In July, in much of Botswana, there is no real heat in the sun. The nights close in at 6pm, the air fills with sudden and surprising dankness that clutches a little at the heart – all too reminiscent of England in November. Long cold evenings are bad for the mood. Maybe this is why it was the right time for George W. Bush and his entourage to make a quick and triumphal visit to Gabarone, the sprawling capital of this political and economic success story of the southern African region.

Since the Bush team left Botswana, some of the local media have been picking away at the reasons and results of the visit. The Americans are not able to recruit any real, popular endorsement for the invasion of Iraq. I am hearing ever more scepticism – no, not so much scepticism as a mixture of something more forthright: indignation and incredulity.

The Bush visit did not focus on Iraq, so much as possible campaigns in two other possible American interventions – one in a nation: Liberia, the other in an issue: HIV/Aids. Botswana eyes are not so much on the Liberian civil war as the threat to themselves from HIV. Botswana is now thought to have the highest HIV rate in the world, with an epidemic that threatens to reduce the working population by as much as 20% within a decade. An economic forecast that evokes catastrophe for a burgeoning economy.

Bush announced tens of millions of dollars to come from the US to fight the pandemic in Africa. Analysts of the new US contributions, however, have been noting that these large new numbers may be something of a sleight of hand. Too much is tied up in US research and drug development, they say. No real attempts are being made to reduce the high-cost retroviral remedies. There is really little more here than is already on offer. At least one columnist has argued that the new US response to a terrible, anguished crisis is twisted and obscured by Bush’s political spin – aid to the US image and pharmaceutical interests; not an authentic response to real and urgent needs.

Cycles of loss

What has this got to do with peoples who live on the margins of Botswana? There are many of them – Kweh, !Xoo, !Kung, Jo’//uan and Naro. They are part of a mosaic of San or Bushman societies that have long and complex links to the greater part of Botswana, and who have had long and difficult relationships with other peoples in the area. They are known collectively by others in Botswana as Basarwa, a Tswana word that seems to mean “inanimate (not quite human) original dwellers.”

Many of these peoples have lost, or are losing, their rights to their own land. Many have been relocated, by a mixture of force and bribery, to settlements outside their territories. A very few hold onto their way of life (a blend of hunter-gatherer with borrowings from pastoralist neighbours) on their own land by living in remote areas or in the recesses of wildlife reserves and national parks. Even the most remote, the most hidden, are at risk – not of modernity so much as dispossession and displacement.

Those who live at the margins of Botswanan society are poor. The communities that have been relocated to places where they can neither find the plants and animals they know or tread the paths of their ancestors, are in disarray. At many of these margins there is little to do and not much to hope for. So the evils take root – feelings of uselessness and powerlessness become endemic, alcohol and soft drugs begin to have an irresistible appeal, anger and petty violence make home life a struggle between the feelings of demoralised parents and the vulnerabilities of children.

Thabo Mbeki made the defiant, some would say embarrassing, claim that poverty, not HIV/Aids, was the problem in Africa. He seemed to imply – before indignant outbursts caused some rethink and political fog – that HIV/Aids was a European or colonial myth of some sort. Perhaps Mbeki’s view was more complex than it appeared: the rapid and unchecked spread of HIV is caused by a failure to resist – not lack of nutrition (though the body’s capacity to avoid infection and delay the progress of the disease is indeed linked to nutrition), but lack of family and social cohesion. The co-factors of HIV are drunkenness, chaotic drug use, and the marketing and seeking of casual sex.

Resistances of hope

These co-factors are to be found, in their most desperate and extreme forms at the margins of society, and the peoples whose lands, livelihoods and heritage have been aggressively denied to them. The San of Botswana are prominent in any calculation of fatal risk. But not all of them: those who continue to live on their own lands, at some distance – of everyday life or mind – from the majority population are less vulnerable. The most obvious co-factor for HIV infection rates is displacement. Government seeking to keep rates in check must do what they can to prevent a development process that causes dispossession and relocation.

The San groups that have reduced their vulnerability are the peoples who have been campaigning for recognition and restitution of their rights. At least one region, on the edges of Botswana, has mapped in detail family territories and the encyclopaedic knowledge that goes with them. By building new partnerships between elders and youth, between holders of knowledge and those able to record and negotiate for it, these San communities are alive and well. Here there is almost no alcohol problem, no casual prostitution, minimal family violence; and reversal of any trend to despair and disarray.

HIV/Aids threatens everyone, of course; no community can feel secure because of a cultural revitalisation or a new community politics. The sexual walls around every society are porous. But those with hope and energy are more likely to understand the risks and minimise them than those who slide, again and again, into pessimistic, self-destructive incoherence.

For the San who search and argue for their own rights, despite the mismatch between their ways of owning resources and the ways of the dominant society around them, there is at least a thin prophylactic guard against the disaster of HIV infection. They do not take the same risks, and have sobriety and sense to look at the ways to meet those risks.

Governments could look at this defense and consider how much it is in their wider, national interests to encourage it. Health at the margins – or a means to defend health being explored at the margins – may have powerful, relevant and deeply moving things to say to those who do battle with the problems at the centre. Some of Bush’s money should perhaps be assigned to indigenous peoples’ wish to secure their place on their own lands – not to endorse land rights but to widen and deepen the war on HIV/Aids. Botswana would be a very good place to begin.