The Red Cross was last night poised to cut back operations in Iraq after its Baghdad offices were struck by a suicide bomber posing as an emergency service worker.
Other organisations providing medical aid have already reduced their staff.
While no decision has yet been made, officials at the International Committee of the Red Cross (ICRC) world headquarters in Geneva said that the attack that killed two Iraqi employees and up to 10 other people outside the compound had forced the organisation to hold a wide-ranging review of its operation. The suicide bomber was in an ambulance bearing the ICRC emblem.
"Such an attack is a major blow for us," said an ICRC spokesman, Florian Westphal. "It's a big shock. It is obviously impossible to move on to a normal day's business, so we really have to step back and take stock. It's too early for us at the moment to say how this attack will impact on our activities. We will have a fairly clear idea within the next few days how we want to proceed."
The bombing was part of coordinated series of attacks that also targeted three police stations and is the first directed at the ICRC in the more than 20 years during which it has operated in Iraq. Since 1980, it has provided assistance during the Iran-Iraq war and the Gulf war in 1991.
But officials said that they believed that the organisation, which has 39 expatriates and more than 700 Iraqi staff, had not been struck by accident.
"We are quite convinced now that we have been targeted as an institution. Our Iraqi staff is as much targeted and threatened by these kind of attacks as expatriate people," Pierre Gassmann, head of the ICRC's Baghdad office, told CNN.
"We are now thinking about what we can do in order to protect [ourselves] and see how we can continue working. We have to think about all of the implications that this attack will have and by Saturday this week we'll have taken decisions.
Mr Gassmann said that the organisation would not be seeking further military protection from the US, in order that it could be "distinguished" from the occupying forces. "That is not an option because if you do militarise the Red Cross and the access to the Red Cross, it will be extremely difficult for the people who are seeking our help to get access to the Red Cross," he said. "We want to avoid that."
The attack on the ICRC, which has been working in conjunction with the Iraqi Red Crescent on projects that included landmine education and the provision of water and sanitation equipment, highlighted the dangers that even organisations not linked to US forces face in Iraq.
Other aid groups, which have been jittery since the August attack on the Baghdad offices of the UN which killed the special envoy, Sergio Vieira de Mello, are now scaling back their operations. The Paris-based humanitarian group Médecins Sans Frontières said that it would "scale down its current expatriate team of seven in Baghdad". It said that by hitting the Red Cross, the attackers "aimed their explosives at the symbolic heart of neutral assistance".
The Greek branch of Doctors of the World, which continued working in Baghdad during the US-led assault, said that it would probably pull out at least two of its three members of staff as a result of the suicide bomb attack.
The German government said that it was considering the withdrawal of a four-member team of water-supply experts sent to Iraq in September.
Mr Westphal said that several weeks ago, the ICRC had received "unspecified warnings that we may at one stage or another be the targets of an attack".
He said it that was unclear which groups would wish to target the organisation. "[The warnings] were not in any way specific and it was really impossible to read too much into that except obviously that the situation is extremely difficult and dangerous,"he said.
AUG 7: Car bomb at Jordanian embassy kills 17
AUG 19: Truck bomb kills 22, including envoy, at UN headquarters in Baghdad
AUG 29: At least125 people killed when car bomb explodes outside the Imam Ali mosque in Najaf
SEPT 9: One killed and 53 wounded in car bomb in Arbil, northern Iraq
SEPT 22: One killed and 19 wounded in suicide car bomb at UN police checkpoint in Baghdad SEPT 25: Bomb at Aike Hotel in Baghdad kills one.
OCT 9: Suicide bomb atpolice station in Baghdad's Shia area kills eight
OCT 12: Six killed and 32 wounded in a blast at Baghdad Hotel, in city
OCT 14: Suicide bomber wounds 10 outside Turkish embassy in Baghdad
OCT 26: Rocket attack on al- Rashid Hotel where US deputy defence secretary, Paul Wolfowitz, is staying, kills one and wounds 17Reuse content