A Pakistani airstrike on a drug rehabilitation hospital in Kabul killed at least 400 people and injured more than 250 on Monday night, Afghan officials said Tuesday, in the deadliest single attack since cross-border hostilities between the two nations intensified last month.
The strike destroyed large sections of the Omid Addiction Treatment Hospital, a 2,000-bed facility near Kabul’s international airport, around 9 p.m. local time, triggering massive fires that engulfed patients and staff as terrified residents who had just broken their Ramadan fast ran for cover. Pakistan denied hitting any civilian sites, insisting it conducted precision strikes on military installations and terrorist infrastructure.
Ahmad, a 50-year-old patient receiving treatment at the facility, watched helplessly as flames consumed the 25 people in his dormitory. He was the sole survivor.
“The whole place caught fire. It was like doomsday,” Ahmad told Reuters.
Health authorities estimated around 3,000 patients from across Afghanistan were receiving treatment at the hospital when the bombs struck. The facility serves as a critical resource in a nation where millions struggle with drug addiction after decades of war and economic hardship, compounded by Afghanistan’s history as a major opium producer.
Anti-aircraft guns opened fire at 9 p.m. as jets patrolled overhead, continuing for roughly an hour before emergency crews could access the devastated compound. When they arrived, they found blackened walls, collapsed buildings reduced to rubble, and bodies trapped beneath the debris.
Omid Stanikzai, a 31-year-old security guard at the treatment center, described the chaos as military units surrounding the hospital fired at the approaching aircraft. He said the bombing began after Taliban forces engaged the jets overhead, sparking an inferno that spread rapidly through the facility.
Taliban Interior Ministry spokesperson Abdul Mateen Qanie reported 408 people killed and 265 injured in the attack. Emergency, an Italian non-governmental organization operating in Afghanistan, received three bodies and treated 27 wounded from the strike.
Ambulance driver Haji Fahim transported at least eight bodies to a nearby hospital over five hours. By Tuesday morning, rescue teams continued pulling victims from the wreckage.
Families gathered outside the destroyed facility searching for loved ones. Baryalai Amiri, a 38-year-old mechanic whose brother had been admitted 25 days earlier, said authorities provided little information about survivors or casualties.
Taliban government spokesman Zabihullah Mujahid condemned what he called Pakistan’s violation of Afghan territory, describing the strike as a crime against humanity. He said the attack targeted innocent civilians and addicts, violating all accepted principles of international law.
Pakistan’s information ministry rejected the accusations entirely. Information Minister Attaullah Tarar said his country’s military conducted precision strikes exclusively on infrastructure used by the Taliban regime to support what he called terror proxies, and dismissed Afghan claims as “entirely baseless.”
The strikes came under Operation Ghazab lil-Haq, which Pakistan launched in late February following what Islamabad described as unprovoked attacks by Afghan Taliban fighters. Pakistan also reported hitting targets Monday in Nangarhar Province in eastern Afghanistan.
Cross-border clashes between Afghanistan and Pakistan escalated in October, subsided temporarily following a Qatar-brokered ceasefire, then resumed on February 26. The United Nations mission in Afghanistan confirmed Friday that at least 75 civilians have died since that date, though Monday’s hospital strike dramatically increased that toll.
About 115,000 people have fled their homes due to the conflict, according to the UN Refugee Agency. The World Food Programme announced Sunday it would deliver food to more than 20,000 displaced Afghan families, warning that further instability would push millions into hunger.
Michael Kugelman, a South Asia senior fellow at the Atlantic Council, said prospects for de-escalation appear bleak. Arab Gulf nations that previously mediated talks between Afghanistan and Pakistan now face their own conflicts, while other mediators including China have achieved limited success despite recent diplomatic efforts.
Pakistan appears determined to keep striking targets inside Afghanistan, while the Taliban seem equally committed to retaliating with operations on Pakistani border posts and potentially asymmetric tactics—from launching drones to sponsoring militant attacks deeper inside Pakistan. No off-ramps are in sight.
The Taliban banned all narcotics in April 2022, including opium poppy cultivation, leading to an estimated 95 percent drop in opium production by 2023 according to the UN Office on Drugs and Crime. Under the crackdown, thousands of people struggling with addiction have been sent to the country’s underfunded and overcrowded treatment centers.
As rescue operations continued Tuesday, workers discovered more bodies trapped beneath collapsed structures. Personal belongings—pillows, shoes, clothing—lay scattered among the debris. In some dormitories, bunk beds remained intact against walls while ceilings had been blown off entirely, leaving rooms exposed to the sky.