Return Home

Report of the Commission on the Truth for El Salvador

UN Commission on the Truth for El Salvador, From Madness to Hope: The 12-Year War in El Salvador, Report, 15 March 1993, in UN Secretary General, Letter to the President of the Security Council (S/25500), Annex. (PDF link)


(g) San Sebastían (1988)

(i) Garcia Arandigoyen (1990)



On 15 April 1989, air force units attacked an FMLN mobile hospital. 275/ Five of the 15 people in the hospital were killed: three Salvadorians - Juan Antonio (a patient), Clelia Concepción Díaz (a literacy instructor) and María Cristina Hernández (a nurse and radio operator) - and two foreigners: José Ignacio Isla Casares (an Argentine doctor) and Madeleine Marie Francine Lagadec (a French nurse).

A Salvadorian air force unit attacked the hospital. Members of that unit deliberately attacked the medical staff in violation of international humanitarian law and captured the French nurse Madeleine Lagadac alive and executed her. Since no autopsies were performed on the other persons killed, it was not possible to ascertain with the same degree of accuracy whether they too were executed.


The attack

According to witnesses, at about 7 a.m. or 8 a.m. on 15 April 1989, two low-flying A-37 aircraft bombed the area surrounding an FMLN mobile hospital located near the Catarina farm in El Tortugal canton, San Ildefonso district, Department of San Vicente. Three UH 1M helicopter gunships, a Hughes-500 helicopter and a "Push-Pull" light aeroplane took part in the attack. A few minutes later, six helicopters carrying paratroopers armed with M-16 rifles arrived on the scene. At 8.15 a.m., the helicopters dropped the troops near the hospital. The bombardment lasted 15 minutes.

Fifteen people were in the hospital when the attack started. Most of them started to escape; one of the patients returned the attackers’ fire before fleeing. María Cristina Hernández, a nurse and radio operator, and Juan Antonio, one of the hospital’s patients, were seriously injured in the attack.

Madeleine Lagadec, a French nurse who had been working with FMLN for three years, refused to run away and stayed behind to attend to María Cristina. José Ignacio Isla Casares, the Argentine doctor in charge of the hospital, and Clelia Concepción Díaz Salazar, the literacy instructor, also stayed behind.

Those who escaped witnessed what happened next. The soldiers closed in and the radio operator for the group of paratroopers informed his commanding officer that "mercenaries" had been captured and requested instructions. The soldiers then questioned the three captives and screams were heard, the loudest being those of Madeleine Lagadec. Next, some shots rang out. The soldiers left that afternoon. 276/

There is substantial evidence that the operation was carried out by a group belonging to the "Special Operations" unit of the Salvadorian air force (paratroopers backed by artillery and aircraft fire). They were part of "Operación Rayo", designed to destroy the logistical and command structure of the Partido Revolucionario de Trabajadores Centroamericanos (PRTC) in the area.

The investigation

On 17 April, a COPREFA communiqué was published announcing that nine people had died in an army attack on a PRTC command post. It also reported that weapons and medical equipment had been seized. 277/

That same day, FMLN members found the bodies at the scene. According to two of them, only Madeleine Lagadec’s torso was clothed, her trousers had been pulled down to the knees, she did not have any underwear on under them 278/ and her left hand had been severed at the wrist. There were bullet holes in the skulls of the five bodies. 279/

The autopsy

An autopsy was performed only on the French nurse, in France on 2 May 1989. 280/

The autopsy found at least five gunshot wounds on Madeleine Lagadec. Two wounds - to the head and in the left shoulder blade region - were potentially lethal. The wounds were significant for the small calibre of the bullets used (between 5 and 6 mm) and their considerable destructive power, for which the only possible explanation is great velocity. No precise explanation was found for the amputation of the left hand. The French doctors said that the diversity of the trajectory of the projectiles made the theory of an execution highly unlikely. 281/

However, Dr. Robert Kirschner, 282/ who analysed the autopsy reports written in France and the sketches and documentation in the possession of this Commission, concluded that Madeleine Lagadec had been executed. 283/

In the analysis he made for the Commission, Dr. Kirschner, one of the world’s foremost analysts of summary executions, explained that "The wounds and their trajectories provide significant evidence of the manner in which Madeleine Lagadec was killed. There were six gunshot wounds of the body, including three to the chest, one in the medial aspect of each thigh, and one to the head. All of these wounds passed from front to rear, upward, and in a medial to lateral direction ... The pathologists who performed the autopsy were of the opinion that the diversity of the trajectory of the projectiles made it unlikely that this was an execution. I disagree with this conclusion. While the gunshot wounds to the chest might have occurred while the victim was standing, the wounds to the thighs almost certainly were inflicted while she was lying on the ground, and those of the chest are more consistent with having been inflicted while she was supine. Of special importance, the gunshot wound of the right temporal region of the head, which passed on a horizontal plane and exited from the left temporoparietal region of the scalp, was a characteristic coup de grace wound, and a trademark of the extrajudicial execution." 284/

Dr. Kirschner’s conclusion that Madeleine Lagadec was executed is also supported in a separate analysis made by experts in electronic microscopy in France. 285/ They first ascertained that the victim had been shot when already half-naked: "(...) there are no traces of bullets on the brassiere, briefs and trousers, while there are gunshot wounds to the right breast, the pelvis and the lower limbs (...) It can be deduced that the victim was not wearing those three items of clothing when the shots were fired." 286/

As for the distance from which the shots were fired, the above Centre puts forward two theories that contradict the assertion that Madeleine Lagadec’s wounds were inflicted from a distance. 287/


The Commission finds the following:

1. There is sufficient evidence that a unit of the Salvadorian air force attacked the field hospital, and substantial evidence that it deliberately attacked medical personnel in violation of international humanitarian law.

2. There is substantial evidence that members of the unit captured the French nurse Madelaine Lagadec alive and executed her.

3. The State of El Salvador failed in its responsibility to investigate the case, bring the culprits to trial and punish them. The Commission was unable to determine whether the other people were also executed, since no autopsies were performed on their bodies.


275/ Located on the Catarina estate, Department of San Vicente.

276/ The operation began at 8 a.m. and ended at 4 p.m. CIHD report, p. 1.

277/ The following items were seized in the operation: Military matériel: 3 machine-guns, 5 machine-gun magazines, 1 M-16 rifle, 1 AR-15 rifle, 8 M-16 magazines, 17 9-millimetre cartridges, 3 40-millimetre grenades, 1 YAESU radio, 1 Sony mini tape recorder, 2 flashlights, 4 rucksacks and 2 soldier’s canteens.

Medicines and medical equipment: 30 injections, 3 antibodies for clinical use, a minor surgery kit, 1 sphygmomanometer and an unspecified quantity of antibiotics. CIHD report, p. 3.

It should be noted that COPREFA news bulletins Nos. 114 and 115 of 17 and 18 April 1989 did not indicate that the equipment seized included medicines and medical equipment.

278/ Madeleine Lagadec’s body was fully clothed in the photographs allegedly taken shortly after the executions and published by COPREFA.

279/ Juan Antonio’s skull had been smashed by a stone, the skulls of Clelia Concepción Díaz Salazar and Isla Casares had bullet exit wounds in the occipital area, María Cristina’s body had, in addition to a shrapnel wound in the stomach, a bullet wound in the forehead with an exit wound in the back of the head. 280/ The autopsy was performed by Dr. Baccino and Dr. Quillien at the morgue of the Keufatras cemetery, Brest, France, at the request of the Public Prosecutor of the Court of First Instance of Brest.

281/ "... the bullet penetrated the skull through the right temple and exited through the left temple; the trajectory was virtually within a frontal and nearly horizontal plane at the level of the base of the skull." Autopsy report signed by Dr. Baccino E. of the SEBILAU Service, Morvan Hospital Research Centre, Brest, and Dr. Quillien J., commissioned by the Public Prosecutor of the Brest Court of First Instance (2 May 1989).

282/ Robert H. Kirschner, MD. Deputy Chief Medical Examiner, Office of the Medical Examiner, Cook County, Chicago, Illinois. Physicians for Human Rights (Board of Directors, Executive Committee).

283/ Report on the autopsy of Madeleine Lagadec. Robert H. Kirschner, MD, Chicago, 10 January 1993.

284/ Ibid.

285/ Report of the Centre d’Applications et de Recherches en Microscopie Electronique. Prepared by Mr. Le Ribault, Doctor of Science, Chairman and Director of the Centre, assisted by Mrs. Monique Roze, whose expert opinions were requested by the Public Prosecutor of the Court of First Instance of Brest, France, 11 May 1989.

286/ It is clear that Madeleine Lagadec was half-naked when she was shot, that she was dressed when her body was photographed by COPREFA, and that her trousers had been pulled down and she did not have any underwear on two days later when she was found by the witnesses who testified to the Commission.

287/ Given the difficulty of analysing the residues of the impact of bullets and also the significant amount of phosphorus present, the Centre d’Applications et de Recherches en Microscopie Electronique puts forward two theories: if the phosphorus was from the explosive, its presence would mean that the shot was fired at close range. It is impossible to determine the range of the shot since neither the type of firearm nor the type of ammunition used is known. The second theory suggests that, if the phosphorus was not from the explosive, it could have been from incendiary bullets based on white phosphorus which ignites in contact with the air. In that case the absence of traces of explosive would indicate that the shot was fired at intermediate range (5 metres or more). It would thus be neither a close-range (point-blank) nor a long-distance shot.