NEW DELHI: At least four people were killed when airstrikes hit a hospital supported by Medecins Sans Frontieres (MSF) in northern Yemen. The aid agency said that the strike in Saada province, a Houthi rebel movement stronghold, had injured a further ten people.

The fact that the strikes were on a Houthi stronghold indicate that the Saudi-led coalition, backed by the United States, could have a role to play in the attack, although MSF has said that it was unclear whether the hospital was hit in an air strike by warplanes of a Saudi-led coalition, or by a rocket fired from the ground. The agency however did add that planes were visible overhead at the time of the attack.

A statement from the agency, also known as Doctors Without Borders, reads: “According to our staff on the ground, at 09:20 one projectile impacted the Shiara Hospital in Razeh district, where MSF has been working since November 2015. MSF cannot confirm the origin of the attack, but planes were seen flying over the facility at the time. At least one more projectile fell near the hospital. The numbers of casualties could rise as there could still be people trapped in the rubble. All staff and patients have evacuated and patients are being transferred to Al Goumoury hospital in Saada, also supported by MSF.”

“This is the third severe incident in the last three months. Our teams struggle on a daily basis to ensure the respect of health facilities... we reiterate to all parties to the conflict that patients and medical facilities must be respected."

In Yemen, previous attacks on MSF facilities have occurred in Sadaa last October and a clinic in Tiaz was hit last month. The Saudi-led coalition was behind both attacks.

MSF was also in the news last October as US aircraft hit a facility run by the agency in the war torn city of Kunduz, Afghanistan, killing 30 patients and staff.

There is a disturbing pattern in both attacks, as MSF maintains that all warring parties are informed of GPS coordinates of the medical facilities in advance. In reference to the attack in Yemen, MSF said: “All warring parties, including the Saudi led coalition (SLC), are regularly informed of the GPS coordinates of the medical sites where MSF works and we are in constant dialogue with them to ensure that they understand the severity of the humanitarian consequences of the conflict and the need to respect the provision of medical services”, says Raquel Ayora Director of Operations. “There is no way that anyone with the capacity to carry out an airstrike or launch a rocket would not have known that the Shiara Hospital was a functioning health facility providing critical services and supported by MSF.”

Similarly, in the attack on the facility in Kunduz, MSF reiterated that its coordinates had been provided to the US coalition and their Afghan counterparts.

“MSF wishes to clarify that all parties to the conflict, including in Kabul and Washington, were clearly informed of the precise location (GPS Coordinates) of the MSF facilities in Kunduz, including the hospital,” MSF stated.

Further, the organisation added that the strikes appeared to continue even after MSF contacted US forces. “The bombing in Kunduz continued for more than 30 minutes after American and Afghan military officials in Kabul and Washington were first informed by MSF that its hospital was struck,” MSF said.