KABUL: Medecins Sans Frontieres (MSF) will review its operations in Afghanistan following last weekend’s deadly US airstrike on a hospital in the city of Kunduz, officials from the international aid group said on Thursday.

At least 22 patients and MSF staff were killed on Saturday when a US aircraft attacked the hospital during fighting between Afghan government troops and Taliban forces. However, the death toll is likely to rise with nine patients and 24 staff unaccounted for and at least 24 bodies reported to be left in the abandoned hospital.

“The overwhelmingly shocking nature of the event forces us to take stock of our work in Afghanistan generally and to carefully weigh the safety and security of our staff and patients,” Christopher Stokes, general director of the group, told a news conference in Kabul.

“Our future ability to work in Afghanistan will now be based on our ability to obtain a clear reaffirmation of the respect for humanitarian law,” he said.

MSF has demanded an independent international investigation to establish the facts of the incident, which prompted US President Barack Obama to apologize to the group on Wednesday. MSF, which has been in Afghanistan since 1980, pulled out for a period after five staff were killed in 2004. It has already shut down its hospital’s operations in Kunduz and has given no indication of when it might reopen.

“At the moment, MSF has not received any explanations or assurances that give us the confidence to be able to return,” said Guilhem Molinie, the group’s country director for Afghanistan.