Our study takes place in predominately Coloured communities in the Northern Cape, South .
The Northern Cape is South Africa’s largest (373,000 km2) and least populated province, harboring extreme TB incidence. We have several sites throughout the Mgcawu District at small community health clinics—the front line for TB screening and treatment.
The Northern Cape’s upper border with Namibia and Botswana is demarcated by the Orange River, and encompasses diverse desert ecologies, including the southern Kalahari, Namaqualand, and the Karoo. Agriculture is the predominate economic industry, from fruit farms and vineyards along the Orange River to cattle, sheep, and goat farming throughout.
Prior to European colonialism and the Bantu expansion, Southern Africa was home to peoples referred to in the archeological and ethnographic record as, Khoe-San. Khoe-San is a term used to include widely diverse (culturally and genetically) groups of people who primarily practiced hunting and gathering, the "San", and pastoralism, the "Khoekhoe", and spoke languages distinguished by their click consonants. Many descendants of the Khoe-San continue to live in southern Africa. In the Northern Cape, some groups maintain a Khoe-San identity, ≠Khomani, bosman/bushman* (i.e., San) or Nama (i.e., Khoekhoe). Other communities do not identify with Khoe-San groups, but individulas carry Khoe-San genetic ancestry. Many of these people are called, "Coloured", stemming from an apartheid racial term.
*Bosman or bushman is often used as a derogatory term, historically used by Afrikaners to call San peoples who lived by hunting and gathering. We use the term here because many people in the community, especially elders, self-identify as, bosman, and do so with pride—though this is without community consensus.