Working in a 'code-red' country

The Afghan National Police guard who opened fire last week on Americans at the Cure International Hospital in Kabul had been working at the facility three weeks, Cure CEO Dale Brantner told me.

Because the shooting took place inside the hospital gates, the gunman—who wounded himself in the incident—was taken into surgery there before he was taken into custody. He was treated by Afghan doctors trained by Jerry Umanos, 57, the hospital pediatrician the gunman killed in Afghanistan’s latest “insider attack.”

Brantner, who spoke to me from Tel Aviv, said his organization does “constant assessments” of security at the Kabul hospital, one of the largest medical facilities in the Afghan capital. But Brantner acknowledged, “Cure works in code-red countries, underserved parts of the world that are broken and corrupt where health care is not a priority.”

“There is always risk,” he said. “We’ve never tried to paint Afghanistan as a safe place.”

But Cure and other organizations also are constrained from taking additional security measures due to a law in Afghanistan that prevents them from having their own armed security. The Afghan government provides armed police guards at the facility considered essential in the war-torn country. “We have no employed armed guards, but we do have employees involved in screening visitors and securing the premises,” said Erin Card, Cure’s vice president of operations.

Neither the Taliban nor other groups have claimed responsibility for the April 24 killing of three American civilians, the latest in a series of similar attacks this year that have killed 22 foreign, non-military workers in Afghanistan. Earlier this month, a German photojournalist with the Associated Press, Anja Niedringhaus, was shot dead by one of her Afghan National Police guards while sitting in the back of a car with AP reporter Kathy Gannon, who was wounded in the attack. Like Umanos, both had long experience working in Afghanistan and by all accounts good relationships with their Afghan colleagues.

The Cure hospital specializes in pediatrics and women’s health. Umanos was the lead physician for training other hospital personnel in pediatric care and surgery, dividing his time between Kabul and Chicago, where he worked at a private clinic for low-income patients, Lawndale Christian Health Center.

The hospital in Kabul is a 100-bed facility with 27 physicians currently on staff. They see 37,000 patients a year from all over the country. Umanos was conferring with colleagues inside the pediatric wards mid-morning last Thursday when he took a call from the gatehouse, where visitors had arrived to see him. It was a protocol similar to one I followed multiple times while visiting the hospital in 2010: The facility is surrounded by a tall block wall and gate with armed security inside and outside. Visitors, including most patients, must present identification and pass through the gate to a waiting area just inside. There they are subject to body searches and must give a contact in order to be admitted to the hospital itself. The hospital contact then comes to meet the visitors and walks them across a courtyard, planted with roses, to enter the hospital itself.

For Umanos and his visitors, the security protocol itself proved deadly. Umanos went out to meet friends, including John Gabel, a physician in Kabul who supervises a pharmacy clinic at Kabul University under the auspices of Colorado Springs-based Morning Star Development. Gabel was there along with his wife and his father Gary, who was visiting from Chicago to see his son’s work. As the group crossed the courtyard, the police guard, named Anyuddin, raised his Kalashnikov rifle and opened fire, according to hospital staff. Then Ayuddin shot himself in the stomach.

Along with Umanos, both Gary Gabel and his son John were killed. John Gabel’s wife, also an American, was wounded.

Gary Gabel and his family for decades have been members of Orchard Evangelical Free Church in Arlington Heights, a Chicago suburb.

Umanos’ wife, Jan Schuitema Umanos, was in Chicago at the time of the attack but read a statement the same day, joined by the couple’s son Ben, a police officer in Grand Rapids, Mich. The family all has lived in Kabul, and Jan Umanos for years taught at the international school there.

“I’d like to start by saying our family has suffered a great loss,” she said. “We are also aching for the loss of the other families … as well as the loss that the Afghan people have experienced. My heart aches for the Afghan people.”

Jan Umanos spoke of her husband’s “love for the Afghan people,” and said “we don’t hold any ill will towards the Afghan people in general or even the gunman who did this.” She said Jerry “always wanted us to serve underserved populations and Afghanistan was just one of them. He always had a desire to be the hands and feet of Christ.”

Brantner told me Cure had begun to draw down American personnel at the hospital to coincide with the expected drawdown and withdrawal later this year of nearby U.S. troops. The hospital’s director currently is a Romanian and its financial officer is Kenyan. Brantner said they are “not targets” in the same way Americans might be.

Going forward, Brantner said Cure will continue to review what happened but does not plan to change its presence in Afghanistan: “We won’t be doing anything different than being culturally sensitive and unapologetically Christian in serving needy Afghans.”