African Urban Poverty Alleviation Program

Africa
Urban
Poverty
Alleviation
Program

Table of Contents
2
2 Foreword – Mary D. Kane
3 About Sister Cities International
4 About the Africa Urban Poverty Alleviation Program (AUPAP)
5 AUPAP Projects – Sister City Relationships and Project
Descriptions
6 Baltimore, Marlyand - Luxor, Egypt: The construction
of a pipeline connecting the potable water source at the
village of Nagaa to the village of Gad, to provide clean,
reliable water to 6,000 residents.
8 Boulder, Colorado - Kisumu, Kenya: The construction
of toilet facilities at the Kudho Primary School benefitting
over 1,200 students and the Migosi Market Center
serving 3,000 buyers and sellers daily.
10 Chicago, Illinois - Casablanca, Morocco: The renovation
and equipping of Al Waha Health Center, benefitting
over 60,000 residents in Sidi Moumen.
12 Corvallis, Oregon - Gondar, Ethiopia: The construction
of four restroom/shower facilities and a public health
clinic, serving over 60,000 residents.
14 Delray Beach, Florida - Moshi, Tanzania: The
construction of skip bucket foundations and provision
of cleaning tools and equipment in the Majengo Ward,
benefitting over 24,000 residents.
16 Fort Worth, Texas - Mbabane, Swaziland: The
construction of a community health and social center,
serving over 1,500 people.
18 Grand Rapids, Michigan - Ga East/Ga West, Ghana:
The renovation of the Mayera Community Health
Clinic and the construction of a mechanized borehole
to provide water for the clinic in Ga West, benefitting
35,000 people. The construction of a 12-seat
community latrine and mechanized borehole for the Taifa
community in Ga East, benefitting 11,000 people.
20 Jacksonville, Florida - Port Elizabeth, South Africa:
The purchase of a mobile clinic in the Chatty Extension
Area benefitting 55,000 residents, and the renovation
of school ablution facilities at two schools in the Nelson
Mandela Bay Area benefitting 1,763 students.
22 Lansing, Michigan - Akuapem South, Ghana: The
construction of toilet facilities benefitting 7,500 people,
and the renovation of two health clinics benefitting
18,000 people.
24 Long Beach, California - Mombasa, Kenya: The
procurement of a water purification plant and medical
equipment for several health clinics in Mombasa.
26 Louisville, Kentucky - Tamale, Ghana: The construction
of a sanitation facility for the Tamale Teaching Hospital
and the purchase of an ambulance for the hospital.
28 Maryland State - Bong/Maryland County, Liberia: The
construction of 34 hand dug wells with hand pumps in
Bong County and the restoration and improvement of
the water system at the JJ Dossen Memorial Hospital in
Maryland County.
30 Milwaukee, Wisconsin - uMhlathuze, South Africa: The
installation of water supply—connecting water from the
main line to standpipes in the KwaDube community,
benefitting 18,000 people.
32 Milwaukee County, Wisconsin - Buffalo City, South
Africa: The renovation and expansion of Aspiranza Clinic
benefitting 2,000 residents in the Buffalo Flats Area—
addition of rooms, purchase of new medical equipment
and furniture, installation of storage facility to stock and
store equipment and supplies safely.

1
34 Oakland, California - Sekondi-Takoradi, Ghana: The
construction of mechanized boreholes and toilet facilities
at the Ketan Cluster of Schools benefitting 3,000 people;
provision of medical screenings benefitting 1,250
students and teachers; and repair of ambulance for
Esikado Hospital.
36 Richmond, Virginia - Segou, Mali: The construction of
toilet and washing facilities in Les Poupons Kindergarten,
Medine Community Health Center, and Small Water
Tower Public Market benefitting over 50,000 residents,
and the renovation of Medine Community Health Center
benefitting 28,000 people in Segou and surrounding
communities.
38 Riverside, California - Obuasi, Ghana: The upgrade
of water facilities of Bossman and St. Philip’s
neighborhoods benefitting over 6,000 people; purchase
of Toyota ambulance for Obuasi Government Hospital
and procurement of medical equipment for six hospitals
and clinics serving over 200,000 people; and upgrade of
the local abattoir.
40 Seattle, Washington - Mombasa, Kenya: The renovation
and expansion of Utange Dispensary to include a
maternal and dental clinic, benefitting 40,000 residents
of the Bamburi division of Mombasa.
42 St. Louis, Missouri - Saint Louis, Senegal: The purchase
of trash collection equipment, benefitting over 200,000
residents in Saint Louis; provision of screenings and
medical equipment for diabetes care benefitting about
20,000 people with diabetes; and renovation of the
Rawane Ngom School.
44 Sonoma, California - Aswan, Egypt: The purchase
of lower and upper endoscopes for the Aswan
Cancer Center and the purchase of trash collection
equipment for the El Nasriya Sanitation Project, a waste
management system serving about 80,000 residents.
46 Toledo, Ohio - Tanga, Tanzania: The construction of
toilet facilities at Sakarani Garden, Mgandini Market, and
Mkwakwani Market serving up to 50,000 people, and
the construction of the Duga Maternity Ward serving up
to 25,000 women and children.
48 Urbana, Illinois - Zomba, Malawi: The construction of
toilet facilities at elementary schools benefitting 5,600
students and an ablution block at Zomba Central
Hospital benefitting 200 patients and family members
daily.
50 Wilmington, Delaware - Osogbo, Nigeria: The
construction of 29 hand pump boreholes throughout all
seven Osogbo districts, providing potable water for up to
140,000 residents.
52 Acknowledgements

Foreword
Mary D. Kane
President and CEO
Sister Cities International
2
I
n 2008, a question was posed to a group of U.S. and African sister city programs – “Can
we come together, with a grant from the Bill and Melinda Gates Foundation, to change the
lives of thousands of our friends and family members both here in the United States and
throughout the continent of Africa?”
Ambitious goals such as this are not unfamiliar to our organization. Sister Cities International is
a non-profit organization that was started in 1956 by President Dwight D. Eisenhower, and at
that time in our history the world was still feeling the effects of two World Wars and the Cold
War was heating up. President Eisenhower stated in his address on September 11, 1956
that “Two deeply held convictions unite us in common purpose. First, is our belief in effective
and responsive local government as a principal bulwark of freedom. Second is our faith in the
great promise of people-to-people and sister city affiliations in helping build the solid structure
of world peace.” This citizen network has grown to encompass 550 U.S. cities that have close
to 2,000 partnerships in 146 countries.
When Sister Cities International received over $7 million to support the Africa Urban Poverty
Alleviation Program, which came to be known as AUPAP, we were given the opportunity to
once again promote our message of peace and closer relations between peoples, this time
through development work. The goal of the program was to complete water, sanitation, and
health projects in African cities through sister city programs, where both communities were
involved in the identification, planning, and implementation of projects. We held a competitive
application process for over 200 U.S. communities that had relationships in Africa, and those
that took on this challenge, which encompassed 13 countries throughout the continent, were
charged with engaging their partners and developing these projects with only local volunteers
and the support of a few dedicated employees of Sister Cities International.
On the following pages you’ll find the results of their work. Each program has the components
of a great story – there were days of hope, tears, anxiousness, anger, sympathy, frustration
and ultimately great joy. I had the privilege of seeing many of these projects in person, and
whether it was the young girl in Kisumu, Kenya who could now collect water from the well in
her school, or the family whose home was saved from fire because of newly installed water
standpipes in uMhlathuze, South Africa, or the community in Ga District, Ghana which now
has access to clean toilet facilities, in each case I saw how these projects deepened the
connection with their U.S. partners. I don’t think anyone involved in these projects will tell you
it was easy, but I do think everyone will tell you that it was worthwhile.
AUPAP supported the vibrant mission of Sister Cities International –To promote peace through
mutual respect, understanding and cooperation – one individual, one community at a time
and when you read the following stories you will understand that the lives of many U.S.
citizens and their family members in Africa were changed – each one for the better.
Enjoy reading about these incredible accomplishments, and my heartfelt congratulations to
the communities who made this work possible.

About Sister Cities International
3
S
ister Cities International is a nonpartisan 501(c)(3)
nonprofit that serves as the national membership
organization for individual sister cities, counties, and
states across the United States. This network unites
thousands of citizen diplomats and volunteers from 522 U.S.
communities with over 2,000 partnerships in more than 140
countries. Sister Cities International was created at President
Dwight D. Eisenhower’s 1956 White House Summit on Citizen
Diplomacy. He envisioned an organization that would be a
champion for peace and prosperity by helping citizens foster
bonds between people from different communities around the
world. President Eisenhower reasoned that if private citizens
built partnerships that celebrated and appreciated differences
between cultures, and didn’t rely solely on national governments
to manage international relations, then it would lessen the chance
of new conflicts.
For nearly six decades, Sister Cities International has served
as a hub for institutional knowledge and best practices in the
field of citizen diplomacy. Sister Cities International continues
to strengthen the sister cities network through strategic
institutional partnerships, grants, programs, and support for its
members. Sister Cities International motivates and empowers
private citizens, local organizations, and municipal officials to
conduct long-term, mutually beneficial sister city, county, or state
relationships.
The mission of Sister Cities International is just as important today
as it was when it was founded. With the advent of the internet
and new technologies, the world is becoming smaller, and the
relationships and interactions between the U.S. and its foreign
counterparts are more complex than ever. Despite this increase
in online communication, the face-to-face meetings and personal
relationships developed through sister cities are still vital and
irreplaceable.
What is a Sister City?
A sister city, county, or state relationship is a broad-based, long-
term partnership between two communities in two countries. A
sister city, county, or state relationship is officially recognized after
the highest elected or appointed official from both communities
sign an official agreement of partnership.
A sister city organization may have any number of sister cities,
with community involvement ranging from a half dozen to
hundreds of volunteers. In addition to volunteers, sister city
organizations may include representatives from nonprofits,
municipal governments, the private sector, and other civic
organizations. Sister city relationships offer the flexibility to form
connections between communities that are mutually beneficial
and which address issues that are most relevant for partners.
They implement projects in a number of areas, including:
Cultural Exchange, Youth and Educational Programs, Economic
Partnerships, and Municipal Assistance.

About the Africa Urban Poverty Alleviation Program (AUPAP)
4
Sister Cities International worked closely with three partner
organizations to promote the sister cities model and twinning
throughout different regions of Africa. African Global Sister Cities
Foundation (AGSCF), based in Accra, Ghana and operating in
West Africa; Africa Sister Cities, based in Casablanca, Morocco
and operating in North Africa and francophone countries;
and Eastern Africa Sister Cities, based in Nairobi, Kenya, and
operating in Eastern Africa. Together they provided programmatic
and informational support to existing partnerships as well as
worked to promote twinning between African cities and other
cities around the world.
The sister city partnerships that participated in AUPAP plan to
follow up on their respective projects and pursue new projects
in the future. Making sure that sanitation facilities and health
clinics are sustainable is an important concern for sister city
members and many U.S. sister city committees are in the
process of returning to their African sister cities, to follow up on
the maintenance of their projects. New relationships with local
schools, municipalities, and hospitals have also allowed sister city
members to build on their relationships and continue taking part
in mutually beneficial projects and exchange.
The AUPAP projects provided meaningful and worthwhile
experiences to the U.S. and African sister cities alike, helping to
create friendships and strengthen relationships. AUPAP partners
recognized the importance of citizen diplomacy and collaboration,
and understood the purpose of the projects—to improve the lives
of the people living in their communities—which dovetails with the
mission of Sister Cities International: to promote peace through
mutual respect, understanding, and cooperation – one individual,
one community at a time.
S
ister Cities International’s Africa Urban Poverty Alleviation
Program (AUPAP) was designed to address urban
poverty through water, health, and sanitation projects
developed collaboratively by U.S. and African sister
city programs. This included participation and support from the
private sector, non-governmental organizations, community-
based organizations, municipal governments and traditional
leaders in Africa to provide sustained technical assistance and
community development strategies. Beyond these projects,
the program has developed a support network for sister cities
on the continent of Africa to promote the mission of peace and
prosperity through international people-to-people collaboration.
In 2010 and 2011, 25 sister city partnerships representing
13 African countries and 16 U.S. states were competitively
selected to participate in AUPAP. Through these partnerships,
community members in the African cities, along with members
of civic, municipal, and private organizations in both the U.S.
and Africa, selected projects in the areas of water, sanitation,
and health to address local problems in these areas. Together
the U.S. and African partners combined their technical expertise
and experience to plan, implement, and monitor their projects,
with administrative and technical support from Sister Cities
International.
The program was funded by a generous grant from the Bill &
Melinda Gates Foundation. Projects included the construction of
toilets and showers, the renovation of health clinics and provision
of medical equipment, the construction of water boreholes and
hand pumps, and the implementation of a waste management
system, among others. These projects were implemented in
Egypt, Ethiopia, Ghana, Kenya, Liberia, Malawi, Mali, Morocco,
Nigeria, Senegal, South Africa, Swaziland, and Tanzania.

T
he sister city relationship between Baltimore and Luxor was formally established
in 1982 under the direction of the Baltimore Mayor’s Office. In 1995, Baltimore
also paired with Alexandria, Egypt. The Baltimore-Luxor-Alexandria Sister Cities
Committee (BLASCC) has done many projects with both of its Egyptian cities,
focusing on art and culture, education, health care, humanitarian aid, government and
public policy, waterfront development, low-middle income housing, transportation, tourism,
science and technology, and the environment.
In the past, BLASCC’s health care program in Luxor successfully worked to improve
hospitals and the overall health care system in Luxor through modernization of facilities,
medical training, and donations of equipment and supplies. In 1988, BLASCC received
Sister City International’s Special Achievement Award for Technical Assistance for their
health-planning model. Dr. Jean Creek of BLASCC is continuing with her efforts to help
prevent and treat diabetes and hypertension, in particular, in Egypt.
The bustling city of Luxor is located on the Nile River in Egypt, and includes the ancient
Egyptian capital of Thebes within its city limits. Luxor has often been called the “world’s
greatest open air museum,” since a number of ancient Egyptian ruins are in Luxor and its
surrounding areas. The temples and monuments attract thousands of tourists annually,
contributing significantly to Luxor’s economy. In addition to tourism, agriculture is another
important part of Luxor’s economy, particularly growing sugarcane.
Despite the thriving tourism industry in Luxor, the city faces certain issues as a result of
urbanization—mainly the lack of clean water. Residents do not have easy access to clean,
safe water for drinking, cooking, and cleaning. The lack of clean water leads to water borne
diseases and chronic health conditions, caused by consuming unsafe water. The Luxor
Sister City Committee and the Baltimore-Luxor-Alexandria Sister Cities Committee partnered
to address this issue and ensure clean water would be provided to the residents of Luxor.
Baltimore, Maryland Luxor, Egypt
At a glance:
Objective: To improve water quality
and sanitation for residents who
previously had only an unclean and
irregular water supply
Project(s): The construction of
a pipeline connecting the potable
water source at the village of Nagaa
to the village of Gad, to provide
clean, reliable water to 6,000
residents
Year sister city relationship was
established: 1982
Luxor, Egypt
n Population: 487,896
n Area: 161 mi² (416 km²)
n Geography: Located in southern
Egypt on the Nile River, surround-
ed by ancient temple ruins
n Economy: Tourism, agriculture
Baltimore, Maryland
n Area: 92 mi² (238 km2
)
n Geography: Located in north-cen-
tral Maryland on the Patapsco
River, near the Chesapeake Bay
n Economy: Service industry, tourism
6

I became friends
with their families,
and I was always
treated like a sister.
I really thank God
every day for being a
part of this.
Amy Riolo, former Chair of
Baltimore-Luxor-Alexandria
Sister Cities Committee
“
”
The sister cities addressed the prevalent water issues in Luxor by completing a community
water project: the construction of a pipeline connecting the potable water source at the village
of Nagaa to the village of Gad Al Kareem. The construction of the pipeline has allowed for easy
access to clean, reliable water in Gad Al Kareem, reducing the residents’ waiting time. It will also
improve the health of residents, by providing clean, potable water to 6,000 people in the area.
Through its strong, lasting relationship with both Luxor and Alexandria, BLASCC has become
very familiar with Egypt. After participating in AUPAP, Baltimore’s relationship with Luxor has
been strengthened even further. Amy Riolo, then Chair of BLASCC, shared,“I became friends
with their families, and I was always treated like a sister.” The relationship ran deeper than
simply fixing issues and completing projects—it was about creating friendships and helping the
Baltimore-Luxor extended sister city family grow and develop.
The project was a success despite the unstable
political climate following the Egyptian revolution.
The political climate resulted in some issues and
delays, but in the end BLASCC was able to work
effectively with the Luxor Sister City Committee
to complete the construction of the pipeline and
provide much needed clean water to the residents
of Luxor. The community was very thankful, and
so was Amy Riolo. “I really thank God every day
for being a part of this,” said Ms. Riolo. It was a
powerful moment for her when the project was
officially complete, knowing that the people of Gad
al Kareem finally had safe, clean water.
Baltimore and Luxor plan to pursue more projects
in the future, and are excited to continue their close
friendship.
7

Boulder, Colorado Kisumu, Kenya
At a glance:
Objective: To improve sanitation
and access to toilet facilities
Project(s): The construction of toilet
facilities at the Kudho Primary School
and the Migosi Market Center
established: 2009
Kisumu, Kenya
n Area: 805 mi² (2,086 km²)
n Geography: Located in western
Kenya on the border of Lake
Victoria, characterized by fertile
agricultural land
n Economy: Subsistence farming,
livestock keeping, fishing, rice
farming, sugar cane farming, small
scale trading
Boulder, Colorado
n Area: 26 mi² (67 km2
)
n Geography: Located in northern
Colorado, situated in Boulder
Valley where the Rocky Mountains
meet the Great Plains
n Economy: High-technology,
electronic, aerospace industries
T
he sister city relationship between Boulder, Colorado and Kisumu, Kenya was
formally established in 2009, after four years of exchanges between a group of
high school children in the Interact Program (a Rotary sponsored youth service
organization) and the children of the Rabour School in Kisumu. The Interact
Program students, along with other local organizations, addressed the water and sanitation
issues at the Rabour School. They raised money to build a fresh water well and sanitation
facilities, which helped keep students healthy and in the classroom. They also helped fund
a self-sustaining orphan feeding program by purchasing chicks, goats, and a local porridge
flour-producing company.
Kisumu is a port city located in western Kenya, bordering Lake Victoria. It is the third largest
city in the country, known historically as a center of trade due to its location. Currently,
Kisumu is one of the fastest growing cities in Kenya, with thriving sugar cane and rice farming
industries that contribute immensely to the national economy. With its beautiful views of Lake
Victoria, Kisumu attracts tourists every year who come to see the Kisumu Museum, Kisumu
Impala Sanctuary, and the nearby Kit Mikaye and Ndere Island National Park.
As a result of rapid urbanization and
population growth, there is a lack of proper
sanitation facilities in public areas like markets
and schools. Inadequate sanitation leads
to poor health conditions of the residents,
child mortality, and degradation of the natural
environment.
Boulder Kisumu Sister City Committee
(BKSCC) partnered with the Kisumu Sister
City Committee to address these sanitation
issues and try to prevent disease from
spreading and the environment from degrading. They did so through two sanitation projects:
the construction of an ablution block at the Migosi Carwash Market and the construction of
a sanitation block at Kudho Primary School.
8

The ablution block was constructed in the heart of the Migosi Carwash District due to
its central and busy location. Workers and residents in the area can easily access the
sanitation facilities while working during the day. The ablution block significantly decreased
the amount of human waste in the area, which reduced the foul odor, the number of skin
infections among children, and the number of insects in the area. The ablution block also
provided an opportunity for additional income for the nonprofit in charge of its management.
The project will benefit 15,000 people in the Migosi Market Center area.
The sanitation block was constructed at Kudho Primary School in order to make sure
students were able to wash their hands and to encourage better hygiene. Promoting better
sanitation and hygiene practices in schools has the combined effect of decreasing child
mortality rates, increasing access to education, promoting gender equality, and encouraging
environmental sustainability. The easy access to toilets and clean water in Kudho Primary
School has allowed students to stay in school instead of being forced to return home or go
outside to relieve themselves.
Through the AUPAP projects, the Boulder-Kisumu sister city relationship has grown stronger
and new opportunities have been discovered. Cultural differences and communication were
a challenge, but the sister city committees were able to work through them. Going through
difficulties and obstacles together during the program helped strengthen their sister city
relationship and bring the two cities closer. Darryl Brown, Chair of Boulder Kisumu Sister
City Committee, said: “Part of our relationship with being a sister city is that we’ve already
done some projects in the community and so we were known to the community—we had a
good group in Kisumu.”
Darryl Brown shared that his favorite moment during AUPAP was
when they were starting to dig into the ground to start a new project.
He said, “I felt the widest range of emotions I have ever felt”—from
frustration to appreciation, as the kids approached them to express
their thanks. Jared Odhiambo, Project Manager of Boulder-Kisumu
Sister Cities appreciated the significance of the AUPAP project in the
Migosi community and shared that “the Sister Cities grant gave us the
opportunity to empower Migosi residents with self confidence in the
ability to change their situation for the better.”
The Sister Cities
grant gave us the
opportunity to
empower Migosi
residents with self
confidence in the
ability to change their
situation for the better.
Jared Odhiambo, Project Manager
of Boulder-Kisumu Sister Cities
“
”
The Boulder Kisumu AUPAP projects
are dedicated to our dear friend Maurice
Jack Osiro who was a great man, a
humanitarian, a husband, and father.
Jack passed away the year our projects
were completed, but we are eternally
thankful that he was able to see their
completion. His soft spoken manner,
insight, and ethics contributed greatly to
these projects. We wish to honor him
with this dedication and thank him for his
friendship and for his service to humanity.

9

Chicago, Illinois Casablanca, Morocco
At a glance:
Objective: To improve access to
health care services
Project(s): The renovation and
equipping of Al Waha Health Center
established: 2002
Casablanca, Morocco
n Population: 3,500,000
n Area: 149 mi² (386 km2
)
n Geography: Located on the
northern coast of Morocco
bordering the Atlantic Ocean,
characterized by the Chawiya Plain
and the Bouskoura forest
n Economy: Manufacturing, tourism,
commerce
Chicago, Illinois
n Area: 234 mi² (606.1 km2
)
n Geography: Located in
northeastern Illinois on the
southwestern shores of Lake
Michigan, with the Chicago River
and the Calumet River flowing
through the city
n Economy: A major financial
and business center, retail,
manufacturing, printing, publishing,
and food processing
I
n 1982, Chicago formed a sister city relationship with Casablanca. Twenty years later in
2002, the Casablanca Chicago Sister Cities Association (CCSCA), headed by Boubker
Mazoz, was established as Chicago Sister Cities International’s (CSCI) counterpart
organization in Morocco. The sister city relationship recently celebrated its 30 year
anniversary, showing the strength and endurance of the relationship. Since 1982, Chicago
and Casablanca have participated in many exchanges and projects throughout the years,
focusing on medical, humanitarian, and educational exchanges, urban planning, economic
development, sports, and youth service learning programs.
Some past projects included establishing formal sister school relationships between ten
schools in Chicago and Casablanca; collaborating with One-on-One, a basketball training
company, to initiate CasaBasket, a youth basketball program in several Moroccan cities;
and creating a joint playwright program called Global Voices, which involved students from
several Moroccan cities. In 2004, the World Bank awarded the Casablanca Committee of
Chicago Sister Cities International (CSCI) a grant for $28,000 to develop a literacy and job
readiness skills pilot project. The Casablanca Committee worked with Moroccan literacy
experts to develop and implement this program.
Casablanca is located on the northern coast of
Morocco, bordering the Atlantic Ocean. It is the
largest city in Morocco, as well as the main port in the
country. Casablanca is now considered the economic
and business center of Morocco, while the capital city
of Rabat is the political center. The city has become
a major tourist destination, contributing to Morocco’s
economy. Its other major industries include fishing, fish
canning, sawmills, furniture production, building materials, glass, textiles, electronics, leather
work, processed food, spirits, soft drinks, and cigarettes.
Despite being a major tourist destination and a growing city, Casablanca faces health issues
due to the growing population and lack of proper infrastructure. Sidi Moumen is one of the
poorest areas of Casablanca, with high unemployment and school dropout rates, pervasive
10

drug use among the youth, delinquency, and extremism. It also lacks access to basic health
care services. The sister city committees of Chicago and Casablanca worked together to
address these health issues and improve the quality of life in Sidi Moumen.
The Casablanca Committee of CSCI partnered with CCSCA to complete a health project in
order to address the lack of health care services in Casablanca: the renovation and equipping
of Al Waha Health Center.
The Al Waha Health Center is located in Sidi Moumen and treats tuberculosis and diabetes,
and has a special focus on women and children. The Al Waha health center had many
problems such as the lack of space for tuberculosis patients and pregnant women—one
room was used for both groups, leading to spread of infection and disease. Rooms were
expanded to accommodate more patients, corridors and other spaces were utilized
efficiently, computers and printers were provided, a kitchen was created for the staff, and a
large fridge and air conditioners were provided to store medicines and vaccines.
The renovation of the health center was a success—it greatly improved sanitation and
prevented the spread of disease within the health center. The Al Waha Health Center now
provides easy access to health care services in Sidi Moumen. The community was extremely
grateful for the renovation of the health center, and both sister city committees were proud of
the work that they accomplished. Mr. Mazoz shared: “We are all proud of this program—it’s
the best we’ve ever had.” He and his colleagues enjoyed working on the AUPAP project and
really felt that it made a difference in the community. “When I see the smiles of the women in
the hospital, the appreciation and thankfulness for the project—that’s what I enjoyed most.”
Mr. Mazoz, President of the CCSCA, worked extensively to make sure that the community
of Sidi Moumen was able to access health care services. He described Casablanca’s
relationship with Chicago as a “good, resourceful, strong partnership.” The AUPAP grant
provided the sister cities with the opportunity to not only improve the health care facilities in
Casablanca, but also to form new relationships with the Ministry of Health, the governor, and
the local community of Casablanca.
The CCSCA plans to add health education programs at the Al Waha Health Center, and
work with Chicago on more health projects in the future. “There are a lot of things we can do
together, and there is still much to be done,” said Mr. Mazoz. The two sister cities continue to
strengthen their friendship and build upon their already strong sister city relationship, in order
to improve the lives of those living in Casablanca.
We are all proud of this
program—it’s the best
we’ve ever had. There
are a lot of things we
can do together, and
there is still much to
be done.
Boubker Mazoz, President
of Casablanca Chicago
Sister Cities Association
“
”
11

Corvallis, Oregon Gondar, Ethiopia
At a glance:
Objective: To improve sanitation
in kebeles (neighborhoods) and
marketplaces in Gondar
Project(s): The construction of four
restroom/shower facilities and a
public health clinic
established: 2005
Gondar, Ethiopia
)
Ethiopia near Lake Tana, situated
on the Lesser Angereb River and
southwest of the Simien Mountains
n Economy: Tourism, retail and
wholesale trade, agriculture,
manufacturing, textiles production
Corvallis, Oregon
)
n Geography: Located in central
western Oregon, situated in the
Willamette Valley and 46 miles
east of the city of Newport and the
Oregon Coast
n Economy: Education, health and
social services, manufacturing
T
he sister city relationship between Corvallis and Gondar was formalized in 2005,
after Corvallis’s success with their first sister city, Uzhgorod, Ukraine. Interest in
Gondar was expressed by Robel Tadesse, a City of Corvallis staff member, who is of
Ethiopian heritage and was raised in the Gondar region. In addition to this personal
connection to Gondar, there was also a level of cultural understanding due to the involvement
of Corvallis’s Ethiopian community in the Corvallis Sister Cities Association (CSCA). Soon
after, delegations visited both cities, and long-term planning in terms of water, health, and
sanitation projects was underway. Assessments of the water situation were conducted in
order to decide which projects to pursue.
Gondar is located in northwestern Ethiopia in the Amhara region, just north of Lake Tana and
260 miles from the country’s capital, Addis Ababa. The city is nicknamed “The Camelot of
Africa” due to the presence of a group of castles built by Emperor Fasilidas and his dynasty
during the 17th century. In addition to attracting tourists, Gondar’s economy is driven by retail
and wholesale trade, agriculture, manufacturing, and textiles production.
Despite its vibrant history and culture, Gondar lacks proper sanitation facilities and public
health services. Fewer than 5% of Gondar households have septic tanks and only 52%
have access to pit latrines. Waste from septic tanks is untreated and often disposed in open
areas near homes. Untreated human waste accumulates in residential areas, contaminates
area wells and streams, and presents a threat to health and well-being. Shower facilities are
also very rare in homes. Upkeep of personal cleanliness is an everyday challenge, although
residents have learned alternate methods for cleanliness (sponge baths, for example).
Medical services are not available to the community, which has proven to be a major issue.
Corvallis Sister Cities Association applied for the AUPAP grant in order to address these
issues, and both the CSCA and Gondar Sister Cities Committee worked together to
construct several toilet and shower facilities, as well as a public health clinic that would
benefit the people of Gondar.
The objectives of the sanitation projects were to improve the sanitation of the affected
kebeles and marketplaces, increase access to improved toilet and shower facilities, provide
12

a model for the construction, maintenance, and sustainability of additional toilet/shower
facilities in Gondar, and develop a working relationship with kebele councils to plan and
implement future projects to improve living conditions and reduce poverty. The restroom
facilities at Azezo Ayermarefia, Tseda, Azezo Demaza, and Arbegnoch were all successfully
completed, despite some delays due to difficulty of access to the facilities, lack of connection
to the city’s electrical grid, and water shortages.
The people of Gondar were very excited about the
restroom facilities, and seeing them so happy was
one of Lee March’s favorite moments. Mr. March,
President of CSCA, shared, “We’re lucky to be living
in the United States, to have toilets and take them
for granted.” Gondar had no sewage system and no
sanitation process, so the four restroom and shower
facilities had a significant impact on the community.
The objective of the health project was to improve
access to public health services in the Maraki kebele.
The public health clinic was constructed successfully,
and will provide particular benefit to women and children. Women now work at the clinic as
well, in addition to working at the restroom facilities as paid attendants.
Although the sister city relationship was relatively young, it was strengthened by the
AUPAP projects. The program widened their scope of interactions, especially increasing
their cooperation with different levels of the city government. Members from the Corvallis
Sister Cities Association were introduced to kebele leaders and councils, and formed new
relationships with them. They had much stronger connections with citizen groups and were
able to get more valuable input from the community.
Mr. March said, “I enjoyed meeting the people of Gondar face to face—it was a lot of fun
getting to know people.” The relationships that were formed were priceless and will be
beneficial in implementing future projects in Gondar.
The Corvallis Sister Cities Association and Gondar Sister City Committee are planning to
continue working together on more sanitation projects in Gondar, with a few in the works
already. They are also currently looking to possibly initiate a microfinance program, and are
committed to the long-term development of Gondar.
Our project team
feels as though we
have made a lasting
difference in Gondar.
It was a challenging
project with many
twists and turns, but
our entire team, both in
the U.S. and in Gondar,
never lost sight of
what we were trying
to accomplish. The
restrooms are now
completed and serving
the public, and the
impact was immediate
and very positive.
Lee March, President of Corvallis
Sister Cities Association
“
”
13

Delray Beach, Florida Moshi, Tanzania
At a glance:
Objective: To improve general
sanitation conditions in Majengo
Ward through increased solid waste
collection
Project(s): The construction of skip
bucket foundations and provision of
cleaning tools and equipment in the
Majengo Ward
established: 2001
Moshi, Tanzania
n Area: 23 mi² (59 km²)
Tanzania near the border of Kenya,
situated on the lower slopes of Mt.
Kilimanjaro
n Economy: Tourism, manufacturing,
coffee, sugar cane, maize, beans
Delray Beach, Florida
)
Florida directly north of Boca
Raton and south of Boynton
Beach, characterized by four miles
of beach along the Atlantic Ocean
n Economy: Tourism
D
elray Beach formed a sister city relationship with Moshi in 2001, due to an interest
expressed by Tanzania’s former First Lady Anna Mkapa in forming a relationship
between the two cities. Several residents of Delray Beach had either lived in Moshi
or conducted business there, and both cities’ economies are largely tourism-based.
Due to the similarities between the two cities and the familiarity with Moshi, delegations from
Moshi and Delray Beach visited each other and started building a relationship.
Delray Beach has focused on sustainability in Moshi through education. Sister Cities of
Delray Beach has purchased children’s books for the Moshi Regional Library and established
an internet café with new computers and internet services. With the AUPAP grant, Moshi
wanted to expand its solid waste collection and disposal for residents outside of its Central
Business District.
Moshi is located in northern Tanzania, close to the border with Kenya. The scenic city
is situated on the lower slopes of Mt. Kilimanjaro, a dormant volcano that is the highest
mountain in Africa. Since Mt. Kilimanjaro is a popular tourist attraction, many climbers use
Moshi as a base for their expeditions, staying at nearby hotels and employing local residents
as guides, porters, and cooks. In addition to tourism, there are also several manufacturing
industries and a few crops are grown in Moshi such as sugar cane and coffee. The outskirts
of Moshi is known for its extensive farms of maize and beans.
Moshi faces a variety of issues associated with urban poverty, the main one being sanitation.
There is a lack of a proper waste management system in Moshi, leading to health and
environmental issues. By addressing this sanitation issue, residents of Moshi will be able to
lead cleaner, healthier lives.
Sister Cities of Delray Beach worked with the Moshi Sister Cities Committee to complete a
significant sanitation project: the construction of skip bucket foundations and provision of
cleaning tools and equipment in the Majengo Ward (one of 15 wards in Moshi Municipality).
14

The project focused on improving waste collection from households and centralized
collection centers on the six streets of Shaurimoyo, Makange, Sokoni, Arabika, Miembeni,
and Mji mwema. Each street received skip buckets, equipment, and tools for waste
collection. The use of skip buckets has made waste collection more efficient and sanitary,
and has decreased environmental degradation, since there is less scattered waste. In terms
of health, this project has reduced the spread of disease and improved the safety of children.
The improved sanitation system has impacted the community significantly, allowing
residents to live in a clean, healthy environment. David Schmidt, President of Sister Cities
of Delray Beach and former mayor,
was pleased by the results: “What
I enjoyed most was being able to
see some tangible change—it gave
me some satisfaction.” The bonds
and friendships made during the
project will provide the foundation
for future projects between the two
communities.
The sister cities worked well together
on the sanitation project and had an
open and honest relationship. Mr.
Schmidt shared: “We couldn’t have
done it without the support of Sister
Cities International—it was a great
program and had a great impact.” The
collaboration and support allowed the
AUPAP projects to be successful and
have an impact on the community.
The sister cities plan to pursue more
development projects together in the
future and continue to build on their
strong relationship.
What I enjoyed most
was being able to
see some tangible
change—it gave me
some satisfaction.
We couldn’t have
done it without the
support of Sister Cities
International—it was a
great program and had
a great impact.
David Schmidt, President of Sister
“
”
15

Fort Worth, Texas Mbabane, Swaziland
At a glance:
Objective: To improve accessibility
of health and social services to the
community of Nkwalini Zone 4
Project(s): The construction of a
community health and social center
established: 2004
Mbabane, Swaziland
n Area: XXXX
n Geography: Located in north-
central Swaziland, situated on the
Mbabane River in the Mdimba
Mountains
n Economy: Tourism, sugar exports,
tin, iron
Fort Worth, Texas
n Area: 349 mi² (904 km2
)
n Geography: Located in north-
central Texas, part of the Cross
Timbers region characterized by
flat prairie land
n Economy: Manufacturing,
construction, mining, tourism,
transportation
T
he sister city relationship between Fort Worth and Mbabane was formally
established in 2004, during Sister Cities International’s Annual Conference in Fort
Worth, Texas. Since then, Mbabane and Fort Worth have enjoyed a strong and
mutually beneficial relationship, collaborating on programs focusing on education,
leadership, municipal government operations, performing arts, and public health. Fort Worth
Sister Cities International has partnered with the City of Fort Worth, local non-profits, and
organizations such as Rotary International and Wheelchairs of Peace to develop programs
that have provided cultural experiences, as well as humanitarian assistance to Mbabane.
Throughout the years, Fort Worth has provided computers and training materials to urban
schools in Mbabane, wheelchairs, books, and more. The two cities have participated in
student exchanges and cultural exchanges, and have focused especially on addressing the
issue of HIV/AIDS in Mbabane.
Mbabane is the capital of Swaziland, located
in the north-central area of the country.
Swaziland is a nation that is surrounded by
South Africa on all sides with the exception
of the east, which borders Mozambique.
Mbabane is the second largest city in
Swaziland and is located on the Mbabane
River. The vibrant city is known as a
commercial hub in the region, but its main
economic activities are tourism and sugar
exports. Tin and iron are mined in the
surrounding areas as well.
Mbabane faces many issues that are a result of urban poverty—health issues being one
of the main concerns. The country of Swaziland is greatly challenged by the HIV/AIDS
pandemic, which further exacerbates the poverty that is prevalent there. One in four Swazi
adults lives with HIV/AIDS and their life expectancy is 48.7 years, the lowest in the world.
The increasing number of AIDS related deaths has resulted in a population where more than
a third is 14 years of age or younger. Nkwalini Zone 4 is an impoverished area in Mbabane,
16

characterized by poor housing structures and lack of infrastructure. Fort Worth Sister Cities
International partnered with Mbabane Sister Cities Committee to address the health issues in
Nkwalini Zone 4.
The sister cities worked together to take on the HIV/AIDS epidemic that was plaguing the
community and help alleviate the issues that result from HIV/AIDS deaths by constructing a
community health and social center.
The Nkwalini Zone 4 Community Health and Social Center was constructed successfully and
has allowed easier and better access to health and social services to the 1,530 residents
living in Nkwalini Zone 4. The center provides voluntary counseling and testing services,
immunization services, and neighborhood care for orphaned and vulnerable children.
Additionally, the center also provides pre-natal and post-natal care for both mothers and
children, which will reduce the spread of disease due to unsanitary conditions and decrease
infant and maternal mortality rates.
The community center is a source of hope and pride for the community of Nkwalini Zone
4. It is a testament to Sister City International’s goal of peace and understanding between
different cultures, and has truly cemented the bond between Fort Worth and Mbabane.
Although Fort Worth and Mbabane are thousands of miles apart, Fort Worth Sister Cities
International was able to work with the Mbabane Sister Cities Committee to make a
difference and a lasting impact on the lives of those living in Mbabane. “That’s what the
project was all about—it was about empowering people,” said Mae Ferguson, President of
Fort Worth Sister Cities International. The AUPAP project benefitted the community, and the
residents of Nkwalini Zone 4 were appreciative of the work completed by Fort Worth Sister
Cities and Mbabane Sister Cities. Benedict Gamedzi, Director of Mbabane Sister Cities
Committee, shared: “It’s not about us at the end of the day—it’s about the community. To
see the joy in their faces, it just fires you up, you just want to do better and achieve more
things.”
Through AUPAP, the sister city relationship became stronger and the partnerships were
sustained. New relationships were made with the local community, based on community
pride and a sense of accomplishment for the work that was done. The sister city committees
were touched and proud when the community center was completed. “We are so happy,
we are so inspired. We have come a long way in this project,” expressed Mr. Gamedzi.
Fort Worth and Mbabane plan to continue strengthening their relationship and pursue more
development projects in the future.
It’s not about us at the
end of the day—it’s
about the community.
To see the joy in their
faces, it just fires you
up, you just want to
do better and achieve
more things.
Benedict Gamedzi, Director of
Mbabane Sister Cities Committee

“
”
17

Grand Rapids, Michigan Ga East and Ga West, Ghana
At a glance:
primary health care services, provide
clean, potable water, and improve
sanitation
Project(s): The renovation of the
Mayera Community Health Clinic and
the construction of a mechanized
borehole to provide water for the
clinic in Ga West; the construction
of a 12-seat community latrine and
mechanized borehole for the Taifa
community in Ga East
established: 1994
Ga District, Ghana
n Population of Ga District: over
500,000
n Area of Ga East: 64 mi² (166 km²)
n Area of Ga West: 274 mi²
(710 km²)
n Geography: Located in south-
central Ghana, near the Gulf
of Guinea
n Economy: Agriculture, tourism
Grand Rapids, Michigan
n Area: 45 mi² (117 km2
)
n Geography: Located in central
Michigan on the banks of the
Grand River, approximately 30
miles east of Lake Michigan
n Economy: Furniture, automobile,
aviation manufacturing
T
he city of Grand Rapids, Michigan reached out to the Ga District in Ghana to form
a sister city relationship in 1994. Since then there have been several exchanges,
including a delegation led by the Ga District Chief Executive to learn about the
culture and resources of Grand Rapids and delegations from the Grand Rapids Area
Center for Ecumenism (GRACE) and the Ga District Area Center for Ecumenism establishing
partnerships with Grand Rapids churches. These visits involved the exploration of business
opportunities, agriculture partnerships, and waste management techniques.
In 2003, Grand Rapids Sister Cities International was one of seven sister cities selected by
Sister Cities International to receive a grant to implement an HIV/AIDS educational program in
Ghana. The AUPAP grant was the second grant they received from Sister Cities International,
giving them the opportunity to work on development projects in Ga East and Ga West. The
sister cities worked effectively and continued to strengthen their relationship through AUPAP.
Mary Edmond, Chair of Ga District Committee of Grand Rapids Sister Cities International,
believed that through the AUPAP projects, “the U.S. was able to show its value” and build a
positive reputation in the Ghanaian community.
Ga East and Ga West are two of ten districts in the Greater
Accra Region of Ghana, located in south-central Ghana near
the Gulf of Guinea. Known for tourism and agriculture, the Ga
District grows pineapples and food staples and is becoming
a tourist attraction due to historical remnants of Dutch
colonial influence in the region. The population of Ga District
has grown from 170,000 people in 1994 to over 500,000 in
2009, and continues to grow rapidly.
The increasing population has put a strain on Ga District and
its ability to support the basic needs of residents. There is a
lack of easy access to primary health care and clean, potable
water, forcing residents to travel far for medical services and
drinking water. Water, health, and sanitation facilities are
much needed for communities in Ga East and Ga West.
18

Grand Rapids partnered with Ga District to work on several water, sanitation, and health
projects: the renovation of the Mayera Community Health Clinic and the construction of a
mechanized borehole to provide water for the clinic in Ga West, and the construction of a 12-
seat community latrine and mechanized borehole for the Taifa community in Ga East.
In Ga West, the Mayera Health Clinic was renovated
and an additional two-unit bedroom quarters for
nurses was completed. The mechanized borehole was
successfully installed, which now supplies water to the
health clinic and provides clean drinking water to the
surrounding communities. The clinic will provide 24-
hour health care services to Mayera residents and serve
35,000 residents. The increased availability of health
care and shortened travel distance to access health
care services has made a significant impact on the
Mayera community.
In Ga East, the 12-seat toilet facility and mechanized
borehole were constructed successfully and will
serve 11,000 residents in the Taifa community. These
important facilities will lead to improved health and
well-being of children and their families. Mary Edmond
enjoyed seeing pictures of the finished product: “My
favorite was a picture of the young boys getting water—that just touches me. It just moves
me, to know that they have water right there in the community.” The Grand Rapids sister
city committee and the local committee in the Ga District were proud of the work they did.
The residents of Ga East and Ga West were incredibly appreciative of the projects and were
excited throughout the whole process. Benjamin Amponsah, Co-Chair of Grand Rapids
AUPAP Committee enjoyed “visiting the construction sites and seeing the excitement on the
residents’ faces as the construction was going on.”
Grand Rapids Sister Cities International and the Ga District Sister Cities Committee plan to
work on the sustainability of the Mayera Health Clinic and provide more medical supplies.
The sister cities look forward to further strengthening their relationship and working on more
development projects in the future.

The fact that the
planned services have
been completed is
rewarding. Equally
rewarding is that the
AUPAP initiatives have
encouraged our Sister
City Municipal leaders
to seek additional help
to address health, clean
water and sanitation
issues. In spite of a
few problems in the
beginning, this was a
worthwhile endeavor.
Mary Edmond, Chair of Ga District
Committee of Grand Rapids Sister
Cities International
“
”
19

Jacksonville, Florida Port Elizabeth, South Africa
At a glance:
Objective: To provide greater
access to improved primary
health care services for residents
in the Chatty Extension area and
to improve hygiene for children
attending schools in the Nelson
Mandela Bay area
Project: The purchase of a mobile
clinic in the Chatty Extension Area
benefitting 55,000 residents, and
the renovation of school ablution
facilities at two schools in the Nelson
Mandela Bay Area benefitting 1,763
students
established: 2000
Port Elizabeth, South Africa
n Populationt: 1,050,930
n Area: 756 mi² (1,959 km2)
n Geography: A major port city
located in the south of South
Africa, bordering the Indian Ocean
n Economy: Motor industry, tourism,
trade
Jacksonville, Florida
n Area: 875 mi² (2,265 km2
)
n Geography: Second largest port on
the East coast, located in northeast
Florida, on the banks of St. Johns
River and the Atlantic Ocean
n Economy: Manufacturing,
transportation, distribution,
financial services, biomedical
technology
T
he sister city relationship between Jacksonville, Florida and Port Elizabeth, South
Africa was established in 2000. The two cities share important characteristics: both
are major sea ports and both rely on tourism. Since 2000, there have been many
exchange programs for conferences and research, focusing on areas including
cultural exchange, economic development, public education, and workforce initiatives.
Public health in particular has always been one of Jacksonville’s and Port Elizabeth’s mutual
interests, resulting in two major projects: the collaborative distribution of dental health
supplies to more than 2,000 children and the distribution of 280 wheelchairs to disabled
citizens in Nelson Mandela Bay. The projects successfully improved health care services, and
with the AUPAP grant, health care continued to improve and was made more accessible to
marginalized communities in Port Elizabeth.
Port Elizabeth is located in the Eastern Cape Province and is one of the largest cities in South
Africa. Nicknamed “The Friendly City” or “The Windy City,” Port Elizabeth’s sandy beaches
and rich history attract thousands of tourists every year. The city is known as a major sea
port, in addition to a tourist destination, and is also South Africa’s center for their motor
industry. Although the city’s economy has been growing, there are still health issues that
need to be addressed. Life threatening diseases like HIV/AIDS and tuberculosis are prevalent
in Port Elizabeth, weakening many communities.
The city of Jacksonville partnered with Port Elizabeth to work on health and sanitation
projects in the Nelson Mandela Bay Municipality, particularly in the Chatty Extension area.
Starting from 2006, many residents were forced to relocate from informal settlements in
the Nelson Mandela Bay Municipality to the new, low-cost, formal settlements in Chatty
Extension. Since the relocation was hurried, many public services were not in place in
Chatty Extension. There were no health and education facilities in the area—residents were
expected to travel long distances to receive any medical care and health services or rely on
a single mobile clinic that visited the area once a week. The schools’ infrastructure for water
and sanitation was old and in major need of repairs, forcing many schools to cut down on
classroom hours given the inadequate ablution facilities.
20

In order to address these issues, the Nelson Mandela Bay Municipality and the Jacksonville
Sister Cities Association decided to apply for funding through AUPAP. Their relationship was
strengthened by the AUPAP projects, as they worked together to provide much needed
health care services to the communities in Nelson Mandela Bay. “Our sister city was charged
and energetic,” said Ron Johnson, Jacksonville Sister Cities Association (JSCA) Board
Member and Vice President of Nelson Mandela Bay Municipality Committee. “We worked
directly—we went out to various communities with our sister city partners and actually
engaged with them.” Throughout the program, new relationships were discovered and
maintained: relationships with the municipality councilmen, the educators, and the engineers
who assisted with procurement and contracting.
JSCA worked with the Nelson Mandela Bay Municipality to purchase a Mercedes van and
convert it into a mobile clinic as well as renovate school ablution facilities at Joe Slovo
Primary School and Phakamisa Secondary School. The mobile clinic provides medical care
for the 55,000 residents living in 11,000 households of Chatty Extension, which has greatly
improved access to health care services especially for women and children. Women and
their children are now treated at the clinic and are educated about proper sanitation hygiene
practices. Since the majority of patients are children and babies, women have a crucial role
in making sure that their children are healthy by bringing them to the clinic when treatment
is needed. Ron Johnson says: “When you educate a man, you educate an individual. When
you educate a woman, you educate a family.” As women are educated about the importance
of health, education, and sanitation, their families and the rest of the community are being
educated as well.
The ablution facilities at Joe Slovo Primary School now serve 1,113 students between the
ages of 5 and 14, and the facilities at Phakamisa Secondary School serve 650 students
between the ages of 13 and 19. Children learned about proper hygiene practices, which
will keep students healthy and in school. Both projects were a success and are now being
sustained by the municipality. Committee members felt a sense of accomplishment, and
Ron Johnson shared what he enjoyed the most: “I really enjoyed the camaraderie and
relationships with our partners, as well as seeing the kids happy and smiling. I was satisfied
with the job we did—every milestone was a good moment.”
JSCA plans to pursue more school related projects in Port Elizabeth. The two cities are
currently in the process of facilitating and establishing a sister school relationship between a
school in Jacksonville and a school in Port Elizabeth. The sister cities are also interested in
continuing to work together on future projects that address sanitation issues in schools and
further strengthening their sister city relationship.
When you educate a
man, you educate an
individual. When you
educate a woman, you
educate a family.
Ron Johnson, Jacksonville
Sister Cities Association (JSCA)
Board Member and Vice President
of Nelson Mandela Bay
Municipality Committee

“
”
21

Lansing, Michigan Akuapem, Ghana
At a glance:
Objective:To improve sanitation,
hygiene, and quality of health care in
Akuapem South
Project(s): The construction of toilet
facilities and the renovation of two
health clinics
established: 1997
Akuapem, Ghana
n Population:133,604
n Area: 194 mi² (503 km²)
n Geography: Located in the Eastern
Region of Ghana, characterized by
hills and a tropical climate
n Economy: Agriculture, commerce,
tourism
Lansing, Michigan
)
n Geography: Located in the south
central part of the lower peninsula
where the Grand River meets the
Red Cedar River, characterized by
the two rivers flowing through the
city and Lake Lansing and Park
Lake in the area
n Economy: Government, education,
insurance, healthcare, automobile
manufacturin
T
he sister city relationship between Lansing, Michigan and Akuapem, Ghana began
in 1997. Since then, they have established a strong, long-term relationship and
have worked with the district government and the area’s traditional leadership
in Ghana to provide sustainable support in the areas of health, education, and
economic development. The Lansing Regional Sister Cities Commission (LRSCC) has
provided around $1,500,000 worth of medical supplies and equipment over the years, as
well as partnered with local hospitals and organizations in Lansing to support business,
education, and medical missions to the Akuapem South district.
Akuapem South is one of 26 districts in the Eastern Region of Ghana, situated among
hills near Lake Volta, a man-made lake. Once a kingdom state, Akuapem is now a
municipality with almost 135,000 residents. Agriculture is the main sector of Akuapem’s
economy, followed by commerce and tourism. Agricultural-based industries are the most
prosperous, which include wood, timber, fruit processing, paper products, mineral water,
pharmaceuticals, and disinfectants.
Urban poverty is prevalent throughout the municipality, due to high unemployment rates
and lack of access to clean water, waste disposal, a secure electrical supply, and adequate
public health services. The lack of sanitation facilities, clean drinking water, and health
facilities have caused illnesses and
led to deaths in the communities.
When Lansing Regional Sister
Cities Commission (LRSCC)
partnered with the Akuapem
South Municipality Sister Cities
Committee, they focused on
addressing sanitation, health, and
hygiene issues in Akuapem.
LRSCC worked with Akuapem
South Municipality Sister Cities
22

Committee to complete several sanitation and health projects in the villages of Pokrom,
Ahodjo, and Sakyikrom and Aburi: the construction of toilet facilities in each village and the
renovation of the Pokrom clinic and the Aburi Presbyterian Clinic buildings.
In each of the three villages, one 8-stall Kumasi Ventilated Improved Pit (KVIP) latrine unit
was constructed. Each unit was equipped with electrical lighting and a rooftop water
collection storage tank for hand washing and facility maintenance. These toilet facilities
benefit 7,500 people who lack access to a hygienic means of waste disposal.
In addition to the latrines, the Pokrom Clinic and the Aburi Presbyterian Clinic were
renovated, the electrical installations and water systems were upgraded, and a borehole was
drilled to provide access to clean water. These renovations will improve hygiene and help
prevent the spread of disease, benefitting approximately 18,000 people.
William Brewer, a member of LRSCC, enjoyed going to Ghana and developing and
maintaining relationships with the people in Akuapem. He describes his favorite moment:
“Once I saw tangible evidence of the projects moving forward and the people’s reactions to
the new facilities—it was exciting.”
Through AUPAP, their sister city relationship strengthened, though the projects were
challenging and communication was frustrating at times. The political issues and changes in
leadership in Ghana were difficult to deal with, often straining the relationship and delaying
the projects’ progress. But the difficulties were worthwhile in the end.
“It’s not about benefactors and
takers—it was about talking
as friends and getting to know
each other.” Mr. Brewer and his
colleagues valued the relationships
they built with the people of
Akuapem, and are looking forward
to working on more meaningful
projects in the future.
It’s not about
benefactors and
takers—it was about
talking as friends
and getting to know
each other.
William Brewer, member of Lansing
Regional Sister Cities Commission

“
”
23

Long Beach, California Mombasa, Kenya
At a glance:
safe, clean water; to enhance the
capacity of health clinics; to address
pre-natal and post-natal needs of
women and children
Project(s): The procurement of a
water purification plant and medical
equipment for several health clinics
in Mombasa
established: 2007
Mombasa, Kenya
n Area: 114 mi² (295 km²)
n Geography: Located partly on the
southern coast of Kenya and on
Mombasa Island, characterized
by flat topography and a tropical
climate
n Economy: Trade, tourism
Long Beach, California
n Area: 51 mi² (133 km2
)
California on the Pacific Ocean,
characterized by a Mediterranean
climate
n Economy: International trade
through the industrial port, high
technology, aerospace, tourism
T
he partnership between Long Beach and Mombasa was formalized in 2007, after
the Los Angeles Kenyan Consulate expressed an interest to form a sister city
relationship between Los Angeles and Mombasa. Later it was decided that the
sister city partnership with Mombasa would be brought to Long Beach instead.
Since then, there have been many exchanges and intercultural community events. The
Mombasa-Long Beach Sister Cities Association (MLBSCA) focused their sister city efforts on
a single core goal—public education of AIDS.
Although their relationship is young, Long Beach and Mombasa have sent delegations to
each other and developed meaningful partnerships over the past 6 years. MLBSCA has
donated more than 600 books to the Kenyan National Library; provided 700 AIDS testing
kits donated by Orasure Technologies for World AIDS day activities in Mombasa; and
hosted Kenya’s Minister of Tourism. Within a short amount of time, MLBSCA has developed
meaningful partnerships with both U.S. and Kenyan community and civic organizations.
Mombasa is the second largest city in Kenya, located on the east coast along the Indian
Ocean. Due to its coastal location and its prominent seaport, Mombasa has been known as
a historical trading center as well as a regional center for tourism. Mombasa has a unique
culture that still has colonial influences from the Portuguese, British, and Omani.
Despite the growth in tourism many services for local residents are still insufficient. There is a
lack of proper health care and clean drinking water in Mombasa, affecting the well-being of its
residents. Basic medical equipment for diagnosing, monitoring, and evaluating patient health
conditions is severely lacking at all of Mombasa’s 19 public health clinics. Diagnostic testing
cannot be done on-site, forcing clinics to send test samples to the national hospital 8 miles away
and wait for weeks, or even months, for test results and diagnoses. Additionally, Mombasa has
no maternity clinic to provide pre-natal and post-natal care to mothers and children.
Water is another issue in Mombasa—70% of the population must rely on water from
boreholes and wells, which yield primarily salt water from the Indian Ocean. Because the
sewage system does not serve the whole community, many residents are forced to use
septic tanks and pit latrines. Often times the water from drinking wells and boreholes and
water from pit latrines mix and lead to contaminated water. As a result, water-borne diseases
24

like diarrhea and cholera are prevalent in
Mombasa.
MLBSCA partnered with the local Mombasa
Sister Cities Committee to address water
and health issues by completing two
different projects: the purchase of medical
equipment for public health clinics and a water
purification plant.
The health project focused on three primary clinics in heavily populated areas: Kaberbhoy,
Shiku Adabu, and Gangoni. These clinics received most of the major medical equipment,
while other clinics in the area received smaller equipment and supplies. The medical supplies
were procured from Project C.U.R.E., a nonprofit humanitarian organization whose goal is to
improve health care infrastructure in developing countries by providing medical equipment,
supplies, and services. The clinics received birthing beds, wheelchairs, crutches, examination
tables and chairs, a microscope and other laboratory supplies, x-ray machines, EKG
machines, and much more.
The water purification project involved the purchase of a potable water purification plant with
the capability to filter out fecal materials and salt. The water plant was installed at Ganjoni
Clinic in the Kilindini District of Mombasa Island, bringing clean site-generated water, which
addressed the issue of the high cost of water. The Ganjoni Clinic now has clean, potable
water on site and will no longer need to purchase water for operations. The clinic will also
be able to sell water to the surrounding community, allowing the clinic to afford proper
maintenance of the water plant using the proceeds from the sales.
Both projects had a great impact on the community in Mombasa—clean water helps
prevent water-borne diseases and proper medical supplies allow quick on-site diagnosis.
The residents appreciated the projects and were excited when they were completed. The
Treasurer of MLBSCA, Phyllis Venable’s favorite moment was the water demonstration after
the water purification project was completed. Her most enjoyable moment always involved
working with the local community. The community was completely engaged with the water
project and was grateful for the medical supplies for the clinics.
Completing the projects was a testament to Long Beach’s commitment to Mombasa.
The sister cities worked together effectively, despite cultural differences. MLBSCA got the
opportunity to meet and interact with the Seattle-Mombasa Sister Cities Association as well—
the other sister city program between a U.S. city and Mombasa. As Ms. Venable shared, “I
enjoy the people—they were the reason I kept coming back. Working so closely with the Local
Community Committee created some special bonds that I feel will last a lifetime!”
MLBSCA is intent on pursuing more development projects in Mombasa, especially projects
involving access to clean water. Lack of clean water is still a significant issue, but one that
can be addressed with a strong sister city relationship and effective collaboration.
There are no words for
the elation that I felt
when the last container
of medical equipment
arrived and cleared
customs. Even though
some pitfalls remained
to be dealt with, I knew
at that moment that
we would successfully
complete the project.
Phyllis Venable,
Treasurer of MLBSCA
“
”
25

Louisville, Kentucky Tamale, Ghana
At a glance:
Objective: To improve health care
facilities in Tamale
a sanitation facility for the Tamale
Teaching Hospital and the purchase
of an ambulance for the hospital
established: 1979
Tamale, Ghana
n Area: 290 mi2
(750 km2
)
Ghana near the Sahara desert,
characterized by mostly flat
terrain and extreme changes in
temperature
n Economy: Tourism, agriculture,
hunting, forestry
Louisville, Kentucky
n Area: 399 mi² (1,032 km2
)
Kentucky in the Bluegrass region,
characterized by a wide, flat plain
surrounded by rolling hills
n Economy: Shipping and cargo
industries, healthcare and medical
sciences
T
he sister city relationship between Louisville and Tamale was formally established
in 1979 at Sister Cities International’s Annual Conference. Since then, Episcopalian
churches in Louisville have maintained a strong relationship with Anglican churches
in Tamale as a Companion Diocese. The African Cultural Center in Louisville has
organized several programs with Sister Cities of Louisville such as sending books to the
Northern Regional Library in Tamale, and the Rotary Club in Louisville also worked together
with Sister Cities of Louisville to send medical supplies to Tamale. Delegations from both
cities have visited each other throughout the years to exchange ideas and build friendships.
In 1995, Dr. Susan Herlin was recognized for her work in Tamale and was installed as Zo-
Simli-Naa, “Chief of Friendship.” This was a great honor and an important milestone in the
sister city relationship between Louisville and Tamale.
Tamale is located in northern Ghana, 373 miles north of Accra, the capital of Ghana. It is the
capital of the Northern Region of Ghana and is the third most populous settlement in Ghana.
Tamale is a hub for administrative and commercial activities in the region, with many regional
branches of financial institutions and international non-governmental organizations—so much
so that Tamale is often referred to as the NGO capital of Ghana. Agriculture, hunting, and
forestry are the main economic activities in the region, in addition to the growing tourism
industry.
As a result of rapid growth and urbanization, Tamale has faced health, sanitation, and water
issues due to the lack of proper infrastructure in the city. Water-related diseases such as
typhoid, diarrhea, and dysentery are prevalent in Ghana. Access to clean water at schools
and hospitals is essential and will help keep children in school and prevent the spread of
disease. Hospitals and clinics often lack proper medical equipment for treating patients,
resulting in inadequate health care services for the community.
Louisville and Tamale worked together to address sanitation and health issues by completing
two projects: the construction of a sanitation facility for the Tamale Teaching Hospital and the
purchase of an ambulance for the hospital.
The toilet and shower facilities at the Tamale Teaching Hospital were successfully
constructed and will benefit patients, families of patients, staff, and visitors. The facilities26

will allow people at the hospital to conveniently use the toilets and showers in a safe, clean
environment and help reduce the spread of disease among patients, staff, and visitors.
The purchase of the ambulance will allow the community access to emergency health
care and even improve health care services overall. Many residents cannot travel far to the
hospital when they are sick, making the impact of a single ambulance incredibly significant.
Both projects were completed successfully due to the
efforts of those involved and the personal relationships
between members of Sister Cities of Louisville and Sister
Cities of Tamale. As Steve Hubbs, member of the Tamale
Committee and water expert, said, “The sister city to sister
city route is the best way possible to provide aid.” Working
with the local communities directly to get their input is
crucial. “We as donors shouldn’t identify and control the
projects—communities themselves should identify the
projects that they value and need,” explained Mr. Hubbs.
The nature of the relationship between Louisville and Tamale
is unique, since the Sister Cities of Tamale is a registered
NGO. This status gives Tamale a separate operational base
with a core team of volunteers that have been active over
the years. A huge part of AUPAP’s success in Tamale was
due to the efficiency and high capacity of Sister Cities of
Tamale. AUPAP strengthened an already strong sister city
relationship—as Susan Herlin said about the community in
Tamale, “They’re friends of mine; I respect them and know
them really well.”
Both sister cities had a memorable experience working on the AUPAP project together;
meeting each other and working with one another was incredibly rewarding. Seeing two
chiefs meeting in Tamale was one of Mr. Hubbs’ favorite experiences: “Witnessing Susan
and another chief meet was unbelievable—we returned with two chickens and two yams in
the back of our van. It was an incredible experience.” Mr. Hubbs, along with the rest of the
Tamale Committee, enjoyed working with Sister Cities of Tamale and look forward to working
on more development projects in the future.
The sister city to
sister city route is the
best way possible
to provide aid. We
as donors shouldn’t
identify and control the
projects—communities
themselves should
identify the projects
that they value and
need.
Steve Hubbs, member of
the Tamale Committee at
Sister Cities of Louisville
“
”
27

Maryland State Bong County and Maryland County, Liberia
At a glance:
clean, potable water in Bong County
and Maryland County
hand dug wells with hand pumps in
Bong County and the restoration and
improvement of the water system at
the JJ Dossen Memorial Hospital in
Maryland County
established: 2007
Bong County, Liberia
n Area: 3,387 mi² (8,772 km2
)
n Geography: Located in the
north central part of Liberia,
characterized by mostly flat to
rolling coastal plains that contain
mangroves and swamps
n Economy: Mining
Maryland County, Liberia
n Area: 887 mi² (2,297 km²)
n Geography: Located in the
southeastern part of Liberia,
bordered by Côte d’Ivoire to
the east and the Atlantic Ocean
to the south
n Economy: Farming
T
he sister state relationship between Maryland State and Bong County and Maryland
County was established in 2007 as a result of an extensive historical relationship
between Maryland State and Liberia. Many of the members of the executive
committee and the subcommittees of Maryland Sister States Program have
personal ties that strengthen their commitment and dedication to developing programs that
will strengthen both Liberia and the state of Maryland.
In 2008, Sharon Pinder, Executive Chair of the Maryland-Liberia Sister State Committee
(MLSSC), led a fact finding mission to Liberia to explore opportunities and mutual interests
with Liberia. She had said, “This trip symbolizes more than a mission, it is a historic journey
for us.” Since then, Ms. Pinder and the other members of MLSSC have worked with the local
communities in Maryland County and Bong County to form meaningful partnerships between
Liberia and the state of Maryland.
Bong County and Maryland County are two
of fifteen counties in Liberia. Bong County is
located in the north-central part of Liberia,
while Maryland County is located in the
southeastern area of Liberia. Named after
the U.S. state of Maryland, Maryland County
borders the nation of Côte d’Ivoire, separated
by the Cavalla River. Farming is the main
economic activity in Maryland County, with
rice and cassava being the main crops raised.
Bong county, named after Mount Bong in southern Liberia, borders Guinea and is the third
most populous county in the country. Coal mining is its main industry.
Both counties have faced water and health care issues, which have caused water-borne
diseases and poor health conditions. There is a lack of water for cleaning, bathing, cooking
and sanitation. Access to clean, potable water and sanitation are priority needs for the people
of Bong County and Maryland County. MLSSC partnered with Bong County and Maryland
County Sister City Committees to address these water and health issues through AUPAP.
28

MLSSC worked with Bong County and Maryland County Sister City Committees to complete
water and health projects in both counties: the restoration and improvement of the water
system at the JJ Dossen Memorial Hospital in Maryland County, and the construction of
hand dug wells with hand pumps in Gbarnga, Bong County.
In Maryland County, the water system was
restored at the JJ Dossen Memorial Hospital,
which greatly improved access to running
water for the staff at the hospital. The easy
access to clean water will greatly benefit those
who come to the hospital for treatment and
help prevent water borne diseases and germs
from spreading. Sanitary conditions have been
improved, which will better the lives of the
4,000 patients who rely on the hospital facilities
every month.
In Bong County, 34 hand dug wells with hand
pumps were constructed, providing clean,
potable water to the people of Gbarnga. This
has reduced the distance people have to travel
in order to get clean water for their families.
The lack of safe, drinking water in the past had
caused serious public health problems. The
increased access to clean water will benefit
over 30,000 residents.
The water and health projects in Bong County and Maryland County were quite an
experience for the members of MLSSC, as Joe Isaac shared: “It was eye opening to all of
us.” He enjoyed working with local committees and local schools in Liberia. Mr. Isaac echoed
the local communities’ appreciation for the projects and added: “As a native of Liberia, I am
forever grateful to this project and honored to serve the community.” AUPAP proved to be
challenging yet worthwhile, bringing Maryland State and Bong County and Maryland County
closer, and they are ready to take on new endeavors in the future.
As a native of Liberia,
I am forever grateful
to this project and
honored to serve the
community.
Joe Isaac, member of
the Maryland-Liberia
Sister State Committee
“
”
At a glance (cont’d):
Maryland State
n Area: 12,407 mi² (32,133 km²)
n Geography: Located in eastern
U.S., characterized by a variety
of topography, ranging from
sandy dunes dotted with
sea grass in the east, to low
marshlands teeming with wildlife
and large bald cypress near the
Chesapeake Bay, to gently rolling
hills of oak forest in the Piedmont
Region, and pine groves in the
mountains to the west
n Economy: Service sector,
transportation industry,
manufacturing, food production
29

Milwaukee County, Wisconsin Buffalo City, South Africa
At a glance:
Objective: To improve health
facilities and services for the
community
Project: The renovation and
expansion of Aspiranza Clinic in
the Buffalo Flats Area—addition of
rooms, purchase of new medical
equipment and furniture, installation
of storage facility to stock and store
equipment and supplies safely
established: 1997
Buffalo City, South Africa
n Area: 979 mi² (2,536 km2
)
east coast of the Eastern Cape
Province South Africa, named after
the Buffalo River
n Economy: Manufacturing, auto
industry
Milwaukee County, Wisconsin
n Area: 1,190 mi² (3,082 km²)
n Geography: Located on the shores
and bluffs of Lake Michigan, with
the three rivers of Menomonee,
Kinnickinnic, and Milwaukee all
flowing through
n Economy: Home to the
international headquarters of 5
Fortune 500 companies: Johnson
Controls, Northwestern Mutual,
Manpower, Rockwell Automation
and Harley-Davidson; fast growing
service and managerial industry
T
he sister city relationship between Milwaukee County, Wisconsin and Buffalo City,
South Africa began in 1997. It began after apartheid ended in 1994, when several
African American supervisors on the Milwaukee County Board felt compelled to
build a relationship with South Africa and get involved in Buffalo City. The shared
purpose of the relationship was to link the two cities through shared information, skills and
experience aimed at improving the quality of life for residents in both metropolitan areas
and encouraging greater understanding between their populations. The relationship grew
stronger through various economic, health, and cultural exchanges. A mutual interest in
nursing, health sciences education, and HIV/AIDS developed after Mark Anderson, then
President and CEO of the Center for International Health (CIH), visited Buffalo City and
initiated discussions with the Buffalo City Ministry of Health.
Food security is an important goal between Milwaukee County and Buffalo City, one that was
met through a grant awarded to the Center for International Health by the U.S. Agency for
International Development Office of Food for Peace. The grant provided four million meals
to Buffalo City’s malnourished and orphaned children, people with HIV and their affected
households, poverty stricken neighborhoods, the elderly, people with chronic diseases and
disabilities, and households headed by single females or a child. This program has been one
of Milwaukee County’s and Buffalo City’s partnership’s most successful endeavors.
Buffalo City is a metropolitan municipality located on the east coast of the Eastern Cape
Province of South Africa. With a coastline on the Indian Ocean, Buffalo City boasts beautiful,
sandy beaches that attract thousands of tourists every year who visit to enjoy the sun and
sand and the many sights that Buffalo City has to offer. The city is named after the Buffalo
River, home to South Africa’s only river port—Port of East London. Buffalo City includes the
towns of Bhisho, East London, King William’s Town, as well as the townships of Mdantsane
and Zwelitsha. In addition to tourism, Buffalo City also has a well-developed manufacturing
base, with the auto industry playing a large role.
As Buffalo City goes through rapid urbanization, one of the main issues that the city faces
is lack of access to health care, which is linked to poverty and poor living conditions.
Many people deal with diarrheal diseases, acute respiratory tract infections and diseases,
30

malnutrition, tuberculosis and HIV/AIDS. Milwaukee County partnered with Buffalo City to
address these urgent health issues and help alleviate poverty.
Terrence Cooley, Chief of Staff for the Milwaukee County Board of Supervisors, worked
extensively with Darby Gounden, Manager of Development, Cooperation and International
Relations of Buffalo City Metropolitan Municipality on upgrading and renovating Aspiranza
Clinic in the Buffalo Flats Area. The clinic specializes in maternal health care, family planning,
and HIV/AIDS treatment, with the majority of the patients being single mothers and children.
AUPAP provided the opportunity for the two cities to become closer and strengthen their
relationship on a personal and professional level. Ms. Gounden shared, “It was great working
with counterparts in Milwaukee, and I really enjoyed the consultations with the community.”
Engaging the community and working with partners was essential, and even the most
enjoyable part of the process. Mr. Cooley said, “I really enjoyed the relationships we had
and the connections we made.” The two
sister cities embodied the values of citizen
diplomacy, friendship, and cooperation during
AUPAP and worked towards the successful
completion of their project together.
The Aspiranza Clinic will benefit 2,000
residents in the Buffalo Flats area and leave
a lasting impact especially for women and
children. “Just seeing the fruits of this project,
to see the clinic all complete, was incredible,”
expressed Mr. Cooley. It was a fulfilling
experience for everyone, and as Emily Schmidlkofer, Program Manager of the Center for
International Health, shared, “I feel really good about what we’ve accomplished.” As a result
of Milwaukee County and Buffalo City’s hard work and collaboration, the Aspiranza Clinic will
be able to provide easy access to health care services and better serve the community of
Buffalo Flats.
Milwaukee County plans to build upon the AUPAP project and work on the sustainability
of the clinic, eventually increasing its role as a teaching facility. Milwaukee looks forward
to working with the Department of Health in Buffalo City on future health initiatives and
continuing to improve the lives of the people of Buffalo City.
I really enjoyed the
relationships we had
and the connections
we made. Just seeing
the fruits of this
project, to see the
clinic all complete, was
incredible.
Terrence Cooley, Chief of Staff
for the Milwaukee County
Board of Supervisors
“
”
31

Milwaukee, Wisconsin uMhlathuze, South Africa
At a glance:
clean, potable water to the KwaDube
community
Project(s): The installation of water
supply–connecting water from
the main line to standpipes in the
KwaDube community
established: 2008
uMhlathuze, South Africa
n Area: 306 mi² (793 km2
)
northeast coast of South Africa
bordering the Indian Ocean,
characterized by sugarcane fields,
timber plantations, wetlands, and
freshwater lakes
n Economy: Aluminum, eucalyptus
pulp, phosphoric acid-based
products, titanium, sugar cane
Milwaukee, Wisconsin
n Area: 97 mi² (250 km2
)
Wisconsin, on the shores and
bluffs of Lake Michigan, with
the three rivers of Menomonee,
Kinnickinnic, and Milwaukee all
flowing through the city
n Economy: Home to the
international headquarters of 5
Fortune 500 companies: Johnson
Controls, Northwestern Mutual,
Manpower, Rockwell Automation
and Harley-Davidson, banks,
service companies, and one of the
country’s ten largest insurance firms
T
he sister city relationship between uMhlathuze and Milwaukee was formally
established in 2008, after interest was expressed by the Consul General in Chicago
for the City of Milwaukee to consider a sister city relationship with the South
African city. The City of Milwaukee had built strong relationships with the Mayor
of uMhlathuze and the Zululand Chamber of Commerce before establishing a formal sister
city relationship. Since 2008, the City of Milwaukee Sister Cities Committee has celebrated
South African culture with their sister city, and created a relationship between the University
of Wisconsin-Milwaukee and the University of Zululand. Milwaukee and uMhlathuze have
also participated in a joint business venture—a Milwaukee area business worked with an
uMhlathuze business to create a company that deals with organic waste and repurposes it
as fertilizer.
Named after the Mhlathuze River, the city of uMhlathuze is located on the northeast coast
of the province of KwaZulu-Natal in South Africa. It incorporates Richards Bay, Empangeni,
Eslkhawini, Ngwelezane, Enseleni, Felixton, Vulindleia, and the tribal areas of Amakhosi
Dube, Mkhwanazi, KwaKhoza and Zunga-Madlebe. Surrounding Empangeni and Richards
Bay are sugarcane fields, timber plantations, wetlands, and fresh water lakes. Richards
Bay is considered to be the industrial hub of the area, and Empangeni is considered to be
the commercial hub. The main industries of uMhlathuze are aluminum, eucalyptus pulp,
phosphoric acid-based products, titanium, and sugar cane.
The bustling city of uMhlathuze faces water and sanitation issues due to the size of the
municipality and lack of clean water and sanitation facilities. These issues affect the entire
community, especially women and children, who must travel long distances for potable water.
The City of Milwaukee Sister Cities Committee partnered with uMhlathuze to complete an
essential water project in uMhlathuze: the construction of a connection from the main water
supply line to standpipes in the KwaDube community.
The installation in the KwaDube community was a success and the standpipes will now
provide clean water to 18,000 residents in the area. Water service was brought to a
traditional area of uMhlathuze, which will leave a lasting impact. Having clean, safe water
32

readily accessible will help the community immensely, since it was previously unsafe for
women and children to travel for water.
Joe Davis, Chair of the City of Milwaukee Sister Cities Committee, shared a story about a
grandmother living in the KwaDube community, who had overturned a candle accidentally
in her home. Her hut caught fire and posed an immediate danger to her and her home. She
was able to quickly get a bucket of water from the pipe nearby and douse the fire. She was
very grateful for the water supply that helped save her house. After hearing this story, Mr.
Davis was humbled and proud of the difference that he and the sister city committees could
make and the impact that the AUPAP project had on the community.
Through AUPAP, the relationship between Milwaukee and uMhlathuze strengthened and
the two cities became closer. The two sister cities worked together to provide technical
support and engage the community in the project. There was open dialogue, despite the
difficulty in communication that involved time differences and language barriers. Mr. Davis,
shared: “I learned about working together and really listening to each other—dialogue and
communication are important to make sure things are getting done.”
“There is a lot of opportunity
for change,” said Mr. Davis.
“This experience was humbling
and a pleasure to be a part of.”
Milwaukee and uMhlathuze
look forward to continuing
to strengthen their sister city
relationship and work on more
development projects in the
future.
I learned about working
together and really
listening to each
other—dialogue and
communication are
important to make sure
things are getting done.
Joe Davis, Chair of the City of
Milwaukee Sister Cities Committee
“
”
33

Oakland, California Secondi-Takoradi, Ghana
At a glance:
Objective: To provide access to
clean water, toilet facilities, and
medical screenings to students at
the Ketan Cluster of Schools and
improve emergency health care at
Esikado Hospital
mechanized boreholes and toilet
facilities at the Ketan Cluster of
Schools; provision of medical
screenings; repair of ambulance for
Esikado Hospital
established: 1975
Secondi-Takoradi, Ghana
n Area: XXXX
southern border of Ghana, on the
coast of the Gulf of Guinea
n Economy: Industries of timber,
plywood, shipbuilding, railroad
repair, oil
Oakland, California
n Area: 78 mi² (202 km2
)
n Geography: Located in western
California, on the San Francisco
Bay, it is a major port city in the
state
n Economy: Marine cargo transport,
retail, high-tech and green energy
companies
T
he sister city relationship between Oakland and Secondi-Takoradi was formalized
in 1975. Both cities have ports and are centers of regional government, similarities
that have fed the sister city relationship over the years. The initiative was led by the
late Alderman Van Lewis, who established the African Sister City Cultural Center,
Inc. to support the sister city relationship with Secondi-Takoradi. Over the years, delegations
have visited both cities for educational and cultural exchanges. In 2003, their relationship
became stronger after receiving an Africa HIV/AIDS Prevention and Education Grant from
Sister Cities International. Through this grant, the sister cities participated in three exchanges,
during which members of both sister city committees learned about the challenges each
community faces in working to stop the spread of HIV/AIDS.
Secondi-Takoradi is comprised of the twin cities of Secondi and Takoradi, and is the
capital of the Western Region of Ghana. It is the fourth largest city in Ghana, and is a major
commercial and industrial center. Located on the coast of the Gulf of Guinea, Secondi-
Takoradi has many beautiful beaches that attract tourists every year. Its main industries are
timber, plywood, shipbuilding, railroad repair, and oil. It is a major port city, Ghana’s first, and
has recently been known as the Oil City of Ghana due to the massive discovery of oil in the
western region of Ghana.
Despite the vibrant trade and discovery of oil in Secondi-Takoradi, there are still significant
water, health, and sanitation issues that need to be addressed. Many schools do not
have access to water for drinking or hand washing,
forcing students to leave school grounds to fetch
water and wasting class time. There are no adequate
toilet facilities, so teachers and students simply relieve
themselves in the foliage on the school grounds.
Providing water and toilets would help prevent the
spread of disease and improve the students’ self-
esteem.
The Oakland and Secondi-Takoradi Sister City
Committees had another opportunity to work on
34

development projects in Secondi-Takoradi, through AUPAP. AUPAP raised the relationship to
a new level—the committees worked effectively together and became closer as a result. The
sister city committees received widespread coverage in the area and became well known to
the community. New relationships were built with the Department of Health and the school
administration and community. The new mayor of Secondi-Takoradi was also involved and
was very impressed with the projects. The community was passionate about the projects
and worked hard to make changes. Gail Berkley-Armstrong, President of the African Sister
City Cultural Center, said, “I was impressed with their dedication.”
The African Sister City Cultural Center in Oakland worked with the Secondi-Takoradi Sister
City Committee to complete several water, sanitation, and health projects: toilet facilities,
mechanized boreholes, and health screenings at the Ketan Cluster of five schools, and
restoration and repair of an ambulance at Esikado Hospital.
At the Ketan Cluster of schools, two ten-seat toilet facilities and two buildings with 2-bay urinals
were constructed for approximately 3,000 students. The toilet facilities will not only keep the
students and teachers healthier, but will improve morale and save class time. Two mechanized
boreholes were drilled and 45 hand washing basins were provided, finally giving students and
teachers access to water for drinking and hand washing. Students will no longer have to travel
far to fetch water, and can spend that time instead learning in the classroom.
Free medical screenings for vision, hearing, malaria, worm infestation, diabetes, hypertension,
and dental health are also being provided for 1,250 students and teachers, allowing for quick
diagnosis and referral for follow up care. Many students that have vision problems have now
received eyeglasses, allowing them to be able to better read the blackboards and books.
At the Esikado Hospital, the ambulance was in major need of repair and restoration.
The interior was restored, the engine was repaired, and the van was painted. The newly
renovated ambulance helps provide the town with emergency health care.
All the projects were successful and incredibly beneficial to the community in Secondi-
Takoradi. Seeing the final products for many sister city members, including Mr. Berkley-
Armstrong, was the best part of the whole program. He shared, “I really enjoyed seeing the
kids happy and smiling. The whole experience was very worthwhile.” He felt that their work
really made an impact on people. Both the African Sister City Cultural Center in Oakland and
the Secondi-Takoradi Sister City Committee look forward to working on more development
projects together in the future and building more worthwhile experiences.
I really enjoyed
seeing the kids happy
and smiling. The
whole experience was
very worthwhile.
Gail Berkley-Armstrong,
President of the African
Sister City Cultural Center
“
”
35

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