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The government’s response to the insurgents’ recent victories has been piecemeal. Afghan forces have retaken some districts, but both the Afghan air force and its commando forces — which have been deployed to hold what territory remains as regular army and police units retreat, surrender or refuse to fight — are exhausted.

In the security forces’ stead, the government has once more looked to local militias to fill the gaps, a move reminiscent of the chaotic and ethnically divided civil war of the 1990s that many Afghans now fear will return.

In Lashkar Gah, an Afghan military officer said government forces had requested reinforcements for days without luck, and described the situation as dire. Reinforcements began arriving on Saturday evening, he said.

In May, Afghan and U.S. airstrikes pushed back an attack on the city, and a few staunch Afghan army units held what territory they could after the local police fled. But this time there is less American air support, and Afghan defense officials were frantically trying to reinforce the cities under siege to stall the Taliban advance.

Just north of Lashkar Gah, in a nearby town, the Taliban on Saturday hanged two men accused of kidnapping children from the entrance gate for all to see — a troubling indicator that the insurgents’ hard-line rule of law was inching closer to the provincial capital.

In an effort to break the siege, Afghan aircraft bombed Taliban positions in neighborhoods across Lashkar Gah Friday night, a tactic that almost always results in civilian casualties when carried out in populated areas. Emergency Hospital, one of the main surgical centers in the city, reported on social media Saturday that it was full.

Attaullah Afghan, the head of the provincial council in Helmand, said the Afghan air force had bombed a private hospital in the city after the Taliban took shelter there, killing a civilian and wounding two others. Several Taliban fighters were also killed in the strike, he said.