The Man on the Operating Table
The Man on the Operating Table...
The Man on the Operating Table
Baynazar Mohammad Nazar was a husband and a father of four — and a patient killed during the attack on the MSF hospital in Kunduz. This is his story.
Photographs and story by Andrew Quilty
Warning: Some readers may find the following images disturbing.
KUNDUZ, Afghanistan — In the first operating room, the surgical bed was empty except for a thin layer of concrete dust. The second room had been harder hit. A man’s body, arms and legs outstretched, lay supine on the operating table with a cannula inserted in his left forearm. Blotches of rust-colored antiseptic stained his torso; there was a steel bracket fixed to his right thigh. A surgical curtain had collapsed across his chest and shoulders above where a ceiling panel lay across his abdomen. On the cushioned head support, the patient’s bearded jaw was all that remained of his head — the rest appeared to have been sheared off by shrapnel or a large ammunition round.
In the corridor outside the operating rooms, a slew of broken ceiling panels lay on the floor covered in dust and debris; a whiteboard hung askew on the wall. Even in the middle of the afternoon, apart from the occasional pop of a Kalashnikov firing in the distance, this part of the hospital was silent and dark.
The main part of the Médecins Sans Frontières Kunduz Trauma Center had fared far worse. Little remained after the deadly strikes carried out by a U.S. AC-130 gunship over the course of an hour. In the weeks after the attack, investigators determined that at least 30 staff and patients had died on Oct. 3. Initially, Afghan commandos claimed they had requested the airstrike after coming under fire from Taliban fighters in the hospital compound. Afghan government officials echoed this account, while a dozen eyewitnesses I spoke to refuted it. A U.S. military investigation released on Nov. 25 admitted human error and technical failures resulted in the “tragic but avoidable accident.”
The body of the man on the operating table had been the only one among the human remains in the trauma center that was still somewhat visibly identifiable. And when I first saw him, this man had been lying dead on that operating table for a week as the fighting continued to rage across the city.
It would be four more weeks before I’d learn his name.
Baynazar Mohammad Nazar, a tall, heavyset father of four with a neat, graying moustache, worked nights as a chowkidor, or unarmed guard. His job consisted mostly of patrolling a row of jewelry shops and currency exchanges about a mile from his family home in Ibrahim Khel, a poor village of mud-brick houses and dusty alleyways in the southeast section of Kunduz.
Even for an uneducated man of 43, it wasn’t a well-paying job, but he was lucky to have a job at all. Unemployment has continued to rise over the last year as the Afghan economy founders.
If it hadn’t been for the protests of his 10-year-old daughter, Raiana, he’d have left Kunduz and traveled to find better-paying work in Iran, like so many of his friends had already done. It was Raiana who watched the door for Baynazar in the mornings after his long nights of work. Sometimes he’d bring home fresh bread or dried fruit, and she — along with her sister, Zahra, 8, and younger brother, Khalid, 6 — would hug her father hello.
Raiana stands in the family’s shared yard, holding a workbook for school.
Toward the end of summer, as the balmy nights Baynazar spent in the bazaar began to cool, the Taliban were consolidating their territorial gains around Kunduz city. Government forces had weathered serious assaults in the spring and summer months, but the insurgents’ most determined push was still to come.
In the early hours of Sept. 28, hundreds of Taliban fighters, who had been hiding within the city, emerged heavily armed to charge and attack in unison with fighters from surrounding districts. Afghan government forces made a chaotic retreat to a nearby airstrip. By noon that day, Kunduz city was under Taliban control. It was the first provincial capital to fall since the group had surrendered the very same city to the Northern Alliance and U.S. special operations forces in November 2001.
Many residents, fearing the government counterattack as much as their new overlords, fled to Kabul or neighboring provinces. But at least half the population stayed and resolved to shelter in their homes until the fighting was over — Baynazar and his family among them.
Just a couple of days after the takeover, Baynazar began to hear rumors of looting. So one night, after evening prayers, he told his wife, Najibah, that he wanted to check on his shops. She pulled at his sleeve, begging him not to go. Najibah was concerned: There was still heavy fighting underway in the city, and it was almost dark.
“It’s my responsibility,” he told her. He reassured her that he’d return quickly, promising to bring home bread from the bakery. But once he reached the bazaar, the Taliban fighters in control of the area sent Baynazar away, claiming it was too dangerous.
Undeterred, Baynazar rose early the next morning, prayed, and then made his way back to the bazaar. There he met Abdul Samad — a fellow chowkidor and close friend. They had spent hundreds of quiet Kunduz nights together, laughing and joking while guarding the bazaar. And just as they had dismissed Baynazar the night before, Taliban fighters told the two men to leave.
Left: A photo of Baynazar before his death. Right: Raiana, Zahra, and Samiullah sit together at home.
Moments after Baynazar and Samad turned to go back, gunfire erupted. Samad ran, ducking down beside a compound wall. He looked for Baynazar and saw him a few yards away, still out in the open, and watched his friend crumple to the ground.
The fighting died down quickly, allowing Samad to get to Baynazar. He’d been struck by a bullet in the thigh, and the wound was bleeding badly. With the help of a few Taliban fighters, Samad loaded Baynazar onto the back of a passing Zarang — a three-wheeled motorbike with a small flatbed — and the driver rushed the two men to the nearby MSF hospital.
Baynazar had already gone into surgery by the time Najibah arrived at the center with Khalid around noon. (Baynazar had been able to reach Samiullah, their eldest son, a tall, thin boy of 19, who then relayed the news to his mother.) He was sitting in his hospital bed, the cage-like metal and screws of an external-fixation bracket holding together the bone where the bullet had broken it apart. She stayed by his side for the rest of the afternoon; teary-eyed, she scolded him for going to the bazaar.
“Don’t cry,” Baynazar said, comforting his wife. “It’s just bad luck.” The doctors had scheduled his second surgery for the following day, and soon after he would be able to come home.
Before Najibah left on that first day, Baynazar raised his leg off the bed. "See?” he told her. “It’s still working!"
The following night — Friday, Oct. 2 — was relatively calm. Gunfire could be heard, but it sounded far off in the distance.
It was as peaceful as any night at the Kunduz Trauma Center since this recent breakout of fighting. The day had been busy: The staff at the center had been working 18- to 20-hour shifts, and with a backlog of patients requiring surgery from the previous days, the operating theater had seen more than 30 operations, with 10 more scheduled for before dawn. But by nightfall on Friday, the rate of arrivals in the emergency room had finally slowed.
Sometime just before 2 a.m., Sergio Borrego Ginebra, a 46-year-old Cuban anesthesiologist on his third mission to Kunduz, was the one who accompanied Baynazar as he was wheeled from his room into the reception area for the operating room. There they met Kamarul Haqq, the orthopedic surgeon who had performed the patient’s first operation the day before and was again on duty early that Saturday morning.
“We’re going to close your wound,” Haqq explained to Baynazar, who struck the surgeon with how comfortable and at ease he appeared. The two exchanged a smile as Baynazar was wheeled into the operating room so the nurses could prepare him for surgery.
At approximately 2:05 a.m., Borrego Ginebra came into the operating room to assist with the spinal anesthesia. Now that Baynazar’s lower half was numb, Borrego Ginebra administered intravenous drugs to sedate him. The procedure itself was relatively straightforward: Roughly a dozen sutures would be made to close the wound, which had remained open after the first surgery. It wouldn’t take more than 30 minutes.
Borrego Ginebra stood back, monitoring Baynazar. Mohammad Safi Sadiqi, the 37-year-old Afghan surgeon performing the operation, was leaning in to make the final sutures on Baynazar’s thigh when a deafening explosion erupted, shaking the room.
Part of the roof started to fall in — one panel toppling directly onto Baynazar. But with his wrists still strapped to the movable arms of the surgical table, unconscious and completely immobile, there was little the staff could do to help him. Glass and debris were flying through the air, and Borrego Ginebra worried the oxygen tank in the room would explode if it were struck. The lights had gone out in the building. It was so dark that Safi, Borrego Ginebra, and the nurses couldn’t even see which way to run.
Because his assistance wasn’t required, Haqq never made it into the operating room for Baynazar’s surgery; he had been scrubbing in the washroom with some nurses between procedures. The sound of the explosion was so loud it shook him. He was stunned, motionless — unable to react. Within moments, he heard another explosion, only nearer and louder this time.
Baynazar’s body on the operating table in the MSF hospital in Kunduz on Oct. 10, one week after the attack.
Haqq and the scrub nurses began to run to the other end of the corridor, toward the main entrance to the OR wing and, unbeknownst to them, closer to the carnage occurring on the main part of the building. Another explosion sent parts of the roof and ceiling crashing to the floor, and they ran, stumbling through the darkness back the way they had come, past the OR and on to the sterilization room at the far end of the OR wing. It was dark; there was glass and debris everywhere. Haqq hid in a corner while the others scrambled under concrete sinks or lay on the floor.
Back in the doorway of the second operating room, Safi took the lead and motioned the two nurses and Borrego Ginebra to follow him to the sterilization room as well.
Now, there were 10 to 12 people in the room, including one patient.
As bullets rained down and the deafening blasts continued to erupt, Borrego Ginebra prayed that if death should come, it would be instantaneous, painless. He prayed that the bomb would fall on top of him and kill him in a single, sparing moment.
The bombardment was unrelenting. Haqq felt it coming nearer and nearer. Even as debris continued to fall on them, he remained calm and prayed it would be over swiftly.
Safi fumbled with his cellphone and called his brother and wife, who were at home in neighboring Takhar province. He told them a plane was bombing the hospital. “Call someone to stop the bombing!” he called over the noise of the chaos. And then, “Please forgive me.”
After five or six minutes, there was a pause in the onslaught and everything was still. But no one in the room dared to move. As smoke and noxious fumes began to fill the air, they heard the voices of colleagues outside yelling for them to get out of the burning building. Everyone except Safi ran for the basement where they found more than a hundred staff, patients, and family members, who had been sleeping there when the attack began. Having survived until now, Safi decided to stay in the sterilization room, alone.
The onslaught wasn’t over; it would continue on and off for as long as an hour, during which time the majority of those who had survived the initial barrage sheltered, terrified, in the basement. Miraculously, the 10 to 12 people who had fled the OR wing survived. But Baynazar was still lying on the table in the operating room.
Early on Saturday morning, Najibah set off again, eager to see her husband after his operation.
As she hurried by Kheyaban Mosque, about half a mile from the trauma center, a woman called out to her. “Where do you go my sister?” she asked.
Najibah told the woman she was going to visit her husband at the trauma center. “But there’s no one in the hospital,” the woman replied. She told Najibah that there had been an attack during the night and that the hospital had been destroyed. The fighting, she told Najibah, was still going on.
“You should go back home,” the woman said.
Baynazar's bicycle, the one he used to ride to work every day. His daughters washed the bike soon after this photo was taken.
Overwhelmed, Najibah sat by a wall crying, and through her tears, she began to pray. Was Baynazar alive or had he been killed? Not knowing what else to do, Najibah went home. Baynazar’s bike leaned against the wall inside the front gate.
By 10 a.m., word came that the fighting had eased, so Najibah, this time with 6-year-old Khalid in tow, returned to the hospital. The trauma center compound was deserted. Together they shuffled into the main building, ducking under the collapsed roofing, and, with the charred ruins crunching underfoot, made their way to the room where she had visited her husband just the day before — but there was no one inside.
After walking the streets aimlessly for hours, crying for her husband, Najibah made it home to call Samiullah. She told him that the hospital had been attacked. Sobbing into the phone, she cried, “I didn’t find your father.”
Five weeks after the ordeal, while sitting on cushioned toshaks that double as beds at nighttime inside their tiny, rented home in Kunduz, Najibah recounted the search for her husband. As she spoke, Samiullah, who prefers to wear jeans and a sweatshirt over traditional Afghan dress, attentively refilled glasses of green tea.
“On [Monday] we went to Chardara district [a Taliban stronghold that borders Kunduz city to the west],” recalled Najibah. “There was another [clinic] belonging to MSF… but my husband wasn’t there.”
Najibah (just inside the door) sits with her children and a cousin near the only doorway of the family’s small two-room home.
Next, in a rented vehicle, she, Samiullah, and Khalid drove two hours south through several contested areas to the public hospital in the capital of Baghlan province, Pul-e-Khumri. Again there was no sign of Baynazar. Najibah did, however, recognize a patient from the ward in Kunduz. “Where is my husband?” she pleaded. But all the patient could tell her was that some survivors had been taken to Mazar-e-Sharif, while others were transferred to Kabul or Takhar provinces.
After returning to Kunduz, Najibah, Samiullah, and Khalid continued their search in the rented vehicle: first, two hours east, across the treacherous Khanabad Highway to Takhar, then back the same way through Kunduz and on to Mazar-e-Sharif, 100 miles and several hours further west.
Najibah and her two sons returned to Kunduz on Wednesday and spent the next two days pleading with military officials to let them into the small hospital they’d established in the Afghan army’s 2nd Brigade headquarters just outside the city during the battle for Kunduz. On Saturday, Oct. 10, they were finally escorted inside and shown around the ward. Samiullah even scanned the admissions records from the previous week, but again the search was fruitless.
Left: Zahra, in a white head scarf, stands outside the front gate of the house her family shares with other families in a poor part of Kunduz city. Right: Raiana (on the left) joined her mother, Najibah, inside the door of their small mud-brick house.
That night Samiullah and Najibah decided they would travel to Kabul the following day. There were numerous hospitals in the capital, and if Baynazar was alive, surely they would find him in one of them.
In the early morning of Oct. 11, eight days after the flames that engulfed the Kunduz Trauma Center had run out of material to consume, Haji Abdul Basir — a baker and neighbor to the trauma center — was approached by local staff of the International Committee of the Red Cross (ICRC) to help identify and transport any victims still in the hospital for burial.
Numerous bodies had already been retrieved by loved ones since the attack, but locals believed there were more still inside; the smell was wafting through the streets.
Although they weren’t close friends, and despite the man’s grievous head wound, Haji Basir recognized Baynazar — a regular customer at his bakery — immediately. There were seven others, most burnt beyond recognition. The bodies were placed in coffins by ICRC staff and driven just outside the city to a barren hillside cemetery.
Haji Basir found Samiullah’s phone number and called. “Stop searching,” he told Samiullah. “Your father is buried on the hill.”
Early one recent November morning, before the children left for school, I joined Baynazar’s family on a visit to his grave.
The smoke from the city’s wood heaters that had been burning through the night hadn’t cleared yet, so the dawn’s cold, blue hues lingered even after the sunrise. Najibah and her children climbed into the back seat of the Toyota Corolla wagon I’d taken with a hired driver from Kabul. I sat on the spare tire in the back. As we drove, Khalid faced backward, leaning over the seat as if to keep me company.
A view of the main road that runs north to south through Kunduz city; this is the road Najibah would have walked to visit her husband in the MSF hospital.
Dowra Hill, less than two miles south of the trauma center, has played host to much of the fighting in Kunduz over the past seven months: In May, 600 families from neighboring districts had erected makeshift tents there after the Taliban’s spring offensive turned their villages into war zones. In the last days of September, thousands of government security forces and civilians fled the city along the road that leads to the safety of the airstrip, as the Taliban took hold of Kunduz. Villages at either end of Dowra Hill have seen house-to-house fighting as Afghan National Security Forces toiled to reclaim the city’s outskirts.
Najibah tries to comfort her daughter Zahra during a visit to Baynazar’s grave.
Now, among dozens of identical mounds of freshly turned soil, Baynazar’s story ended there, too. Samiullah crouched quietly and let tears well in his eyes. His family would rely on him now as the sole breadwinner, and the weight of responsibility, he said, rarely left his thoughts.
Khalid was more quiet than usual. Earlier, he’d told me how he saw the whole hospital all burned and damaged. “But I wasn’t afraid,” he said. Now he stood mute, watching his mother and sisters, occasionally turning away, either distracted by something in the distance or unsure of how to behave in the face of his family’s grief.
Zahra, dressed in the same clothes as the day before, her cherubic face framed by a white headscarf, moaned inconsolably as she lay across her father’s grave. Najibah cradled her daughter as she cried.
“Father, we washed your bicycle — please wake up — you can come home now.”
Andrew Quilty is a freelance photojournalist based in Kabul.
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