The “beltway buzz” around think tank outfits over recent South China Sea developments is almost palpable. After all, defense analysis related to the Western Pacific has proved to be a potent growth industry. However, a more complete and balanced appreciation of contemporary Chinese foreign policy includes the realization that Beijing’s “new assertiveness” is simultaneously accompanied by an impressive degree of restraint.
When terrorists attacked the PRC embassy in Kyrgyzstan a few weeks back, China did not unleash special forces or drones. When Vietnamese mobs enraged by deployment of a Chinese exploration rig near the Paracels rampaged through the country attacking Chinese (and other Asians mistakenly thought to be Chinese), Beijing refrained from making an assault on Hanoi’s numerous and vulnerable outposts in the disputed maritime zone. When a new, democratic government took power in Myanmar and called into question a range of major Chinese investment projects, Beijing did not respond by sending in an airborne division to secure its interests, but rather sought to use diplomacy to adjust to the new political landscape in Naypyidaw. Most important, China has rather remarkably not resorted to the use of force in a significant way against any other state in more than three decades. Restraint and prudence are admirable qualities in the practice of foreign policy, with a growing cast of American thinkers calling for a greater degree of restraint in US national security policy.
China is actually often criticized for being too restrained – failing to act on the world stage even when it might have the capabilities (military/diplomatic/economic) to make a positive difference. For example, some would say that Afghanistan, a neighbor of China, presents a situation where a major global security challenge could be alleviated by a much stronger Chinese approach. In fact, a discussion has been developing among researchers and strategists in Beijing over the last decade regarding the imperative for China to offer “public goods” [公共产品] to both the regional and larger international system. This edition of Dragon Eye will peek into that discussion and also briefly explore one obvious example of China’s attempt to offer public goods in the maritime domain: Peace Ark, one of the world’s few purpose-built hospital ship.
Among the very first Chinese scholars to highlight the imperative to provide public goods was the Peking University scholar Wang Yizhou (王逸舟) back in 2012. His argumentation was rather innovative in that it seemed to turn many conventional Chinese historical interpretations upside down, suggesting that British hegemony had promoted navigational exploration and market-oriented trade, while the successor US post-war dominance had facilitated the development of many international organizations. If China was going to escape its unflattering image abroad as a “lame colossus,” [跛足巨人] it was going to have to make similarly major contributions to the international community. Since that time, discussion of provisioning public goods has mushroomed in the most important Chinese international relations journals. For example, the important journal of Peking University The Journal of International Studies [国际政治研究] ran a series of articles in mid-2015 on “public goods,” including a paper on “Regional Public Goods and Changes of the East Asian Regional System during the Ming Dynasty.”
For the PLA Navy, the most obvious symbol of its commitment to the Humanitarian Assistance and Disaster Relief (HADR) mission has been the hospital ship, Peace Ark [和平方舟], which entered fleet service in 2008. The roughly 14,000 ton ship is quite unique in that it is one of the only purpose built large hospital ship in the world, since other ships with a similar mission have mostly been converted merchant or passenger ships. With 300 beds and eight operating rooms, the ship represents a formidable mobile hospital capability – though there have been some “teething problems” as discussed below.
In late January 2016, Peace Ark completed a voyage spanning four continents and lasting 142 days. After visits to Malaysia and Australia, the hospital ship crossed the Pacific and transited the Panama Canal, making visits to Barbados and then Venezuela before returning to the Pacific. Nor was this the ship’s first sortie into the Caribbean. Illustrating Beijing’s evident interest in Latin America, Peace Ark additionally made port visits in Peru and Mexico before heading home via San Diego and Hawaii. It is perhaps noteworthy that the US Navy’s hospital ship Comfort was also active in the Caribbean during 2015. According to a trip report in Navy Today [当代海军], Chinese medical personnel aboard Peace Ark treated 17,441 cases and also conducted 59 successful surgeries. As of late summer 2016, Peace Ark arrived in Hawaii (with four other PLAN vessels) to participate once again in RIMPAC exercises.
Several 2015 articles from the Chinese Navy’s Journal of Navy Medicine [海军医学杂志] offer a deeper look into Chinese hospital ship operations. An interesting comparative study published in that journal seeks differences and similarities among four different Peace Ark missions from the 2010-2013 period. Three of those missions involved “friendly port calls” [出访任务] and just one was a genuine disaster relief [救灾任务] mission as the Peace Ark was deployed after Typhoon Haiyan hit the Philippines in late 2013. During the friendly port call missions, similar to the late 2015 voyage described above, the illnesses most frequently encountered were chronic gastritis, high blood pressure, cataracts, and diabetes. Comparing the 2013 port call mission to the 2010 mission, nearly three times as many patient cases were accepted (increasing to 30,086) and some further refinements included a Chinese medicine unit and a larger obstetrics team. A hardly surprising, but nonetheless interesting conclusion of this particular study is that the illnesses encountered in the disaster relief mission are almost entirely different than those seen on the port call visits. The top four diagnoses during the Typhoon Haiyan mission were reported as: skin and soft tissue wounds, infections, fractures, and respiratory infections. It is noteworthy, of course, that the Chinese deployment of Peace Ark to the Haiyan disaster in the Philippines was not without controversy. Critics charged that the mission was too little, too late. Indeed, the relatively low number of cases treated by Peace Ark doctors in the Philippines (2,208) could lend support to this line of critique. One may speculate that the mission was not easy to organize given the tense relations prevailing between Manila and Beijing during that period. Nevertheless, Beijing did gain critical “experience, exploring a model for providing medical relief in humanitarian disasters.”
Another article from the same journal made note of numerous areas that needed improvement on the PLAN hospital ship. Written by personnel that had served on Peace Ark, the piece underlines that the ship’s mission extends “from peacetime to wartime …” and discusses roles, such as “island and reef medical rounds” [岛礁巡诊], in addition to port visits and humanitarian relief operations. Some of the problems with ship-board equipment included, for example, the electrocardiogram machine, as well as the breathing apparatus for administering anesthesia (especially for children). The authors registered concerns about testing and safeguarding blood supplies for “far seas” [远海] requirements. Concerning ship design, the authors criticized the storage of oxygen cylinders as “unsafe … and extremely inconvenient,” and also noted difficulties in controlling temperature fluctuations on board the ship. Reported to have two thousand or so piece of medical equipment, the challenge of maintenance and upkeep in the oceanic environment of “high temperature, high salt, and high humidity” are also emphasized. The authors include a plea for a reformed maintenance organization apparatus to support the PLAN’s hospital ship operations.
Of course, the Peace Ark is not the only PLA Navy ship capable of undertaking humanitarian missions. On the contrary, China’s building of large, advanced amphibious assault ships (e.g. Type 071) provide another ideal platform for HADR missions. For example, that ship can launch large helicopters and air-cushioned craft that are ideal for getting supplies of food, medicine and clean water into remote locations, especially when roads and docks have been destroyed. The PLAN has indeed taken up the humanitarian mission in recent years as when the Chinese Navy carried many foreign nationals (along with Chinese citizens) out of the deteriorating war zone in Yemen last year.
The efforts outlined above, moreover, should be seen in a larger context in which Beijing has made growing efforts in both HADR and international security missions. Chinese “blue helmets” have made the ultimate sacrifice in dangerous and difficult locations, such as Lebanon and Haiti. Two Chinese peacekeeping soldiers were recently killed in South Sudan. The PLA has conducted relief operations in recent years in both Pakistan and also Nepal. Perhaps the most challenging HADR operation undertaken by China’s armed forces in recent years was the deployment to West Africa to meet the unfolding Ebola crisis during 2014. In extremely difficult circumstances, China stepped up and made a major contribution.