All the international aid agencies had last night pulled their staff out of the immediate vicinity of Grozny, which was deemed too anarchic for them to operate in effectively, or were prepared to do so if the situation deteriorates.
"This is an attack directed at far more than six aid workers from the International Committee of the Red Cross", said Kim Gordon-Bates, a spokesman for the Geneva-based organisation, which operates in war zones to protect victims of war, whether prisoners, wounded or victims of associated diseases such as TB and polio.
"It is an image of conflict to come. It is what happens when people in positions of responsibility have hidden agendas. It is very serious writing on the wall. If someone wants to boast of the murder of five women in their beds - let them boast..."
The Red Cross had 20 workers in Chechnya. Last night the 13 who had survived and not been wounded had been withdrawn to Nalchik, the main airfield for Grozny, used by the Russian forces in the disastrous military campaign terminated recently.
The Red Cross said the move was temporary and that the organisation remained independent of other international agencies. "We've frozen operations for now," Mr Gordon-Bates said. "A certain number of answers have to be given: the whos, the whys. The people who did this knew what they were doing. They knew damn well it was a hospital. It was extremely well-marked."
The Red Cross make a point of being well-known in the areas where it is operating as this is the best form of security. The ICRC has a "Dissemination Department" whose job is to ensure every official and soldier on every checkpoint is told what the Red Cross does and why, and why the Red Cross should be allowed to do it. Only when full "political preparation" is complete does it set up a permanent base, such as the hospital where the staff attacked early yesterday morning were working.
The international aid agencies or non-governmental organisations recruit people, mainly in their thirties, with a wide range of relevant skills for relief and development work. Medical staff - doctors, nurses and medical technicians - are particularly valued. Service abroad with an international agency, gaining experience of primary health care and certain diseases rare in the West, is a step on the promotion ladder for many medical personnel, while others find work as a GP or junior hospital doctor in Western country dull or frustrating. Former armed services personnel, officers and senior NCOs, are also attracted to the work.
Like everyone who works in the aid business in Chechnya, the Red Cross workers were willing to do their job amid considerable danger. Since the war began, in December 1994, two foreign aid workers - an American and a Finn - have been killed. Others have been subject to threats, intimidation, and kidnappings. This year nine people from the ICRC, have been kidnapped, for brief periods, in a rash of abductions from almost every aid agency.
One of these occurred at the Novye Atagi hospital this autumn, although it was quickly resolved by the agency, using its Chechen contacts.
According to the Red Cross, security had since been tightened up, but the building was not heavily guarded. Clearly, the murders - a low point, even by the dismal standards of blood-soaked Chechnya - were beyond anyone's worst expectations.
Yesterday leaders in Chechnya's temporary separatist-led government were quick to condemn the killings. The deputy prime minister, Movladi Udugov, described them as "a dreadful link in the chain of provocations aimed against the fragile peace in Chechnya".
But it will require more than words to coax the Red Cross back to the republic, where it has been providing extensive medical aid, food and other assistance. The agency, the largest in action in the war zone, will want solid guarantees that its workers will be safe.