KABUL, Afghanistan — Seven minutes after a truck bomb went off in the Afghan capital on Tuesday, the first teams from Kabul Ambulance Service reached the scene of devastation.
Right away, they knew the attack was bad, but not that it would turn out to be the deadliest in the Afghan capital in 15 years of war.
The teams radioed in the extent of the carnage, activating the small department’s contingency plan: All of its 15 vehicles and staff from across the city were dispatched to the bomb scene, behind the compound of an elite security force along the Kabul River.
Mechanics got behind the wheel and clerks took on nursing duties, ferrying the wounded to the city’s hospitals for hours. “The doors of two ambulances came off the hinges because they were packed with too many wounded,” said Dr. Alem Asem, the ambulance service’s director.
On Wednesday, the Afghan government confirmed that the death toll was double what was initially reported. Sediq Sediqqi, a spokesman for the Interior Ministry, said that 64 people had been killed and 347 were wounded.
But questions have been raised about how the insurgents managed to take large amounts of explosives into the city, detonating a bomb behind the walls of an elite force that is supposed to protect the government’s top officials.
On Wednesday, the police had cordoned off the site of the bombing, which destroyed a large parking lot and the windows of Kabul’s largest mosque, as well as homes and shops. Not even military personnel were allowed through.
The assault has put more pressure on the dysfunctional coalition government, brokered by the United States after the 2014 election ended in a stalemate. The infighting between two former rivals, President Ashraf Ghani and Abdullah Abdullah, the chief executive, has created stagnation on almost every front. Even as insurgents have increased their attacks, the government still doesn’t have a confirmed intelligence chief and minister of defense, because Mr. Ghani and Mr. Abdullah cannot agree.
“This attack isn’t the first, and it won’t be the last one either,” said Mohammad Omar Azizi, the Kabul provincial head for the Afghan spy agency, the National Directorate of Security. To the 108 people who work for Kabul Ambulance Service, that is a warning to be prepared for the worst.
The department, created by the Norwegian Red Cross in 2003, was transferred to the Afghan government a few years ago. It runs a 24-hour call center, coordinating with five small substations across the crowded capital. On Tuesday, the entire Kabul Ambulance Service staff that was present rushed to the scene of the explosion, which occurred before 9 a.m., except for Dr. Asem, the director, as well as two guards and two workers who staffed the call center.
Even as the firefight between the security forces and militants holed up in the compound continued after the explosion, the service rushed victims — as many as 12 in a vehicle meant for one or two — to city hospitals.
“I swear bullets were landing, and we had to duck and rush a body to the ambulance,” said Muhammed Farooq, who has been a mechanic with the service for eight years. “The cars were full of blood.”
Altogether, Kabul Ambulance Service made 83 trips. (Police ambulances also arrived at the scene, underscoring the gravity of the situation.) The last of the wounded was taken to a hospital at 2 p.m., but several ambulances remained at the site until 4 p.m. in case more victims were pulled from the rubble.
For most of the day, “routine callers” from across the city were told no ambulances were available, Dr. Asem said.
By 4 p.m., all 15 ambulances were back at headquarters, and staff members were able to eat lunch, a humble bowl of rice topped with potato and chickpea curry. The ambulances were scrubbed down, the first-aid kits restocked, the fuel tanks refilled.
By 7:30 p.m., the vehicles returned to their substations across the city, ready for another day.