Cradled in the arms of a US special forces soldier, a fragile young girl is levered on to a Black Hawk helicopter, an American "ambulance of the sky" bristling with machine guns and operated by gun-toting medics.
Her body is listless and wan; her face wracked by confusion rather than contorted in pain.
She is wearing a crimson dress, painstakingly embroidered with shimmering green thread.
But the eye is drawn constantly to the bandage wrapped around her injured foot, which by now is drenched in blood.
A medic crouches over her, looking anxiously at his wristwatch. She has lost so much blood that he struggles to find a pulse.
Her name is Kamila, and she is eight years old, possibly 10. She has just stepped on a landmine and she is clinging to life.
The flight to the American field hospital at Camp Salerno, a US base within artillery range of the Pakistan border, takes 20 minutes.
Treatment in Peshawar, Pakistan, her only other realistic option, would have taken eight hours by land - a journey she would likely not have survived.
For landmine victims, speed of treatment is essential. Yet two-thirds of Afghans do not have access to adequate healthcare.
Rushed inside the hospital, where the Stars and Stripes hangs proudly above the operating table, Kamila is sedated, offered more oxygen and given an urgent transfusion.
Masked and gloved, Dr Sloane Guy examines the wound.
A lanky North Carolinian in his late 30s with a lilting southern accent and an air of imperturbability, he joined the army because his parents could not afford to put him through medical school.
Nowadays, almost 90% of his patients are Afghans.
He makes a quick diagnosis, almost by rote. Kamila's mangled foot cannot be saved.
He takes out an electric saw, presses it against her bloody flesh and begins cutting at the skin.
The sound is excruciating. Dr Guy operates on about three landmine victims a month, which often involves performing the same macabre routine.
"A local hospital would have done some kind of amputation," he says, as he wraps bandages around the stump.
"But she would not have got a transfusion and she very well could have died from this."
When Kamila wakes up she comes to realise that she will have to confront life without her right foot.
Speedy treatment of landmine victims is essential
Fighting back tears, she tells the medics how she has no friends and that her only joy in life came from chasing mountain goats.
Four days later, we fly by US helicopter to her village.
Its mountainous terrain and proximity to Pakistan have made it one of the most dangerous places in the country and it forms part of the blurred frontier in America's ongoing fight against al-Qaeda and the remnants of the Taleban.
We run into the Special Forces soldier who helped Kamila on to the helicopter. He offers more fragments of her story.
She has nine brothers and sisters and both her parents are dead.
Her family is in terrible debt and the main source of income comes from her elder brother, who serves in the Afghan National Army.
The cost of getting Kamila medical treatment in Pakistan would have been equivalent to three years of his income.
The US soldiers have had a whip round and raised hundreds of dollars. But it is nowhere near enough to cancel the family's debts.
The landmine which damaged her limb could have been planted at any stage over the past 30 years but may well have been laid recently as part of an ongoing tribal dispute.
About 700m sq metres of mines and unexploded ordnance remain
Each month, 100 people are killed or injured by landmines in Afghanistan, an estimated 50% of them children.
In the past year, 100m square metres of contaminated landscape has been cleared.
But at least 700m square metres remain littered with mines and unexploded ordnance.
According to the United Nations, which is leading the clearance effort, it will take seven more years to complete the task.
The last time we see Kamila is in Khost, the regional capital, at a dilapidated local hospital.
A barrel-chested doctor with a booming voice and dense black beard is towering over her.
"Do you feel any pain in your legs?" he shouts.
"No," mumbles Kamila.
"Your leg is injured but you will be able to walk soon," he barks. "Then you can go to school and look forward to the future."
Kamila looks mystified - and then tries to sleep.