Sarah Cunningham, in Ghana

Sarah Lynn Cunningham works for the Louisville and Jefferson County Metropolitan Sewer District in Kentucky, implementing the principles of the Coalition for Environmentally Responsible Economies (CERES). This week, she's doing reconnaissance in Tamale, Ghana, to assess ways to improve water and waste management.

The final report that Steve and I will submit to the sister-city committees in Louisville and Tamale will come in plain English and technical editions. It will summarize our findings, list conflicting information that needs reconciliation, and suggest steps toward realizing their goals of having more clean drinking water and increased environmental protection.

In interacting with our counterparts in the developing world, we sister cities face the following challenges (beyond the obvious one of pervasive poverty):

1. How far can we use our outside-expert status to prod our sister city to make positive changes without offending them? If we're too nice, nothing will come of our visit and Tamale will be less likely to reach the goals they set for themselves. If we're insensitive to cultural differences or the universal need to save face, we've gotten their hopes up for nothing.

2. How can we provide more water and appropriate wastewater treatment -- to avoid conveying pathogens further -- in the face of a common misperception that sewage disposal isn't a big problem? We'll need to focus not just on engineering, but also on the reality that adults don't adopt new attitudes or behaviors without seeing how it benefits them. We'll have to use social marketing; for example, we're told women would value the safety and privacy of using a privy next to their compounds and their children rather than going in open fields or into drainage ditches.

3. How can we tackle problems facing hundreds of thousands of people and maintain credibility? Can we do demonstration projects in villages within Tamale, where we can expect proper construction and maintenance to catalyze other villages and elected officials to get involved?