JOHANNESBURG — The death toll from a cholera outbreak in South Africa has climbed to 26 in recent days, with dozens more hospitalized while frustration mounts over the government’s response to the disease, which is common in several areas of Africa but rarely spreads in this country.
Cases have been reported in five of South Africa’s nine provinces in recent days, but the rising death toll has been in a predominantly Black area north of the capital, Pretoria.
The government, ruled by the African National Congress, says it is still trying to discover the source of the outbreak. Protests have erupted in some areas, and opposition groups say government malfeasance has contributed to the spread of the disease.
Analysts point to chronic power outages that have left economically impoverished areas of South Africa without electricity for up to 12 hours a day as winter takes hold in the Southern Hemisphere.
Cholera is a waterborne disease. Although rainfall in the region has filled dams, specialists say South Africa lacks the electricity to pump water to reservoirs before it can be filtered and piped into homes.
Along with the shortage of clean drinking water in some areas, overnight temperatures approach freezing in Johannesburg and Pretoria. Colds and flu are annual hazards, and crowds of families often huddle together around open fires for warmth.
President Cyril Ramaphosa has visited the worst affected area at Hammanskraal on Pretoria’s outskirts and promised to improve the water and electricity supplies.
Other senior members of Mr. Ramaphosa’s ruling ANC have been met with protests when they try to address residents.
The cholera outbreak may have dramatic political implications for the ANC, which has held power in South Africa for nearly three decades.
The ANC is polling below 50% before elections in less than a year.
Eugenia Modisa, 46, a Hammanskraal native who is widowed with two children, said she supported the ANC since Nelson Mandela swept to power under the party’s banner in 1994.
“I will not be voting for the party next year,” Ms. Modisa said. “But it is painful. The ANC has been my life, and now they don’t care about the poor. Ministers come to visit in their big cars with their bodyguards, and they say they will sort [out] our problems, and nothing happens.”
Ms. Modisa’s neighbor died last month from cholera. “You don’t expect to be killed by the tap in your kitchen,” she said.
Ms. Modisa said funerals have become rallying points for change. “We are a small community, and people know each other here,” she said. “Every week now, we are burying someone else who has died from cholera. There is a lot of anger against the government.”
Although the United Nations classifies access to water as a basic human right, the South African government charges a 15% value-added tax on the water supply piped to homes.
University of South Africa professor Anja du Plessis, a leading authority on water quality, has stated publicly that roughly 90% of the 800 filtration plants across the nation release raw sewerage, or only partially cleaned wastewater, into reservoirs.
Opposition groups say government contracts for upgrading dams, storage tanks and filter systems have been granted to firms linked to the ANC and that the work has not been completed in some cases.
The Washington Times was unable to verify the allegations.
Mr. Ramaphosa has quickly accepted responsibility for the outbreak, which he said was linked to “poor governance and poor maintenance of infrastructure.”
He said his government was determined “to remedy those shortcomings in a sustainable way and as a matter of urgency.”
Mr. Ramaphosa has also warned of “a difficult winter” as consumption of electricity rises, leaving a further shortfall that will affect water pumping.
Talk radio in South Africa has been inundated by callers saying they fear a spread of cholera, which can cause severe diarrhea and fatal levels of dehydration.
Cholera historically is rare in the nation, and drinking water has traditionally been regarded as safe.
Cholera outbreaks are common across much of Africa, including in neighboring Zimbabwe.
A 2009 epidemic in Zimbabwe affected an estimated 100,000 people and resulted in more than 4,000 deaths.
The World Health Organization has warned that cholera has made “a devastating comeback” in at least 43 African countries after an absence of several years, leaving more than 1 billion people at risk.
Vaccines can protect people from cholera infections, but their availability in South Africa is in doubt.
Bloomberg News has cited a lack of vaccines globally. It reported that the Biovac Institute, a partly state-owned vaccine producer in South Africa, secured a deal last year to make an oral cholera inoculation but the country has not said whether it has stock to disperse locally.
In Washington, the State Department has not issued a travel warning for the region, but safari companies recommend vaccinations for cholera, tetanus and yellow fever as standard precautions.
Government health officials in South Africa have encouraged citizens to wash their hands regularly with soap and to boil drinking water in vulnerable areas.
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