The doors of Emergency Hospital in Lashkar Gah, the capital of Afghanistan’s Helmand Province, swung open. Ehsanullah, 14, his face a swollen mess of flesh, was the first to be wheeled in.
His younger brother Hedayat, 4, was next. He had deep wounds up and down both legs, a skull injury, and a bubble of intestine that was protruding from a small hole in his abdomen. Then came Noor Ahmad, 7, and Parwana, 9, whose face was spider-webbed with blood from a wound on the crown of her head. All arrived totally silent, muted by the shock. And still more kept coming.
Within a few minutes, 13 members of the same extended family had been admitted to the hospital—10 children, an elderly man, and two women, one of whom was pregnant.
They had been struck by munitions from an American aircraft as they sheltered in their house on November 24. Alongside the 13 injured, two members of the family had died at the scene—15-year-old Esmatullah and his father Obaidullah.
Civilian casualties resulting from U.S. military operations had declined significantly after measures were taken to stop them in 2009. This trend started to change after U.S. airstrikes picked up pace again in 2015, and the last year has seen a particularly acute reversal of it.