KABUL, Afghanistan — Afghan officials sharply increased the tally of dead in an attack last week on a military hospital, saying Wednesday that at least 50 people, including patients and staff members, were killed.
In addition, 24 people have been arrested in connection with the March 8 attack, including Afghan generals, according to Lt. Gen. Helaludin Helal, the country’s deputy minister of defense for strategic and intelligence affairs. The arrests were for a variety of charges, including negligence, incompetence and complicity, General Helal said at a contentious news conference that raised more questions than it answered.
The news conference was called after Afghan news reports and social media accounts suggested that the casualty toll was actually in the hundreds; that three wounded Afghan generals were among those killed by the attackers; and that the minister of defense, Abdullah Habibi, had personally signed the V.I.P. vehicle pass that allowed the attackers to enter the heavily guarded hospital complex in a car packed with explosives and carrying weaponry for the five attackers.
The reports seemed to be fueled partly by contradictory government claims immediately after the attack that only two people had died, a number many officials stuck to even after Ministry of Defense personnel confirmed at least 31 dead.
In addition, it took the authorities seven hours to quell the attack, leaving the armed insurgents prowling Sardar Daud Khan hospital for hours, hunting down patients and medical staff members in the 400-bed facility, which is usually full or nearly full.
General Helal maintained that the news reports in general were distorted and incorrect, without getting into specifics. As the questioning grew heated, General Helal abruptly left, leaving the defense ministry spokesman, Maj. Gen. Dawlat Waziri, to take over.
General Waziri confirmed that officials were investigating the possibility that the attack was carried out by insiders, but he did not directly address assertions that doctors working at the hospital were involved. He did not identify the generals who were arrested, nor did he specify how many generals were arrested on what charges.
He confirmed that the attackers brought their vehicle into the hospital compound using an official pass, which he described as “fake.”
One of the attackers detonated the explosives-laden car with a remote-controlled detonator as they entered the hospital grounds dressed in white medical clothing, according to the official accounts. They then carried out the attack using guns, grenades and suicide vests, one or more of which exploded later.
The authorities said all five attackers were killed, but Afghans have widely questioned that assertion as well, and raised questions about whether wounded Taliban prisoners who had been in the hospital might have escaped.
The Islamic State claimed on one of its websites that it was responsible for the attack, while the Taliban denied any role. Government officials, however, have blamed the Taliban, and General Helal said “we cannot deny” that one of the attackers shouted, “Long live the Taliban.”
The Islamic State, or ISIS as it is commonly known, has a relatively small number of fighters in Afghanistan, mostly in the eastern province of Nangarhar. And while their members have carried out attacks in Kabul — such as one last July at a protest that killed 80 people — the military hospital assault was more complex and sophisticated than anything the group has done before in Afghanistan.
The Taliban, who often clash with the Islamic State and are bitterly opposed to the group’s presence in Afghanistan, have never previously carried out a large-scale attack on an Afghan hospital, and their own fighters are often treated in Afghan medical facilities.