Taiwan’s response to the COVID-19 pandemic is often applauded internationally as a success story, yet it has only been possible because of Taiwan’s strong medical profession and vibrant civil society. Few scholars have investigated both the colonial origin of Taiwan’s medical profession and the development of Taiwan’s public health system and civil society engagement after democratization. Since the 2000s, Professor Ming-Cheng M. Lo has produced many pioneering writings on doctors, disasters, grassroots activism, and cultural identities in Taiwan. How did the medical profession in Taiwan emerge in the Japanese colonial era? Why are there many doctors actively participating in today’s Taiwanese politics? How did civil society engagement contribute to Taiwan’s pandemic response?

The Taiwan Gazette is pleased to interview Professor Lo to discuss these important questions related to public health and civil society in Taiwan.

Ming-Cheng M. Lo is Professor of Sociology at the University of California, Davis. Professor Lo’s research focuses on the cultural codes, narratives, and networks in East Asian civil societies. She has also written about the sense-making processes regarding disasters and cultural traumas. Applying similar cultural approaches to medical sociology, her research also addresses how individuals make sense of healing, illness, and suffering, and how medicine intersects with politics, ethnicity, colonialism, and neoliberalism. Lo is the author of Doctors within Borders: Profession, Ethnicity, and Modernity in Colonial Taiwan (University of California Press, 2002; Japanese edition published in 2014). She has published actively on culture, civil society, and health and illness in sociology and interdisciplinary journals.

The interview was conducted online in English and has been edited for clarity.

Interviewed by Sida Liu and Man Xu
Transcribed and edited by Man Xu
Cover Image: Lisanto on Unsplash

“[A]fter reaching a temporary closure, societalization can resume at subsequent eventful moments. Legacies from earlier phases of societalization shape subsequent efforts of re-societalization, while also being expanded, redefined, or both, in the process. As such, the civil and systemic repairs in response to societal crises not only engender institutional changes, but equally importantly serve to structure the civil sphere’s memories of injustice, sculpting the social and cultural landscape of the local civil sphere.”

— Ming‑Cheng M. Lo and Hsin‑Yi Hsieh, “The ‘Societalization’ of Pandemic Unpreparedness: Lessons from Taiwan’s COVID Response”

Taiwan Gazette: Moving on to your recent work, you wrote a lot on civic society in Taiwan and Hong Kong and civil society’s participation in post-disaster reconstruction in the last decade. How did you become interested in the topics of civil society engagement and grassroots activism? Is there any change in the civic engagement in Taiwan that you observed in the recent decades?

Ming-Cheng M. Lo: This is a question that I asked myself often. I don’t have a very good answer, but I wonder: could it be that I have inadvertently and unconsciously followed the footsteps of the doctors that I have studied? I’m interested in how a society treats the people who need to be taken care of. On the one hand, this is about physical illness; on the other hand, we can think of illness in a metaphorical sense, such as social injustice. I realized that I have become one of the doctors I studied who looked at healing and political activism as two sides of the same coin. That’s the best answer I can give.

To the second question, I’m afraid that I cannot give a concise answer that is also complete. But let me highlight three phases. In the beginning phase of democratization in Taiwan in the 1990s, civic engagement was mostly about democratizing the regulatory institutions, such as pushing for democratic elections and eliminating laws that allowed for government overreach. This is a time that is characterized by state-society opposition.

The second phase is between 2000 and 2010, roughly speaking. We started to see more rigorous mutual engagement within civil society itself. The earlier emphasis on state-society antagonism assumed that the state is the main oppressor and that civil society is more or less coherent. There was perhaps an implicit expectation that, once the state is pushed back and that civil society is free to express and organize itself, most social injustices would be addressed.

These assumptions were challenged after Chen Shui-bian (陳水扁) was elected as the first Taiwanese president who did not come from the KMT. Civil society agents came to realize that, even though the authoritarian government has become democratized to some extent, “we the people” don't actually agree with one another, we don’t have a common set of interests, and we don't necessarily share a coherent cultural identity. A lot of political and cultural work was done to address these issues in this period of time.

In 2006, Shih Ming-teh (施明德), former Chairperson of the Democratic Progressive Party, spearheaded the “Million Voices against Corruption, President Chen Must Go” (百萬人民反貪腐倒扁運動) mass campaign to pressure former President Chen Shui-bian to resign in 2006. Earlier sit-in protests near the Presidential Office grew into the “Surround the City” protest near the Taipei Main Station on 15 September 2006. (Credit: Wikipedia Commons CC BY-SA 3.0)

Finally, in the last decade, the rise of populism became a more serious threat, which is part of a global phenomenon very much fueled by misinformation campaigns. Reports published by the Freedom House, for example, discuss how Beijing influences Taiwanese society by pumping money into certain media to shape public opinions. I think that started around 2008 or 2009. In the last decade, misinformation campaigns and the rise of populism became a major issue.

Taiwan Gazette: Can you tell us about your recent research on COVID-19 intervention in Taiwan? Taiwan’s pandemic management has been portrayed in the global media as a success, what do you think about that narrative? What lessons do you think we can learn from Taiwan’s COVID-19 experience?

Ming-Cheng M. Lo: I became interested in COVID management because I was living it. I was in the U.S. when the pandemic started, and I had to stay at home with my son who was in kindergarten at the time. I was teaching two classes online while taking care of my son. And I felt that my husband and I had been forced to take on several very demanding jobs simultaneously, and for a prolonged period of time. So, I was living the U.S.’s miserably failed response to COVID-19 while reading the stories of pandemic management in Taiwan. These stories were the painful daily reminder of what a miserable failure the U.S.’s response was in comparison to Taiwan. However, everything that Taiwan can mobilize at its disposal - be it the political system or medical science - the U.S. had more than enough to do the same. So why the contrast? That’s how I started the research.

In terms of the media coverage about Taiwan’s COVID response, it was interesting and uplifting but also frustrating in its incompleteness. Most of the reports explained Taiwan’s success with its SARS experience, saying that because Taiwan experienced an epidemic before, it was better prepared to deal with COVID. And my response to that is, what about Hong Kong and Korea? What about China in the beginning phase of COVID? These places all had SARS experiences, why didn’t they also successfully contain COVID? Most importantly, I’ve been interviewed about this a couple times, and I asked the reporters: now that the U.S. is having such a horrible time with COVID, do you think we’re better prepared to respond to the next pandemic? And the journalists opened their mouths but couldn't find an answer. So, I feel the historical experience itself is not a sufficient explanation.

Another thing people often refer to is the so-called collectivist culture in Taiwan. For one thing, other Asian countries share the so-called collectivist culture, yet it doesn’t guarantee a successful response to COVID. Also, for anyone who is familiar with Taiwan, it is not that collectivist. You often see physical fights in congress in Taiwan. Just about three months ago, there were fights over a bill that would allow Taiwan to import pork from the U.S, and the opposition party brought buckets of pig organs and threw them on the legislators who were trying to pass the bill. It was completely awful. Taiwan is a very politically polarized society, and the collectivist culture argument is very much a stereotype. As scholars, we need to be more nuanced.

For me, part of the impetus for writing my COVID articles is to go beyond the arguments from the media, which were interesting but had blind spots. No cultural and social mechanisms can guarantee a successful response against unfolding contingencies when we’re living through a pandemic.

“Compared to the alleged ‘authoritarian advantage’ of crisis responses, the bottom-up impetus of societalization appears to demand greater accountability from the state and the profession and nurtures a greater self-awareness of civic interdependence among citizens. . . . Indeed, unless civil society actors engage in serious systemic and civil repairs after the COVID-19 pandemic, the U.S. and other heavily impacted democratic societies are unlikely to respond well to the next outbreak. Perhaps how Taiwan learned its SARS lessons is instructive for other societies in learning from their COVID-19 crises.”

— Ming‑Cheng M. Lo and Hsin‑Yi Hsieh, “The ‘Societalization’ of Pandemic Unpreparedness: Lessons from Taiwan’s COVID Response”

Former U.S. President Donald J. Trump and airline CEOs discussed COVID-19’s possible impact on the travel industry. (Official White House Photo by Joyce N. Boghosian via Wikimedia Commons)

Taiwan Gazette: So how do you understand the different responses to COVID-19 in Taiwan, China and the U.S.?

Ming-Cheng M. Lo: I haven’t done serious systemic comparative research on this issue, so you would have to take my answer with a grain of salt. Based on my incomplete understanding, I would say that the U.S. case represents a largely uncoordinated, incoherent response to COVID. The only advantage is that the US had very advanced biomedical knowledge, and it had a large number of vaccines at a much earlier time than other places, as well as the resources to distribute as many vaccines as possible. But the state’s response was largely uncoordinated at least until Trump stepped down. The American civil society was overly individualistic. I know that’s a cliché, but vaccine hesitancy or the politicization of masks is indeed an issue. Based on some academic articles and media coverage I read, I think China’s response represents a fairly successful one that is based on top-down control and regulations. Taiwan represents a fairly successful response as well, but mostly based on bottom-up mobilization for policy reforms, as well as the formation of a culture of civic interdependence. In Taiwan, you don’t see police on the street forcing people to wear masks, but there is this social pressure that has been consolidated through civil society discourses. This is my very coarse-grained typology.

Taiwan Gazette: Lastly, we want to ask you about the connection between your work on Covid-19 responses and your previous research on civil society. Can you talk about that?

Ming-Cheng M. Lo: Having grown up under martial law in Taiwan and witnessed how people struggled against authoritarian rule for democracy in my youth, I think a strong interest in how democracy works is ingrained in me. And for all its flaws, I still think democracy is better than authoritarianism. It’s a long-term academic interest of mine rooted in my personal biography and the experiences of my youth.

In my adulthood, climate change and related natural disasters have become grave concerns. I feel that natural disasters have become as urgent as the threats of authoritarianism. And both are man-made problems. Our daily decisions are collectively manufacturing disasters that are hurting the wellbeing of the future generations. I view disasters, COVID being an example, as what William H. Sewell Jr. terms “eventful moments” -- moments where enduring structures are challenged and reconfigured, stable cultural tools are questioned, and human agencies are called for. This kind of moment can also be described using Ann Swidler’s notion of “unsettled times”. While climate change may be a form of “slow violence,” disasters can be seen as empirical windows to observe how people respond to the trends that are slowly destroying the earth’s biodiversity and eco-system. And looking at civic engagement is one of the ways to address the question of “how people respond”.