At the St Joseph COVID Treatment Centre in Kinshasa, patients lie in ramshackle rooms breathing oxygen from old tanks. The clinic has 38 beds, and all but one are occupied.
In a backyard littered with medical equipment, tents are needed to cope with the overflow. The Democratic Republic of Congo is the least vaccinated country against COVID-19 in the world.
Now a fourth wave of the coronavirus threatens to put greater pressure on its limited health system than at any time during the pandemic.
Francois Kajingulu is the head of St Joseph.
"We have experienced the three previous waves and gradually, we saw the cases increase. In the fourth wave, there are overnight jumps. On Monday, we had five to six cases and on Saturday, you go straight to between 30 or 36 cases. So six times greater. So there is a very rapid rise in COVID-19 cases in this fourth wave."
The increase is part of an Africa-wide surge that saw weekly COVID cases spike 83% in mid-December, driven by the Delta and Omicron variants, although deaths remain low, the World Health Organization said.
Congo registered 6,480 new cases in the week of Dec. 13 - more than double the number hit during its previous record week in June, WHO data show.
The official infection tally in Congo, which has a young population and where few people get tested, is still low compared to many countries.
But the low level of inoculations worries health officials who say that unvaccinated populations increase the risk of new variants emerging.
Fewer than 300,000 people out of a population of 90 million have received at least one dose, Reuters data indicate, lower than anywhere else.
Hostile terrain, remote populations and lack of resources have stunted vaccine rollouts. The recent surge in cases has pushed authorities to ramp up inoculations, and the weekly vaccination rate is at its highest yet.
This tented 'Vaccinodrome' in capital Kinshasa is part of that effort, where some who received their shots said they were persuaded to do so because of the latest surge.
(SOUNDBITE) (Lingala) VACCINATED PERSON, POPOL KABASALE SAYING:"Before we were in the dark about the consequences associated with this fourth wave of Covid-19. This is too strong and COVID really exists and to protect myself I've come to get the vaccine."
Health workers at the center are vaccinating around 200 people per day, but that is still below its 300-person capacity.