Grahamstown was established in 1812 and grew into the economic and military hub of the settler frontier under British rule. Today Grahamstown, although well known as a centre of educational excellence, is still a place of contrast and deep economic divisions.
The commonly accepted estimate for the population of Grahamstown is over 100,000 people. There are few sources of formal employment in Grahamstown – municipal departments, the legal courts, Rhodes University, a number of independent and government schools, a small commercial sector and the military base provide a few thousand jobs.

According to the Department of Health statistics, the HIV prevalence rate is 16.8% for the region. TB, diabetes and high blood pressure account for a great proportion of illness. Alcoholism remains a social problem with major ramifications for the health and welfare in many communities. Many of these problems are the result of rural migration to urban areas where lifestyle habits, diet and cultural changes, and the disintegration of family and social structures, are contributing factors. Both a high unemployment rate and low incomes contribute to, and exacerbate, these conditions.

There are still large areas without water-borne reticulation systems. In some of these homes as many as fifteen people can depend on the bucket toilet, which the municipality will clear no more than twice a week. There is still high dependency on paraffin for cooking and lighting. Due to infrastructural challenges, the availability and quality of water has recently become a community-wide issue.