South Africa’s Gauteng province declared a cholera outbreak on Sunday, with 41 confirmed cases and 15 deaths so far.

The health department in Gauteng declared a cholera outbreak on Sunday in Hammanskraal, an area about 50 kilometres (31 miles) north of its administrative capital Pretoria, in the city of Tshwane.

Almost 100 people have been seen at hospitals and 37 have been admitted to wards, the city government said on Monday, warning residents of Hammanskraal and surrounding areas not to drink tap water.

There are now 41 cases confirmed nationwide, including 34 in Gauteng province, one in Limpopo province and six in Free State, a health department spokesperson said. The cases in Free State province are not connected to the others, he added.

In Hammanskraal, resident Kagiso Sadiki said he could not remember a time when Hammanskraal’s tap water was fit for consumption. His 53-year-old cousin Michael Sadiki died within a week of falling ill.

The tap water is brown and dirty, the 37-year-old told reporters.

“Everybody has the right to have clean water,” Sadiki said, visibly distressed, sitting under a lemon tree. “I hope my cousin’s death is not in vain”.

“We are drinking that water, but they don’t want to clean that water, or to … put another pipe to give us the all right water,” said 36-year-old Sello Samuel Lekoto, an unemployed resident of Hammanskraal who is being treated at Jubilee Hospital for cholera.

The municipality said in statements that the water supplied by the city in Hammanskraal is not potable, but that the city provides clean drinking water through tankers to informal settlements several times a week.

“The issue of water in Tshwane has been a problem for a number of years,” South Africa’s Deputy Minister of Water and Sanitation David Mahlobo said in a briefing.

“There have been problems politically … [and] issues over conflicts in such a way that citizens were exposed,” he said.

Cholera can cause acute diarrhoea, vomiting and weakness and is mainly spread by contaminated food or water. It can kill within hours if untreated.

South Africa recorded its first two cholera cases in February on the back of outbreaks in nearby Mozambique and Malawi, the two most severely affected countries in 2023, according to the United Nations.