KABUL, Afghanistan -- Three Americans -- a pediatrician and a father and son -- were killed by an Afghan government security officer at a hospital Thursday, the latest in a series of attacks on foreign civilians that has rattled aid workers, contractors and journalists.
Another American, a female medical worker, was wounded in the attack at Cure International Hospital of Kabul, run by a U.S.-based Christian charity, and the gunman also was wounded, officials said.
The hospital staff performed surgery on the attacker, who had shot himself, before he was handed over to Afghan authorities, Cure said in a statement. But Interior spokesman Sediq Sediqqi said the assailant was shot by other security guards.
The attacker's motive was not clear, police said, and there was no Taliban claim of responsibility by Thursday night.
As international troops withdraw, civilian workers increasingly fear that they are considered prime targets by militants. Some are rethinking their safety -- and even if they will stay.
All three of the dead were identified as American doctors by Bektash Torkystani, a Health Ministry spokesman. But the U.S. Embassy confirmed only that three American citizens had been killed. Cure said a doctor was one of three people killed.
Among the dead was Jerry Umanos, a 57-year-old pediatrician from Chicago, according to his mother-in-law, Angie Schuitema. The Lawndale Christian Health Center in Chicago said Dr. Umanos worked there for more than 16 years before moving to Afghanistan in 2005.
Health Minister Soraya Dalil said the other two dead Americans were a father and son, who were visiting, and that a U.S. nurse was wounded.
The shooting continued a deadly pattern of attacks on civilian targets in Kabul. In January, a Taliban attack on a popular restaurant with suicide bombers and gunmen killed more than a dozen people. In March, gunmen slipped past security at an upscale hotel and killed several diners in its restaurant. Two foreign journalists were killed and another one wounded in two separate attacks.
But attacks on Western civilians have not been limited to Kabul. On April 4, an Afghan police officer shot two Associated Press journalists working in the eastern province of Khost, killing photographer Anja Niedringhaus and wounding reporter Kathy Gannon.
The hospital shooting is also the second "insider attack" this month by an Afghan security forces member targeting foreign civilians.
While aid groups have been targeted before, the frequency of such attacks has disturbed a community used to the daily risk of working in conflict zones.
"We're not seeing aid workers running for the airport, but many organizations are taking a careful look at their security postures," said Graeme Smith, a senior analyst in Kabul for the International Crisis Group.
Violence has spiked overall in Afghanistan, as insurgents sought to disrupt the April 5 presidential election and sow insecurity ahead of the troop withdrawal, nearly 13 years after the U.S.-led invasion to topple the Taliban's radical Islamic regime.
Afghan civilians, of course, have suffered the longest. A United Nations report said 2,959 Afghan civilians were killed last year, up 7 percent. Most of those deaths were caused by the insurgency, many of them by roadside bombs planted around the country.