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 that is common in several areas of Africa but rarely spreads in this country.
Recent days have seen cases reported in five of South Africa’s nine provinces, but the rising number of deaths has occurred in a predominantly Black area north of the capital, Pretoria.
The African National Congress-ruled government, which says it is still trying to discover the source of the outbreak, has faced protests in some areas while opposition groups claim government malfeasance 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 temperatures take hold in the southern hemisphere nation.
Cholera is a water-borne disease. While the region has enjoyed good rains and dams are currently full, experts say there is not enough electricity to pump water to reservoirs from where it can be filtered and piped to homes.
The resulting shortage of clean drinking water in some areas comes as overnight temperatures approach freezing in Johannesburg and Pretoria, where colds and flu are an annual hazard, and where crowds of families often huddle together during winter for warmth around fires lit in the open.
President Cyril Ramaphosa has visited the worst affected area at Hammanskraal on Pretoria’s outskirts and promised to improve the supply of both water and electricity.
However, other senior members of Mr. Ramphosa’s ruling African National Congress (ANC) have been met with protests when they tried to address residents.
As the health crisis churns onward, there are signs the outbreak may have dramatic political implications for the ANC, which has held power in South Africa for nearly three decades.
With elections due in less than a year, the ANC is currently polling below 50%.
Eugenia Modisa, 46, who was born in Hammanskraal and is widowed with two children, said she had been a supporter of the ANC since former President Nelson Mandela swept to power under the party’s banner in 1994.
“I will not be voting for the party next year,” Mrs. 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.”
Mrs. Modisa’s neighbor died last month from cholera. “You don’t expect to be killed by the tap in your kitchen,” she said.
Mrs. Modisa added that 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.”
While the United Nations classifies access to water as a basic human right, the South African government charges a 15% value-added tax or VAT on the piped supply of water 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 allege that government contracts for upgrading dams, storage tanks and filter systems have been granted to firms linked with the ANC, and that in some cases the work had not been done.
The Washington Times was unable to verify the allegations.
President Ramaphosa has been quick to accept responsibility for the outbreak, which he said was linked to “poor governance and poor maintenance of infrastructure.”
His government, he said, was determined “to remedy those shortcomings in a sustainable way and as a matter of urgency.”
But Mr. Ramaphosa has also warned of “a difficult winter,” as consumption of electricity rises, leaving a further shortfall that will affect the pumping of water.
Talk radio in South Africa has been inundated by callers saying they fear a spread of the illness, which can cause severe diarrhea and fatal levels of dehydration.
Prior to the current outbreak, cholera has been rare in the nation, where drinking water has traditionally been regarded as safe.
But cholera outbreaks are common across much of the rest of the continent, including in neighboring Zimbabwe.
A 2009 epidemic in Zimbabwe affected an estimated 100,000 people with the disease, resulting in more than 4,000 deaths.
The World Health Organization has warned that after an absence of several years, cholera has made “a devastating comeback” across at least 43 countries in Africa leaving more than a billion people at risk.
Vaccines that can block cholera infections exist, although their availability in South Africa is in question.
Bloomberg News has cited a lack of vaccines globally, reporting that the Biovac Institute, a partly state-owned vaccine producer in South Africa, last year secured a deal to make an oral cholera inoculation, but that the country has yet to say whether it has stock to disperse locally.
In Washington, the State Department has not issued a warning on travel to the region, but safari companies recommend vaccinations for cholera, tetanus and yellow fever as a standard precaution.
With that as a backdrop, government health officials in South Africa have encouraged citizens to wash their hands regularly with soap and to boil drinking water in vulnerable areas.