Tunisian hospitals are battling to keep operating as the number of people dying of Covid-19 spikes and bodies are left in rooms because mortuaries are running at full capacity.
"Some patients have died without us realising it," said Imen Fteiti a nurse at the Ibn Jazzar hospital in the central city of Kairouan, one of the hardest hit by the pandemic.
Some bodies of Covid victims have been left lying in rooms, next to other patients, for up to 24 hours because there were not enough staff to organise their transfer to overstretched mortuaries.
Tunisia has officially recorded more than 15,000 deaths since the start of the pandemic last year with the toll rising in recent weeks.
More than 600 Covid patients are in intensive care units around the country, and authorities have set up field hospitals to cope with a crisis they have compared to a "tsunami".
Doctors, nurses and non-governmental organisations have sounded the alarm particularly for Kairouan, a marginalised region where intensive care beds and oxygen supplies are lacking.
"We have reached a point where we don't know who to assist first," Fteiti said.
In Kairouan, 5,500 litres (195 cubic feet) of oxygen are now needed daily to treat those stricken by Covid compared to 400-500 litres two weeks ago before the number of cases spiked, regional health officials said.
And there are only 45 beds in intensive care units in Kairouan hospitals, both private and public, and just 250 oxygen cylinders are available, they added.
Since June 20, authorities have imposed a total lockdown on six regions across Tunisia, including Kairouan, as the number of Covid cases spiralled in the North African country.
The capital Tunis has been placed under partial lockdown since last week, with weekend lockdowns from July 10 to prevent crowds at beaches.
- 'Touch and go' -
But the health situation in Kairouan, home to 593,000 people, is among the worst and for health workers it has become a nightmare.
At the Ibn Jazzar hospital there are only three nurses for 35 Covid patients.
"Our day begins very early in the morning and we never know when it will be over," said nurse Fteiti.
The day starts with caring for incoming patients who have slept on the floors of hospital corridors because no beds were available when they arrived, she said.
Fteiti recalled a young woman whose mother had just died of Covid who pleaded with her to check on her ill father. "Unfortunately, he too passed away," said the nurse.
Health officials say the daily number of Covid deaths in Kairouan has climbed to 20, including children.
"We have been through tough days with the ICU beds full," said regional health official Mohamed Rouiss.
When the spike began last month, patients from Kairouan could be transferred to other hospitals in the region.
"But now they too are full," he said.
Slah Soui, a doctor at Kairouan's second largest hospital Aghlabides, blames the situation on "recklessness" and people failing to respect hygiene rules, including social distancing.
But "a severe lack of vaccination" is also at fault, he said.
Tunisia has struggled with a lack of vaccines and launched its campaign in March, a month later than planned.
In the Kairouan region, just 95,000 people have registered to be vaccinated and only half of those have received a first dose.
Across Tunisia, only four percent of the population of 12 million have received the full two doses.
In June, the director of the Tunis Pasteur Institute Hechmi Louzir told reporters that the country had received only 1.6 million doses of vaccine.