飲酒行為是身體、社會與文化糾纏的體現。原住民高比例的飲酒現象,不但在文化上具有其模糊性,同時也對應著政治、經濟殖民與現代性治理的歷史過程。新竹縣五峰鄉是飲酒高盛行率地區,衛生政策與醫療介入成為晚近解決問題的方式,M醫院也在此背景中,進行改善部落失業困境的節制飲酒計畫,卻成效有限。本研究透過對M醫院五峰鄉節制飲酒計畫的觀察,重構「原住民飲酒」的認識論,洞見部落居民主體性,記錄居民與醫療工作者之間的互為主體(intersubjectivity)之關係,以及醫療介入的反思性實踐(reflective practice)過程。 筆者以介入計畫作為觀察對象,發現醫療門診的施行困難,繼而調整介入形式,以焦點團體進行,卻仍無法避免污名效應的產生。研究繼之以節酒班成員為核心,透過深度訪談,耙梳部落居民的生命史,發現介入計畫預設部落居民因「失業」而「喝酒」的立場背後,是經歷殖民與現代國家治理下,一連串環境變遷、社會與家庭解組的過程。「酒」作為創傷療癒的媒介,亦是矛盾的認同象徵,而醫療本身也成為對現代性抵抗的對象。
This paper aims to trace the social and cultural origins of the high prevalence of problematic drinking in a Taiwan indigenous area, and the difficulties of medical intervention, during the author’s fieldwork under a local hospital’s outreach abstinence plan in Wufeng to intervene the drinking behaviors. In this study, the author carries out an ethnographic work, which reveals the intersubjectivity between indigenous people and medial staffs, as well as the reflective thinking on medical intervention. It is found that, in one way, drinking was seen as a ritual behaviors for its local culture of worship ancient spirit. In another way, drinking as “self medication” behaviors may be caused by a collective depressive state related to cultural trauma. The abstinence strategies prescribed by modern medicine contradict to local people’s living style, which have been deprived during societal change throughout the history of colonization and modern state governing.
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