday.

The Taliban, however, claimed it remained in control of most of Kunduz, our correspondent said.

Kunduz is facing a humanitarian crisis, with thousands of civilians caught in the crossfire between government forces and Taliban fighters.

Precise losses in the fighting were not known, but health authorities said on Friday that at least 60 people have been killed and 400 wounded.

As fighting spreads in neighbouring Badakhshan, Takhar and Baghlan provinces, concerns are mounting that the seizure of Kunduz was merely the opening gambit in a new, bolder Taliban strategy to tighten the grip across northern Afghanistan.

Afghan forces, backed by NATO special forces and US air strikes, have been going from house to house in Kunduz in a bid to flush Taliban fighters out of the city.

Al Jazeera’s Qais Azimy, reporting from Puli Khumri, about 130km from Kunduz, said heavy fighting was ongoing in the centre of Kunduz.

“Sources inside the city are reporting heavy clashes between the Taliban and the Afghan army. There is no set frontline between the two sides so the fighting is from street to street at the moment.

“People inside the city are suffering. There is a shortage of food, water and electricity,” our correspondent said.

The Taliban’s offensive in Kunduz, their biggest tactical success since 2001, marks a major blow for Afghanistan’s Western-trained forces, who have largely been fighting on their own since last December.

Civilian and military casualties caused by NATO forces have been one of the most contentious issues in the 14-year campaign against the Taliban, provoking harsh public and government criticism.

US-led NATO forces ended their combat mission in Afghanistan last December, though a 13,000-strong residual force remains for training and counterterrorism operations.

But there has been an escalation in air strikes by NATO forces in recent months despite the drawdown.

Additional reporting by Shereena Qazi. Follow her on Twitter @ShereenaQazi

Source: Al Jazeera and agencies

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Doctor accused in 300 deaths

WTKR.com

(CNN) — A Brazilian doctor who appeared in court for allegedly killing seven patients, could be responsible for up to 300 deaths to free up hospital beds in the southeast city of Curitiba, multiple media reports suggest.

Virginia Helena Soares de Souza recruited a group of doctors to help administer lethal doses of anesthetics, sedatives and painkillers, according to authorities.

In addition, the group allegedly altered oxygen levels for patients, leading to deaths by asphyxiation, police said.

Seven other health care professionals have been charged in the case.

Prosecutors allege de Souza pulled the plug on victims against the wishes of patients and their families, and in so doing broke the law. She did that to free up beds in the ICU and clear up the “clutter” the patients were causing, according to police.

De Souza was arrested in February, but was later released until trial. Her court appearance Wednesday…

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Scotland: Legionella Outbreak in South West Edinburgh 1 dead, 37 confirmed, 45 suspected cases – Updated 11 June 2012

NHS Lothian is now investigating 17* confirmed cases and 15* suspected cases of Legionnaires’ disease. (*See update below)

(Image: basingstoke.gov.uk)

One patient, a man in his 50s with under lying health conditions, has died while being treated at the Royal Infirmary of Edinburgh.

Thirteen men and two women aged between 33 and 74 are in a critical condition with the disease and are being treated in intensive care in hospitals in Lothian. One man has recovered and has been discharged.

Although unconfirmed, 15 other cases, ten men and five women are also being investigated. All of these patients are being treated in hospitals in Lothian.

The majority of the confirmed cases are linked geographically to the Dalry, Gorgie and Saughton areas of Edinburgh. Investigations into the other cases and possible links with the area are on-going.

The source of the outbreak continues to be investigated by officials from the City of Edinburgh Council’s Environmental Health Service and Scientific Service and the Health and Safety Executive.

Industrial cooling towers have been identified as a potential source of the infection and the cooling systems at four facilities in the area have been subject to an additional chemical treatment.

North British Distillery is being investigated among other sources

Further inspections of these facilities will be carried out by the Environmental Health Service and the Health and Safety Executive over the coming days to ensure control measures continue to be effective.

Samples have been taken from these four facilities but, legionella is a difficult bacteria to culture and it may take up to ten days before results of the samples are available.

Other possible sources are not being ruled out.

Dr Duncan McCormick, Consultant in Public Health Medicine and Chair of the Incident Management Team, said:

“I would like to express my sincere condolences to the family of the patient that died.

Investigations into the possible source of this outbreak are on-going. Meanwhile, medical staff have been actively identifying possible cases to allow us to ascertain the full extent of this outbreak.

I would like to reassure the public that household water supplies are safe and that Legionnaire’s disease cannot be contracted by drinking water.

Older people, particularly men, heavy smokers and those with other health conditions are at greater risk of contracting the disease.

I would urge anyone who develops symptoms of Legionnaires’ disease to contact NHS 24 or their GP.”

BBC: Industrial water cooling towers in the south west of Edinburgh have been treated in an attempt to stop an outbreak of Legionnaires’ disease.

A man in his 50s has died as the number of confirmed and suspected cases in Edinburgh continues to rise.

NHS Lothian’s Dr Duncan McCormick said medical staff were identifying possible cases in an attempt to discover the full extent of the outbreak.

About Legionnaires’ disease

The first case was identified on Thursday 28 May. The symptoms of Legionnaires’ disease can begin anytime from between 2-14 days after exposure to the bacteria.

Legionella bacteria sometimes find their way into artificial water supply systems, such as air conditioning systems, hot water services, and cooling towers. Given the right conditions, legionella bacteria can contaminate these water systems.

Legionnaires’ disease is contracted by breathing in small droplets of contaminated water. However, the condition is not contagious and cannot be spread directly from person to person. It cannot be contracted through drinking water.

There are strict regulations regarding the maintenance and control of water supply systems, such as either keeping the water cooled below 20C (68F), or heated above 60C (140F), in order to prevent an outbreak of Legionnaires’ disease.

Symptoms usually begin with an initial phase lasting 1-2 days, in which you experience mild headaches and muscle pain. This is followed by the onset of more severe symptoms including, high fever, usually a temperature of 40C (104F) or above, more severe muscle pain and chills.

Once the bacteria begin to infect your lungs, you may also experience a persistent cough, which is usually dry at first but as the infection develops you may start coughing up mucus or possibly blood, shortness of breath and chest pains.

About 30% of people with Legionnaires’ disease will also experience gastrointestinal symptoms including nausea, vomiting, diarrhoea, and
loss of appetite.

About half of those with Legionnaires’ disease will also experience changes to their mental state, such as confusion.

STV: Health Secretary Nicola Sturgeon says it is important not to point fingers as the number of Legionnaires cases continues to rise.

Speaking on Good Morning Scotland, Sturgeon said there was a strong working assumption the source of the outbreak had been traced.

She said: Health Protection Scotland are taking the appropriate steps to identify the source as quickly as possible.

Theres the strong working assumption surrounding cooling towers in the south west of Edinburgh and those towers have been chemically treated.

While the source is being investigated it is important not to point fingers at individual companies.

New ITV blog worth a visit

Update 6 June 2012 1940 BST:

There are now 21 cases of Legionnaires’ disease and 19 suspected cases in Scotland, the country’s health secretary Nicola Sturgeon has confirmed.- Sky News

Update – 08/06/2012 15:30 BST

NHS Lothian advise that…

Number of cases stands at 74

The latest reports from the Scottish Government Resilience Room (SGoRR) on the Edinburgh Legionnaires’ disease outbreak show that there are now 28 confirmed cases and 46 suspected cases. This is an increase of 13 on the total numbers of confirmed and suspected cases.

As at 12pm today, of those cases being treated in hospital, 14 were in intensive care and 30 are on general wards.

A total of 15 cases are being treated in the community, ten have been discharged from hospital and one person has sadly died.

Four cases are being treated outside of the NHS Lothian area. A patient who was yesterday being treated in NHS Highland has now been transferred to Glasgow, one patient is being treated in the north of England, one in NHS Tayside and one in NHS Lanarkshire. At this stage all these cases are considered to be linked to the south west Edinburgh outbreak.

The ages of the confirmed cases ranges between 33 and 76, with more males than females affected.

As of 10pm yesterday, NHS 24 had received 492 calls to the dedicated helpline for Legionnaires’ disease.

The Health and Safety Executive and Edinburgh City Council are continuing their investigations into the possible source of the outbreak. The HSE has today served an Improvement Notice on one of the companies responsible for one of the cooling towers which is being investigated, although this does not mean that this tower has been identified as the source of the outbreak.

Health Secretary Nicola Sturgeon said: “As we expected, we have seen a rise in the number of cases associated with this outbreak today. It is reassuring to see that ten people have now been discharged from hospital.

“NHS Lothian continues to be very busy and contact has been made with other health boards in case capacity at other hospitals is required.

“The fact remains that the risk to the general public remains low but anyone with concerns should contact their GP or NHS 24’s dedicated hotline on 0800 0858 531.

“I want to stress that this bacteria is not passed on person to person or by drinking water.

“Investigations into the source of this outbreak are continuing. It is important to note that in issuing an Improvement Notice, the HSE does not believe there is an immediate risk to workers or members of the public. Nor can it be assumed that this tower is the source of the outbreak.

“Investigations into all of the other towers in the area are continuing.”

Dr Duncan McCormick, Chair of the IMT and Consultant in Public Health Medicine at NHS Lothian, said: “The number of patients with confirmed or suspected Legionnaires’ disease has increased since yesterday. This is exactly in line with what we expected and what we have predicted so far, based on the first presentation of patients and the incubation period of Legionnaires’ disease which is between two and 14 days, but usually has an average of five to six days.

“We expect that the numbers of patients affected will peak over the weekend and then begin to fall as we move into the beginning of next week.

“The majority of patients who are presenting now are also on the lower end of the sickness scale and are therefore more likely to be treated in the community with appropriate care than be admitted into hospital, meaning that they are also unlikely to have underlying health conditions.”

Update – 11/06/2012 1417 BST

This is the latest at this time

Outbreak of Legionella in South West Edinburgh. Update – 10/06/2012 16:00

Legionnaires’ outbreak update

Number of cases stands at 82

The latest reports from the Scottish Government Resilience Room (SGoRR) on the Edinburgh Legionnaires’ disease outbreak show that there are now 37 confirmed cases and 45 suspected cases. This is an increase of one in the total number of confirmed cases and an increase of one suspected case.

As at noon today, of those cases being treated in hospital, 15 are in intensive care and 26 are on general wards.

A total of 16 cases are being treated in the community, 19 have been discharged from hospital and one person has died.

Five cases are being treated outwith the NHS Lothian area. One patient is being treated in the north of England, two in NHS Tayside, one in NHS Lanarkshire and one patient from NHS Highland is now being treated in Glasgow. At this stage all these cases are considered to be linked to the south west Edinburgh outbreak.

The ages of the confirmed cases ranges between 33 and 76, with more males than females affected.

NHS 24 has received 630 calls to the dedicated helpline for Legionnaires’ disease.

The Health and Safety Executive and Edinburgh City Council are continuing their investigations into the possible source of the outbreak.

Health Secretary Nicola Sturgeon said: “These latest figures are reassuring and in line with expectations, and although it is too early to be definite they do suggest we are now in the later stages of this outbreak. All those involved are responding extremely well: NHS Lothian services are coping with the demands on them and the City of Edinburgh Council and the Health and Safety Executive continue to make significant progress in their investigation to identify the source of this outbreak.”

Dr Duncan McCormick, Chair of the IMT and Consultant in Public Health Medicine at NHS Lothian, said: “We are pleased with the slow down in the number of cases presenting and we hope this will continue over the coming days.

“The risk to the general public is low but anyone with concerns should contact their GP or NHS 24’s dedicated hotline on 0800 0858 531.”

Legionnaire’s disease symptoms