連結社群復返健康：排灣族文化照顧的省思

Integrating Community to Regain Health: Reconsidering Culture Care in Paiwan Society

本研究藉由執行科技部人文創新與社會實踐計畫，剖析排灣族啦里吧部落文化健康站實行臺東縣政府所推行之「原住民傳統醫療保健計畫」的歷程，思考上山（務農）的實踐如何體現在地社群對於「全人」的認知，進而討論健康的多樣含意，並反思照顧「專業」的多元認知。透過人類學視角解構排灣族對於caucau（人）、sasusuwan（行為準則）、kakudan（互動慣習）等三方面的理解，本研究以田野工作搭配行動研究，陪伴啦里吧文健站運用懷舊療法，以虛擬及具象的務農活動，促使長者於闡述回憶與實踐知識的過程中，與在地青年互動；並經由執行basatja（納貢）儀式，將小米回饋於部落，藉此減緩長者因生理機能衰退，而產生的社會性失能；且探索文化與健康之關聯於長照體制中，建構多樣照服模式的可能性。此外，透過檢視人類學者如何進行跨文化溝通，周旋於政策擬定者與地方文健站之間翻譯雙方對於彼此的想像，本研究試圖強調文化照顧應同時站在雙方的立場思考，使社群文化邏輯與專業照顧機制異音共鳴，將長照政策與在地動能編織為支持長者的網。

This research is carried out through the examination of Ministry of Science and Technology's Humanities Innovation and Social Practice (HISP) Project conducted by the National Taitung University (NTTU) in Lalepa tribal. By analyzing the Lalepa tribal culture health station participating in the ''Aboriginal Traditional Medical Care Project'' promoted by the Taitung County Government, this article aims to explore how farming enables people to be complete, and how health can be regained in the context of Paiwan culture.
Through deconstructing the Paiwan understanding of caucau (human), sasusuwan (code of conduct) and kakudan (interactive customs), this research adopts fieldwork and action research to accompanied Lalepa tribal culture health station implemented reminiscence based on the Paiwan culture. The NTTU employs farming to conduct reminiscence therapy. In the reminiscence therapy, the NTTU used virtual and concrete farming activities to encourage elders to interact with youths in elaborating memories and practicing local knowledge to reconstruct the individual value of the elders. Additionally, the basatja (offering tribute) ceremony enables sharing millet with the tribe that relieves the social disability of the elderly due to the decline of physical function. By participating in these activities, the relationships between health and culture in Paiwan society was explored to reconsider the Possibility of establishing diverse models in the long-term care system.
Moreover, it is needed to reconsidered the specialty of taking care of the elder. By examining how anthropologists translate imaginations of each other between policymakers and local care-taking practitioners, this research highlights that practicing cultural care should think from different angles. Through the example of how the Taitung University interact with the Lalepa tribal, this article argues that only through resonating the logic of local culture and the mechanism of professional care can the net supported the elderly be weaved.