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

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。 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.