China has announced plans to establish three hospitals in Bangladesh, including a 1,000-bed specialized hospital in Nilphamari as a gift, a 500–700-bed facility in South Karnaphuli, Chittagong, and a 100-bed rehabilitation center in Dhamrai, Dhaka, for patients with disabilities. Additionally, a robotic physiotherapy center is planned at Bangabandhu Sheikh Mujib Medical University (BMU) in Dhaka. These initiatives, coupled with China’s “commitment” to execute the long-delayed Teesta River water-management project, signal a deepening of Beijing’s influence in Bangladesh, according to Chinese Ambassador Yao Wen.

China’s commitment to Bangladesh doesn’t obviously have very good intentions as two of the hospitals being built are close to India’s border– Nilphamari and Karnaphuli.

Speaking at a seminar in Dhaka, Ambassador Yao confirmed China’s readiness to take on the Teesta project, one of the largest irrigation initiatives in the region, which also holds significant strategic importance for West Bengal and eastern India. He emphasized that China’s engagement with Bangladesh transcends political regimes, focusing on “serving the interests of the people”. Yao also proposed collaboration with Bangladesh and other nations, including the European Union, to counter what he described as the “crazy” U.S. policies under the Trump administration. Meanwhile the announcement has put Indian security agencies on tenterhooks.

Strategic Implications for India

China’s growing footprint in Bangladesh, particularly through infrastructure projects like the Teesta Barrage and healthcare investments, poses a multifaceted security concern for India:

1. Proximity to the Teesta Project: The placement of a major hospital near the Teesta project site in Nilphamari is particularly alarming. The Teesta River is a critical water resource shared between India and Bangladesh, and any foreign involvement in its management could affect India’s water security and agricultural stability in West Bengal. China’s role in this project could grant it leverage over a vital regional resource, potentially complicating India’s negotiations with Bangladesh on water-sharing agreements. Also the place is hardly 100 Km away from chicken’s neck or the Siliguri corridor.

China’s hospital projects and infrastructure investments are part of its broader Belt and Road Initiative (BRI), aimed at expanding influence in Indian subcontinent. By funding high-visibility projects like a 1,000-bed hospital and the Teesta initiative, China strengthens its soft power and economic ties with Bangladesh, potentially shifting Dhaka’s foreign policy alignment away from India. This is especially concerning given Bangladesh’s strategic location along India’s northeastern border and its proximity to the Siliguri Corridor, a narrow strip connecting mainland India to its northeastern states.

For India, the Teesta project is not merely an irrigation scheme but a cornerstone of regional stability, affecting millions of livelihoods in West Bengal. Any external control or influence over this project could disrupt India’s agricultural planning and exacerbate tensions with Bangladesh over water rights. Moreover, China’s expanding presence in Bangladesh through healthcare and infrastructure projects strengthens Beijing’s strategic foothold in India’s immediate neighborhood, challenging New Delhi’s regional dominance.

The combination of China’s economic investments and its diplomatic overtures, such as framing Sino-Bangla relations as “people-centric” rather than government-specific, suggests a long-term strategy to entrench its influence regardless of political changes in Dhaka. For India, this necessitates a proactive response, including enhanced diplomatic engagement with Bangladesh and accelerated development assistance to counterbalance China’s growing clout.

China’s hospital projects may appear benevolent, their strategic placement and alignment with the Teesta initiative signal a deeper intent to expand influence in a region critical to India’s security. New Delhi must closely monitor these developments and strengthen its partnership with Dhaka to safeguard its interests in this geopolitically sensitive area.