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Geographically isolated rural communities face compounding structural barriers to formal healthcare, yet their capacity to organize health governance through culturally embedded frameworks remains undertheorized in health communication scholarship. Using the culture-centered approach (CCA) as theoretical framework and analytical lens, this qualitative study examined how the Ogan Malay community of Ulu Ogan, South Sumatra, Indonesia, mobilized cultural practices to sustain health resilience during COVID-19 amid structural marginalization. Through in-depth interviews with 17 informants, we analyzed the dynamic interplay between cultural agency, structural constraints, and geographical isolation. Findings document two indigenous governance frameworks—biye (institutionalized mutual aid) and getage (collective crisis preparedness)—through which the community organized health action without adequate state support. Rather than passively receiving official directives, communities demonstrated sophisticated hybrid governance: selectively adapting formal health protocols through local moral logics, mobilizing ecological health literacy rooted in agrarian embodied knowledge, and developing culturally grounded pandemic responses that formal health systems failed to provide. Critically, traditional and religious leaders were formally listed in governance structures but systematically excluded from substantive authority—constituting what this study theorizes as performative inclusion, a distinct modality of epistemic violence that manufactures the appearance of participatory governance while preserving centralized biomedical control. These findings advance CCA scholarship by reframing subaltern agency as organizational capacity, theorizing hybrid governance as dialectical co-production, and introducing performative inclusion as a new analytic concept for health communication. Implications call for health governance models that move beyond nominal community participation toward genuine redistribution of epistemic authority and decision-making power.
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Rosihan et al. (2026) studied this question.
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