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原住民族部落健康與文化主權:磯崎村復健站的自主性發展歷程

Indigenous Health Promotion and Cultural Sovereignty in Taiwan: The Autonomy of the Jiqi Rehabilitation Center

摘要


本文以花蓮縣豐濱鄉磯崎村復健站為基礎,揭露多族群的原住民部落健康促進行動關注族群和諧,熟稔運用在地社會關係、在地資源、深度理解地方人情義理,並與醫護專業協作的自主性老人照顧模式,以達成貼近生活的社區賦權自決行動。強調「文化主權」概念,以民族誌思考當代原住民族部落健康。立基於部落日常生活文化實踐的長者照顧,在族群文化與健康行動的思辨中,對國家政策與實務運作提出挑戰。為減緩政策與實踐間的落差,強化資源分配和運作的結構性差異、弱化績效評鑑指標、信任具備文化能力的文化轉譯者等成為政策規劃的思考方向。

並列摘要


This paper, based on experiences at the physical rehabilitation center at Jiqi (磯崎), a multi-ethnic Indigenous community, explores how the health initiative sought community empowerment and self-determination through utilization of internal resources , social relations, deep understanding, and flexible deployment of local knowledges, in connection with support from external medical institutions. Building on ethnographic work and expanding on the concept of 'cultural sovereignty', the paper reveals how elderly care grounded in daily local cultures challenges existing health promotion policies and practices. To increase compatibility between policy and local implementation, this paper proposes two directions worth considering for Indigenous health policy-making: 1) highlight structural differences for resource allocation and program operation while reducing reliance on quantitative and indicative evaluation and, 2) release decision-making and operation capacities to local cultural translators with both mainstream and Indigenous knowledges.

參考文獻


王佳涵 2009  〈撒奇萊雅族裔揉雜交錯的認同想像〉,國立東華大學族群關係與文化研究所碩士論文。(Wang, C.-H., 2009, “The Hybrid Identity Imagination of Sakizaya Descendants,” Master Thesis, Department of Ethnic Relations and Cultures, National Dong Hwa University.)
花蓮縣縣政統計 2017  〈花蓮縣106各鄉鎮市村里現住原住民人口數按性別、原住民身分族別分〉。2017年4月6日,取自https://static.hl.gov.tw/files/11–1054–7854.php?Lang=zh-tw (Hualien County Government Statistics, 2017, “Indigenous Population by Village, Gender, Indigenous Groups in Hualien County,” Retrieved April 6, 2017, from https://static.hl.gov.tw/files/11–1054–7854.php?Lang=zh-tw)
邱淑媞 2001  〈宜蘭縣營造健康社區之過程與現況〉,《護理雜誌》48(1): 28–35。(Chiou, S.-T., 2001, “Developing Healthy Communities in I-Lan County: The Process and the Progress,” The Journal of Nursing 48(1): 28–35.)
洪清一、洪偉毓 2008  〈花蓮東海岸撒奇萊雅族豐年祭之研究—以豐濱鄉磯崎村為例〉,《台灣原住民研究論叢》4: 65–99。(Hong, C.-I. and W.-Y. Hong, 2008, “Study of Sakizaya Harvest Festival on Hualien East Coast: A Look at Jiqi Village in Fongbin Township,” Taiwan Indigenous Studies Review 4: 65–99.)
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