( CNN ) -- Once again , the news from Afghanistan fills us with sadness and suggests that perhaps we should despair , that maybe it 's time to give up hope for the country . On Thursday morning , an Afghan guard allegedly opened fire at the gates of a hospital in Kabul , killing three Americans , including Chicago pediatrician Jerry Umanos and a father and son , also doctors , visiting the medical facility . Civilians have suffered the brunt of Afghanistan 's decades of turmoil , but when the killers target aid workers , people who have left their lives behind to come and help , their message is loud and painfully clear : `` Go away ! '' In the anger , frustration and heartbreak that follow these attacks , I 've heard it many times , people declare : `` That 's it . It 's time to leave . '' In today 's incident , the guard opened fire on a group of five doctors as they walked from the gate to the building housing the hospital run by CURE International , a Christian charity that says it came to Afghanistan in 2005 at the invitation of the Afghan government . CURE says it treats patients without regard to religion , gender or ability to pay . The hospital specializes in child and maternity care . Umanos had worked in Afghanistan since 2005 . His colleagues say he loved the country . In addition to treating Afghan patients , Umanos helped train Afghan physicians , a key requirement for building a country that eventually can become independent and self-sustaining . Attacks against foreigners have been on the rise in Afghanistan . Earlier this month , two journalists from The Associated Press were shot . Photographer Anja Niedringhaus was killed . In January , a Taliban suicide bomber blew himself up in a restaurant popular with foreigners , killing 21 people , most of them expatriates working for the local university , the United Nations , and the International Monetary Fund -- all trying to help Afghanistan rebuild . Last month , Taliban gunmen burst into the restaurant in Kabul 's Serena Hotel , killing nine people , including women , children and several foreigners , some in the country as international observers for the April 5 presidential elections . What to do ? There is no more difficult decision for a humanitarian organization than pulling up stakes under fire . It 's a choice each group makes considering its own circumstances , just as individuals choose how much risk to take for a cause they believe worthwhile ; just as news executives anxiously decide how close to the line of fire to send their journalists . You could hear the pain in the voices of Doctors Without Borders ( MSF ) leaders last year , for example , when the group announced it was leaving Somalia after 22 years as `` a direct result of extreme attacks on our staff , '' occurring while , the organization said , civilian leaders were tolerating and condoning the killing and kidnapping of aid workers . Over the course of more than two decades , MSF staff had endured enormous risks . But , they said , `` We have now reached our limit . '' What makes these decisions particularly difficult is that they victimize the people who suffer the most and they reward the brutality of perpetrators , people who blow up schools , shoot doctors , and massacre civilians . The latest tragedy in Kabul will undoubtedly prompt emergency meetings and anguished soul searching . Organizations working in Afghanistan will weigh the desperate needs of the Afghan people against the dangerous reality for their workers . Some may pull out . Others will strengthen security , while conscious that the latest victims were killed by their supposed protectors . There is no shame in leaving or cutting back . But there is one thought all who have worked in Afghanistan should keep in mind . There is one point that those who have been hurt there and the families of those who died in Afghanistan should always remember : It has not been in vain . Afghanistan is still a place where terrible things happen , and it is a country with a long and steep road ahead . But it is not what it once was . At the turn of the century , Afghanistan was a ruin of a state , a maelstrom of suffering ruled by the Taliban , who were succeeding in their effort to move their country to their pre-medieval ideal . The `` government '' held public executions , often by stoning , in the local stadium . Afghanistan had become an international terrorist base , a place where modernity and freedom were banished . In 1998 , Physicians for Human Rights described Kabul as `` a city of beggars , '' where women who had been doctors and nurses and teachers moved through the streets `` like ghosts '' in their all-enveloping Burkas selling everything they owned to feed their children . PHR declared the Taliban 's threat to women 's rights as `` unparalleled in recent history . '' Today , the Health Minister who described the attack to CNN is a woman , as are other cabinet members . Women can be found -- albeit in small numbers -- in most sectors of the country . And , incredibly , Afghanistan surprised even itself with a successful presidential election on April 5 . The results wo n't be known for a few weeks , a second round of voting will likely follow , but the verdict from the people is in with enormous force . Despite threats from the Taliban to punish anyone who participated , despite terrible or nonexistent roads and awful weather , Afghans went to the polls by the millions . One member of Parliament , Shukria Barakzai , told CNN , `` As much as they killed our children , our journalists and innocent women , we say now , we will go and vote . ... We want to see real change . '' The next president , elected by the men and women of Afghanistan , will face a mountain of overwhelmingly difficult challenges . And he will do it while American troops pull out . He , and the people of Afghanistan , will continue to need help against individuals who are willing to shoot doctors to keep foreigners out , throw acid in girls ' faces to keep them from going to school , and massacre civilians in order to take power . There is no doubt that we will hear more sad news from Afghanistan . More people will die . But we should remember that those who have sacrificed have done it for something important , worthy . They have alleviated suffering and helped bring the prospect of a lasting , better future for the people of Afghanistan . It 's no time to despair .
Three American doctors killed by Afghan guard at Kabul hospital . Ghitis : Our first step is to ask if it 's worth withdrawing American workers in Afghanistan . She said aid organizations face tough decisions about withdrawing staff . Ghitis : There 's no doubt that Afghanistan is a better country than at start of century .