As relations between Tokyo and Beijing appear increasingly in need of major surgery, officials in the far north of Japan are hoping the infant industry of medical tourism can thrive unscathed.
They are quietly confident that a row over disputed islands will have little impact on the growing number of relatively wealthy Chinese visiting Japan for its high-quality treatment, keeping the lifeblood pumping in an industry that analysts say could one day be worth US$7 billion (HK$54 billion) a year.
For a tourism industry that was battered by the tsunami and subsequent nuclear disaster of last year, with visitor numbers down by around a quarter, that might be just what the doctor ordered. Zhang Lan, 30, two translators in tow, said as staff welcomed her to a well-equipped hospital in Asahikawa in Hokkaido: "I came here because Japanese medicine has a very good reputation in China."
Treatments at the Asahikawa hospital range from head-to-toe check-ups, with a focus on cancer screening and neurological diseases, to anti-ageing and cosmetic surgery, including breast enhancements and liposuction.
Getting a clean bill of health was at the top of Zhang's agenda, but she also liked the idea of breathing fresh air in a region known for skiing and nature tourism, a big change from her hometown of Shenyang , an industrial city in northeastern China.
"I'm here this time for a follow-up to the last check-up, as the doctor said I needed careful observation of my stomach," she said of her US$2,400 trip, which took place before the current tensions erupted.
"But I really liked the hot springs, the food and the sea the last time I visited. I'm not interested in big cities such as Tokyo and Osaka, because China has many big cities. Hokkaido is placid and pastoral. The air is fresh and you can relax here."
Of the several hundred thousand foreign tourists who visit Hokkaido annually, the lion's share are from East Asia, with many keen to see the dramatic mountains, extensive pastures and rich woodlands.
That image is a key selling point for Zhang's tour operator, Medical Tourism Japan, which brought 270 Chinese customers to northern Japan last year, a number it hopes will grow.
Company president Katsuya Sakagami said most clients chose Hokkaido because it "has the image of being an 'Asian Switzerland' to the Chinese".
"I was originally selling medical equipment and came to realise the potential of medical tourism for Chinese people."
A long-running dispute over the sovereignty of islands in the East China Sea known as the Senkakus in Japan and the Diaoyus in China is a worry for the industry, said Kayo Uemura, researcher at the Development Bank of Japan. Violent anti-Japanese protests shook a number of Chinese cities last month after Japan nationalised the islands, and airlines linking the two countries reported a fall-off in demand.
Japanese exports to China, its biggest trading partner, tumbled 14.1 per cent that month as a result of the row and the impact of a broader slowdown.
Uemura said: "The territorial row could last longer than most Japanese had expected, so we have to watch how many Chinese tourists will come back to Japan, say, by the start of next year."
Cho Shosho, a senior official and a medical translator at Medical Tourism Japan, said the company had noticed some impact from the row, including cancellations during the long Chinese holiday at the start of October.
"But we think it is a temporary phenomenon," she said.
"Wealthy Chinese are not very hostile to Japan and I think our customers want to come to Japan but are staying away because anti-Japanese sentiment is rising at the moment.
"We are still receiving inquiries from Chinese customers and I think they will come back later, probably after the Chinese leadership change [in mid-November]. It will be like the temporary drop in tourism in Japan after the quake and tsunami disaster last year," Cho said.
Japan's medical tourism sector is a sliver of the wider industry, with just 10,000 visitors annually, Uemura said. She said the potential demand could see those figures soar to more than 400,000, with Russians and Americans among those visiting in a market that could be worth 550 billion yen (HK$54 billion).Topics: Medical Tourism Territorial Dispute Hokkaido Chinese consumers