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Ambulance volunteers say a key road in Western Australia's Midwest is in such a poor state that they cannot transport people with spinal injuries or work on patients while travelling on it.
The Mingenew-Morawa Road joins the two shires and is a heavily used port route for trucks carrying resources and produce.
Locals say years of degradation has made it increasingly dangerous for users, but Main Roads WA says its hands are tied after property holders halted improvement works a decade ago.
About 100 community members aired their concerns at a town hall meeting with Main Roads representatives on Tuesday, as the Shire of Morawa attempted to "prove" to locals it would support future works to upgrade the road.
St John Ambulance volunteer Debbie Collins said some areas of the 110 kilometre-per-hour road were so uneven that drivers were forced to slow to 60kph.
"The actual state of the current road is atrocious and every single farmer or truck owner or truck driver and bus driver will back me up on that," she said.
Others at the meeting raised concerns about the narrow width of the road.
Shire president Karen Chappel said this had been aggravated by increased truck movements during an ongoing trial of a transport task by Terra Mining.
"There's a lot more trucks and they go in 24 hours a day and they're travelling together," she said.
"It's just near impossible to overtake these trucks on these narrow roads.
"So everybody's getting a little bit agitated and a little bit nervous because the roads are narrow."
Main Roads representatives Louise Adamson and Leon Wilson said upgrades would depend on whether local landholders would allow the agency to acquire portions of their properties to widen the road and build emergency shoulders.
A project to improve the road was canned in 2014 when four landholders objected to the acquisition of sections of their land.
The compulsory acquisition was part of a now-defunct recommendation by the Environmental Protection Authority.
Main Roads said in a statement that a road reserve to the width of 50 metres could still be required at some sections to allow for the extension of culverts and construction of off-road drainage.
Grain farmer Darren Yewers said the previous plan had required him to give up 30 metres of paddock land on either side of the road.
But he said he would support efforts to widen the road if he was appropriately compensated for the property he would have to relinquish.
"I've just spent a lot of money on fence lines and gateways and stuff like that. That will have to be changed and somebody will have to pay for that," Mr Yewers said.
Terra Mining chief executive Barry Cook said the company was negotiating a deal to use rail to transport ore and reduce usage of the road.
"We have to look at what rail can do for us to make sure that meets our requirements for our long-term movement," he said.
"So that's the other question we've got. Can they meet our needs to ship all our products to port?"