Abstract
Although the government designed several rural health policies for solving the severe health disparities among indigenous and non-indigenous people in Taiwan, the fact that inequality of the health condition and the disparities in allocation of healthcare resources still remain in mountain indigenous townships after years. This study suggests another way to understand the causes of the health issues through the local perspectives. This study investigates the everyday work of health professionals in mountainous area and tries to ask several questions as following: What is the specificity of their work in mountainous area? How does the mobile medical services operate? What is the impact of mobile medical services on doctor-patient relations? Finally, how do health issues and related policies influence the way of their work? During August 2014—January 2015 and August 2015, the researcher had conducted fieldwork at the health center in Mudan township in Hengchun peninsula in southern Taiwan by means of participant observation, interview and text analysis, following the everyday course of the health professionals, and recording the details about their works. This study finds, firstly, that the rural health professionals may adjust their strategies of work to the different environment, geographic context and facilities. Besides, the doctor-patient relations in the tribes have been altered since the mobile medical services funded by IDS operated in the same lifeworld as the habitants living in. Thirdly, the betel quid prevention policy, focusing on quantitative outcome overwhelmingly, results in disregarding the difficulties of practices and the life experiences of habitants; and it is the policies without integration that cause the inconsistency of the working experiences of front-line health professionals. All in all, this study concludes that the local practices of medicine in Mudan township have been deeply influenced by the natural and social context; on the other hand, this study also reconsiders the problems within health policies, and understands the health professionals’ contributions objectively; in the future, hope to contribute to the rural healthcare reform, by revealing the difficulties of practice and the shortcomings of quantitative way of assessing policy impact.