So much so that in the Pacific region major powers are increasingly flexing their humanitarian muscles by sending hospital ships and similar aid missions to the region.
China’s 10,000-ton medical ship, the Peace Ark, has cut a broad arc through the Pacific, stopping off in Papua New Guinea, Vanuatu and Fiji and Tonga.
The raw numbers alone are impressive. According to Chinese state media, the ship has 300 beds, eight operating theatres, and can conduct 60 surgeries in a day.
The Peace Ark said it has so far provided free medical treatment to more than 4,000 people in PNG’s capital Port Moresby, 4,500 people in Vanuatu, 6,000 in Fiji and more than 5,500 patients in Tonga.
In smaller nations with strained health care systems, that is a significant figure.
And both the tempo and scale of these humanitarian missions are increasing as strategic competition heats up in the Pacific.
The quest for Pacific influence
China is not the only nation using its navy as a public diplomacy tool.
Last week the Indian frigate INS Sahyadri stopped off in Fiji’s capital Suva, offering free medical screenings to hundreds of people in a public park.
The Sahyadri isn’t a hospital ship like the Peace Ark and its medical outreach is much more modest.
But the message being conveyed is the same — India, like China, is a capable and generous power, with both the capacity and the goodwill to help smaller nations which sometimes struggle to deliver basic services.
The Charge d’Affaires of the Chinese embassy in Fiji, Yang Zhaohui, told local reporters that the Peace Ark was a powerful symbol.
“Serving as a peace messenger, the Peace Ark embodies China’s new security concept with peace, development and cooperation,” he said.
How about Australia?
Canberra doesn’t have the resources to match Beijing, but our doctors and nurses have been working on the US Nursing Ships Mercy and Brunswick, which have offered free healthcare to a host of Pacific Island and South-East Asian nations this year.
Australian medical experts on some of our largest naval vessels have also conducted medical workshops in Vanuatu, Fiji, Tonga and Samoa, as well as helping with Australia’s disaster relief efforts across the region.
Humanitarian aid or political stunt?
Hospital ships generate plenty of attention, and both the Peace Ark and the Sahyadri have been greeted by glowing headlines across the Pacific region.
But are their visits invaluable public health interventions — or empty media stunts?
Dr Tess Cain from TNC Pacific consulting said that whenever the Peace Ark has pulled into port it has been greeted by long queues of people who want medical help.
“They are obviously meeting some need because we’ve seen in all of the ports of call there have been thousands of people wanting to take advantage of the services available,” she said.
However there are limits on what these ships can provide.
Doctors on hospital ships can offer useful health checks and fix niggling problems like toothaches and abscesses.
The Peace Ark has also conducted more complex surgeries while in the Pacific, such as fixing eye cataracts.
But the ships are only ever in port for a short period of time, so medical professionals who are only stopping off simply cannot provide the long-term care and follow-up which is needed to deal with chronic disease, particularly lifestyle diseases like diabetes, cirrhosis and hypertension.
“If you talk to people who manage public health budgets, they would say — quite rightly — that these ships are not able to contribute to some of the bigger, long-term issues that these countries are dealing with, like the management of non-communicable diseases,” Dr Cain said.
“These ships are not geared for that.”
Still, that might be changing.
When the Peace Ark departed Port Moresby it left behind a team of 10 Chinese medical specialists.
They’ll spend the next three years working in the capital’s General Hospital.
Dr Cain said that could set a new precedent for hospital ships in the region.
“This is quite a significant investment, and it will be interesting to see if other countries in the region look at that and decide they will also make a request to the Chinese Government as well,” she said.
And if China leads — then other nations might soon follow.