Faculty of Social Sciences University of Helsinki Finland SOCIAL POLICIES AND INDIGENOUS PEOPLES IN TAIWAN ELDERLY CARE AMONG THE TAYAL I-An Gao (Wasiq Silan) DOCTORAL THESIS To be presented, with the permission of the Faculty of Social Sciences of the University of Helsinki, for public examination in lecture room 302, Athena, on 18 May 2021, at 8 R¶FORFN. Helsinki 2021 Publications of the Faculty of Social Sciences 186 (2021) ISSN 2343-273X (print) ISSN 2343-2748 (online) © I-An Gao (Wasiq Silan) Cover design and visualization: Pei-Yu Lin Distribution and Sales: Unigrafia Bookstore http://kirjakauppa.unigrafia.fi/ [email protected] ISBN 978-951-51-7005-7 (paperback) ISBN 978-951-51-7006-4 (PDF) Unigrafia Helsinki 2021 ABSTRACT This dissertation explores how Taiwanese social policy deals with Indigenous peoples in caring for Tayal elderly. By delineating care for the elderly both in policy and practice, the study examines how relationships between indigeneity and coloniality are realized in today’s multicultural Taiwan. Decolonial scholars have argued that greater recognition of Indigenous rights is not the end of Indigenous peoples’ struggles. Social policy has much to learn from encountering its colonial past, in particular its links to colonization and assimilation. Meanwhile, coloniality continues to make the Indigenous perspective invisible, and imperialism continues to frame Indigenous peoples’ contemporary experience in how policies are constructed. This research focuses on tensions between state recognition and Indigenous peoples’ everyday experience of the policies of national long-term care in the case of a specific indigenous group, the Tayal. My research questions are: (a) What are “Indigenous problems” represented to be in the long-term care (LTC) policies in Taiwan? (b) How do the Tayal experience care in a care center funded by the nation state? How is the policy contested in their everyday experiences? What alternative visions of care do the Tayal have? (c) What are the discrepancies between the policy and practice of LTC for the elderly? And how do they reflect the relationship between coloniality and indigeneity in multicultural Taiwan? An Indigenous research paradigm is utilized as a critical lens to examine the contexts of care for the elderly. The rationale of this approach is that it counters the effects from the fact that research is inextricably linked to colonialism and imperialism and that conventional research tends to treat Indigenous peoples as mere research objects. For this reason, this study has incorporated an epistemological and methodological positioning that is devoted to indigenizing research and employs it to understand the concepts of aging and care. Tracing the multiplicity of meanings of the elderly and care and presuppositions behind the dominant biomedical perspective, this dissertation draws from the Indigenous research paradigm and broadens the concept of elderly care with perspectives of relationality, sacredness of life, humanness, interconnectedness and co-existence. The study employs two methods for answering the questions posed above. On the one hand, in order to answer the first research question, it utilizes critical policy analysis to explicate the “problems” in long-term care policy as problematizations which are constituted in discourse. Data from seven social policy documents produced in 2013–2018 are used to examine how “Indigenous problems” are constructed in Taiwanese long-term care policy. On the other hand, in order to provide answers to the second research question, the study utilizes critical ethnography to explore the perspectives of elderly Indigenous people. I utilize ethnographic fieldnotes and interviews 3 about care stories of the experiences of elderly Tayal people conducted primarily in 2016–2018 to examine how care is practiced and experienced by the bnkis (Tayal elders) in a state-funded “Day Club”. The study grounds the experience of the Tayal by reflecting on their experiences through the Indigenous research paradigm, in which I use the term “Tayal hermeneutics” as a way to privilege their voices in reconfiguring the concept of care. Results from these two research tasks are analyzed to shed light on the relationship between coloniality and indigeneity through investigating the dynamics between policy and practice in Taiwan. The study identified three policy frames on caring for Indigenous peoples that can be delineated from the policy discourses. They are the frame of secludedness, the frame of inadequacy and the frame of culture. These frames exhibit the grounds and lens the state has utilized to create and produce the “Indigenous problem”. The policy frames of secludedness and inadequacy fix Indigenous elderly into disabled seniors and depoliticize care as a logistical distribution and lack of staff with biomedical expertise. On the other hand, the frame of culture privileges culture as a critical component to good care. Contrary to the depoliticized and victimizing stance of the previous two frames, the frame of culture also creates space where Indigenous peoples can act and find solutions on their own. On the other hand, the ethnographic analysis found that the state’s organization of care for Indigenous peoples generates an uneasy tension among the intermediaries (care workers) and the bnkis in the Day Club. The tension arises because idealized “tribal care” promoted in the Day Club turns a blind eye on the fluid, contextual and living Tayal culture that lays ground to the kind of care that the bnkis prefer. Investigation of experiences of the bnkis shows that the Day Club is nevertheless appropriated, re-purposed and re-defined by the Tayal community to negotiate identities and contest predominant the conceptualizations of aging and care. Thus, Tayal hermeneutics offers novel alternatives to understanding care as living well. These findings suggest that, contrary to Taiwan’s promise to recognize Indigenous rights, the care policy shows in its construction of “Indigenous problem” and Tayal elders’ experience that no matter how multicultural Taiwan claims to be, the approach to accommodate Indigenous elders still derives from a middle class, urban, Han-Chinese norm. The current care system in Taiwan individualizes, generalizes and medicalizes what care ought to be, and marginalizes what Indigenous elders’ view of good care is. The novelty of this study lies in its aspiration to develop Indigenous epistemology and Tayal hermeneutics in the context of care. These perspectives allow us to encapsulate that different dimensions of living well and the Tayal visions of care in the Day Club should be valued and cherished. A wholistic, relational and Indigenous-informed approach in care is needed to reform Taiwanese long-term care policies. Moreover, the results of this research contribute to literature in critical policy analysis, care studies, Indigenous studies, critical gerontology and Taiwan studies, as they raise 4 important questions about what indigeneity is and the role that the nation state plays in the making of social policy for Indigenous elders. 5 TIIVISTELMÄ Tässä väitöskirjassa tutkitaan, miten Taiwanin sosiaalipolitiikassa käsitellään atayalin alkuperäiskansaan kuuluvien vanhusten hoivaa. Tutkimuksessa tarkastellaan vanhustenhoivan politiikkaa ja käytäntöä ja selvitetään, miten alkuperäiskansalaisuuden ja koloniaalisuuden väliset suhteet toteutuvat nykypäivän monikulttuurisessa Taiwanissa. Dekolonialisaation tutkijat ovat esittäneet, että alkuperäiskansojen oikeuksien parempi tunnustaminen ei ole lopettanut alkuperäiskansojen taistelua. Sosiaalipolitiikalla on paljon opittavaa koloniaalisen menneisyytensä kohtaamisesta ja erityisesti sen yhteyksistä kolonisaatioon ja assimilaatioon. Koloniaalisuus jatkaa alkuperäiskansojen näkökulman piilottamista, ja imperialismi kehystää edelleen alkuperäiskansojen nykyisiä kokemuksia julkispolitiikkojen kehittämisestä. Tässä tutkimuksessa keskitytään valtion osoittaman huomion ja alkuperäiskansojen jokapäiväisen kokemuksen välisiin jännitteisiin kansallisen pitkäaikaishoivan politiikoissa tietyn alkuperäiskansan, atayalien, osalta. Tutkimuskysymyksiäni ovat: a) Mitä ”alkuperäiskansoihin liittyviä ongelmia” Taiwanin pitkäaikaishoivan politiikassa on? b) Millaisena atayalit kokevat hoivan kansallisvaltion rahoittamassa hoivakeskuksessa? Miten politiikkaa kyseenalaistetaan heidän jokapäiväisissä kokemuksissaan? Mitä vaihtoehtoisia näkemyksiä hoivasta atayaleilla on? c) Mitä eroja vanhusten pitkäaikaishoivapolitiikan ja - käytännön välillä on? Entä miten erot heijastavat koloniaalisuuden ja alkuperäiskansalaisuuden välistä suhdetta monikulttuurisessa Taiwanissa? Alkuperäiskansojen tutkimusparadigmaa käytetään kriittisenä näkökulmana vanhustenhoivan kontekstien tutkimiseen. Tämän lähestymistavan perusteena on sellaisten vaikutusten torjuminen, jotka johtuvat tutkimuksen kytkeytymisestä erottamattomasti kolonialismiin ja imperialismiin ja perinteisen tutkimuksen taipumuksesta kohdella alkuperäiskansoja pelkkinä tutkimusobjekteina. Tästä syystä tähän tutkimukseen on sisällytetty epistemologinen ja metodologinen asetelma, jossa pyritään tutkimuksen indigenisointiin sekä ikääntymisen ja hoivan käsitteiden ymmärtämiseen. Tässä väitöskirjassa jäljitetään vanhusten hoivan moninaisia merkityksiä sekä vallitsevan biolääketieteellisen näkökulman taustalla olevia olettamuksia. Väitöskirja perustuu alkuperäiskansojen tutkimusparadigmaan, ja siinä laajennetaan vanhustenhoivan käsitettä relationaalisuuden, elämän