Essays

Medical Team 197 min read

The Quaker aid group in China that the West forgot – Christopher Magoon

When the Friends Ambulance Unit Medical Team 19 – a Quaker-organized aid group – left China, memory of their humanitarian mission was nearly erased. Like many Western aid organisations, they traveled thousands of miles and saved countless lives during the Chinese Civil War. Yet unlike the others, they served Mao Zedong’s Communist forces.

The seven-member pacifist group, called Medical Team 19 or MT19 for short, built mobile hospitals in caves, completely cut off from news of the outside world, often traveling at night to avoid detection. While serving, the volunteers were widely praised by Western powers and the Chinese Communist Party alike. But as post-World War II tensions congealed into the Cold War, there was little room for humanitarian overtures. They were unceremoniously forced out of China, and became a political liability on both sides of the Pacific.

Yan’an in 1947 (the old walled city is to the right)

If any aid group could have bridged the fault lines of the early Cold War, it was MT19. They were a member of the Friends Ambulance Unit (FAU), a Quaker-organized humanitarian aid organisation that practiced extreme nonpartisanship. Their charge was to “live in such a way that you can do away with a cause for war.”  In the aftermath of World War II, the FAU played a major role in China, delivering up to 80% of all medical supplies in a country newly riven by civil war between the Communists and Nationalists.

The seven-member pacifist group built mobile hospitals in caves, often traveling at night to avoid detection”

Until MT19 landed in the Communist base of Yan’an in 1947, the FAU was limited to Nationalist-held areas of China. Up until then, the Chinese Communist Party (CCP) had rebuffed the FAU’s efforts to establish service in areas under control of the People’s Liberation Army (PLA); they preferred to accept aid from international Communist experts such as Dr. Norman Bethune, who had died in 1939 but whose eponymous hospital in Yan’an remained. 

Why was the FAU suddenly able to send MT19 behind Communist lines in early 1947? In short, because it fit the political interests of both the Western and Communist powers. When MT19 landed in Yan’an, they were met by the dregs of the Dixie Mission – a failed American diplomatic endeavor to negotiate an end to the Chinese Civil War. With negotiations stalling, Western leaders wanted to maintain ties and goodwill with the CCP, and began propelling the FAU’s efforts to get behind Communist lines. MT19 even flew to Yan’an on American military planes. The nascent United Nations – which had predominantly been supplying the Nationalists – also wanted to demonstrate neutrality, and supplied MT19 before they embarked for Yan’an.

Zhou Enlai greets members of MT19 on their arrival in Yan’an

On the Communist side, CCP leaders accepted MT19 in a show of characteristic pragmatism.  As the American diplomat John Service described of the CCP’s governing strategy during the Chinese Civil War, “the test of everything was whether it works.” In early 1947, the CCP still had a legitimacy problem. They were seen as ragtag underdogs and wanted to prove they could be a proper governing force. Healthcare in their territories was rudimentary at best. Even at the flagship International Peace Hospital in Yan’an, many of the staff had never seen an IV. Hosting foreign medical exports helped prove to the Chinese people that the CCP was serious about improving their lives – and showed a friendly, familiar face to the international community. A CCP journalist was even assigned to cover the group full time, and MT19 members often found themselves visiting with foreign journalists and dignitaries in Yan’an.

The members of MT19 were, in many ways, a natural fit with the CCP forces. Like the Communists, their fervent ideology had led them to the fringes of society. Many Quaker FAU members had served prison sentences for refusing military service. MT19’s members were also thrifty and industrious: officially considered volunteers, they received a stipend of just $2.50 per month – one hundred times less than the average salary of an American GI at the time. MT19 doctor Douglas Clifford, a New Zealander, reflected on the relative ease of adjusting to the sparse PLA life: “I was young and resilient and brought up in a country where people were used to living outdoors.” Like their hosts, the small group of doctors, nurses, and technicians dressed, ate and lived simply.

Hosting foreign medical exports helped prove to the Chinese people that the CCP was serious about improving their lives”

Mere days after MT19 arrived in Yan’an in March of 1947, the PLA evacuated the city. The Dixie Mission having failed, the CCP expected a Nationalist attack and offered MT19 a chance to fly back to Shanghai. They refused, and fled into the vast expanses of Central China with the CCP. There, they worked behind the lines of the PLA’s guerilla forces for the next year, completely cut off from the outside world, save one mail drop ten months later. 

They began by walking. For over 400 miles, they retreated with the PLA, moving at night to avoid strafing from Nationalist planes, washing their clothes in streams along with the troops. Eventually, they established a mobile hospital in a series of caves on the banks of the Yellow River. Maintaining supplies and hygiene was a constant struggle. The beds were often little more than stone slabs. In the cave that served as the operating room, they hung a sheet above the operating theater to prevent dirt from falling into the surgical field. “We had a delousing campaign and I learned to kill lice by the dozen, searching them out in the seams of bedding and clothing,” wrote MT19 nurse Margaret Stanley.

The First International Peace Hospital in Yan’an, operating out of caves dug into the cliffside

MT19 served both soldiers and civilians, many of whom traveled for days to reach their camp.  These journeys, on top of poor baseline conditions, often accelerated the severity of illness. Dr. Douglas Clifford treated one patient with such severe venereal disease that his urinary outflow was completely blocked. This blockage caused a dangerous buildup and backflow of urine within the body. Dr. Clifford had to emergently stick a needle through the patient’s abdomen into his bladder to give the urine a path to the outside world. The patient endured this procedure without anesthesia. He later died due to complications from the prolonged urinary blockage.

After a few months, patients who initially came by the dozens only trickled in. The new enemy was boredom, and MT19 members began to realize that excitement for their project had cooled. Though they had no way of knowing it, geopolitical forces shook the tenuous humanitarian ground on which they stood. Mere days after they evacuated Yan’an, President Truman announced that American foreign policy would be dedicated to fighting Communism. Though the policy – which became known as the Truman Doctrine – targeted the Soviets, Mao took note. The war was going well for the PLA, and the CCP no longer needed symbolic displays of legitimacy. Mao upped his anti-foreign rhetoric and land reforms. The fault lines of the Cold War were beginning to pull apart, leaving MT19 dangling in the middle.

Inside a ‘cave’ ward, using a villager’s cupboard as an operating table

With little to do, MT19 members left Communist territory when their contracts expired. The group’s work halted with little fanfare. Though their service was legendary, reception of them in both China and the West had been tepid. After 1949, in the newly established People’s Republic of China, only faithful Communists such as Norman Bethune were memorialized. And in the nascent Red Scare in the U.S., Western powers were loathe to highlight aid they had given to Communist forces. 

Seventy years later, Medical Team 19 is finally receiving recognition from the people they served. The Eighth Route Army Museum in Xi’an opened a permanent exhibit on the group in July 2018. For the first time, visitors can learn about the group of Western pacifists who stayed behind when American diplomats and military disengaged from the Communists. China now celebrates the Quakers who traveled hundreds of miles and saved thousands of lives – a last hurrah of nonpartisan humanitarianism at the dawn of the Cold War. ∎

Header and all other images from the Douglas Clifford collection, used with permission.

Christopher Magoon

Currently in residency training for psychiatry at Columbia University, Dr. Christopher Magoon has spent multiple years in China. Most recently, he was on a Fulbright grant studying public health while completing his M.D. from the University of Pennsylvania Perelman School of Medicine. He was a 2018 American Mandarin Society Next Generation China Scholar, and he received a degree in history from Yale University. www.christophermagoon.com; @c_magoon.