On January 9, WHO reported that more than 54 percent of cumulative deaths had occurred outside health facilities, cholera treatment centers (CTCs), and cholera treatment units (CTUs). The figures reflect significant challenges in providing sufficient treatment access to cholera-affected populations, including staff and material shortages at health facilities, CTCs, and CTUs, and a lack of community-level awareness about cholera. ' According to the U.N. Office for the Coordination of Humanitarian Affairs (OCHA), the outbreak has affected border areas of neighboring countries, with confirmed cholera cases reported in Botswana, Mozambique, Zambia, and South Africa. As of December 31, South Africa health authorities and WHO reported 1,419 cholera cases in South Africa, including 1,334 in Limpopo Province alone, with 13 deaths. On December 24, OCHA noted the start of indigenous transmission in South Africa, although Zimbabwe nationals continued to account for most cases.