A suicide car bomber killed at least 20 people in an attack at a hospital in a remote district of eastern Afghanistan on Saturday that damaged its maternity ward, officials said.
Estimates of the casualties, which included patients and medical staff, varied widely in chaotic scenes outside the hospital in the remote Azra district of eastern Logar province, which is just south of Kabul. Dozens more were wounded in one of the worst attacks this year.
Deen Mohammad Darwish, a spokesman for the Logar provincial government, said as many as 35 people were killed, although Afghanistan's interior ministry put the death toll at 20.
"The exact target is still not clear," Interior minister deputy spokesman Najib Nikzad said.
Taliban spokesman Zabihullah Mujahid denied responsibility and said the Islamist insurgents never attack hospitals.Afghan President Hamid Karzai condemned the attack as "savage and ignorant" in a statement released by his office. It came as Karzai told a counterterrorism summit in Tehran that militancy was on the rise in both his country and the region.
The United Nations said the maternity ward was hit in the bombing. "This is a despicable attack against civilians who were seeking medical care, as well as visiting family members and health workers," Staffan de Mistura, the UN chief in Afghanistan, said in a statement.
In an statement the ministry of public health said: "This inhumane act is unprecedented in the history of the conflict in our country and targeted a place where wounds are healed and patients receive treatment."
One man who lives near the hospital, Abdul Rahman, told AFP that he lost seven relatives in the explosion.
"Seven members of my family including three women and two children went to that hospital this morning," he said, through tears.
"I was at home, then I heard a big explosion. When I rushed to the site, I saw many dead and injured people. "Many of them were burning, on fire. There were body parts everywhere. My family is dead, I can't find them, they are under the rubble."
It came at the end of a week when Obama announced that 33,000 US forces would leave Afghanistan by the end of next summer.
All foreign combat forces are due to pull out of the country by the end of 2014. There are currently up to 150,000 foreign forces in Afghanistan, including about 99,000 from the U.S.
Some analysts fear that Afghan security forces may struggle to contain the insurgency, which has hit record levels of violence, as withdrawals begin.
Tensions have flared over civilian casualties, with insurgents and the Afghan government alike criticising NATO-led forces for killing innocent Afghans while hunting for militants.