部落照顧典範或薛西弗斯巨石：從偏遠地區試辦計畫經驗探討泰雅族照顧服務的想像

Tribal Care Paradigm or Sisyphus Rock: Discussing the Care Services of the Atayal from the Experience of Trail Plan in Remote Areas

103年起衛福部於東部縣市「推動偏遠地區社區照顧試辦計畫」執行三年已告段落，試辦經驗能否建立具有泰雅族群部落特色的照顧典範，或者如薛西弗斯巨石 一般，仍然一如往日宣稱試辦卻是徒勞無功。本文將探討推動該計畫之單位的經驗，從泰雅族照顧服務員觀點，勾勒泰雅族的部落照顧模式，同時瞭解發展部落合作機制的中介組織是否有可能。研究發現與結論包括：部落照顧據點適法性取得不易；山地原鄉部落聘僱鐘點時薪抑或全職薪給夾雜著兩難；照顧服務員進入傳統私領域服務時，有著被接受卻又遭挑剔的弔詭現象；但也因服務部落族人的經驗造就泰雅婦女的韌性；關注整體生活文化系統之維繫是原鄉部落服務模式的特色；對於菁英化、政治化滲入的中介組織普遍不信任；分立的教會派系組織似乎是社區發展協會以外原鄉部落整合的另類難題；傳統gaga價值規範是失能長者在選擇服務時的，參考卻也可能是某些情境禁忌。提出建議包括：原鄉部落的照顧服務，應降低建築法規條件，俾便建築空間之取得；採時薪抑或全職薪給聘僱都應先將交通距離成本納入，即便全職者也應該有底薪搭配時薪激勵機制；照顧服務工作發展，須向部落宣導整體面向以減少家戶對於服務人員的不友善，增進部落對於專業服務的尊重；培育新的中介組織經營，以重塑泰雅族婦女部落在服務角色上的形象；重視部落最早的社會服務機構－教會組織，允為部落社區整合另一重要議題。

 

Since 2014, it has been three years since the implementation of the "Trial Plan for Promoting Community Care in Remote Areas" by the Ministry of Health and Welfare in the eastern counties and cities of Taiwan. Whether the trial experience can set up a model of care with the characteristics of the Atayal tribes or, like the Sisyphus Rock, it is still futile as usual. This paper explores the experience of the unit in promoting the project, outlines the tribal care model of the Atayal people from the perspective of the caregivers of the Atayal people, and at the same time, understands whether it is possible to develop the intermediary organizations of the tribal cooperation mechanism. Research findings and conclusions include: the legitimacy of tribal care locations is not easy to obtain; the dilemma of hiring hourly or full-time salary caregivers in mountain native tribes; the paradox of acceptance and criticism of caregivers when entering traditional private services; the work resilience of Atayal women due to the experience of serving tribal people; the attention to the maintenance of the overall life and cultural system of the tribe, which is the characteristic of the service mode of the native tribes; the distrust of the intermediary organizations, which are penetrated by elitism and politicization; the separated church factions, which seem to be another difficult problem in the integration of native tribes; the traditional gaga value norms, which are the reference for disabled elders in choosing services and yet the taboos in some situations. Suggestions include: the care services of native tribes should relax the stringent requirements of architectural laws and regulations to facilitate the acquisition of building space; the cost of transportation and distance should be included in either hourly or full-time salary, and even full-time employees should have a base salary tied in with hourly salary incentive mechanism; the development of care service work should be publicized to the tribes to minimize the overall unfriendliness of households toward the service caregivers, and enhance tribal respect for professional services; foster and cultivate new intermediary organizations to rebuild the image of the Atayal women’s service role; another important issue is to attach importance to the tribe’s earliest social service organization - Church organizations, allowing for tribal community integration.