Taiwan possesses numerous natural advantages when it comes to providing hot-spring resorts, spas, and medical tourism.

The big positive to living in a land of volcanoes and earthquakes is the plentiful hot springs they produce. In recent years the springs have become a big draw for tourists to Taiwan. After all, what could be better than a relaxing soak, spa, or treatment at a wellness retreat, where mental and physical stresses are literally washed away?

Until a few decades ago, Taiwan’s hot spring resorts were mostly somewhat shabby and catered almost exclusively to local customers. But steady upgrades have brought them from being one of the country’s best-kept secrets to a prominent place on lists of the world’s top hot-spring destinations. The influential media travel brand Matador Network recently chimed in with its assessment of the country’s offerings: “Influenced by nearby Japan, and now some would say they are even surpassing their northern neighbor in quality and variety of baths.”

The Taiwan Tourism Bureau has taken to calling Taiwan a “Hot Spring Kingdom,” and it has compelling reasons for doing so. The island balances on the fault lines where the major Euro-Asian and Philippine continental plates meet. The resultant geothermal activity has resulted in at least 128 hot springs, cold springs, and seabed springs. They produce six varieties of spring water – sodium carbonate, ferrous, sodium hydrogen, sulfur, salt, and hydrogen sulfide – as well as some springs that are mainly mud.

Springs are found all over Taiwan proper (except for Changhua and Yunlin counties) and on some outlying islands too. In recent decades the population’s increased recreational time and disposable income have spurred a burgeoning hot spring based domestic leisure industry that has included the development of a wide variety of vacation spots, children’s fun parks, and hospital hydrotherapy centers.

When the cold weather starts to creep in around October, hot spring festivals are held in many locations, and families will spend a day or a weekend at their favorite resort. A healthful hot-spring cuisine has even emerged, based on fish and fresh vegetables grown nearby. In its publicity materials aimed at international travelers, the Bureau now places considerable emphasis on hot springs as a key component of Taiwan’s culture.

In the private sector, the hospitality industry has also been developing offerings aimed at combining tourism with healthfulness. Planners in the MICE (meetings, incentives, conferences and exhibitions) segment of the market, for example, have come to regard the inclusion of a hot-springs visit as an excellent way to incentivize a business trip or to make an event more memorable. “Hot springs never fail when planning events,” says Kitty Wong, president of both K&A international and the World PCO Alliance. “We often take clients to Beitou hot springs and the museum, sit on tatami mats, and eat dinner. It’s difficult to find an experience like this outside of Japan, but of course it’s much cheaper here.”

She adds that the carbonated cold spring in Yilan County’s Suao – it’s just like bathing in Perrier — is one of just two in the world (the other is in Venice), while the rare hot-mud springs in Tainan’s Guanziling are rich in minerals and chemicals that can be found elsewhere only in Italy and Japan. “We have the highest density of springs in the world, an embarrassment of riches,” says Wong.

Jiaoxi in Yilan County is a personal favorite of mine. While some complain of over commercialization, there are plenty of solid options to explore, such as the swimming pool and hot springs at Senlin Fenglu (森林風呂), also known as the “Forest Bath,” in the Jiaoxi Hot Springs Park complex, and the Japanese-style Smoking Rock Resort in the center of town. Wulai in New Taipei City gets decent reviews and is upgrading, though it recently got rid of the free public-spring area on the riverside. Green Island off the eastern coast has an exceptionally scenic hot spring, while Miaoli County has the internationally recognized King’s Resort and Spa. If resorts aren’t your thing, though, it is fairly easy to find some totally non-commercial hot springs off the beaten track in more natural settings.

During their 1895-1945 occupation of Taiwan, the Japanese were the first to point out to locals that these bothersome leaks of superheated water from the center of the Earth were in fact a treasure, not a curse. Previously, for instance, the Atayal indigenous tribe described the hot water rising out of the banks of the Nanshih River as “poisonous” (ulai) – which is how the hot spring resort of Wulai got its name.

The Taipei district of Beitou was named after a witch from the indigenous Ketagalan tribe who was said to live in the steamy bowels of Thermal Valley. Again, the hot springs were thought to be toxic and of no use. The only commercial activity in the pre-Japanese period was the mining of sulfur by the Dutch and Spanish. This all changed with the Japanese takeover. Just one year after their arrival, the country’s first hot-spring hotel was opened. Soon after, dozens of tea houses and hotels sprouted up and the area became not only a place to soothe away aches and pains, but was also famed for its nakasi singers, geishas and having a good time generally. It became a red-light area under the Japanese military during World War II – a tradition maintained by American soldiers when they arrived.

But after the Japanese left the island and the Kuomintang marched in, the popularity of hot springs faded somewhat. In fact, it wasn’t until 1994 that members of a school outing discovered the deserted Beitou Public Bathhouse. Built in 1913, it was at the time East Asia’s biggest and most lavish hot-spring resort. Following a petition for its conservation, the city government restored the building and it was reopened as the Beitou Hot Springs Museum in 1998.

It’s now a place of pilgrimage for hot-spring enthusiasts and really gives a flavor of how things used to be in Beitou’s “golden age” when Japan’s crown prince visited to sample the waters. One can easily imagine the rickshaws dropping off clients at the outdoor pavilion and customers drinking tea and playing chess on tatami mats in the lobby. The central bathing pool is surrounded by pillars and arched supports, with gorgeous stained-glass windows shedding a multi-hued light.

With interest rekindled, a “Spa Law” was passed in 2003 to regulate the industry, which in turn led to establishment of the Ministry of Education-approved Hot Spring Industry Institute in 2007. The objective was to elevate Taiwan’s hot-spring, spa, and wellness industry to a level where it would have true “destination competitiveness.”

As outlined by Lee Cheng-fei and Brian King from Australia’s Victoria University in a 2008 paper, Taiwan has all the natural advantages for developing the hot-springs tourism sector, including a comfortable year-round climate and scenic areas. However, these natural resources need to be managed properly because they are finite. Government support was also identified as a key element to developing the industry while providing health and safety oversight.

The paper also advocated that Taiwan adopt better management, training, and marketing for the sector.

By and large, the government and private sector have worked together to implement these proposals, and the results have been positive. Hot-spring resort facilities have been improved, while the spa industry has grown in both quantity and quality.

Health-related tourism

Another of Taiwan’s big positives is healthcare, with its comprehensive National Health Insurance system and high-quality and inexpensive medical services. Combining medical care, spas, and hot springs is the Taipei Wellness Clinic and Resort (TWCR). Set up in 2014, it offers medical-tourism packages that combine a holiday with checkups, medical work, beauty treatments, and cultural activities. It brings the first-class hospitality of the Hotel Royal Beitou together with the healthcare expertise of the Taipei Beitou Health Management Hospital. Situated on the second through fifth floors of the hotel, TWCR boasts cutting-edge medical technology, highly qualified doctors, and a service-centered approach. Headed by neurologist Tsai Ching-piao, TWCR is a pilot project supported by Taipei City government. It aims to take advantage of the medical tourism trend, while staying within government rules that medical resources should not be in the hands of purely commercial enterprises.

“Taiwan is best for healthcare, and it’s not just me saying this – it’s CNN, The Economist, and others,” Tsai states. “We are the first such organization to be government-backed for medical tourism in this country. We are the showroom and model. Trust is the key issue, and we provide it.”

Mark Chen, executive assistant to the board at TWCR, notes that Tsai was doctor to the family of former president Chiang Ching-kuo. “If you can take care of the president, you can take care of anyone,” he says. “You are in good hands with Dr Tsai.”

Following a tour of the facilities, including the MRI and CT scanners, spa treatment rooms, and rehabilitation centers, Tsai explains that Taiwan’s competitiveness is based not only on the quality of care, but also price. He suggests that typical treatments cost about half the price in Japan, one-third that of Western countries like the United States and Europe, and a fifth of some private hospitals in China.

Though TWCR is a pilot program, its early success indicates that it is likely to be continued and even replicated, according to Tsai. He notes the potential value to the country’s economy, because healthcare and tourism are two of the world’s fastest-growing industries.

While the medical benefits of balneotherapy, or bathing in mineral springs, may be open to debate, the list of claimed remedies is long. The Taipei Hot Springs Association, for example, recommends hot-spring baths for hypertension, diabetes, chronic skin diseases, and joint pain. Furthermore, hot-spring hydrotherapists swear to the efficacy of water’s natural buoyancy to aid muscle recovery. They are also confident that their batteries of equipment, such as hydro jets and ultra-sonic massages, will leave patients feeling better, however great their aches and pains.

While some people go to hot springs for medical reasons, others just want some pampering, and this is where spas go to work. Hot-spring and spa resorts are sometimes combined, and the move toward improved facilities is often led by foreign brands. For example, the Japanese media group Dafeng took over a property in Beitou from a local company and refurbished it. The renamed Gaia Hotel offers luxury and prices to match, with rooms costing up to NT$60,000 plus a night. Such hotels mainly cater to the affluent visitor or MICE meeting crowd.

In general, no self-respecting four-star hotel will forego providing a spa experience (not necessarily including hot springs) for its guests. The emphasis is on therapeutic treatments and massages, feeling positive and special.

W Hotel’s AWAY Spa, for example, has or example, has established a reputation for being a “wellness destination” that rewards loyal customers, attracts new guests, and broadens the market for the hotel, says Jade Lin, W’s assistant PR manager. “It’s buying a service, paying to make ourselves feel better,” she says. “When we work hard, we feel like we need a treat, especially the younger generation. People love to be pampered.”

Debbie Chen, the assistant manager of Away Spa, says the spa environment of 3D bubble motifs and soothing scents is designed to put the guest at ease before they choose treatments that range from pedicures to facials, massages, and beauty treatments. Athletes can also benefit from specialized ministrations.

“This is an age of machines social media, and reduced personal connections,” Chen says. “Our unique selling point is contact with another person who offers a personalized or customized service that makes them feel special and connected. It’s not something a machine can do.”

Chen says Taiwan is making good strides in the wellness market, pointing to the Tourism Bureau’s promotion of hot-spring festivals and the development of hot-spring and spa destinations. In addition, she says student training courses are producing qualified personnel that will further enhance the market and make Taiwan a wellness destination that can compete with the best in the world.