A man injured in a blast leaves a hospital after he received treatment June 3 in Kabul. (Omar Sobhani/Reuters)

As the doctors tried to dress the wounds of patients recovering from a terrible bomb blast, an anti-government protest raged outside the surgical center in Kabul’s diplomatic zone. Men armed with Kalashnikov rifles tried to scale the walls but were turned back by guards.

That was four days ago. On Monday, protesters were still camped outside the gates of the Emergency Surgical Center for War Victims in Kabul, and the hospital administration is threatening to shut down operations because of the shaky security situation in the capital.

In a letter sent to authorities Sunday, the hospital’s program coordinator said that the trauma center “has been put on the front line” and that the doctors, nurses and staff “do not feel safe anymore continuing our job here in Kabul.”

If the hospital — which has treated 1,350 Afghans with war injuries so far this year — stopped operating because of violence, it would be the first time since Taliban rule ended 16 years ago.

On Monday, the hospital — a series of low-slung white buildings trimmed in red, surrounding a garden courtyard — was an oasis of calm as anti-government protesters continued to shout their demands into a megaphone just outside the gates.

Abdul Matin comforts his son Fahim, 10, who had surgery at the Emergency Surgical Center for War Victims in Kabul after being hit with shrapnel by an explosive device. The center may shut down because of the security situation in the capital. ( Annie Gowen/The Washington Post)

“We fear that the protests could become a target. Nothing is off limits now. They have attacked funerals, hospitals. There is no decency left in Afghanistan,” said Dejan Panic, the program coordinator for the center, part of an Italian nongovernmental organization that treats the injured in conflict zones around the world.

The group — founded by an Italian surgeon named Gino Strada — began working in Iraq in the 1990s and later expanded into Afghanistan. In 2000, Taliban leader Mohammad Omar agreed to let it open a hospital in Kabul, in a former Soviet-built kindergarten where five children had once died in a rocket blast.

In 2010, the hospital began treating only patients with war injuries — mostly civilians who are hit by shrapnel or bullets or who step on land mines. Afghan civilian casualties are at an all-time high, according to the United Nations, with nearly 11,500 killed or wounded last year, two-thirds by militants.

The staff has seen dangerous times before. In 2012, six Taliban insurgents dressed in burqas scaled a nearby building and waged an 18-hour gun battle with security forces. Gunfire ricocheted down into the hospital garden and across the lawn.

But a spokesman says the NGO has never stopped operating because of violence, although it has twice been shut down for political reasons when staff and an Italian journalist were kidnapped in separate incidents.

On Wednesday, the hospital was rocked by the massive blast of a bomb hidden in a sewage tanker just steps away. That explosion killed at least 150 and injured more than 500 in central Kabul. Around 120 of those victims ended up at the emergency center.

In the protests that followed, six more people were killed.

Afghan men receive medical treatment at a hospital in Kabul on June 1, a day after a massive truck bomb in the Afghan capital killed nearly 100 and injured more than 500. (Shah Marai/AFP/Getty Images)

Abdul Matin, 28, a wheat farmer from the northeastern province of Takhar, arrived at the hospital with his son on Wednesday not long after the bomb blast, winding his way through police barricades. He was intent on only one thing — getting his son to surgery.

Fahim, 10, had been seriously injured the week before by an improvised explosive device that a relative had picked up off a road.

The violent protests that followed Fahim’s hospital admission only heightened his father’s anxiety, Abdul Matin said, as he wheeled his badly injured son around the hospital grounds.

“His mommy, too, is very concerned,” he said. “She calls and he can make little sounds now, and that makes her happy. She’s desperate that he come home alive.”

Medical coordinator Giorgia Novello said the staff — doctors, nurses, aides and guards — is more stressed than she has seen since she began working in Afghanistan in 2009.

“The guards are exhausted; the staff is exhausted. They are scared, too,” Novello said.

A spokesman for Afghanistan’s Ministry of Public Health, Wahid Majrooh, said he expected that the surgical center would remain open and that officials were trying to negotiate with the protesters to move to a different site. If the 120 patients were to be moved, there are 17 state-run hospitals in Kabul, five of which receive war or other trauma victims.

“We have seen better days,” Panic said. “After all these events, it’s hard to believe Kabul will become safe again. I’m just hoping there’s no more violence between protesters and security forces, because we’re exactly in the line of fire.”

Sharif Walid and Sayed Salahuddin contributed to this report.