There's an enormous, weather beaten photo of Hamid Karzai glued to the crumbling brick wall of Afghanistan's Helmand airport terminal. Karzai, whose family hails from the Kandahar province next door, won't be president for long. But it's unlikely anyone will move too quickly to peel the photo down.

There are just over 200,000 Afghans living in Lashkar Gah city, where the airport is based. But there's little evidence here in this desolate Taliban region that many of its people have been thinking about Kabul politics.

Votes lodged by the 7 million Afghans who turned up last Saturday will take weeks to count, but few expect a clear winner. Afghanistan's constitution requires the elected president to have more than 50% of the total vote. It means a further battle between the two most popular contenders, Ashraf Ghani and Abdullah Abdullah, is inevitable.

In the remote parts of Helmand province, voting papers were transported on donkeys and will be retrieved the same way.

There are few vehicles on the roads. Mostly it's rickshaws, donkeys pulling carts, and the occasional emaciated grey horse. And camels. In Lashkar Gah they plod down the road loaded with goods, and sometimes languorously graze unfenced areas on the outskirts of town.

Heading towards the region's main public hospital, the streets are noticeably absent of women. The one or two who duck in and out of shops along the sparse, dusty bazaar are in burqua, but not the light blue worn up north – these are a soft moss green, gold, or a deep rich red.

This is the province where the girl from Steve McCurry's famous National Geographic cover grew up. In Afghanistan, it seems, the brightness and beauty of the young women and their clothing is an inverse marker of social progress.

Inside the hospital, a Congolese volunteer midwife does the rounds of a post partum unit, lamenting the lack of room to keep young mothers in for longer than a couple of hours after the birth. It's particularly difficult, she says, because many are terrified of hospitals, don't trust the expat staff, and have husbands who don't like them being out of the home.

A surprisingly high number of the women are gone within an hour, trudging past the wilting eucalyptus trees and clumps of people languishing on the hot bitumen of the hospital driveway. It's not uncommon for them to begin the six-day walk back to the remote towns in the province the same day they give birth.

They start breeding them young here. 'Oh yes,' the midwife says, completely unperturbed. 'We had a woman in who had given birth 24 times. She died with number 25.'

Much has been made of Afghanistan's patronage from the West, about the vast improvements to social policies and living conditions wrought by astronomical aid budgets and the international military intervention. Diplomats from some Western countries said privately they were even pleasantly surprised at how forward thinking former mujahidin factional leader and presidential candidate Abdul Rasul Sayyaf seems to be now.

Over cocktails in Kabul, hardly anyone mentions the era when Sayaff and his political ally Gulbaddin Hekmatyar spent months building fundamentalist Islamic militias in Peshawar with money and weapons supplied by the CIA and rich Saudi sheikhs like Osama bin Laden.

Instead, it feels as if every expat is talking enthusiastically about economic development, stimulus to trade, boosts to farming and agriculture, the potential for mining, the glowing possibilities now Afghanistan has dodged communism and the Taliban.

That might be so, in Kabul. But Afghanistan is not the sum total of its capital city, the former Paris of the East. Kabul is a political island, where social change is beginning to take effect, where Islam is moderated by the accepted presence of Westerners, where dress shops sell traditional afghan attire to tourists for wads of American dollars and English-speaking taxi drivers deliver bottles of contraband vodka to raucous dinner parties for their English speaking clients.

But in Lashkar Gar, at this time of year, burns are the biggest issue. Two year-olds are admitted with 40% burns after being given the chore of topping up the household oil heater while it was still on. Mothers nurse four year-old boys whose eyelids have been scarred shut after the diesel bottle they were using to light the family's fire blew up in their face.

The policy challenge for international governments seeking to engage and assist Afghanistan after the next president is declared will be to reconcile these disparate realities: Kabul's island and the provinces it floats above.

For now, there's very little evidence the people in Helmand are thinking of the election at all. They're concerned about exactly when NATO's troops will withdraw, and their next meal. Foreigners are merely tolerated by a slim segment of the town's community. Up north in the remote parts of the province, past the British military base at Camp Bastion, foreigners are not tolerated at all. It is a landscape completely apart from Kabul — of rigid traditions, non-existent education and militant attitudes towards infidels.

Soldiers based in the warring provinces are right to be derisive of romantic attitudes about Afghanistan proselytized by visitors who don't leave their compounds in the capital city. To them, Afghanistan is a 'shithole', 'one giant sandpit', 'beyond help'. These soldiers share none of the hope expressed by international aid organisations and embassies that the country will emerge from 2014 with a stable government and a united will to create national prosperity and social transformation.

Instead, they see the poppy fields and the girls married at twelve and the men whose only hope of a better life is a third wife or a belief in the promises of hardline preachers touting religious riches.

In Kandahar, a twenty-minute detour on the way back from Helmand to Kabul's international airport, the plane lands to pick up supplies. On the runway behind it, a US military drone takes off, its grasshopper legs and flat wings grey against the clear blue sky, casting shadows on the red dirt of the outlying hills. In Kandahar, like Helmand, these weapons of war are still the only currency of social change, and even they, eventually, will be gone.

Map courtesy of Wikipedia.