金錢、政治與臺灣官方醫療援外的泥沼

Money, Politics and the Predicament of Taiwan's Official Medical Aid

賴姿邑(Tzu-Yi Lai)

指導教授 ： 陳嘉銘

國立臺灣大學/社會科學院/政治學研究所/碩士(2015年)

https://doi.org/10.6342/NTU.2015.02274

摘要

長期以來，持續掙扎於爭取外交承認的臺灣政府，自1962年對利比亞輸出六名軍醫開始，透過對外輸出國內醫療人力的方式，將醫療化為國家外交工具的一環。然而臺灣與其他著名的醫療外交實踐國，古巴與中國相比，不僅從動機而言，既不像古巴是為了實踐人人可及醫療的建國理念。即便與中國都是基於現實主義的外交動機，而對外輸出醫療外交，但臺灣卻始終面臨規模有限的窘境。顯然僅以動機分析的中國現實主義醫療外交，無法解釋臺灣政府在規模有限，導致成效無力之下，為何沒有依循現實主義的思維，停止官方醫療外交，反而從1962年持續實踐至今。促使本研究希望藉由研究臺灣個案的經驗，釐清臺灣醫療外交的實踐類型。利用文獻探究法搜集我國外交部檔案，再以內容分析法排比檢視檔案。本文爬梳臺灣醫療外交的歷史脈絡，從1962年的緣起，到九○年代為止的發展。發現臺灣受限於不斷受挫的國際外交承認，促使官方不間斷的對外輸出醫療外交。臺灣醫療外交是一種基於持續而絕望的國際外交結構困境，使臺灣官方即便因國內醫療資源動員不足，導致醫療外交的規模與成效，都無法達成現實主義的外交目標之際，仍舊無所不用其極的持續投入。並且受到外交受挫的長期結構困境影響，使得臺灣政府對於任何的外交突破，都會與曾經投入過的官方努力相連結，形成宛若真的實踐現實主義醫療外交的自我想像。在2006年臺灣總統專機出訪邦交國回程之際，中停斷交近三十載的利比亞，更讓官方與民間掀起想像的高峰。扭曲了臺灣官方醫療援外的實存效益與實際樣貌，形成一種自我想像的現實主義醫療外交。

關鍵字

醫療外交 ； 官方醫療援助 ； 人道援助 ； 臺灣

並列摘要

Medical aid has been viewed as a kind of humanitarian outreach. But Taiwan’s official medical aid is far beyond such trend. Considering Taiwan has long been struggled in gaining diplomatic recognition, Taiwan government has kept using official medical aid as a diplomatic tool since 1962 by dispatching 6 military doctors to Libya. However comparing to Cuba and China, who also practiced medical diplomacy, Taiwan’s case showed a different kind of medical diplomacy. Taiwan was unlike Cuba who had an ideal in promoting medical service to everyone. And even though Taiwan had shared similar realistic diplomatic motive like China, Taiwan’s medical diplomacy had struggled in its limited scale. Making China’s realistic medical diplomacy experience could not explain why Taiwan kept exporting its medical diplomacy considering it could not fulfill Taiwan’s diplomatic goal due to its limited scale. Using documentation and historical methods on Taiwan’s confidential government diplomatic files that have been declassified, the author reveals that the medical diplomacy of Taiwan is one self-imagining realistic medical diplomacy practice. Struggling in gaining diplomatic recognition, the diplomats of Taiwan had a conscious awareness in trying every mean to earn friendship in international society. Causing Taiwan kept exporting its medical diplomacy, even though its limited scale seemed useless in fulfilling any diplomatic goal. Suffering from the structural dilemma in earning diplomatic recognition for decades, Taiwan officials tended to view every diplomatic breakthrough as a result of their past efforts which was easily led to a self-imaging illusion. In 2006, when the presidential aircraft of Taiwan made a stopover in Libya, Taiwan government had wrongfully connected this diplomatic breakthrough to its past official medical aid to Libya. By distorting and misconnecting the real impact of its official medical aid, Taiwan official had formed a kind of self-imaging realistic medical diplomacy.

並列關鍵字

medical diplomacy ； official medical aid ； humanitarian aid ； Taiwan

參考文獻

外交部檔案（中央研究院近代史研究所檔案館藏）

張武修，2011，〈愛的心願—臺北醫學大學如何建立駐史瓦濟蘭醫療團〉，《台灣醫界》，54(6): 58-60.

黃麗卿等，2011，〈短期醫療支援某南太平洋島國就醫個案疾病型態分析研究〉，《臺灣家庭醫學雜誌》，21：131-40。

———，2012，〈農技援助之外：小中國對非洲的大想像〉，《臺灣史研究》，19:141-71。

王文隆，2004，《外交下鄉，農業出洋：中華民國農技援助非洲的實施和影響(1960-1974)》，臺北：國立政治大學歷史學系。