The boy had lost his legs in a February airstrike by U.S. Special Operations forces helicopters that killed more than 20 civilians. Karzai scooped him up from his mattress and walked out to the hospital courtyard, according to three witnesses. "Who injured you?" the president asked as helicopters passed overhead. The boy, crying alongside his relatives, pointed at the sky.  The tears and rage Karzai encountered in that hospital in Uruzgan province lingered with him, according to several aides. It was one provocation amid a string of recent political disappointments that they said has helped fuel the president's emotional outpouring against the West and prompted a brief crisis in his relations with the United States. It was also a reminder that civilian casualties in Afghanistan have political reverberations far beyond the sites of the killings.  Before dawn Monday, American soldiers strafed a passenger bus that approached their convoy outside Kandahar City, killing at least four Afghans, including a woman, and wounding 18 others in another incident that Afghan officials warn could hurt the U.S. military effort. The city, which spawned the Taliban movement, has become the focal point of American military efforts for the next few months. Of the 30,000 additional U.S. troops President Obama ordered to Afghanistan, 13,000 have arrived, and thousands more are headed to Kandahar in preparation for a summer offensive intended to roll back the insurgency.  But Karzai told a gathering in Kandahar last week that he would not permit an American offensive there unless the people supported it. After Monday's shooting, residents blocked a road, denounced the American presence and demanded justice.  "This is a savage action. They have committed a great crime," said Bismillah Afghanmal, a member of Kandahar's provincial council. "They knew that this was the public transportation way. . . . Buses always use that road."  Tooryalai Wesa, the governor of Kandahar, condemned the shooting and called it "very irresponsible."  Under Gen. Stanley A. McChrystal, the top U.S. commander in Afghanistan, NATO forces have made reducing civilian casualties a top priority. McChrystal has restricted night raids, home searches and the close air support that troops often request during firefights, all in an effort to mitigate collateral damage to Afghan civilians. The U.S.-led NATO force issued a statement Monday saying it "deeply regrets the tragic loss of life" in Kandahar.  But high-profile civilian killings continue to attract wide attention in Afghanistan. A Feb. 12 nighttime raid by U.S. Special Operations forces near Gardez, in the southeast, that killed five people, including two pregnant women, is being investigated after Afghan officials alleged that U.S. troops tampered with evidence at the scene.  After the Feb. 22 Uruzgan airstrike -- on a bus mistakenly thought to be carrying insurgents -- killed more than 20 people, Canadian and American forces patrolling far from the scene in Kandahar City reported a sudden deterioration in residents' attitudes toward them. In some cases, residents threw rocks and spit at troops, according to U.S. military officials.  "We have to calm people. You have to give them some satisfaction as to whether this will continue or not," Shaida M. Abdali, the deputy national security adviser, said in an interview last week.  Abdali praised McChrystal's efforts to reduce civilian casualties and said the commander "has always been quick to apologize," but he said the Afghan government thinks more needs to change.
KABUL -- Twelve days before President Hamid Karzai denounced the behavior of Western countries in Afghanistan, he met a 4-year-old boy at the Tarin Kowt civilian hospital in the south.