Dr. Jerry Umanus had seen a lot of violence in Afghanistan, spending more than a decade training doctors and tending to the poor in the war-torn country. But lately, he was growing more worried about his safety.
The pediatrician from Chicago had been shot at while jogging, and a dentist who lived in a neighboring compound had been killed in January.
"He was obviously concerned," said his friend and colleague, Dr. Art Jones. "At the same time, you can't count the number of children that Jerry's impacted, the lives he's saved on his own, and the doctors he trained. That's who he was. He was driven by the kids."
Thursday morning, Umanus was among three Americans killed when a security guard opened fire at a Kabul hospital funded by a U.S. Christian charity, in the latest of a spate of attacks on foreign civilians in Afghanistan.
Umanos was gunned down along with a father and son visiting the CURE Hospital, which specializes in children's and maternal health, according to Health Minister Suriya Dalil.
"As they were walking out of the hospital, the security guard opened fire on them, killing three and wounding another one," an Interior Ministry official said.
Umanos had worked as a pediatrician at Lawndale Christian Health Center in Chicago for more than 16 years when he and his wife moved to Afghanistan. Umanos worked at a community health center and at a children's hospital in Kabul, helping train Afghan doctors.
He coordinated Afghanistan's only residency training programs and directed clinical care for under-served residents of Kabul, according to his online biography.
"He was a great person, a great doctor. It's a great loss," said Umanos' mother-in-law, Angie Schuitema. "He was doing what he wanted to do. He thanked God for allowing him to help people there.
"He always wanted to be a missionary and he felt this was one way he could do it," she added. "He was brought up knowing the Lord and wanting to do work for the Lord. . . .His desire was to work with other people and help them."
She said Umanos worked with both patients and doctors in Afghanistan. Although he "knew people who were killed over there," he didn't talk much about it. "He probably tried to save me from that," she said.
"He had a great sense of humor. He loved funny stories," Schuitema said.
Umanos' wife had been a social worker in Chicago, then got her degree to teach special needs children. She taught at the international school in Kabul for two years before returning to Chicago, where she is a special needs teacher for Chicago Public Schools.
"She feels the same way he did," Schuitema said of her daughter. She said the family was waiting for details about getting the body back home.
Usman Sharifi, 28, a military doctor who has worked as a journalist for Agence France-Presse for the past two years in Kabul, said he saw Umanos at a wedding reception in the center of Kabul the night before the attack.
"He seemed very happy and nice,'' Sharifi said during a phone interview. "He seemed comfortable.''
Umanos was sitting at a table with about seven or 10 others and shook hands with the groom when he came in, Sharifi said.
"Dr. Jerry was there with some Afghan doctors to attend the wedding party of Dr. Wasy Payenda, who had been trained as GP in CURE Hospital,'' Sharifi said. "They were trying to get him to dance the Afghan way.''
Sharifi was not at the hospital at the time of the attack but was working at an office about 5 or 10 kilometers away. "I called a doctor friend and asked, 'What has happened? Is everybody fine?' He said in a sorrowful voice that 'We are fine but Dr. Jerry is dead.'
"So I called two more doctor friends and they also confirmed. One was crying. They were all Afghan doctors, colleagues working in CURE Hospital,'' Sharifi said. "I couldn't believe Dr. Jerry was dead, because I had seen him happy and well and alive in the wedding hours earlier.
"It's very tragic,'' Sharifi said. "How could this happen? I was shocked. It's the first time a hospital was attacked."
Umanos had been one of the first doctors hired at the Lawndale clinic, and it took little convincing to recruit him despite the fact that his salary would be the same as when he was a medical resident, according to Jones, one of Lawndale Christian Health Center's founders.
"He was just the fourth doctor we had, and he was with us ever since," Jones said. "He was committed to his faith and to helping the poor."
About seven years ago, Umanos took a brief trip to volunteer at the CURE clinic in Afghanistan, and within a few years he was spending most of the year in the war-torn country, training doctors and living in spartan conditions.
While "Dr. Jerry" was less frequently on hand at the Lawndale clinic, a wall in the lobby was covered with pictures and statistics about conditions in Afghanistan, Jones said.
"I don't know anyone who went as often or stayed as long as Jerry. He sort of realized that how he was spending his time, the magnitude of impact he could have in a place like Afghanistan, even compared to the inner city in Chicago, was just so much greater," Jones said.
"He basically came back here for a few months each year, to make enough money so he could go back," he added.
Jones visited Umanos in Afghanistan twice, spending a few weeks each time.
"I was there for a few weeks five years ago. It was winter, and the house was so cold, they didn't need a refrigerator. They could just leave the food out in the kitchen," Jones said.
The Lawndale Christian Health Center provides affordable health services. Founded in 1984 by a local church on the site of a former Cadillac dealership, the health center has expanded to offer a fitness center and has satellite clinics in Homan Square, Farragut Career Academy and Archer Heights.
More than 30 staff members from the Lawndale clinic have traveled to Kabul "to assist in teaching physician residents, midwives and community health workers," the clinic says on its website. "Additionally, many LCHC providers and staff have traveled to countries such as Haiti, the Dominican Republic, Pakistan, Indonesia and Liberia."
Attacks on security forces, Afghan civilians and Westerners have been on the rise since the beginning of the year as Western forces prepare to leave the country and Afghans choose a new president.
The shooting occurred in the grounds of the CURE Hospital, considered one of the country's leading hospitals, as well as being a training institution.
"They were not the people carrying guns, they did not have military uniforms, they came here under immense pressure and were here only to serve the people of Afghanistan," Dalil said.
"This was an inhumane and brutal action, and unfortunately will impact our health services."
The CURE organization began operating the hospital in 2005 at the invitation of the Afghan government. According to CURE's website, 27 doctors and 64 nurses work there.
The attack came almost three weeks after Associated Press photographer Anja Niedringhaus, 48, was killed and reporter Kathy Gannon, 60, wounded while they were sitting in the back of a car in the east of the country.
The assault on the journalists came shortly after an Afghan journalist with the AFP news agency was killed alongside eight other people when Taliban gunmen opened fire inside a luxury hotel in the center of Kabul.
Also in March, a gunman shot dead Swedish journalist Nils Horner, 51, outside a restaurant in Kabul.
Eight Afghans and 13 foreigners were killed in January when a Taliban suicide bomber and gunmen attacked a restaurant in Kabul's diplomatic district.