Fierce battles near Lashkar Gah, the sand-swept capital of Afghanistan’s remote but strategic Helmand province, are continuing to rage between a handful of Taliban fighters and hundreds of Afghan forces backed by ground reinforcements and American airstrikes. Thousands of civilians have fled the surrounding districts, insurgents have blown up bridges, and the only highway out of the region has been cut off for nearly two weeks.

Officials said Lashkar Gah does not appear to be in danger of falling, but large patches of Helmand — a vast, dry territory in southern Afghanistan — have been under insurgent control for months, and their forces have moved steadily closer to the city. Recapturing the former bastion of Taliban power, which was liberated and controlled by NATO forces for years, would give the Islamist militia a launchpad near its current sanctuaries in Pakistan, control of the region’s vast opium trade and a huge propaganda boost.

So far, the insurgents have fought partway into the urban area but are being repelled elsewhere, according to local officials. Fighting continues in one district of the capital, Babaji, and safer neighborhoods have been flooded with more than 18,000 families fleeing conflict in outlying areas. Many have erected tents in vacant lots and abandoned stores, but only a fraction are receiving emergency food and supplies, they said.

“The situation is one of intense fighting, and the people are under a lot of pressure,” Kareem Atal, head of the provincial council, said in a telephone interview Saturday from Lashkar Gah. “Buses and trucks cannot go in and out of the province, so the price of rice and potatoes is rising very high, and the price of our melons and other fruits for export has fallen.”

Doctors Without Borders, the medical aid group, said Friday that “sick and injured people are struggling to reach” the 300-bed hospital the group runs jointly with the Afghan health ministry in Lashkar Gah. “The intensification and proximity of fighting is clearly limiting access,” said Guilhem Molinie, the group’s representative in Afghanistan. “In the immediate aftermath of conflict, one in four patients are unable to reach our emergency room.”

Atal said fighting is also continuing in several nearby districts of central Helmand, including Garmser and Nawa, and that the hotly contested highway linking Lashkar Gah and Marja, which had been cleared and reopened Thursday by government forces, is now back under Taliban control. The insurgents still hold several northern districts, including Nowzad and Musa Kala. If not for the recent addition of U.S. airstrikes, Atal said, “The Taliban would have surrounded Lashkar Gah by now.”

The council leader’s account differed sharply from that of the provincial governor’s office, which painted a much more positive picture of the conflict. Omar Zhwak, the governor’s spokesman, said on Saturday that the situation was “normal” in Lashkar Gah and that Afghan forces were “on top of the situation” across the province. He said the fighting in nearby Garmser was “under control” and that Gov. Hayatullah Hayat had visited the front line there Friday.

“All the Taliban’s major attacks are being repelled,” Zhwak said by phone. In addition to crediting the surge in U.S. airstrikes, he said hundreds of reinforcement ground troops have arrived in the past week, as well as Afghan Special Forces. “The Taliban are now being defeated where they first launched their attacks, and the highway to Helmand has been reopened. This is a major achievement,” he said.

The Taliban launched a strong offensive in Helmand last year, winning control of several large northern districts, but they backed off during the opium poppy harvesting season, when many fighters were working in the fields. Meanwhile, President Ashraf Ghani installed a new governor and regional military commander, and U.S. military officials sent hundreds of trainers to work with Afghan army troops there and strengthen their performance.

But local officials said that poor communication and coordination had persisted among Afghan security forces in the region and that the actual number of fighting forces was inflated by nonexistent “ghost soldiers” on the payroll. For some police and others, Atal said, “fighting is a kind of business, where you use 500 bullets in a clash and then ask for 10,000 more so you can sell them.” As a result, he said, as few as 600 active Taliban fighters have been able to make headway against thousands of Afghan forces.

Other critical reports from the region blame government inattention and negligence for allowing the Taliban to reclaim much of Helmand last year, including most of its northern districts, after years of ferocious fighting by NATO forces and Afghan troops that won control of the province at a cost of extremely high casualties. From the north, Taliban forces swept south this summer, aiming at Lashkar Gah.

“If we had successfully defended our northern districts last year, we wouldn’t be facing the enemy in Babaji,” Bashir Shakir, a provincial council member, told Radio Free Afghanistan this week. He said the withdrawal of thousands of foreign troops from Helmand in 2014 left Afghan officials unprepared to fend off the Taliban threat, even after more than 30,000 army troops and police were sent to man abandoned NATO camps. “They understood the gravity of the situation but failed to mobilize resources and make the right decisions at the right time,” he said.

Earlier this week, Hayat told Radio Free Afghanistan that Helmand and its capital city were in no immediate danger of falling to the Taliban, but he acknowledged that such a victory would be a huge blow to the country. “The fall of Helmand will resonate strongly in Kabul and beyond,” he said.

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