In Helmand and Kandahar, the two provinces where most of military and economic efforts are focused, there has been a sharp improvement in the lives of Afghans, but that has been more than offset by deterioration in other parts of the country.
"It's a very, very tough battlefield for our young company commanders, our young sergeants on the ground, making life and death decision every day," said Maj. Gen. John Campbell, commander of the 101st Airborne Division. Campbell commands all forces in the volatile eastern part of the country.
The toll on his troops has been staggering. In July, just five weeks into his tour, he told us 27 of his soldiers had been killed. In September, he said it was up to 76.
Today, Campbell said, it has reached 96.
"I've lost 96 heroes straight from the 101st and I've lost another 45 attachments from the 101st. So it's been a big toll," he said.
The toll is especially personal for some.
Sgt. Christian Gatison is a seasoned soldier, having served for 11 years, with two previous deployments in Iraq. This is his first deployment in Afghanistan.
He can't utter the name of his fallen friend, Sgt. Shaun Mittler, because it is too painful.
Mittler, a 32-year-old father of a young daughter from Austin, Texas, was killed this July in an enemy attack.
While the capital of Kabul is now relatively secure, with troops expected to begin thinning out there first in July 2011, it seems that all those stationed at remote combat outposts around the country know someone who has died.
"We started taking fire from all angles, they had us in a 360," said Pfc. Megan Devoy.
Devoy, born in Indiana, Texas, has been at Camp Joyce, Kunar Province for eight months, but already she's lost a good friend, Pfc. Barbara Vieyra.
Vieyra was a 22-year-old mother from Arizona. She had deployed to Afghanistan in April. She was killed in September when insurgents attacked her unit.
Lt. Mike Conforti describes a day less than a month ago when his convoy was hit.
U.S. Forces in Afghanistan See Personal Sacrifice, But Also Winnable War
"We were hit by an IED and the two guys in the truck were killed. I was right behind the truck. I was blown off my feet and a couple my other soldiers were blown off their feet also. It was tough.
"It happened so quickly. We're working through it. We went outside the wire again a couple of days later and we're continuing to do patrols," Conforti said. "The best thing we can do is to keep going out, keep working hard."
"The IEDs have been real bad for us, it's where we have taken most of our casualties," said Staff Stgt. William Stuckey, who is on his first deployment to Afghanistan, third overall. He said he's already lost a few good friends.
"You just go on with it, it's going to happen. We knew that coming here, taking casualties, but not much you can do to prepare for it," he said.
Yet after all this sacrifice, and an additional 30,000 U.S. troops ordered, only 36 percent of the Afghan people express confidence in U.S. forces, according to a Dec. 6 ABC News/ARD/BBC/Washington Post poll on Afghans' views of the war.
Almost two years ago, before the surge, Afghan poll director Jameel al-Rahmanay told ABC News that Afghans didn't think adding troops would do any good.
Today, he said, that hasn't changed.
"It's almost the same as last year, it depends on the part of the country," al-Rahmanay said. "Last year we didn't have any problems in the north of the country, while today, we are having a lot of problems in the north. In the south some provinces are more secure than last year."
"There are still a lot of security problems in the country," he said, "Even with all these troops in the country."
But Lolila Karimi, an Afghan widow with four children, told ABC News that two years ago she was pessimistic about her future. Today, she said it is because of the U.S. that she has improved security, 24-hour electricity and clean water.
If the U.S. forces left, she said, Afghans would be back to the "wildest days."
The U.S. troops ABC News spoke to in Afghanistan agree it is better to stay than leave too soon.
"You can't just rip apart a country and just leave it to turmoil. You have to fix what's broken," Gatison said. He thinks if they pulled out now, the Taliban would move back in, even stronger. "Definitely even stronger in the areas that we have occupied, coming with a stronger force definitely."
They said despite polls showing low Afghan support, they see progress every day, which they believe will ultimately lead to success.
"Can I win this war? Well, I certainly wouldn't be here if I didn't think we could make a huge difference," Campbell said. "I mean, what people here really want is a place to go work, they want their kids to go to school, they want to live in freedom, they don't want to be terrorized, many areas we have that already."
But Campbell says he doesn't want to fool anyone. He admits it will take time and sacrifice.
ABC News' Kristina Wong and Richard Coolidge contributed to this report.