Despite years of aid, medical care in Afghanistan remains severely limited as casualty rates from violence climb, humanitarian organisation Medecins Sans Frontieres (MSF) warns in a report.
Gaping holes in the war-torn country's healthcare system are being obscured by misleading narratives of success, it says.
Reliable data is hard to come by, but MSF says patient testimonies paint a troubling picture.
Many struggle to access basic care.
The research - conducted over six months in 2013 with more than 800 patients in the hospitals where MSF works in Helmand, Kabul, Khost and Kunduz provinces - reveals the serious and often deadly risks people take to seek medical help.
Most said they had had to bypass their closest public health facility during a recent illness, pushing them to travel greater distances for aid.
Some had to travel 80km (50 miles) or more and cross military roadblocks and security checkpoints.
People spoke of clinics lacking medicines, qualified staff and electricity, and of facing mounting debt to pay for treatment.
Others told about being having to watch over their sick or injured relatives throughout the night, hoping they would survive until morning when it might be safe enough to make it to a hospital.
Many wait until their condition has deteriorated to the point of endangering their health or lives before risking the journey to reach treatment.
Christopher Stokes, MSF's general director, said: "One in every five of the patients we interviewed had a family member or close friend who had died within the last year due to a lack of access to medical care.
"For those who reached our hospitals, 40% of them told us they faced fighting, landmines, checkpoints or harassment on their journey."
MSF says international donors, aid providers and Afghan authorities must urgently address serious shortcomings in healthcare provision, and put aside any consideration other than people's needs.
Mr Stokes said: "As international interest in Afghanistan wanes, MSF sees a conflict that still rages in many parts of the country alongside a failure to meet rising medical humanitarian needs.
"While the international community seeks refuge in rhetoric, the Afghan people have to deal with the harsh reality."