Kabul, Afghanistan - A sport utility vehicle packed with explosives blew up on Saturday outside a small hospital in a remote area of eastern Afghanistan, killing at least 20 people and injuring at least 23 more, government officials said.
The powerful mid-morning blast ripped through the Akbar Khail hospital, a 10-bed clinic in the Azara District of Logar province, about 40 miles southeast of Kabul near the Pakistan border.
The explosion leveled the one-story building and sent debris crashing down on patients, visitors and staff inside, Din Mohammad Darwish, a spokesman for the provincial governor’s office, said.
Rescuers continued to pull the dead and injured out of the wreckage late into the afternoon, Mr. Darwish said.
“The hospital is totally destroyed,” he said. “The numbers may go higher.”
The Ministry of Public Health in Kabul at one point Saturday said 60 people had been killed and 120 wounded but later downgraded it to 43 killed and wounded. Dr. Mohammad Zaref Nayebkhail, the provincial health director for Logar Province, said the explosion killed at least 50 and injured another 90. The conflicting numbers reflected the confusion surrounding the scene and the difficulty of getting information out of the isolated and mountainous area, where telephone coverage is spotty.
Even as he spoke, Dr. Nayebkhail was boarding a helicopter in the provincial capital of Puli Alam, about 70 miles west of the hospital, to help in the rescue. Another helicopter filled with doctors, nurses and supplies had left moments earlier, he said.
“Helicopter is the only way to get there, it is a very difficult area to reach,” he said.
No one has claimed responsibility for the attack, and the Taliban has denied any involvement. ”We strongly condemn this inhuman attack which was carried out by some other elements who are trying to defame the Taliban and blame us for doing this,” Taliban spokesman Zabiullah Mujahid said by cellphone from an undisclosed location.
Dr. Nayebkhail said the bomber rammed his vehicle through front gate of the compound around 10:30 a.m., striking and killing a guard who tried to stop him. The vehicle struck a second guard in front of the main clinic and then detonated.
“It made a huge explosion,” he said. The hospital was fairly new, he said, built with money from the United States Agency for International Development. It was originally intended as a maternity clinic but was recently expanded to be a full-service health center.
Midwives and a number of children were believed to be among the dead, he said.
Insurgent activity has been on the rise in the province. Attacks in the first two weeks of June surpassed the figure for the entire month of May, according to the Afghanistan NGO Safety Office, which tracks insurgent activity. Coalition forces have also increased the number of night raids in the province searching for Taliban leaders. Last week, a Taliban leader and another insurgent were killed in an airstrike in the Charkh district, according to NATO reports.
The leader, Khalil, was involved in coordinating and carrying out attacks against Afghan government officials and was supported by both the Taliban and the Haqqani networks, NATO said. Other night raids last week in the districts of Charkh and Baraki Barak captured several individuals with suspected ties to the Haqqani network and a leader with the Hezb-E Islami Gulbuddin insurgent group, reflecting the range of varying insurgent networks active in the province.
According to NATO, the Haqqani network, a particularly brutal group based in the tribal areas of Pakistan, was responsible for the May 2 suicide attack on the national military hospital in Kabul, which left six people dead and wounded 20 others.
Mollawi Qalamudin, a former high-ranking Taliban official from Logar who is now a member of President Hamid Karzai’s High Peace Council, said he believed it unlikely that the Taliban would have targeted a purely civilian medical facility.
But, he said, “there might be some irresponsible commanders who carry out these kind of heart-breaking attacks without informing their higher ups.”
Saturday’s attack comes one day after a bicycle rigged with explosives blew up in an outdoor market in the northern Afghanistan province of Kunduz, killing at least 10 people, including a police officer.
While violence was expected to increase in the warmer summer months, civilians have borne the heaviest toll so far, even as NATO casualties are down slightly from this period last year. The United Nations said that May was the deadliest month for Afghan civilians since it began keeping count in 2007, with 368 civilian deaths.
Most of the casualties, 82 percent, were caused by Taliban and other militants, while 12 percent were caused by NATO troops and Afghan forces; in 6 percent of the cases, it was not clear who was responsible.