Proposed Global Service Course:  Community Health in Tanzania

Program Goals:

Students in this program will spend three weeks abroad, experiencing cultural immersion in a rural area of Tanzania and learning about the community health programs and culture of this part of East Africa.  Our local collaborators are the Nyakahanga district hospital, the Karagwe Diocese of the Lutheran Church of Tanzania which owns the hospital grounds and manages it for the government of Tanzania, and the AIDS control program there plus numerous NGO’s and programs that are associated with the hospital or the local community (see list below).  The program is designed to expose students to a broad variety of topics related to health services and programs in Africa, public health, and international development.  In addition to the academic components of the program, all students will be involved in helping to build an orphanage adjacent to the hospital.  This orphanage was designed by the hospital and its funding agency (the Lutheran Church of Tanzania) as part of their community service program to house orphans that are referred by the AIDS control office.  The program is open to 13 students, three of whom can take the program as research students.  The research students will complete research projects with the AIDS control office or other hospital programs within the program instructor’s research project in addition to other program requirements.  This research opportunity is open only to very motivated upper level undergraduates or graduate students (limit of 3).  It requires meeting with Dr. Linda Winkler in Summer 2005 prior to departure in order to learn about health issues in Tanzania, her research there (including IRB guidelines) and to develop the research project.  Students who are interested in taking the research track should indicate so during the course application process.

There are no prerequisites for this program although a background in the health sciences or anthropology is useful.  This is a very intensive program in which students will be involved in class related activities from 8:30 am until 8:30 pm nearly every day of the week.  It includes daily lectures (2 hours), group discussion (1.5 hour) and cultural immersion activities (2-3 hours a day).  Students will live on the grounds of the hospital community in western style guest houses with running water so will have easy access to the resources (including staff of the programs housed here) of the hospital.  In addition, students are expected to keep daily journals, interview local individuals to learn more about the topics they have chosen to do papers on, and will also be given reading assignments while in Tanzania.  The first course meeting will be scheduled for early May 2006.  Weekly assignments will be posted on the West Virginia University's Vista system throughout May to prepare students for departure. 

Students who are interested in learning Swahili (one of the national languages of Tanzania) (English is the other national language) will be pointed to resources for tutoring in Swahili prior to departure.  Swahili lessons are not included in the program cost. 

Textbooks and Readings

Required:
Setel, Philip (1999) A Plague of Paradoxes: AIDS, Culture, and Demography in Northern Tanzania. University of Chicago Press, Chicago, IL.

Dettwyler Katherine A. (1994) Dancing Skeletons. Waveland Press, Prospect Heights IL (ISBN 088133748X)

http://www.tanzania.go.tz/districts/karagwe/karagwef.html (print this web-site off and bring it with you)

Required reading will also include several articles that will be given out during the class.

Recommended (Nonfiction):
Creighton, Colin and Omari, C.K. (2002) Gender, Family, and Work in Tanzania. Ashgate Press, Burlington, VT. (184014100X)

Feierman, Steven and Janzen, John (1992) Social Basis of Health and Healing in Africa. University of California Press, Los Angeles, CA. (0520066812)

Guest, Emma (2001) Children of AIDS Africa’s Orphan Crisis. University of Natal Press, Scottsville South Africa.

Hunter, Susan (2004) Black Death, AIDS in Africa. Palgrave MacMillan, New York. (1403967172)

Nugent, Paul (2004) Africa Since Independence. Palgrave MacMillan, New York. (0333682734)

Other Books (fiction and non-fiction) that provide information about African culture:

Barley, Nigel (1983) The Innocent Anthropologist. Waveland Press, Inc. Prospect Heights, IL (1577661567)

Hochschild, Adam (1999) King Leopold’s Ghost.  Mariner’s Books, New York.

Kingsolver, Barbara (1999) The Poisonwood Bible: A Novel

Harper Collins, New York, NY       (0060930535)

Linde, Paul R. (2002) Of Spirits and Madness: An American Psychiatrist in Africa. McGraw-Hill, New York, NY (0071367349)

Lugalla, Joe L.P. and Kibassa, Colletta G. (2002) Poverty, AIDS, and Street Children in East Africa. The Edwin Mellen Press, United Kingdom (0773471065)

Moorhead, Alan (1960) The White Nile. Dell Publishing Company New York, NY

Smith, Alexander McCall(2000) Tears of the Giraffe. Random House, Inc. New York, NY (1400031354)

Webb, Douglas (1997) HIV and AIDS in Africa. David Phillip and University of Natal Press, Scottsville, South Africa (0864863411)

Overall Program Grade Policy

Details on grading:  Each student will be required to attend a series of lectures, group exercises and cultural immersion activities as part of the study abroad program. The initial lecture will be a trip orientation and overview of the community and program requirements. 

Students in this program earn 6 credits with the program divided into two 3 credit courses. Therefore, students will receive grades for two components: one for a three credit independent study and a second for the community health component of the program (including in-country lectures and presentations and journals).   All students will register for the “Community Health in Tanzania” component of this program (ANTH 1787).  In addition all students will register for an independent study component (ANTH 1901), but this component has two tracks as described below.

Community Health Component

The community health component of the program will include daily lectures and group discussions.  Community members will also be invited to do presentations of local community health initiatives. Additional readings will be handed out during the study-abroad experience to supplement the required textbooks.  All students will also be required to keep a daily journal while on the trip, in which he/she will be asked to reflect upon the discussions and their impressions and experiences during the twenty-one days of the study abroad class. This journaling will include reflection questions that are provided by faculty, some of which will be based on assigned readings.  Students are strongly encouraged to supplement these written materials with photographs.

Independent Study Component

The independent study has two tracks: a research track and a cultural issues track.  These two options have similar but slightly different requirements.  Students in both tracks will attend an introductory orientation seminar prior to departure, do readings and take-home assignments that are posted on courseweb, access web-sites on Tanzania, and each student will need to complete a written research review of at least five pages in length (including both Internet and library research) on a topic relevant to Tanzanian community health or culture prior to departing on the trip.  For the students in the research track, this paper will be on their topic of research and will include a research design section.  The students in the cultural issues track will choose a topic relevant to the cultural experience.  The topics for the research students have to be within the limits of the faculty members IRB.  The topics for both tracks will be selected after discussion with the course faculty. 

During the in-country study-abroad experience, all students will be expected to gather data relevant to their pre-trip papers.  However, the research students will be expected to spend significantly more time in implementing their research design (from their pre- trip papers) and gathering data in one of the community health program associated with Nyakahanga Hospital and the AIDS Control Program.  The research students may substitute research data collection for some of the cultural immersion activities with the permission of the faculty.  In contrast, the cultural issues students will gather information through their cultural immersion activities and ethnographic interviews with community members.  The students will be exposed to a wealth of cultural experiences and presentations from member of the community.  These contribute significantly to the independent study component of the courses in providing information about the culture of the area and in providing the students with local contacts and acquaintances.

The pre-trip papers will be revised and resubmitted after the trip and a group presentation relevant to the paper topic is required after returning from Tanzania.  The research students will be expected to include their research data and data analysis in their post-trip papers.  The cultural issues students will be expected to include information from their cultural activities and ethnographic interviews in their post-trip papers.

Summary of expectations and grading:

Community Health Component (ANTH 1787): 

Completion of lectures and group exercises 40%
(attendance and participation is required)
Journal entries (based on readings, group discussions, and reflection assignments)  60%

Independent Study (ANTH 1901 or HRP 1399):

Cultural Issues Track

Completion of assignments 25%
Research review and paper 20%
Participation & completion of required cultural activities in Tanzania 20%                             Revised paper after trip 25% 
Research activities (interviews) in-country to work on project 10           %

Research Track

Completion of assignments 25%
Research review and research design proposal 25%
Participation & completion of cultural activities in Tanzania 10%                             Research paper after trip 25% 
Research activities (gathering data) in-country to work on project 15%

Journal Grading

Journals are due periodically throughout the program. We will try very hard to return them to you within two days when we have to borrow the actual journal. Be sure to continue journaling while they are being read and evaluated. We will respond to them in two ways:

1. With written comments and questions. The purpose of the comments is to both provide support and challenges for your learning. We will reinforce your efforts to better understand yourself and the world around you while asking questions and raising issues to encourage you to continue exploring.

2. With a number score between 0 and 4: the scale below describes the criteria for grading:
Grading criteria and numerical grades:

4 = Assignment thoroughly completed. Reflections on each reading are included, student reflected on class activities and discussions and on experiences within culture. Connections between site, readings and class are made. Reflections go beyond the ‘weather report’ and truly demonstrate thought and introspections on the part of the writer. Good amount of detail. Language free of careless error appropriately used to suit the occasion. Shows insight into the ways in which claims contribute to shared understanding of theoretical concepts under discussion.


3 = Student has made an effort and reflections show some depth of introspection and thought. However, the following have not been adequately reflected upon: readings, class activities or community experiences. Language reasonably free of careless error and stylized to suit the occasion. Substantiates claims with analysis, clarity and example

2 = Student has made some efforts but has not adequately reflected on any of the following: readings, class activities or community experiences. Reflections are rather ‘surface’ reflections without sufficient exploration and explanation of feelings and opinions. Language contains patterns of grammatical error.

1 = Journal turned in, but minimal effort has been presented. Neither readings, class activities or community experiences have been reflected on adequately. Writes predominantly in incomplete or careless prose. Does not respond to all assignments. Offers short undeveloped claims.

0 = Journal not turned in.

NOTE: One point is deducted when your journal is late. If your journal is more than seven days late, at least two points will be deducted.

Academic Integrity:

Students in this program will be expected to comply with the University of Pittsburgh's Policy on Academic Integrity. Any student suspected of violating this obligation for any reason during the semester will be required to participate in the procedural process, initiated at the instructor level, as outlined in the University Guidelines on Academic Integrity. This may include, but is not limited to, the confiscation of the examination of any individual suspected of violating University Policy. Furthermore, no student may bring any unauthorized materials to an exam, including dictionaries and programmable calculators.

Disabilities:

If you have a disability that requires special testing accommodations or other classroom modifications, you need to notify both the instructor and the Disability Resources and Services no later than the 2nd week of the term. You may be asked to provide documentation of your disability to determine the appropriateness of accommodations. To notify Disability Resources and Services, call 648-7890 (Voice or TTD) to schedule an appointment. The Office is located in 216 William Pitt Union.

Schedule

Cultural Immersion Programs and Speakers

Programs that present lectures or which students may visit or observe:

1. Maternal and Child Health Clinic (infant vaccination and reproductive care, sponsored by UNICEF and the Government of Tanzania, located on hospital grounds) *
2. Community Health Services Office (community outreach programs including vaccination and water quality, located on hospital grounds)
3. Dr. Amos Nyirenda, Director of the Hospital (programs at the hospital) *
4. Karagwe AIDS Control Project ( provider of educational programs, orphan, widow, and client support and legal aid throughout the district though their eight district-wide offices, speakers will include the director, Mr. Venant Mugenyi plus caseworkers, located on hospital grounds) *
5. WOMEDA (local NGO providing support to women on issues related to women’s rights, economic development, and legal issues) *
6. Karaseco High School (secondary school that students visit, each student assigned a local student host at this school where students range in age from 16-23) *
7. Community health workers, native healer coop (local group comprised of native healers and local health workers from villages in areas around the hospital *
8. Bisheshe AIDS widows coop (group comprised of AIDS widows who are producing crafts as a means of generating income to help support their families) *
9. Bisheshe church, children and women native dancing groups (ngoma) *
10. home visits to experience local hospitality
11. local African mosque
12. FADECO (local NGO that is attempting to develop a number of subsistence agriculture and conservation programs in the area *
13. local soccer match (students may play)
14. Bridget Hathaway (director of local NGO that provides services to individuals with disabilities, works in the hospital but also in villages throughout the area) *
15.  Dr. Rev Benson Bagonza, Bishop of Karagwe Lutheran Church (the Lutheran church is the largest social service provider in Karagwe and the largest employer if hospital staff are included) *
16. Mr. Josiah, local business man and former social studies teacher (lecture on the history of Tanzania) *
17. Opportunistic social events (previous events have included: dinner at the Bishop’s house, attending a wedding and being part of the post-wedding procession, attending a party celebrating consecration of the Bishop (including hearing the Prime Minister of Tanzania speak), visiting the rural home of one of the AIDS control office caseworkers and meeting his family) *
18. Visiting officials or specialists to the Hospital community (previous visitors have included Danish student nurse interns, a Danish college student doing a project at the hospital, Danish social workers on projects in the area, visiting surgeons and medical specialists from elsewhere in Tanzania and Kenya).
19.  Visit to markets of Lukajange, visit to tailors *
20.  Hairstyling and hair design by local beauticians

Activities that are required as part of the course are followed with an *.

Note that almost all lectures will be in English, including those from our Tanzanian consultants.  English is taught in high school and all Tanzanians who have been to high school  know it.  In addition, it is the language of medicine so all hospital records, AIDS control office records, etc. are kept in English.  It is also the language of instruction at the secondary school and university level.  In those instances, when the class meets with non-English speakers (native healer group), a local translator will be provided.