China’s Belt & Road Initiative (BRI) is known as the project of the century and Sri Lanka is considered as a vital nod of BRI because of its strategic geographical location.However, due to the increase of commercial financing of BRI projects in Sri Lanka, the term ‘Debt Trap Diplomacy’ was capitalized targeting the island state during the last few years.  As the general public has access to the government’s debt portfolio, the term ‘Debt Trap’ is now been argued by numerous renowned academics, yet within the local communities, this narrative is broadly socialized.  Moreover, prominent Sri Lankan think-tanks published a number of research articles after undertaken comprehensive analyses to argue the Chinese debt burden to Sri Lanka and conclude that none of these sources suggest China is ‘Debt-Trapping’ the island. Nonetheless, it’s also one of the most controversial topics in past years globally due to lack of research based on local primary sources of information. Conversely, up to date, there is no definition of what BRI is, the closet interpretation is that it’s a framework to rebuild distant relations among the countries along the ancient Silk Road.  

The word ‘Initiative’ can be interpreted as ‘taking the first step’ or ‘giving it a start’ and by which the flexibility to formulate its interpretation gives all member states to explore in diverse areas by not only being centric to infrastructure development projects but other areas as education, sports, culture, history, environment, health care, etc. In recent years, China has expanded its support for global health, and in January 2017, China and the World Health Organization (WHO) agreed to jointly establish the “Health Silk Road” under the BRI. The Health Silk Road intends to renew ancient links between cultures and people by creating a framework to enhance health spending in areas as research, cooperation, and funding between countries within the BRI. China in August 2017, made public financial commitments towards building a resilient health system at the BRI Forum for Health Cooperation, highlighting “Towards a Health Silk Road” by giving its member states to further cooperate within BRI. They also committed to providing international development assistance for global health; strengthening regional cooperation by establishing joint research centers; providing easy access to medicines for the initiative partners; and improving environmental justice for the betterment of health. Recently, in phone conversations with world leaders, Chinese President Xi Jinping said China is willing to contribute to international cooperation in the fight against the COVID-19 spread and to enhance cooperation under the ‘’Health Silk Road’’  So, as the COVID-19 pandemic slowly coming under control, China has been providing humanitarian assistance in the form of supplies or medical expertise on a bilateral basis, to a number of countries, often delivered directly by local Chinese embassies.

Sri Lanka along the Health Silk Road.

Sri Lanka, officially the Democratic Socialist Republic of Sri Lanka, highlighting its code socialist values as the country provides free health care for all citizens, which has been a national priority for decades.

Over the years, China is not only one of Sri Lanka’s key trading partners and investors but has also been one of the most important donors to Sri Lanka by providing aid and technical assistance which contributed to Sri Lanka’s healthcare improvements.  However, the Sri Lanka – China cooperation in the healthcare sector is less quoted in media yet it remains as a valuable contributor in improving the quality of the Sri Lankan national health service sector. Even though China officially established the “Health Silk Road” in 2017, China’s support in Sri Lankan healthcare can be traced to a few decades back. One of the landmark projects was when China provided a grant to Sri Lankan Government to build a nine-story new wing of the Lady Ridgeway Hospital which was opened in the year 2000.

However, the present fight against COVID-19 pandemic with lack of resources and considerably limited capacity threshold in Sri Lanka, the Sri Lankan government has turned to the international community for aid and technical assistance. As a result, China was one of the countries to step up and coordinate with assistance, the first to respond was the companies that are involved in major projects in Sri Lanka donating a large number of medical supplies such as masks, PPE, and test kits. Among these companies are China Merchants Port Group (CMPort), CHEC Port City Colombo, Metallurgical Corporation of China (MCC), China National Aero-Technology International Engineering Corporation, Sinopec, Huawei, etc. 

Further, on a request made by the Sri Lankan government, China has urgently provided a concessionary loan of US$ 500 million with a term of 10 years, to help Sri Lanka financially and also offered to share its experience in the prevention, control, and treatment of the COVID-19. However, in terms of Chinese funding, Sri Lanka is considered as one of the countries to receive the largest quantity of Chinese aid, in which the healthcare sector receives around $20 million annually. Besides, with the assistance of the Government of China, the Sri Lankan Government has planned to develop the Beruwala Dharga Hospital, Aluthgama Hospital, Sammanthurai Hospital, Eravur, Pottuvil, Karapitiya, Polonnaruwa, Padaviya, Walasmulla, Kalawana, Mahiyanganaya and Rikillagaskada hospitals.

“China is assisting with a grant to build an outpatients’ building at the National Hospital in Colombo, as well as a fully functional National Nephrology Specialist Hospital for kidney disease in Polonnaruwa as a gift given to Sri Lankan People by Chinese People”

In the heart of Colombo, a 37.9-meters-high OPD complex of the Colombo National Hospital is now under construction and is expected to be completed by December 2020. The project is set to function as an outpatient department complex which will include separate emergency and outpatient departments, clinics, medical and technological rooms, logistics and administrative offices, wards, etc. Upon completion, it will become an important landmark and will be capable of treating about 6,000 patients daily.

The other landmark project is the Kidney Hospital in Polonnaruwa, this is initiated as result following a request by former President Sirisena to the Chinese government in 2015. President Maithripala Sirisena and National Committee of the Chinese People’s Consultative Conference (CPPCC) Chairman Yu Zhengsheng jointly laid the foundation stone for this project on 21^st July 2018 and expected to be opened by the end of 2020. The new Chinese funded hospital will consist of a 200 bedded ward complex, OPD with 100 dialysis machines and six modern operation theatres, which will be constructed at a total cost of Rs. 12 billion, equal to nearly $ 80 million. Nonetheless, Polonnaruwa is an ancient capital of Sri Lanka and also known to have one of the world’s first hospitals back in the 11^th century. The ‘Alahana Pirivena’ belongs to the reign of King Parakramabahu I in the Polonnaruwa era which was a part of a wider network of medical practices along the region and the Silk Road played an important role in spreading medical knowledge during these times. 

Besides, sherds of Chinese jars which dates back to Sung dynasty period of China was found in surrounding scattered areas of Polonnaruwa ancient Alahana Pirivena, highlighting the historic links in healthcare between Sri Lanka and China along the Silk Road. Also, some written sources from the 5^th century AD and later centuries testify that acupuncture, great healing art that came from China during ancient times was known in ancient Sri Lanka. This medical practice has been known to ancient monastic hospitals of Sri Lanka and indicates the diffusion of the science between South Asia and China.

“The ancient city of Polonnaruwa which architectures the ‘Alahana Pirivena’as one of the world’s first Hospitals, will soon open the largest Kidney Hospital in South Asia with fully equipped state-of-art laboratory and technology facilities to treat kidney patients in Sri Lanka if not region”

China- Sri Lanka long term Cooperation in Eye Donation 

 Sri Lanka is recognized as a major donor of corneas to the world. It began in 1961 when late Dr.Hudson Sliva founded the Eye Donation Society as a non-profit organization in Sri Lanka. Currently, around 47,015 cornea donations have been made internationally and around 28,150 island-wide. It’s been said that every one in five Sri Lankans have pledged to donate their corneas. One of the major recipients of cornea donations from Sri Lanka is Muslim countries as culturally it’s forbidden to damage the human remains before or after death. 

However, in 2014, the Eye Donation Society exported 2,551 corneas, including 1,000 to China, 850 to Pakistan, 250 to Thailand, and 50 to Japan. Pakistan and Egypt have been major recipients of Sri Lankan corners, along with Malaysia, Nigeria, Sudan, and more.  Over the last few years, annually around 1,500 corneas have been flown to China for transplant and China is the second-largest recipient of cornea donations from Sri Lanka.  The Chinese embassy in Colombo reciprocate cornea donations by Sri Lankan locals to Chinese patients. Moved by the sympathetic act of Sri Lankan people, Chinese medical teams perform all expenses covered annual quota of cataract surgery for Sri Lankans as a gratitude.

These partnerships developed overtime and in 2013, the Sri Lanka International Eye Bank signed an agreement with hospitals in Sichuan Province, southwest China pledging to donate at least 500 corneas to patients in Sichuan each year. Moreover, Shandong Ophthalmology Research Centre has also signed agreements with the International Eye Bank of Sri Lanka, as it looks to ensure that it has a reliable cornea supply from overseas, to help restore the sight of people in the province.

So, is media propagating a wrong narrative?

Developing a regional ‘Health Silk Road’ will not only help countries in need but it can reengage distant cultures, languages by creating people to people relations along the BRI. However, China has become a household name in Sri Lanka due to Chinese substantial investment in the country and the influx of Chinese construction workers, added the “debt-trap” narrative as portrayed by some media. The relations between China and Sri Lanka started back in 415 BC along the Silk Road but now the relationship being quoted globally with the propagated term ‘Debt Trap’ diplomacy. Mainly because China was a frontrunner in funding projects in Sri Lanka which increased by 40 percent since the end of civil war on the island back in 2009. Most of the BRI funded projects such as Katunayake expressway, Southern express way, Hambantota Port, Colombo Port City, Colombo port expansion, and Central expressway were proposed since the opening up of Sri Lankan economy in 1977, if not Post-independence. However, During the Post-civil war, BRI was a good opportunity for the Sri Lankan government to launch projects which were dragging for generations.

So, the unquoted fields of partnerships such as Health Silk Road between Sri Lanka and China could help build a strong Sri Lanka China relationship along the Belt and Road Initiative. 

End.