As cholera deaths and hospitalizations continue to rise in South Africa, Auditor-General Tsakani Maluleke said the issue was a "harsh reminder" of the poor municipal infrastructure.

Speaking in the Parliament on Wednesday, Maluleke said out of South Africa's 257 municipalities, only 38 of them have received clean audits, noting that this number was 41 in 2021.

She mentioned these clean audits were for municipalities in Western Cape, and not for those in the Free State or the North West.

"The deterioration of institutions in the local government sphere is, unfortunately, continuing," Maluleke said, News24 reported.

"Our teams have witnessed the impact of water supply issues, and experienced directly the impact of untreated wastewater. They have seen that in far too many communities there is inadequate sanitation," she continued.

The cholera outbreak has killed 23 people, and hospitalized 48 in Hammanskraal--north of South Africa's capital Pretoria--so far. The toll is reportedly rising due to contaminated water.

Pointing out the cholera deaths in Hammanskraal, the auditor-general said this was a "harsh reminder" for the municipalities to understand the impact of "continued neglect."

Maluleke went on to share that even though billions of rands were available in funding for the municipalities, the infrastructure was not being given enough attention.

"We have got to start setting a culture where there is an insistence on performance [and] integrity and an attention to matters of transparency and accountability," she added. "Much of what I am saying will be familiar to you."

She concluded, "The real problem we will place at the door of those that lead the municipalities."

Hammanskraal Residents Forum Chairman Tumelo Koitheng had said last week that the municipality had failed to maintain a nearby water treatment plant and as a result, raw sewage started seeping into the water supply.

"The water had a greenish color and you smell feces," Koitheng said.

According to the Gauteng health department, 229 patients visited Jubilee District Hospital in the last 15 days.

"The number includes 23 patients transferred to other Tshwane-based hospitals. In the past few days, fewer patients have presented at health facilities with symptoms of diarrhoeal disease," department spokesperson Motalatale Modiba said.

"The number of laboratory-confirmed cases of cholera seen at the hospital is 48. To date, 23 people have, unfortunately, passed on from the disease outbreak. As of 27 May, 77 people were admitted for diarrhoeal disease."

Citizens digging small holes at the shore to get pure water at the banks of the White Nile in Khartoum