By Chia Yu Lien
While writing a blog article for Synapsis: a health humanities journal on Taiwan’s governance in relation to COVID-19, I found myself ill-equipped to talk about meanings of the common good when thinking of border controls, resource allocations, and policy communications. Considering Michel Foucault and Giorgio Agamben’s theories of governance and power, micro-interactions, and states of exception, I was at first tempted to uncharitably criticize the state apparatus. However, a public opinion poll has shown that the Taiwanese people hold a positive attitude toward the government’s response to COVID-19, with more than 90% satisfied with the policies and actions. I was perplexed by the discrepancy between what I was learning from theories and what I was learning from the public response.
In this essay, I turn away from what Sherry B. Ortner (2016) calls “dark anthropology” in order to ask when operations of power might be seen as “good.” I do this for two reasons. First, as predicted by John Hopkins University, Taiwan should be one of the hardest-hit countries from COVID-19. So far, however, among its population of 23 million, only 385 people have been infected, and only 6 have died. Second, I think that Taiwan’s story presents an opportunity to think about the state as a caregiver. In Arthur Kleinman’s words, the state as caregiver is “reorganized explicitly so as to advance care and maximize acts of humanity that advance community well-being” (Kleinman 2019:262).
Expecting an outbreak of the COVID-19 pandemic, Taiwan’s Central Epidemic Command Center (CECC) was activated in January 20th as a disaster management center that provided centralized leadership in communications and decision-making with and among central, regional, and local authorities. The CECC thus coordinates medical authorities as well as transportation, economics, labor, education, and environmental protection administrations. By the end of February, the CECC had issued 124 actions and policies in three categories: (1) border control, travel restrictions, and case finding; (2) resource allocation; and (3) communications and politics. The CECC actions and policies are communicated daily to the public via press briefing, television news, newspapers, Facebook, Instagram, and Taiwan’s online communications system, the LINE app.
Travel restrictions require those returning from overseas to quarantine for 14 days upon arrival. Recent travel history was integrated into the National Health Insurance Administration database, allowing physicians and clinical professionals to access the information. Each traveler’s cell phone was registered upon arrival, giving CECC officials the ability to track movements and know immediately if a person violated the quarantine order. To prevent shortages and price hikes, Taiwanese government collaborates with private sectors to launch a “national mask team”. The team had increased face mask production from 1.2 million per day to 13 million by putting in place 60 production lines The government also set a price limit of around USD $0.17 per mask and a purchasing limit of 9 masks every 2 weeks. In addition, colleges and K–9 schools were prescribed guidelines about shifting classes online in case of community spread. Some large events such as the Mazu Pilgrimage (March 2020), the Taipei International Book Exhibition (February 2020), and the Presidential Inauguration Ceremony (May 2020) were cancelled.
The Taiwanese know they will be fined if they violate a quarantine order or if they spread false or misleading information , but they are taken care of. In The Logic of Care (2008), Annemarie Mol notes that patient choices do not always lead to the best outcomes. When facing disease, people may not have the knowledge or material resources to assess all the advantages and disadvantages of one course of therapy over another. Care, as she describes it, does not start with what people want, but with what people need. Care, as a matter of improvement in health (e.g. lowering a person’s blood sugar or stopping the spread of a virus), sets goals requiring different strategies and different personnel in a process, involving both caregivers and care receivers. Care receivers are not passive; they are asked to actively participate in their healing. Patients participate in care, she writes, “not because they are being bossed around. Instead, most people do not want to die: they would rather live… [they] feel no freedom not because they have been submitted to the force of an authority,” but because they need to find a way to nurse themselves back to a good life (Mol 2008:40).
The goal of the Taiwanese government is simple: to contain COVID-19 and to effectively treat infected people. The care team comprises medical professionals, public health experts, and CECC officials and staff, as well as police. Those in quarantine receive from government officials a thermometer, face masks, snacks, sodas, instant noodles, and an amulet (the amulet is to ward off evil or illness or to bring good fortune). People also receive calls regularly to check whether they are eating, sleeping, and feeling well. People who test positive are immediately sent to hospitals. Similarly, people who violate quarantine orders risk being caught by police and fined. As mentioned before, everyone entering the country is required to register their cell phone numbers. Police will intervene when the cell phone is not picked up or is tracked leaving the quarantine site. Public perception of these policies has been largely positive. Many citizens have flown back to Taiwan to seek protection, firmly believing that if they contract COVID-19 they will not be abandoned but will be taken care of by the government. My point is that both caregivers and care receivers need to participate in the care process to prevent the spread of COVID-19 and the collapse of a medical system.
At first glance, the Taiwanese government seems to rely on authoritative forms of governance that many in places like the United States would consider draconian. Taking a closer look at Taiwan prompts consideration of what it means to live by the rule of law. The government of Taiwan uses both disincentivizing (fines) and a technique called sajiao to persuade the public. Defined by cultural studies scholar Hsin-I Sydney Yueh, sajiao means to manufacture a sense of vulnerability (like that associated with traditional notions of femininity or childishness) to achieve a goal. Sajiao “express the vulnerability and helplessness of the actor through imitating a child’s immature behaviors” (Yueh 2017:2). In Taiwan, sajiao is widely used by all genders to generate feelings of compassion and guilt. It is a weapon underprivileged people use to persuade the powerful.
Over the past two decades, sajiao has been incorporated into elections and policy communications in Taiwan.
For example, as shown in the first image, President of the Executive Yuan Su Tseng-Chang warns that those who violate a quarantine order will be fined up to USD $33,000, yet this tough message is conveyed in the form of sajiao, in which he appeals to Taiwanese conceptions of cuteness, appearing like an infant. In the second image, President Tsai Ing-Wen warns of the consequences of spreading fake news. Again, the message is conveyed in the form of sajiao; this time, not by the president but by her cat.
These tactics are not simply a cultural phenomenon; they are also a tactic of democratic accountability. The elected officials in the Taiwanese government are re-evaluated every two years in elections, and this prevents the government from imposing rules that will not be perceived as positive. In other words, the government does not command people but pleads with them in and through sajiao to change their behaviors for their own good and for the common good.
COVID-19 has prompted new considerations about the self and relationality. Many people have lost somebody, and most have been transformed by the pandemic. But the loss of others, Judith Butler writes, prompts us to remember that it “is not as if an ‘I’ exists independently over here and then simply loses a ‘you’ over there, especially if the attachment to ‘you’ is part of what composes who ‘I’ am. If I lose you, under these conditions, then I not only mourn the loss, but I become inscrutable to myself” (Butler 2004:22). Might COVID-19 ask us to revisit an insistence on autonomy and personal freedom? Butler reminds us that “[a]lthough we struggle for rights over our own bodies, the very bodies for which we struggle are not quite ever only our own.” We are instead “physically dependent on one another, physically vulnerable to one another” (Butler 2004:26–27). In Taiwan, more than three-quarters of infections are travel-related (meaning they are among people who have recently traveled outside the country), yet the first person who died from COVID-19 had not traveled internationally. He was an airport taxi driver. COVID-19 prompts us to think of the self not as a separate individual but as part of a wider community, and in doing so to remember the vulnerability of others.
The Taiwanese government’s aggressive strategy is paying off in the fight against COVID-19. The results are positive: fewer people are being infected and killed. Gatherings and activities have not been banned, despite restaurants, night markets, and travel industries having lost a number of customers. National level baseball – games have not been canceled. By April, community spread was limited; only a few colleges had switched online; and K–9 schools remained open with face-to-face instruction.
As I write, the President of the Executive Yuan, Mr. Su, announced that despite the mask export ban, Taiwanese citizens overseas can receive thirty masks purchased by their family members from the government every two months, which is more than sufficient for a stay-at-home student. My sister quickly bought the masks and sent them to me. While I am waiting, I sincerely feel and appreciate the co-presence of the government amid omnipresent uncertainty.
Chia Yu Lien is a psychiatric nurse practitioner and a second year Ph.D. student of Anthropology at Washington University in St. Louis. Her research interest sits at the intersection of anthropology, gerontology, and psychiatry. Specifically, she explores how older adults make sense of their bodies, constitute their relations with others, and inhabit the world while navigating competing cultural and moral frameworks between the pursuit of “health” and of pleasures.
I sincerely appreciate Professor Guo Pei-yi at Academic Sinica and to the editors at MAQ for guidance and feedback on the essay.
Butler, Judith.2004. Precarious Life: The Powers of Mourning and Violence. New York: Verso.
Kleinman, Arthur. 2019. The Soul of Care: The Moral Education of a Husband and a Doctor. New York: Penguin.
Mol, Annemarie. 2008. The Logic of Care: Health and the Problem of Patient Choice. New York: Routledge.
Ortner Sherry. 2016. “Dark Anthropology and its Others: Theory since the Eighties.” Journal of Ethnographic Theory 6 (1): 47-73.
Yueh Hsin-I Sydney. 2017. Identity Politics and Popular Culture in Taiwan: A Sajiao Generation. New York: Lexington.