從貴州山區高嬰兒死亡率談侗族婦女受苦的社會根源

The Social Origins of Kam Women's Suffering: Exploring the Issue of High Infant Mortality Rates in Mountainous Guizhou

顏芳姿

《人文社會與醫療學刊》 1期 (2014/04) Pp. 103-127

https://doi.org/10.6279/JHSSM.2014.1(1).05

摘要

本文探討貴州山區侗族女人如何面對高嬰兒死亡率，筆者使用侗話訪問這些婦女，為的是將長期被男性（村幹、菁英和決策者）思維主導、淹沒和禁聲的話語權重新由侗族女人發聲，揭示侗族婦女受苦的社會根源及其後果。高嬰兒死亡率不只是健康問題，對貴州山區侗族來說，夭折早逝更是一個社會、文化和政治問題。政府和衛生單位展開對高嬰兒死亡率的現代化治理，父系社會的男性掌權者—寨老和鬼師操弄命觀，國家和地方社會紛紛怪罪已婚婦女生育失敗，卻抹去高嬰兒死亡率背後複雜而重要的問題。本文討論黃崗村高嬰兒死亡率的官方論述後，將婦女的經驗和敘事嵌入社會文化脈絡，透過她們的所知所感，彰顯侗族婦女受苦的社會根源與性別體系和生育政治的關連。結論主張，要降低高嬰兒死亡率必先改善婦女的社會受苦，進行侗族社會性別關係的轉型以及生育政治下婦女的賦權，以改變侗族婦女的命觀。

關鍵字

嬰兒死亡率 ； 侗族婦女 ； 社會受苦 ； 命觀

並列摘要

This article explores how Kam women face high infant mortality rates. I interviewed Kam women in the Kam language, uncovering women's voices, as their voices are long-term dominated, flooded and silenced by men, including village cadres, elites and policy-makers. High IMR in the Kam society of mountainous Guizhou makes premature death go beyond just a problem of maternal and infant health and become matters of society, culture and politics. Government and health departments launched modernization governance over minorities. The elders and the sorcerers manipulate the notions of fate to justify social regulations on reproduction. Both the state and local society have blamed married women for reproductive failure, but omitted complex and important issues behind high infant mortality rates. This study discusses official discourses and then women's experiences and narratives are embedded in the social and cultural context. Through these women's sensations, it clarifies that women's suffering arising from the gender system and the influence of reproductive politics. Overall, this paper makes clear the social origins and consequences of Kam women's social suffering, and suggest that to reduce high infant mortality rate, we must improve women's social suffering in advance. Transformation of gender relations in the Kam society and women's empowerment under the politics of reproduction should be put in the priority of the related policy, in so doing, Kam women can stop blaming themselves for losing children as their fate.

並列關鍵字

infant mortality rate ； Kam women ； social suffering ； fated concept

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