Rethinking Indigenous pathways to health in Eastern Taiwan: negotiating the complex terrains of local sociality, cultural sovereignty, and biomedical governmentality

This thesis explores pathways to Indigenous health as complex negotiations between local sociality, cultural sovereignty, and biomedical governmentality. It examines how Indigenous-centered health initiatives in two Eastern Taiwan communities are challenging the hegemony of the biomedical models favored by the Taiwanese state. These two Taiwan-based ethnographies are paired with textual research and interviews with policy makers and health professionals in both Taiwan and New Zealand. The thesis considers how the Taiwanese state governs Indigenous health through a dominant biomedical approach and problematizes 1) the state’s imaginary of a singular framing of the Indigenous population and, 2) the multiple ways in which the state (mis)understands Indigenous cultures. Identifying significant disjunctures between state policy and community realities, it suggests that conceptualizing health as assemblage with emphasis on heterogeneity, connectivity, and indeterminacy as a way to move beyond the linear, individualistic, and risk avoidance notions of health presupposed by biomedical and social-determinant models. Based on the ethnographic evidence, it also suggests conceptualizing Indigeneity as articulating across spatial, temporal, and ethnic categories as a way to address the intricacy of contemporary Indigenous cultures. Using an innovative field-informed literature review, the thesis also draws insights from Whānau Ora, a Māori health initiative in Aotearoa / New Zealand. Whānau Ora highlights the values of self-determination, strength-based thinking, and relationality. The thesis argues that approaches to Indigenous health that are biomedicalized through a deficit-based mode founded on a statistical comparison between Indigenous and general populations with the former needing ‘improvement’, require careful reconsideration. It offers a reframing of pathways to wellbeing through claiming cultural sovereignty – which, as an alternative to the externally defined political sovereignty, is founded from within Indigenous knowledges and future-oriented - to validate contemporary hybrid cultures of everyday Indigenous experiences as legitimately Indigenous and to value sociality in the context of current Indigenous cultural identity.