Public Health Education 410/510 & University Studies 421
Global Aging and Health: Enhancing Communities in Nicaragua
Urban Center (URBN) 411
Spring 2011 Course & Summer 2011 Travel to Nicaragua
Instructor of Record:
Email
Telephone and Voice Mail
Margaret B. Neal, Ph.D.
nealm@pdx.edu
503.725.5145
Additional Instructor:
Email
Keren Brown Wilson, Ph.D.
kwilson@jfrfoundation.org
Additional Instructor:
Email
Phone
Alan DeLaTorre
aland@pdx.edu
503.725.5236
Course Description:
This multidisciplinary undergraduate-/graduate-level, six-credit course has two components:
(1) a classroom component at Portland State University (PSU), and (2) an in-country servicelearning experience in Nicaragua. Students and instructors will meet most Fridays throughout
the spring term before traveling to Nicaragua from June 16th - July 2nd, 2011 (dates tentative).
This service-learning program focuses on sustainable community development and local capacity
building and involves the involvement of students, faculty, and members of communities in
Portland and Nicaragua. Service-learning is a teaching and learning strategy that integrates
meaningful community service with instruction and reflection to enrich the learning experience,
teach civic responsibility, and strengthen communities.1
While in Nicaragua, students will meet with government officials, work in homes for older
adults, and conduct projects in areas of interest, such as community development, education, and
public health, all of which are intended to enhance the quality of life for older adults and others
within communities in Nicaragua. Upon return from Nicaragua, students and instructors will
convene once more in order to discuss the service-learning experience and to present their
experiences to PSU and the larger community.
The course represents a collaborative effort between the Jessie F. Richardson Foundation (JFR),
PSU’s Institute on Aging (IOA), and Education Abroad. Additional collaborators include the
College of Liberal Arts and Sciences (CLAS), the Pan-American Health Organization (PAHO),
and educational, advocacy, and governmental organizations in Nicaragua.
1
National Service-Learning Clearinghouse: http://www.servicelearning.org.
Course Goals:
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Increase student awareness and understanding of global aging and health issues, community
development and capacity building principles, service learning approaches, and Nicaraguan
history, culture, geography, and politics
Allow for students to engage in hands-on community development experiences in
Nicaragua in partnership with local stakeholders
Provide students with a meaningful study abroad experience
Course Objectives:
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Provide opportunities for learning from and interaction with experts in the field of
international aging and health
Learn about life in Nicaragua and the experiences, contributions, and needs of Nicaragua’s
elders and others within their communities
Foster cross-cultural communication skills and ability to connect one-on-one with elders
and other community members from a different culture
Enhance students’ abilities to work as effective team members in a social service capacity
to improve quality of life for Nicaraguan elders by:
o Improving the physical environment
o Coordinating with organizations that work with elders
o Providing training materials and assistance to caregivers of older adults and other
community members
o Providing direct service to older adults and others within their communities
These objectives will be accomplished through a combination of didactic coursework, using
lectures, discussions, reflective assignments, class exercises, and service-learning projects in
Portland and Nicaragua.
Team Objectives:
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Teams will form during the spring term based on skills, interests, and fit with other
students, faculty, and team leaders
Each team will write its own goals, objectives, and action plans in order to organize,
strategize and evaluate its projects
Each team will work toward completing a project, writing a final project report, and
presenting the project findings to communities in Nicaragua and Portland
General Course Requirements and Expectations:
Students are expected to travel to Nicaragua and to take responsibility for the success of the
program through individual action and through working well in a team environment. Although a
main focus of the program is hands-on learning and service done within Nicaraguan
communities, preparation will consist of 10 class sessions over the spring term that will orient
students to issues pertinent to the international travel portion. All class sessions are mandatory
for students wishing to travel with the group.
If extenuating circumstances occur, each student is responsible for reporting those to the course
instructor and making alternative arrangements. More than one absence constitutes grounds for
lowering the course grade by one level (e.g., A to A-) or disenrollment from the program if not
due to extenuating circumstances.
Students should expect to spend approximately two hours per week on course reading and
reflections and an additional two hours per week on team projects. On dates that project team
meetings are scheduled, rooms can be reserved in the Urban Center at for these team meetings.
Team meetings will be facilitated by the team leaders, which will consist of a mix of faculty,
staff, and students determined throughout the course.
Students are also encouraged to participate in program activities associated with securing
resources (e.g., funds and goods for Nicaragua) and to participate in post-travel
activities. Fundraising activities are optional but encouraged for any student who is interested in
subsidizing the cots of their program costs. Fundraising disbursements will come from the JFR
foundation and will be coordinated by JFR and IOA faculty and staff.
It is expected that students will be respectful to the classroom learning environment, which
includes, among other things, turning off you phone’s ringer before the class begins, refraining
from text messaging in class, and leaving you computers/PDAs/I-Phones off unless we are
working on a project that requires the internet – checking your emails, Facebook/Twitter
accounts, or anything else that is not relevant to the class should be done on your time, not
during class.
If you are a student with a disability please speak with the course instructor if you may require
some modification to the course. We will work with you and the Disability Resource Center to
arrange needed supports.
Please note that plagiarism will not be tolerated in this course. If you are quoting or relying
heavily on another’s work in your written assignments, you must use quotation marks or
acknowledge the source appropriately. Please use the American Psychological Association
(APA) format for all citations.
All students must adhere to the PSU student code of conduct and in-country behavior code.
Specific Course Requirements:
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Completion of all required reading assignments
Completion of all required written assignments (all assignments will be due via e-mail by
4:00 p.m. on the due date noted in the course outline to aland@pdx.edu):
o Pre-class questionnaire (due April 8)
o Reflective assignments – 2 total (due April 15, June 10)
o Team project description, goals and objectives (due April 22)
o Team progress report, request of supplies/materials (due May 13)
o Team action plan (Nicaragua) and portfolio of materials (due June 3)
o Team Evaluation (due June 10, with reflective assignment 2)
o Final evaluation/reflection (due July 8)
o Final project report (due July 8)
Full participation in class discussions and activities
Participation in all course-related activities in Nicaragua
Participation in a team project, including all project assignments and final team report
Participation in a group presentation to the Nicaraguan and/or PSU communities
(responsibilities will be assigned throughout the program)
Please note that in order to receive an A in the course, active participation in the course and
activities is required, and all requirements must be completed fully and on time. An “A” grade
is not assumed at the beginning of the course.
Detail Grading Overview:
Assignments and Grading Scale
Portland Assignments
100 Points
Pre-class Questionnaire
10
Reflective Assignments (2 total)
30 (15 each)
Team Project Description, Goals and Objectives
10
Team Progress Report, Request of Supplies/Materials
10
Team Action Plan (Nicaragua) & Portfolio of Materials
20
Team Evaluation
20
Due Date
4/8
4/15, 6/10
4/22
5/13
6/3
6/10
Performance in Nicaragua
Field Participation (partially based on peer evaluations)
Final Evaluation - Program and Team
Final Project Report
Due Date
6/16-7/2
7/8
7/8
Course grade
100 Points
50
20
30
200 Points Total
Additional Descriptions of Assignments:
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Questionnaires and evaluations will be anonymous.
Reflective assignments and team assignments will be detailed at a later date.
Field Participation grades will be based on the following:
o Punctuality and attendance: Students shall attend and arrive at all team and
community meetings on time.
o Presentation (appropriate dress): Students are representatives of Portland State
University, the Jessie F. Richardson Foundation, and the United States. While casual
clothing is acceptable, students encounter a high amount of visibility in Nicaragua
and shall maintain a neat and well-groomed appearance. Skirts, khakis, tailored
shorts, cardigans, polo shirts, plain and tailored t-shirts, and sandals are
suitable. Students may dress down on free days, and if they are working on a project
involving physical labor.
o Active contribution to the team’s project.
o Positive attitude.
General Course Outline:
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April 1 – Program orientation/past program experiences
April 8 – Global aging and health/project group formation
April 15 – Community Development
April 22 – Gerontology
April 29 – Nicaraguan history, culture, politics, and society
May 6 – Public Health
May 13 – Field work: Testing what we know
May 20 – Cross-Cultural Communication
May 27 – No class (Memorial Day)
June 3 – Project workshop/group reporting
June 10 – Packing party
Week/Date
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Program orientation/ 
past program
experiences
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Week 1 – April 1
Activities
Introductions
Program overview
Presentation: Past Program
Experiences
Fundraising opportunities
Travel logistics
Required Readings Assignments – Due
for Class (i.e., before by 4:00 p.m. on
class)
Indicated Date
Week 2 – April 8
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Global aging and
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health/ project group
formation
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Pre-class
Questionnaire
-United Nations
/Madrid Plan
Reflective
assignment 1
Team building activity
Presentation: Global Aging
and Health
- Kinsella & He
Project team organization (Chapters 1& 2, pp.
1-17)
Week 3 – April 15
Community
Development
-Neal, Wilson,
DeLaTorre, Lopez
(pp. 19-28)
Presentation: Community
Development
Project team work
- Panfichi (pp. 1-7)
- Cupples (pp. 3-14)
Week 4 – April 22
Gerontology
Week 5 – April 29
Nicaragua
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- Hooyman & Kiyak Team project
(Chapter 1, pp. 3-38) description, goals
Presentation: Gerontology
and objectives
Project team work
- Moody (pp. 14-26;
287-296; 309-316)
Guest Speaker
Presentation: Nicaraguan
Culture, History, and
Politics
Project team work
Week 6 – May 6
Public Health
- Plunkett
(Introduction &
Chapter 1, pp. 1-24)
- CRS Report to
Congress (pp. 1-6)
- Wallack (pp. 4-6)
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Presentation: International
- Koplan, et al. (pp
Public Health
1,993–1,995)
Project team work
- Brown (pp. 62- 72)
Week 7 – May 13
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Field work: Testing
what we know
Class in field (location
TBD)
- Popkin (pp. 289298)
Team progress
report, request of
- Benatar, et al. (pp. supplies/ materials
824 – 826)
- Uauy, et al. (pp.
893S – 899S.)
Week 8 – May 20
Cross-Cultural
Communication/
Education Abroad
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- Belli (Chapters 6-9,
Education Abroad: Review
pp. 32-58)
of Education Abroad
Expectations & Documents
-Kruckewitt packet
Presentation: Cross
(IOA)
Cultural Communication
Week 9 – May 27
No Class
Week 10 – June 3 
Project workshop/ 
Team presentations
Project wrap-up
Team action plan
(Nicaragua) and
portfolio of materials
Packing party (location
TBD)
Team evaluation/
Reflective
Assignment 2
group report
Week 11 – June 10 
Packing Party
June 16 – July 2:
Travel to Nicaragua
July ____ :
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Debriefing
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July 8
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Final Presentation 
(later summer/
early fall)
90-minute post-trip
debriefing session
Discussion of final
presentation
Post-travel assignments due
via email
Final evaluation/
reflection and final
project report
PowerPoint presentation to
greater Portland and PSU
communities
Final Presentation
(date TBD)
References
Neal, M.B., Wilson, K.W., DeLaTorre, A., Lopez, M. (2010). A Service-Learning Program in
Nicaragua: Aging, Environment, and Health. Global Ageing: Issues & Action: Ageing and the
Environment, 6(2), pp. 19-28.
Kinsella & He (2009). An Aging World: 2008. U.S. Census Bureau:
http://www.census.gov/prod/2009pubs/p95-09-1.pdf
United Nations (2002). Madrid International Plan of Action on Ageing. Report of the Second
World Assembly on Ageing, Madrid, Spain:
http://www.un.org/ageing/madrid_intlplanaction.html.
Panfichi, Aldo (2002). Building Barrios: Community Development in Latin America. Harvard
International Review.
Cupples, J. (2004). Rural Development in El Hatillo, Nicaragua, Nicaragua: Gender,
Neoliberalism, and Environmental Risk. Singapore Journal of Tropical Geography, 25(3), 2004,
343-357
Hooyman, N.R., & Kiyak, H.A. (2008). Social Gerontology: A Multidisciplinary Perspective (8th
Ed.). New York, NY: Pearson.
Moody, H.R. (2010). Aging: Concepts and Controversies. Los Angeles, CA: Pine Forge.
Plunkett, H. (1999). History: Tyranny and Revolution and Society: Culture of Resistance. In
Nicaragua in Focus: A Guide to the People, Politics and Culture. Brooklyn, NY: Interlink
Books. (Available for pick-up in IOA).
CRS Report for Congress (2008). Nicaragua: Political Situation and U.S. Relations.
http://assets.opencrs.com/rpts/RS22836_20080317.pdf.
Wallack, L. (1987). What is public health? Propaganda Review. 9, 4-6.
Koplan, J.P., Bond, T.C., Merson, M.H., Reddy, K.S., Rodriguez, M.H., Sewankambo, N.K., &
Wasserheit, J.N. (June 6, 2009). Towards a common definition of global health. The Lancet.
373,1,993 – 1,995.
Brown, T.M., Cueto, M., & Fee, E. (January 2006). The World Health Organization and the
transition from “international” to “global” public health. American Journal of Public Health.
96:1, 62 – 72.
Popkin, B.M. (2006). Global nutrition dynamics: The world is shifting rapidly toward a diet
linked with noncommunicable diseases. The American Journal of Clinical Nutrition. 84, 289 –
298.
Benatar, S.R. & Singer, P.A. (September 30, 2000). A new look at international research ethics.
BMJ. 321, 824 – 826.
Uauy, R., Albala, C. & Kain, J. (2001). Obesity trends in Latin America: Transitioning from
under-to-overweight. The Journal of Nutrition. 131, 893S – 899S.
Belli, G. (2002). The County Under My Skin: A Memoir of Love and War. New York, NY:
Anchor Books. (Available for pick-up in IOA).
Kruckewitt, B. (1999). The death of Ben Linder: the story of a North American in Sandinista
Nicaragua. New York, NY: Seven Stories Press.
Additional Readings and Websites:
Film “Nicaragua – A Nation’s Right to Survive” by John Pilger (1983).
http://www.youtube.com/watch?v=zJWNof0e2TM
National Institute on Aging – Spanish Publications:
http://www.niapublications.org/shopdisplayproducts.asp?id=8&cat=Spanish+Language+Materials
Nicaragua: The Election of Daniel Ortega and Issues in U.S. Relations:
http://assets.opencrs.com/rpts/RL33983_20070419.pdf
U.S. Department of State travel page: http://www.travel.state.gov/travel/cis_pa_tw/cis/cis_985.html
U.S. Department of State profile page: http://www.state.gov/r/pa/ei/bgn/1850.htm
WHO country cooperation strategy:
http://www.who.int/countryfocus/cooperation_strategy/ccsbrief_nic_en.pdf
PAHO/WHO country profile: http://www.who.int/countryfocus/cooperation_strategy/ccsbrief_nic_en.pdf
World Bank country page:
http://web.worldbank.org/WBSITE/EXTERNAL/COUNTRIES/LACEXT/NICARAGUAEXTN/0,,conte
ntMDK:22255024~pagePK:1497618~piPK:217854~theSitePK:258689,00.html
World Trade Organization country page:
http://www.wto.org/english/thewto_e/countries_e/nicaragua_e.htm
United Nations country page (only a shell): http://www.un.int/wcm/content/site/nicaragua/
La Prensa: Nicaraguan newspaper: www.laprensa.com.ni
Latin American Network Information System (200+ links to Nicaragua):
http://lanic.utexas.edu/la/ca/nicaragua/
HelpAge International (various dates) Copies of AgeWays and Ageing and Development will be
distributed in class.
Novelli, W.D. (2005). Managing Health, Health Care, and Aging. In Foege, W.H., Dualaire, N., Black,
R.E. and Pearson, P.E. (Eds.), Global Health Leadership and Management. San Francisco, CA: JosseyBass.
Garfield R., Williams, G. (1992). Health Care in Nicaragua: Primary Care Under Changing Regimes.
New York, NY: Oxford University Press.
Chapter 2: A Health Service for All: 1979-1983
Chapter 5: The War On Health
Pilisuk, M., McAllister, J., Rothman, J., Larin, L. (2004). New Contexts of Organizing: Functions,
Challenges, and Solutions in Minkler, M. (Ed.) Community Organizing and Community Building for
Health. New Jersey: Rutgers University Press.
Pan American Health Organization (n.d.) The state of aging and health in Latin America and the
Caribbean.
Reitenauer, V.L., Cress, C.M., Bennett, J. (2005). Creating cultural connections: Navigating difference,
Investing power, unpacking privilege in Cress, C.M., Cellier, P.J., Reitenauer and Associates (Eds.)
Learning Through Serving: A Student Guidebook fro Service-Learning Across the Disciplines. Sterling,
VA: Stylus Publishing.
Peruse this website: http://www.merck.com/mmhe/sec01/ch003/ch003a.html
(please note the “Next” link at the bottom right corner at the end of each section)
Lewis, O. (1966). The Culture of Poverty. In Seligson, M.A., Passe-Smith, J.T. (Eds.) (2005)
Development and Underdevelopment: The Political Economy of Global Inequality. Boulder, CO: Lynne
Rienner Publishers.
Wood, M.J. (2006). Immersion in another culture: One strategy for increasing cultural competency.
Journal of Cultural Diversity, 13, (1).
Crigger, N.J., Holcomb, L. (2007). Practical strategies for providing culturally sensitive, ethical care in
developing nations. Journal of Transcultural Nursing, 18, (1).
Bankrupt Future: The Human Cost of Nicaragua’s Debt. Northwest Witness for Peace.
http://www.witnessforpeace.org/downloads/Bankrupt%20Future.pdf
Mathie, A. & Cunningham, G. (2003). From clients to citizens: Asset-based Community Development as
a strategy for community-driven development. Development in Practice, (13), (5).
Hemisphere for Sale: The Epidemic of Unfair Trade in the Americas
http:www.witnessforpeace.org/downloads/hemisphere_1.pdf
Beauchamp, D.E. (2004). Public health as social justice. 267 – 284. In R. Hofrichter, Health and social
justice: Politics, ideology, and inequity in the distribution of disease. San Francisco, CA: Jossey-Bass.
Wood, M.J., & Atkins, M. (Spring 2006). Immersion in another culture: One strategy for increasing
cultural competency. Journal of Cultural Diversity. 13:1, 50-54.
Bhutta, Z.A. (2002). Ethics in international health research: A perspective from the developing world.
Bulletin of the World Health Organization. 80: 2, 114 – 120.