The Daily Lives and Constants of the Tribe: Health Inequalities from Past to Present

The Shan people have remained in Africa since the dawn of humanity. Over decades, anthropologists studying their culture discovered that the Shan regard sunlight as a symbol of death, while fire represents life, unity among their people, and the survival of their families. Elderly individuals, too frail to continue living with the community, are left behind to await death, surrounded by thorny bushes to keep hyenas at bay, with a fire at their feet to illuminate their path to the afterlife.

Many indigenous tribes across the world face the aging population with a view of natural selection. During our field research, we found that Tian Zhenyu, wife of Ma Dashan and a pivotal figure in the Gaoshan tribe, contracted an unknown illness between the 34th and 40th years of the Republic(Note1.). Fear of contagion led to her being exiled to the mountains, a form of isolation from the community.

Despite Ma Dashan’s skills as a shaman, neither his rituals nor medicine could cure her. Her sister Sulumei, moved by compassion, took Tian Zhenyu to live with her 20 kilometers away in Lushan, to care for her. Her condition worsened, and she became emaciated. Due to the hospital’s distance, they abandoned treatment and awaited death at home.

Then, a miracle occurred. A preacher from the True Jesus Church saw Tian Zhenyu hunched in a corner like a monkey, and began praying for her. The church leader even carried her to Lishan Church, an hour’s walk, for services. Gradually, her health improved, and she miraculously recovered.

In an era where science was not widespread, many phenomena defied rational explanation, leading to fear or unexpected grace.

After recovering, Tian Zhenyu and Ma Dashan settled in Gaoshan, at the summit of Jialulan, an area abundant with siam (umbrella sedge). Before his death from colorectal cancer in the 48th year of the Republic, Ma Dashan suffered greatly. Given the long journey to Fenglin Hospital, both Tian Zhenyu and their son Ma Mingyi learned to administer injections at home. Despite his strength and years of shamanism, Ma Dashan finally surrendered to a higher power and decided to be baptized.

The eldest member of the Gaoshan tribe today, Tina Ani (林瑞妹), is the daughter-in-law of Ma Dashan and Tian Zhenyu. She speaks of her mother-in-law with deep respect and gratitude. Tina Ani recalls her carrying a torch, venturing down the mountain at night to assist with births. Trained as a midwife during the Japanese era but without a license, she would deliver babies and cut the umbilical cord, leaving before the public health workers arrived to avoid penalties.

Delivering her daughter-in-law’s baby was only natural. Tina Ani’s eldest daughter was born with her mother-in-law’s help. However, the baby developed a high fever seven months later and died three days after returning from Fenglin Hospital. Transportation was challenging, and the grief-stricken family could not investigate the cause of death.

Following this, Tina Ani delivered her subsequent children at Liming Foster Home, where her mother-in-law diligently cared for her using Han customs. When Tina Ani’s fifth child was due during the New Year, the hospital asked them to return after three days. Contractions started, but with the hospital 40 kilometers away, her mother-in-law intervened again, successfully delivering Xiao Ma (Ma Zhongyuan) at home.

In remote areas, medical care is often inaccessible. This was true half a century ago, with Ma Dashan and Tian Zhenyu unable to receive timely treatment due to hospital distance. The revered role of midwives in the tribe dwindled with Western medical intervention, and Xiao Ma’s birth further highlighted the inadequacy of rural healthcare, relying on luck or prayer.

Health inequalities persist today. Organic vegetables and five daily servings of fruits and vegetables are scarce in remote areas. Limited food choices and high prices force economically disadvantaged tribes to opt for cheap, substandard food or processed items. Prolonged nutritional imbalance and strenuous labor worsen physical and mental health, with hospitals a lengthy bus ride away, turning an entire day into a struggle for the elderly.

“May God watch over you!” is a phrase I often hear in the tribe. While it might seem normal to Christians, in remote areas, the transportation and treatment of the elderly and sick are inconvenient, relying on divine intervention for blessings and peace.

uninang miqumisang! (烏尼囊.米呼米桑) is a common Bunun greeting, meaning “You’re still alive!” It conveys gratitude, signifying “Thank you for returning alive, thank you for being here.” For the Bunun and many indigenous people, “Living well is a battle in itself!”(Note2.)

Photography and text: Ouyang Mengzhi Old photos provided by: Lin Ruimei

Note 1: It is now speculated that Tian Zhenyu suffered from adenocarcinoma of the lung. Note 2: Quoted from the PTS drama “Heaven on the Fourth Floor.”

*This article was published in PULIMA LINK By: Ouyang Mengzhi.

Mina Ou-Yang (minaoy@gmail.com). A non-native of Hualien, I am a freelance worker who moved here, drawn by the allure of the grand mountains, vast oceans, trees, and whales. If I could sow seeds with my words along the thorny paths of gender, age, culture, and environment, I believe I could lived happily ever after.

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