Zimbabwe has recorded new cases of cholera several months after declaring the end of an outbreak that killed more than 700 people over an 18-month period.

On Wednesday, Zimbabwe confirmed a new outbreak of cholera has been recorded in the district of Kariba — on the border with Zambia — where 21 cases have been confirmed and one person died.

Dr. Godfrey Muza, the Kariba district medical officer, said the government is working to contain the situation:

“We have set up cholera equipment camp and also some oral rehydration points within the affected villages,” said Muza. “We are getting assistance from our local and regional partners like MSF [Medecins Sans Frontieres, also known as Doctors Without Borders] and UNICEF. And our teams are on the ground doing risk communication and community engagement activities on health promotion, hygiene promotion and assisting the community in terms of improving sanction.”

In August, the Zimbabwe government declared that the 18-month long cholera outbreak was over. The outbreak affected up to 35,000 people and claimed more than 700 lives.

Zimbabwe has dealt with cholera outbreaks in the past. In 2008, an outbreak resulted in more than 98,000 cases and more than 4,000 reported deaths.

Independent health experts such as Dr. Norman Matara of Zimbabwe Doctors for Human Rights said the government needs to address the conditions that enable the waterborne disease to spread.

“In public health, we often say cholera is a disease of poverty which mainly affects people with inadequate access to safe water and basic sanitation,” said Matara. “In Zimbabwe, we have witnessed perennial cholera outbreaks in recent years and these outbreaks are being caused by a lack of safe drinking water supply and a broken-down sanitation system which leaves residents in densely populated communities surrounded by flowing sewer. This sewer will then contaminate alternative sources of water such as shower wells, streams, rivers and even boreholes resulting in people drinking or eating food contaminated with the cholera bacteria.”

He said that those conditions have been chronic over the years in Zimbabwe, contributing to the repeated outbreaks.

How does Zimbabwe get out of this cycle of recurring cholera outbreaks?

“We need to make sure that our hospitals are well-supposed with the real addressing solutions and medicines so that people can be assisted,” said Matara. ” … Also, those high-risk communities, especially in towns and urban cities, we may give them the oral cholera vaccine so that they may be protected. In the long term, the government needs to invest more in proper sanitation facilities and infrastructure as well as making sure that people are provided with clean safe water for drinking and cooking.”

Matara said he hopes the current outbreak is contained quickly and does not spread to other parts of Zimbabwe.

But with raw sewage flowing in some streets of Harare, it might be a question of time.