Semaphore: Chinese Hospital Ships and Soft Power

The Chinese philosopher, Lao Tzu, once said, “Whatever is soft is strong.” Soft power is considered to be a fundamental aspect of an effective foreign policy and has been defined by Joseph Nye as “the ability to achieve desired outcomes through attraction.”^[1] But the concept of soft power is not new. In the 15th century, Zheng He, the renowned navigator, visited the Kenyan coast where he brought Chinese treasures and, in return, the Kenyans gave the Chinese a giraffe for the imperial court. Zheng He’s voyages and the resulting ‘giraffe diplomacy’, as the gesture was referred to in a recent African newspaper, are one of the first examples of the use of soft power.^[2] Soft power has also played an important role in the history of the United States. In December 1907 President Roosevelt sent a US Navy battle fleet on a mission to circumnavigate the globe. The ‘Great White Fleet’, so named due to the white paint used on the ships’ hulls, highlighted the soft power of the United States and provided a staging-off point for modern soft power initiatives.

More recently, at the 17th Communist Party Congress in 2007, Chinese President Hu Jintao spoke of China’s need to increase its soft power. His resolve resulted from China’s divergence from Zheng He’s example centuries ago. With the advent of the modern Chinese state, hard power, “the use of coercion and payment”, had been emphasised over soft power. Soft power is seen as a requirement for China to become a responsible great power. Of soft power and China’s foreign strategy, Yu Xintian said “China wants to become a new dominant power and must learn from the experience of other major powers.”^[3]

Much of this experience in soft power over the past six years has been as a result of the annual United States humanitarian assistance and disaster response (HA/DR) missions to Asia (PACIFIC PARTNERSHIP) and Central and South America (CONTINUING PROMISE). These HA/DR missions are performed by the two mega-hospital ships the USNS Mercy and Comfort. Significantly, in October 2007, HA/DR was listed as one of the core interests of the US Navy in A Cooperative Strategy for 21st Century Sea Power, increasing the already existing importance of hospital ships in soft power missions.

Since the 1980s, China has experienced a radical evolution of its hospital ship program, with much of the development occurring within the past seven years. Before 2000, China only had three hospital ships in its fleet including two medium-sized ships commissioned in the early 1980s the (832 and Nanyi-09 Nankang Class hospital ships); the third is a national defense mobilisation ship (the 82 Shichang), commissioned in 1997, which can serve as a hospital ship if medical modules are positioned onboard. Currently the Chinese have 11 hospital ships. The eight additional hospital ships developed by the People’s Liberation Army Navy (PLAN) since 2000 include a purpose-built hospital ship (the 866 Peace-Ark), a large containerised hospital ship (the 865 Village-River), five small hospital ships/ambulance boats (Beiyi-01, Nanyi-10, Nanyi-11, Dongyi-12 and Dongyi-13) and finally, a small catamaran.^[4]

Commissioned on 22 December 2008 and belonging to the East Sea Fleet, Peace-Ark is considered by the Chinese to be the world’s first purpose-built hospital ship.^[5] The exterior of the ship is painted white and has six red crosses. This is in keeping with the Geneva Convention for the Amelioration of the Condition of the Wounded, Sick, and Shipwrecked Members of Armed Forces at Sea 1949, which stipulates that hospital ships be painted white with red crosses, remove encryption on all communication channels and have no armament. All other Chinese hospital ships likewise either have white hulls, or, in the case of the modularised Shichang and Village-River, grey hulls but the medical modules are painted with the necessary white paint and red crosses.

On 26 December 2004, a powerful tsunami struck Asia and the United States’ response included sending Mercy to the scene of the disaster. It is commonly thought that the inability of the Chinese to send a hospital ship to the disaster zone was the reason they designed and built Peace-Ark. This is simply untrue as it was already under construction as early as May 2004.^[6] Naval ships are built for naval purposes and Peace-Ark is no exception. The primary historical reason for building hospital ships has been to assist combatant ships in wartime by caring for the sick and wounded. Chinese authors give examples of conflicts such as the 1970s skirmishes in the Paracels and the Spratlys, the 1982 Falklands War and a potential conflict in the Taiwan Strait that convinced them of the need to build hospital ships.^[7] Use in a Taiwan Strait scenario or in the South China Sea to help ensure Chinese island claims are the reasons given by Chinese authors for the emergence of Peace-Ark. Village-River, under construction about the same time as Peace-Ark, is also stated to be of value in a Taiwan Strait conflict. Village-River is also said to be a more economical soft power asset as it can be used as a commercial or naval asset and saves the cost of maintaining a purpose-built hospital ship in peacetime.^[8]

The PLAN hospital ship Peace-Ark.

While the 2004 Asian tsunami was not the impetus for the Peace-Ark’s construction, the resulting changes in United States foreign policy over the last few years, putting an emphasis on hospital ship HA/DR missions, likely caused a response by the Chinese in their own foreign policy. In 2005 at the 60th anniversary summit of the United Nations, President Hu advocated a new Chinese idea known as ‘Harmonious World’. Harmonious World is a proposal that calls for multilateralism, mutually beneficial cooperation (mostly economic cooperation) and inclusiveness.^[9] Hospital ship HA/DR missions would most definitely fit into this concept. In fact, prior to the tsunami, US hospital ships had only been used to assist in wartime conflicts such as both World Wars, the 1990-91 Gulf War and 2003 Iraq War. But following the arrival of Mercy to Indonesia’s tsunami-devastated coast, the value of hospital ships in peacetime was displayed to the world. And the Chinese undeniably were watching.

From 31 August to 26 November 2010, China performed a revolutionary soft power mission to five African and Asian countries including Djibouti, Kenya, Tanzania, Seychelles, and Bangladesh. HARMONIOUS MISSION-2010, as it was called was the PLAN’s first international medical diplomacy mission, conducted by Peace-Ark. ‘Medical diplomacy’ as coined by former United States Secretary of Health and Human Services, Tommy Thompson, is the ability for a country to improve its image on the international scene by providing medical care to those in need. Rear Admiral Bao Yuping, Peace-Ark’s Commanding Officer, said the ship visited less-developed nations to help people in desperate need and let the local people ‘know more about China, the Chinese military and Chinese navy’ thereby executing a vital medical diplomacy mission.^[10] However, HARMONIOUS MISSION-2010 exhibits new historical significance in that it is the first time that the Chinese have engaged in naval medical diplomacy with the use of a hospital ship.

Chinese soft power missions like the hospital ship mission to Africa align with President Hu’s ‘New Historic Missions’ and help to expand Chinese influence. These missions increase China’s image as a ‘responsible stakeholder’, a term put forth in 2005 by former Deputy Secretary of State Robert Zoellick to describe the process by which states work to ‘sustain the international system that has enabled [their] success’. The Chinese are also engaging in what is referred to as the ‘diversification of naval missions’. This requires the application of soft power to achieve strategic objectives. The most common strategic objective with regard to the humanitarian assistance mission to Africa of Peace-Ark is the establishment of favourable relations aiming to secure important economic resources.

It is important to note that while these medical diplomacy missions have a critical strategic impact, they are also important operational and tactical achievements. In addition to providing medical care to the local population, Peace-Ark engaged in a high-seas medical service exercise named BLUE SEA ANGEL-2010 in the Gulf of Aden, which took place on 7 October 2010 and was jointly conducted by Peace-Ark, the sixth PLAN escort formation’s destroyer Lanzhou and comprehensive replenishment ship Weishanhu.^[11] Over the 88 day mission, Peace-Ark treated over 15,000 patients and performed over 90 surgeries.^[12]

In a recent article, the Chinese announced a new strategy referred to as ‘subtle power’. Subtle power is designed as a counter to US ‘smart power’. Coined by Joseph Nye, ‘smart power’ is a strategic combination of hard power and soft power. Smart power is a strategy - the use of all of the tools at one’s disposal to achieve a planned goal or objective. Subtle power is defined as “the art of using three minimalist axioms - non-confrontation, non-interference, and readiness for paradigm change - compatible with classical Chinese strategic thinking.” The article goes on to say that subtle power is softer than soft power. Expanding on Lao Tzu’s wisdom, perhaps “whatever is softer is stronger and, just maybe, whatever is softest is strongest.”^[13] We will have to wait and see. But it is evident that the United States’ shift towards a use of smart power concurrently juxtaposed by the introduction of Chinese subtle power will have an effect on the foreign policies of both countries.

Finally, the introduction of hospital ship HA/DR missions has created a unique opportunity for US Navy-PLAN cooperation. As stated in the United States Quadrennial Defense Review “We cannot simply “surge” trust and relationships on demand.”^[14] Trust must be built over time through mutually beneficial cooperation initiatives. In April 2009 during the PLAN’s International Fleet Review, Chief of Naval Operations Admiral Gary Roughead, USN, was invited to tour Peace-Ark. Subsequently, an invitation was extended to the Chinese to observe CONTINUING PROMISE 2009. From 10-16 June 2009, four Chinese military officers and civilians visited Comfort while it was in Colombia. Just as many nations have been participating in counter-piracy missions off of the Gulf of Aden, medical diplomacy missions provide an extraordinary opportunity for multinational cooperation. This opportunity also allows for relationship building so that when a natural disaster occurs and both navies respond, there can be a seamless transition to providing emergent care.

1. ↑ Joseph Nye, ‘The US can Reclaim ‘Smart Power’, Los Angeles Times, 21 January 2009, latimes.com/news/opinion/commentary/la-oe-nye21-2009jan21,0,3381521.story, (2 May 2011).
2. ↑ Liu Guangyuan, ‘Kenya: From Giraffe the Diplomat to ‘Peace-Ark’, Daily Nation, 10 October 2010, allafrica.com/stories/printable/201010110030.html, (15 April 2011).
3. ↑ 俞新天 [YU Xintian], ‘软实力建设与中国对外战略’ [‘Construction of Soft Power and China’s Foreign Strategy’], 国际问题研究 [International Studies], 2008-2, pp. 15-20.
4. ↑ Pictures of the five small hospital ships are available from bbs.i918.cn/viewthread.php?action=printable&tid=1325422, (2 May 2011).
5. ↑ ‘First 10,000-ton Hospital Carrier Delivered to Navy’, People’s Daily Online, 3 November 2008, english.people.com.cn/90001/90776/90786/6526458.html, (19 April 2009).
6. ↑ 陈万军, 吴登峰 [Chen Wanjun and Wu Dengfeng], ‘China Has Established Its Military’s First Maritime Hospital Ship Medical Team’, China Maritime Newspaper: Military Roles Edition, 25 May 2004, coi.gov.cn/oceannews/2004/hyb1310/44.htm, (July 2009).
7. ↑ 舰载武器 [Shipborne Weapons], December 2008, pp. 32-37; 现代武器 [Moderns Weapons], March 2009, pp. 12-15; and 现代舰船 [Modern Ships], October 2007, pp. 10-12.
8. ↑ 刘向宏, 徐丽, 赵卫, 刘文保, 叶春林, 秦士新, [Liu Xianghong, Xu Li, Zhao Wei, Liu Wenbao, Ye Chunlin, and Qin Shixin], ‘关于医院船改装的思考’ [Considerations on the Refitting of Hospital Ships], 中国医学装备 [China Medical Equipment], Vol 5 No 4, April 2008, p. 9.
9. ↑ ‘HU Makes 4-point Proposal for Building Harmonious World’, Xinhua News Agency, 16 September 2005, china.org.cn/english/features/UN/142408.htm, (2 May 2011).
10. ↑ Li Xiaokun, ‘Chinese Hospital Ship Back After Treating Thousands’, China Daily, 27 November 2010, chinadaily.com.cn/cndy/2010-11/27/content_11618117.htm, (29 April 2011).
11. ↑ ‘PLA Navy’s PEACE ARK Conducts High-seas Medical Service Exercise 7 October’, video on CPP20101122048005 Beijing CCTV-7, 8 October 2010.
12. ↑ ‘Hospital Ship Peace Ark Successfully Completes Overseas Mission’, People’s Daily, 15 November 2010, english.peopledaily.com.cn/90001/90776/90882/7200011.html, (29 April 2011).
13. ↑ David Gossett, ‘Smart power vs subtle power’, China Daily, 15 April 2011, europe.chinadaily.com.cn/epaper/2011-04/15/content_12332906.htm, (29 April 2011).
14. ↑ Department of Defense, Quadrennial Defense Review Report, Washington DC, February 2010, p. 63.

Sea Power Centre - Australia

Sea Power Centre - Australia
Department of Defence
Canberra ACT 2600
seapower.centre@defence.gov.au