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研究生:趙麟宇
研究生(外文):Lin-yu Chao
論文名稱:緬甸臘戌華人健康劣勢成因的探討
論文名稱(外文):Exploration of the Health-related Disadvantages of Ethnic Chinese in Lashio, Myanmar
指導教授:梁莉芳梁莉芳引用關係黃嵩立黃嵩立引用關係
指導教授(外文):Li-Fang LiangSong-Lih Huang
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:國際衛生碩士學位學程
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2014
畢業學年度:102
語文別:中文
論文頁數:249
中文關鍵詞:民族誌研究批判民族誌華人緬甸臘戌健康的社會決定因子
外文關鍵詞:ethnographycritical ethnographyethnic ChineseMyanmarLashiosocial determinants of health
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本研究利用批判民族誌,於 2013 年在緬甸臘戌,探討華人族群健康相關的 經驗,特意著重在其社會不平等的議題,希望能為當地帶來改變。研究中有 34 次訪談、9 次參與觀察以及 4 次焦點團體的討論。使用立意採樣中的機會採樣 與範疇採樣。資料以初級資料分析法和主題式資料分析法處理。
結 果 : 華人婦女之間交換生產與避孕的資訊,但有些資訊有誤導的可能性。 大多華人因為 1982 年的公民法而無法擁有完整的公民權,因此不能在大學中選 擇專業性質的科系就讀,選擇的工作範圍也受到許多限制。要入戶籍到臘戌有 很多的障礙。許多孩童在學校受到體罰因此無法完成緬文小學的課業。在社區中有種種的社會支持。
結 論 : 不識緬文使得華人無法有效與醫療工作者溝通。但是,可能因為健康照護體系與學校體系複製了緬甸民族主義的意識形態,對人缺少了關懷。緬甸臘 戌的華人因為被公民法刻意排除於合法原住民族之列,使得他們因為族群的因素而容易落入社會的低階層。階級、教育、工作、與隔離都是影響緬甸臘戌華人健康的因素。
This study is to find the health related experience of ethnic Chinese in Lashio and was conducted in way of critical ethnography in 2013, focusing on inequalities in the society, to advocate changes. There were totally 34 interviews, 9 participant observations and 4 focus group discussions, using opportunistic and criterion samplings. Data was managed by preliminary data analysis and thematic data analysis. RESULTS: It was sisterhood that helped women to choose ways of childbirth and contraception but misunderstanding of both issues were surprisingly prevalent. Most Chinese had only incomplete citizenships under the1982 citizenship law, which limited selection of professional lines in education and employment. Registration for permanent residence was almost impossible. Many children failed to attain Burmese school because of physical punishment. Social support played an important role in the community in different ways. CONCLUSION: The incapability in Burmese language prevented ethnic Chinese from effectively communicating with health care providers. However, the lack of local engagement in health care and school systems might be a replication of Myanmar’s nationalism ideology. Arbitrary social exclusion by the Citizenship Law in terms of non-indigenous ethnic group rendered most Chinese to a low social class. Social class, job selection, education and segregation all impact health of ethnic Chinese in Lashio, Myanmar.
目 錄
論文電子檔著作權授權書………………………………………………… ii
論文審定同意書…………………………………………………………… iii
誌謝………………………………………………………………………… iv
中文摘要…………………………………………………………………… vi
英文摘要…………………………………………………………………… vii
目錄………………………………………………………………………… viii
圖目錄……………………………………………………………………… xi
表目錄……………………………………………………………………… xi
附件目錄…………………………………………………………………… xi
第一章 緒論………………………………………………………………………… 1
第一節前言………………………………………………………… 1
第二節問題陳述與研究目的……………………………………… 3
第三節文獻回顧…………………………………………………… 8
第四節研究重要性………………………………………………… 20
第二章 研究方法論與方法………………………………………………………… 22
第一節民族誌學研究法與批判民族誌…………………………… 22
第二節研究方法…………………………………………………… 27
第三節取樣方法…………………………………………………… 30
第四節研究對象…………………………………………………… 32
第五節資料收集過程與方法……………………………………… 34
第六節資料分析與處理…………………………………………… 36
第七節研究嚴謹度………………………………………………… 37
第三章 我在田野…………………………………………………………………… 38
第一節誰是華人⋯⋯……………………………………………… 38
第二節緬甸當地社會對華人的看法……………………………… 41
第三節 研究者的反身性…………………………………………… 45
第四章 臘戌華人的健康經驗 ……………………………………………………… 52
第一節在偏遠山區華人的健康情況……………………………… 52
一、公共衛生…………………………………… 52
二、醫療………………………………………… 54
第二節婦幼健康…………………………………………………… 59
一、產前檢查…………………………………… 59
二、生產經驗…………………………………… 67
三、大醫院與私人醫院的差別………………… 73
四、疫苗………………………………………… 82
第三節就醫經驗…………………………………………………… 87
一、癌症治療的經驗⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯ 87
二、瘧疾復發?真的嗎?⋯⋯⋯⋯⋯⋯⋯⋯⋯ 91
三、去哪裡就醫?⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯ 106
第五章 影響華人健康的社會結構因素…………………………………………… 113
第一節華人教育程度與學校的選擇………………………………… 113
一、華人不識緬文字的社會成因………………… 113
二、中文健康資訊難以獲得……………………… 125
三、緬校與華校資源的差異……………………… 129
四、小結…………………………………………… 132
第二節緬甸臘戌華人的工作偏好與出路…………………………… 132
一、工作是為了改善家裡的生活………………… 132
二、村子裡的小學畢業生………………………… 133
三、高中生畢業生的出路………………………… 139
四、高等教育……………………………………… 142
五、出國打工……………………………………… 145
六、小結…………………………………………… 149
第三節臘戌的華人,沒有完整的公民權…………………………… 150
一、是「果敢人」還是「華人」………………… 150
二、成為緬甸人…………………………………… 156
三、不完整的公民權:教育與工作機會的限制… 169
四、小結…………………………………………… 178
第四節社區與社會支持……………………………………………… 179
一、盡力而為的非政府組織……………………… 179
二、喪禮:提供族群聚首的場合………………… 190
三、村裡的接生婆………………………………… 194
四、打歌:果敢人的歌唱戲劇…………………… 203
第六章 結論與應用…………………………………………………………………………… 209
第一節 結論…………………………………………………………… 209
第二節對國際衛生與政策面的建議 ………………………………… 214
第三節研究限制與對未來研究的建議 ……………………………… 216
參考文獻…………………………………………………………………………… 218
附錄………………………………………………………………………………… 225

圖目錄
圖一,產前檢查卡,正面 ⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯61
圖二,產前檢查卡,反面 ⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯63
圖三,在婦幼健康中心 ⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯84
圖四,急難救助中心的外觀 ⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯91
圖五,病患在功德箱裡投錢⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯ 92
圖六,功德箱裡 的紙鈔⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯92
圖七,急難救助中心落成紀念碑⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯ 93
圖八,急難救助中心門前的黑板⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯ 95
圖九,各方對急難救助中心的捐贈 ⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯96
圖十,大醫院的門診時間表 ⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯97
圖十一,醫師電話 ⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯98
圖十二,求診華人的病歷記錄⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯103
圖十三至圖十五,街頭的衛教看板⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯125
圖十六、十七,香菸盒旁邊的警語⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯127
圖十八,緬文學校的教科書是UNICEF送的 ⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯129
圖十九,與臘戌婦女會成員的合照⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯182
圖二十,招攬來台灣健診的廣告⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯183
圖二十一,健診項目⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯183
圖二十二,招攬來臺體檢的旅遊醫療團廣告⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯183
附圖一,台灣到緬甸臘戌的路徑⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯245
附圖二,大臘戌地區的地圖⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯246
附圖三,臘戌衛星空照圖⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯247
附圖四,臘戌的街景⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯248
附圖五,九桃村的景色⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯248

表目錄
表一,從1931年到1983年之間,緬甸華人與緬甸總人口數⋯⋯⋯⋯⋯⋯⋯17
表二,訪談的歷程與主題⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯32
附件目錄
附錄一,前驅研究的結果⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯224
附錄二,臘戌的地圖⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯245



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