The Daily Defense News

Russia Continues Attacks on Ukraine Civilian Targets

Posted on October 31, 2022 by George McGinn

Two service members stand in a field and fire a shoulder-launched missile.

Russia Continues Attacks on Ukraine Civilian Targets
Oct. 31, 2022 | By Jim Garamone
Russia is continuing its campaign of terror attacks on Ukraine as it targets civilian infrastructure, said senior defense officials.

The Ukrainian military has been able to defend against some of the Russian attacks, but air defense remains a priority. “Damage to the electric grid and water supply are serious concerns directly harming the civilian population,” a senior defense official said.

The United States is working with the Ukrainian military, allies and partners to improve Ukraine’s defenses.

The United States has already provided 1,400 Stinger short-range air defense weapons. Allies and partners have also provided short-range air defense.

The U.S. has committed to sending eight National Advanced Surface-to-Air Missile Systems – NASAMs – to Ukraine. Two of those systems are being sent in the next few weeks with the others following. Ukrainian soldiers are already being trained to use the system, which shoots many different missiles. NASAMs can defend against a wide range of airborne threats.

“We also have committed to a suite of counter, unmanned aerial systems, including the Vampire system and other radar systems,” officials said.

And more is being done. “The U.S. also helped support Slovakia’s donation of an S-300 system earlier in the war,” the official said. “This was incredibly important to protect Ukrainian infrastructure at that point in time, and the U.S. also sourced many spare parts to keep Ukraine’s Soviet-type air defense systems up and running.”

Germany and Spain have recently sent air defense systems to Ukraine. A key to this is integrating all of these systems from many different nations to protect Ukraine, and that remains an on-going effort.

The senior defense official said the latest tranche of security assistance the United States will provide Ukraine includes additional ammunition for High Mobility Artillery Rocket Systems, or HIMARS; 500 rounds of precision-guided 155 millimeter artillery rounds; and more than 1,300 anti-armor systems, including the shoulder-launched multipurpose assault weapon. The package – valued at $275 million – also includes Humvees and satellite communications antennas.

On the ground, the battle continues with Russia’s attack on infrastructure causing widespread power outages. In and around Kharkiv, Ukraine’s second largest city, Ukrainian forces have liberated some additional villages as they continue to press toward the east. Russian forces in this area are focused on reinforcing their defensive lines.

Farther south, Russian forces are attempting to pursue offensive operations. In Kherson, “we continue to see deliberate and calibrated operations by Ukrainian forces as they press Russian forces along the three main axes,” a senior military official said. “We assess that the Russians in this area continue to reinforce their defensive lines, as well.”

U.S. officials said they’re tracking the reports and Russian statements regarding an alleged attack against Russian navy vessels in Sevastopol, a city in Crimea.

DOD Featured Photos

Posted on October 31, 2022 by George McGinn

Abrams Expertise
Army Staff Sgt. Caesar Arreaga shows a Polish soldier the Abrams M1A2 SepV3 main battle tank during … Photo Details >

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Today in DOD: Nov. 1, 2022

Posted on October 31, 2022 by George McGinn

Today in DOD: Nov. 1, 2022 Open Press Events

Secretary of Defense
The secretary is traveling. Read More >

Deputy Secretary of Defense
The deputy secretary has no public or media events on her schedule. Read More >

Chairman, Joint Chiefs of Staff
The chairman has no public or media events on his schedule. Read More >

Vice Chairman, Joint Chiefs of Staff
The vice chairman speaks at 12:15 p.m. EDT at the Naval Submarine League Annual Symposium, Hyatt Regency Crystal City, Arlington, Virginia. Read More >

Additional Open Press Events
Deputy Assistant Secretary of Defense for Nuclear and Countering Weapons of Mass Destruction Policy Richard C. Johnson participates in a virtual and in-person fireside chat on the Nuclear… Read More >

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Contracts For Oct. 31, 2022

Posted on October 31, 2022 by George McGinn

FOR RELEASE AT 5 PM ET

Contracts For Oct. 31, 2022
NAVY

General Electric, Lynn, Massachusetts, is awarded a not-to-exceed $1,085,106,892 indefinite-delivery, performance-based logistics requirements contract for repair, replacement, and program support of 784 F414 engine components in support of F/A-18 aircraft. This contract includes a five-year base with no options. Work will be performed in various continental U.S. contractor locations that cannot be determined at this time (99%), and in Jacksonville, Florida (1%). Work is expected to be completed by October 2027. Working capital (Navy) funds in the amount of $81,383,017 will initially be issued for delivery order N00383-23-F-0DM0 as an undefinitized contract action at time of award, and funds will not expire at the end of the fiscal year. Individual delivery orders will be subsequently funded with appropriate fiscal year appropriations at the time of their issuance. One company was solicited for this non-competitive requirement pursuant to the authority set forth in 10 U.S. Code 2304 (c)(1), with one offer received. Naval Supply Systems Command Weapon Systems Support, Philadelphia, Pennsylvania, is the contracting activity (N00383-23-D-DM01).

Sikorsky Aircraft Corp., a Lockheed Martin Co., Stratford, Connecticut, is awarded a not-to-exceed $280,946,361 firm-fixed-price modification (P00004) to a previously awarded contract (N0001922C0004). This modification exercises an option to procure long lead items in support of full rate production Lot 8, CH-53K aircraft. Work will be performed in Stratford, Connecticut, and is expected to be completed in December 2023. Fiscal 2023 aircraft procurement (Navy) funds in the amount of $230,000,000 and Foreign Military Sales customer funds in the amount of $50,946,361 will be obligated at time of award, none of which will expire at the end of the current fiscal year. The Naval Air Systems Command, Patuxent River, Maryland, is the contracting activity.

KBR Diego Garcia LLC, Houston, Texas, is awarded a $66,497,640 firm-fixed-price modification to exercise Option Five under previously awarded, indefinite-delivery/indefinite-quantity contract N62742-17-D-3600 for base operations support services at U.S. Naval Support Facility Diego Garcia. Award of this option brings the total cumulative contract value to $392,988,652. Work will be performed in Diego Garcia, British Indian Ocean Territory, and is expected to be completed by November 2023. No funds will be obligated at time of award. Fiscal 2023 operation and maintenance (Navy and Air Force); and fiscal 2023 non-appropriated funds in the amount of $21,747,671 for recurring work will be obligated on an individual task order issued during the option period and will expire at the end of the current fiscal year. The Naval Facilities Engineering Systems Command Far East, Yokosuka, Japan, is the contracting activity.

L3 Technologies Inc., Camden, New Jersey, is awarded an $40,965,044 firm-fixed-price, cost-plus-fixed-fee, and cost-plus-award-fee modification to previously awarded contract N00024-22-C-5218 to exercise options for Cooperative Engagement Capability System spares, signal data processors, AN/USG-3B systems, stock point operation and program support, engineering studies and analyses, configuration, obsolescence, and tech data management, and technical data package. Work will be performed in Largo, Florida (48%); Melo Park, California (19%); Lititz, Pennsylvania (17%); and Salt Lake City, Utah (16%), and is expected to be completed by October 2024. Fiscal 2021 aircraft procurement (Navy) funds in the amount of $30,646,110 (80%); fiscal 2023 other procurement (Navy) funds in the amount of $7,182,663 (18%); fiscal 2023 research, development, test and evaluation (Navy) funds in the amount of $159,000 (1%); and fiscal 2023 operations and maintenance (Navy) funds in the amount of $50,000 (1%) will be obligated at time of award, of which funding in the amount of $30,696,110 will expire at the end of the current fiscal year. The Naval Sea Systems Command, Washington, D.C., is the contracting activity.

DCS Corp., Alexandria, Virginia, is awarded a $28,078,107 cost-plus-fixed-fee, cost reimbursable modification (P00026) to a previously awarded, indefinite-delivery/indefinite-quantity contract. This modification extends services, adds hours, and increases the ceiling to provide continued technical support services, to include full systems integration to all Naval Air Warfare Center Weapons Division’s aircraft integrated product teams and their associated aircraft weapons and support systems, to include Foreign Military Sales versions of each aircraft or system. Work will be performed in China Lake, California (87%); Eglin, Florida (7%); Ridgecrest, California (5%); and Point Mugu, California (1%), and is expected to be completed in July 2023. No funds will be obligated at the time of award; funds will be obligated on individual orders as they are issued. The Naval Air Warfare Center Weapons Division, Point Mugu, California, is the contracting activity.

Huntington Ingalls Inc. – Newport News Shipbuilding, Newport News, Virginia, was awarded a $16,611,034 cost-plus-fixed-fee modification to previously awarded contract N00024-21-C-2104 for engineering and technical design effort to support research and development concept formulation for current and future submarine platforms. Work will be performed in Newport News, Virginia, and is expected to be completed by September 2023. Fiscal 2023 research, development, test and engineering (Navy) funding in the amount of $3,175,000 (99%); and fiscal 2022 research, development, test and engineering (Navy) funding in the amount of $43,000 (1%) will be obligated at time of award, of which $43,000 will expire at the end of the current fiscal year. The Naval Sea Systems Command, Washington, D.C. is the contracting activity. (Awarded Oct. 27, 2022)

Sikorsky, A Lockheed Martin Co., Stratford, Connecticut, is awarded a $14,280,171 firm-fixed-price modification (P00001) to an order (N0001921F0434) against a previously issued basic ordering agreement (N0001919G0029). This modification exercises an option to provide supplies or support necessary for efforts associated with the CH-53K Production Rate Tooling Procurement 3 for full rate production for the Navy. Work will be performed in Stratford, Connecticut, and is expected to be completed in July 2026. Fiscal 2023 aircraft procurement (Navy) funds in the amount of $14,280,171 will be obligated at the time of award, none of which will expire at the end of the current fiscal year. The Naval Air Systems Command, Patuxent River, Maryland, is the contracting activity.

DCS Corp., Alexandria, Virginia, is awarded a $9,608,036 cost-plus-fixed-fee contract (N0017323C600) for the research, development, and application-oriented activities in the generation, propagation, detection, and use of radiation in the wavelength region between near-ultraviolet and far-infrared wavelengths. The contract does not include options; the cumulative value of this contract to $9,608,036. Work will be performed in Washington, D.C., and is expected to be completed by Oct. 31, 2023. Fiscal 2022 research, development, test, and evaluation (Navy) in the amount of $200,000 will be obligated at time of award and will not expire at the end of the current fiscal year. This contract was not competitively procured per Defense Federal Acquisition Regulation 6.302-1 — only one responsible source and no other supplies or services will satisfy agency requirements. The U.S. Naval Research Laboratory, Washington, D.C., is the contracting activity (N0017323C6000).

Beacon Training Services Inc.,* Richardson, Texas (N39430-23-A-0051); Coley & Associates Inc.,* Spring Branch, Texas (N39430-23-A-0052); Elevate USA Inc.,* Ridgeland, South Carolina (N39430-23-A-0053); Gotham Government Services LLC,* Haymarket, Virginia (N39430-23-A-0054); Horizon Strategies LLC,* Winston Salem, North Carolina (N39430-23-A-0055); and Phoenix Technology Solutions LLC,* Columbia, Maryland (N39430-23-A-0056), are awarded a combined-maximum-value $9,500,000 firm-fixed-price blanket purchase agreement under the General Services Administration’s (GSA) multiple award schedule 611430 (professional and management development training) to provide in-person and virtual synchronous/instructor-led non-technical-competency-based training at various Naval Facilities Engineering Systems Command (NAVFAC) activities within and outside the continental U.S. Work will be performed at both continental U.S. and outside the continental US. NAVFAC locations and is expected to be completed by October 2027. The contracts include an option which, if exercised, would extend the period of performance through April 2028. No funding will be obligated at time of award. Task orders will be funded with operation and maintenance (Navy); and supervision, inspection, and overhead (Navy) funds. This contract was competitively procured via GSA’s ebuy website, with seven proposals received. The Naval Facilities Engineering and Expeditionary Warfare Center, Port Hueneme, California, is the contracting activity.

ARMY

Cubic Defense Applications Inc., San Diego, California, was awarded a $35,289,602 firm-fixed-price contract to upgrade, procure, produce, integrate, test, deliver, install, train and sustain a multitude of equipment and training. Bids were solicited via the internet with one received. Work will be performed in San Diego, California; and Tbilisi, Georgia, with an estimated completion date of April 30, 2027. Fiscal 2022 Foreign Military Sales (Georgia) funds in the amount of $35,289,602 were obligated at the time of the award. U.S. Army Contracting Command, Orlando, Florida, is the contracting activity (W900KK-23-C-0001).

Cox Construction Co.,* Vista, California, was awarded an $18,541,000 firm-fixed-price contract to renovate Dorm B1332 at Travis Air Force Base. Bids were solicited via the internet with five received. Work will be performed in Fairfield, California, with an estimated completion date of June 27, 2024. Fiscal 2023 sustainment, restoration and maintenance funds in the amount of $18,541,000 were obligated at the time of the award. U.S. Army Corps of Engineers, Sacramento, California, is the contracting activity (W91238-23-C-0002).

General Dynamics Land Systems Inc., Sterling Heights, Michigan, was awarded a $14,885,334 modification (P00022) to contract W56HZV-22-C-0012 for Abrams Systems technical support. Work will be performed in Sterling Heights, Michigan, with an estimated completion date of Aug. 1, 2024. Fiscal 2010 Foreign Military Sales (Australia); and Army working capital funds in the amount of $14,885,334 were obligated at the time of the award. U.S. Army Contracting Command, Detroit Arsenal, Michigan, is the contracting activity.

Lockheed Martin Missiles & Fire Control, Orlando, Florida, was awarded a $13,090,263 modification (P00004) to contract W58RGZ-22-F-0130 for a refurbishment support effort for the Modernized Target Acquisition Designation Sight/Pilot Night Vision System. Work will be performed in Orlando, Florida, with an estimated completion date of Aug. 31, 2025. Fiscal 2010 Foreign Military Sales (Egypt) funds in the amount of $13,090,263 were obligated at the time of the award. U.S. Army Contracting Command, Redstone Arsenal, Alabama, is the contracting activity.

AIR FORCE

H.V. Collins Co., Inc., Providence, Rhode Island, has been awarded a $24,481,285 firm-fixed-price contract for the Hanscom Air Force Base building 1614 Air Force Life Cycle Management Center acquisition building renovation project. This contract provides for the acquisition of a new design-bid-build contract to complete a “gut” renovation of the northeast end of Building 1614, which includes but is not limited to, the architectural, mechanical, plumbing, electrical, fire protection, fire alarm and various building alarm systems. Work will be performed at Hanscom AFB, Massachusetts, and is expected to be complete by Oct. 30, 2023. This award is the result of a competitive acquisition of which the solicitation was posted to www.sam.gov. This was a 100% small business set-aside utilizing lowest price technically acceptable evaluation procedures with two offers received. Fiscal 2023 operations and maintenance funds in the amount of $22,912,805 will be obligated at the time of the award. Air Force Life Cycle Management Center, Hanscom AFB, Massachusetts, is the contracting activity (FA283523C0003).

BAE Systems Information & Electronic Systems Integration, Merrimack, New Hampshire, has been awarded a $10,068,222 modification (P00016) to contract FA8651-20-C-0043 for research and development seeker integration and testing. Work will be performed in Merrimack, New Hampshire, and is expected to be completed by June 2024. The award of contract FA8651-20-C-0043 was based on broad agency announcement procedures under solicitation FA8651-17-S-0003. Fiscal 2022 research and development funds in the amount of $3,836,101 are being obligated at the time of modification award. The cumulative face value of the contract is $27,491,746. Air Force Research Laboratory, Eglin Air Force Base, Florida, is the contracting activity.

University of Dayton Research Institute, Dayton, Ohio, has been awarded an $8,044,206 cost-plus-fixed-fee contract for research and development. The Proficient Research of Onboard Subsystems Technology contract will leverage commercial, and government developed sensors to research and develop and test and evaluate electro-optical, hyperspectral, radiofrequency, and electronic warfare subsystems. Work will be performed in Dayton, Ohio, and is expected to be completed by Jan. 31, 2028. Fiscal 2022 research and development funds in the total amount of $1,409,926 are being obligated at time of award. Air Force Research Laboratory, Wright-Patterson Air Force Base, Ohio, is the contracting activity (FA8650-23-C-1135).

*Small business

Readout of Secretary of Defense Lloyd J. Austin III’s Call With Polish Deputy Prime Minister and Minister of National Defense Mariusz Błaszczak

Posted on October 31, 2022 by George McGinn

IMMEDIATE RELEASE

Readout of Secretary of Defense Lloyd J. Austin III’s Call With Polish Deputy Prime Minister and Minister of National Defense Mariusz Błaszczak
Oct. 31, 2022
Attributed to Pentagon Press Secretary Air Force Brig. Gen. Pat Ryder:

Secretary of Defense Lloyd J. Austin III spoke with Polish Deputy Prime Minister and Minister of National Defense Mariusz Błaszczak to discuss the current security situation along NATO’s Eastern Flank and joint efforts to enhance Ukraine’s defense capabilities. Secretary Austin praised Poland’s leadership in providing support to Ukraine, and the two leaders agreed to continue to work closely together to enhance Alliance deterrence and defense.

HEART 22 Mission Results in Healthy Teeth, Strong Partnerships

Posted on October 31, 2022 by George McGinn

A dentist performs dental work on a patient.

HEART 22 Mission Results in Healthy Teeth, Strong Partnerships
Oct. 31, 2022 | By C. Todd Lopez
Building partnerships with local dental professionals while promoting healthy smiles was the focus of the recent HEART 22 operation, which concluded last month in Guatemala. 

As part of HEART 22, which stands for Health Engagements Assistance Response Team 2022, soldiers and airmen of Joint Task Force-Bravo, Soto Cano Air Base, Honduras, led U.S. military medical professionals on a mission in Honduras and Guatemala to provide dental, orthopedic and ophthalmology services to citizens in both nations. A big part of that mission was building enduring partnerships and relationships with medical doctors already there. 

About 70 miles west of Guatemala City, the capital of Guatemala, is Quetzaltenango, also called Xela. Air Force Maj. (Dr.) Rondre F. Baluyot, who’s stationed at Minot Air Force Base, North Dakota, and Air Force Master Sgt. Julian Blyden II, who’s stationed at Keesler Air Force Base, Mississippi, helped relieve the burden experienced by dentists there who are overtaxed and who have limited equipment. 

“What we saw here in Xela they’re pretty limited with the of dental procedures that they can do,” Baluyot said. “It’s mainly extractions and no type of fillings or cleanings or anything like that. There was a limitation to the amount of work that we’re able to do.” 

What Baluyot said he saw in Guatemala at the facility in Xela was different from what he saw in Honduras at Hospital Escuela, in the capital city Tegucigalpa. 

“As far as Hospital Escuela in Honduras, they did have a more procedures we were able to do there,” he said. “We were able to do fillings, we were able to work with children; there were a couple of cases that I was able to do prosthetic work. And they even had orthodontics and oral surgery. At Hospital Escuela, we were able to see pediatrics to geriatrics.” 

What was the same in both places, he said, were the struggles with age of equipment and lack of supplies. 

Blyden said the game plan for the two locations was different — but the goal was the same — to treat patients and create professional partnerships. 

“In Honduras, we had the opportunity to come together as a team and come up with a game plan and figure out exactly how the patient loads were looking for the day,” Blyden said. “We spoke with the director at the dental clinic there at Hospital Escuela and figured out exactly how many patients they were seeing that day and assisted as much as possible with them.” 

In Guatemala, he said, it was unknown each day how many patients would need care, as patients arrived at-will for treatment. 

“The patients typically would just show up and we had to diagnose exactly what was going on, and then treat the patient,” he said. 

In both places, both medical professionals said they think they made a difference with the work they did. 

In Guatemala, Baluyot said he was able to work together with one dentist 

“The one dentist that I was able to work with we were able to share ideas,” Baluyot said. “We were able to look at radiographs and … confirm … each . And a lot of times we came up with the same thing. Even though we had a little bit of a language barrier we always had, when we concurred with a diagnosis or a treatment, it was the ‘yes’ and then the nice camaraderie that we actually agreed, even though there was that language barrier there.” 

Compassion is a universal language.”

In Guatemala, Baluyot said, the biggest contribution might have been to relieve the dentist there of the grueling patient load they often experience. 

Further south, in Honduras, Blyden said he saw there had been more opportunity for U.S military dentists to partner with Honduran dentists. 

“I think we have more opportunity to actually train and run different ideas against each other,” Blyden said. “One of our providers, our periodontist, was able to set up a briefing and a training for a lot of the local dentists there. And he was able to provide different surgery procedures that they were able to sit in on and watch. He was able to educate them and show them the reasoning behind certain procedures and how to provide those procedures to the patients.” 

In all, Baluyot said U.S. military dentists saw about 350 or so patients in Guatemala and Honduras, and the work they did there as part of HEART 22 didn’t just benefit the patients. It also benefited the doctors in Honduras and Guatemala and the U.S. military medical professionals, as well. 

Baluyot said in Honduras, the work he did there as part of HEART 22 highlighted the training he got in the Air Force, due to the diverse array of cases he saw there — which is a different mix than what he might see back home. 

“We had a diverse of cases there ranging from pediatrics to fillings, to extractions, to ” he said. “It really made me just dig back into a lot of the knowledge that we are trained for in the Air Force with my program. I think it also strengthened my passion for teaching. I had an opportunity to work with the Honduran oral surgery residents and the pre-doctoral dental students. And I think that was probably one of the highlights, so far. of just my whole dental career was working at the dental school. Being able to teach dental students from a different country, I think that just strengthened my passion for teaching others.” 

He said he looks forward to taking what he learned and the experience from HEART 22 and bringing it back home to teach other dentists at Minot AFB. 

What the HEART 22 experience provided Blyden was a different perspective on dental care and service. 

“I always knew there were different countries that are at different levels than we are,” he said. “But it made me have a better appreciation for what I do, and how taking care of patients is very important. Also, even after the procedures were done, the gratitude the patients felt for us was phenomenal. Even though … there’s a language barrier, we understood how grateful they were. Compassion is a universal language.” 

Spotlight: Helping Hands

The HEART 22 mission kicked off in Tegucigalpa, Honduras, in mid-July and closed out in early September in Guatemala. About 50 U.S. military medical professionals and support personnel from both the Air Force and the Army participated in the operation.

HEART 22 Mission Strengthened Bones, Relationships in Latin America

Posted on October 31, 2022 by George McGinn

Personnel in surgical gowns surround a patient on a hospital bed.

HEART 22 Mission Strengthened Bones, Relationships in Latin America
Oct. 31, 2022 | By C. Todd Lopez
Healthy bones and muscles were just one of the goals of the recently concluded HEART 22 mission, which finished up last month in Guatemala. 

The Health Engagements Assistance Response Team stood up in mid-July in Honduras.  As part of that operation, the soldiers and airmen of Joint Task Force-Bravo out of Soto Cano Air Base, Honduras, led U.S. military medical professionals on a mission in Honduras and Guatemala to provide dental, orthopedic and ophthalmology services to citizens in those nations.  

Air Force Lt. Col. (Dr.) Jacob F. Riis, an orthopedic surgeon stationed at Davis-Monthan Air Force Base, Arizona, was a big part of the HEART 22 mission. 

“We specialize in treatment of conditions of the musculoskeletal system,” he said. “It’s bones, muscles, joints, tendons and ligaments. My primary focus in the military is with sports medicine, which, again, focuses primarily on the shoulders, hips, knees, and ankles.” 

Riis also does trauma work, which he said was the primary focus for him during HEART 22. 

Spotlight: Helping Hands

In Honduras and Guatemala, Riis said his role was a kind of “advise and assist” type of mission. As part of the HEART mission, he said he worked alongside national partners in both Honduras and Guatemala, including medical professionals there, as well as medical residents, on cases that might have already been scheduled. 

But the difference, he said, is that in his work in the United States, the patients he’d see were past emergency care. If they’d experienced trauma, he said, his patients in the U.S. would have already been through the emergency medicine department. 

“The trauma that I see has already been kind of managed at an emergency department, and then, I come along later and do the surgery, which is not an urgent procedure,” he said. “, we’re in bigger hospitals. And, so, the trauma and things that we’re seeing are more like what I would see in a larger hospital in the states. It’s all within our purview, but it’s a little bit higher-level of injury and a little bit more complicated surgery than we would do on a day-to-day basis in my outpatient clinics.” 

Like the ophthalmologists, Riis said his work as part of HEART 22 involved more partnering than humanitarian work. 

“I would characterize it as information exchange,” he said. “There are international standards for management of trauma. And all of the hospitals we worked in were aware of those standards. And so as opposed to maybe an operation where we come in and set up a tent and we bring all of that equipment and we just bring patients in and knock them out, this is more of we’re working alongside them.” 

As part of HEART 22, Riis said he found himself being asked to weigh in on and participate in treatment of trauma patients that he knew either Honduran or Guatemalan orthopedic surgeons could handle, but that they wanted another set of eyes on. 

“I’ve had several physicians, both in Honduras and Guatemala, ask me to help them with more complicated sport medicine cases that they certainly could do themselves, but they’d like to have somebody else who does things a little bit differently walk them through the case,” he said. “Then, we get to obviously experience some of the limitations that they have and, in some ways, support in areas where we can. It was less of a set up a tent and run the place and more of come alongside and just demonstrate that we’re strategic partners with them.” 

What HEART 22 showed Riis was how to operate in an environment that doesn’t have all the things he’d have back in the U.S. That’s something that might come in valuable to him as a military doctor as part of a U.S. combat operation. 

“It’s good exposure to operating in a little bit more austere environment than we’re typically used to,” he said. “In my practice in the states I kind of have what I want, when I want it all the time. We’ve been exposed to a system here that has some limitations. They’re not limitations to prevent you from doing patient care. But they’re limitations that if you weren’t able to adapt, you’d find it difficult to provide consistent care. That perspective has been helpful because if I were tasked to run an austere clinic, then I would have already had the experience I’ve had here to know how to manage with a little bit less than I’m used to.” 

As part of HEART 22, he said, he saw that everybody on the U.S. team was able to adapt to the different environment. 

“I think that’s probably the biggest takeaway,” Riis said. “There are some things that they have to do because they have limitations here that I probably wouldn’t do in the states; not that they’re wrong, it’s just different. But that perspective has probably been the most valuable thing, I would say.” 

Another takeaway from HEART 22 was the importance of working within the system already in place, such as for finding necessary medical supplies. Riis said sometimes there’s a mindset that the U.S. must bring in a lot of U.S.-procured supplies and dump them and expect recipient nations to make use of them. But that isn’t always the case. 

“What we found on this mission — particularly in ortho, and I think also in dental and maybe ophthalmology — is that sometimes using local supply chains and developing relationships with the country’s system, which already exists and already functions really well, that we can leverage that in the future and maybe tailor the missions to make them even more hard-hitting and also more efficient in terms of monetary and fiscal responsibility,” he said. 

What also made an impression on Riis, he said, is that the U.S. military can be more than just a fighting force. 

We don’t have to come in and do things necessarily our way. But we can share and grow together … I think that that’s the most valuable thing that I’ve seen from this type of operation.”
“It’s opened my eyes up to the opportunities and the impact that we can make outside of some of our primary missions,” he said. “I was fortunate to be involved with special operations for several years, and there’s obviously an emphasis in asymmetric warfare — in winning hearts and minds and building up communities and developing relationships — which sometimes is lost in the bigger military picture.” 

As part of HEART 22, he said he was impressed that the Air Force, Army, and other components of the U.S. military were able to come together to support a mission focused on partnering. 

“We’re not here to just dominate your system or change you to doing the things that we always want to do, we’re here to work alongside you within your system and within the setup that you have already in place,” he said. “We don’t have to come in and do things necessarily our way. But we can share and grow together … I think that that’s the most valuable thing that I’ve seen from this type of operation.” 

Relationship building was also a big part of HEART 22, Riis said. And after working in both Honduras and Guatemala, he said he was able to build lasting professional relationships he thinks might come in useful later. 

“We certainly have built relationships and opened up doors for, I think, future opportunities in these places,” Riis said. 

Over lunch one day, Riis said one of the doctors he worked with told him the HEART 22 experience had been better than other similar experiences in the past with other foreign nationals or even U.S. teams. 

“For me, the indicators of success are that … one, they want us to come back. Two, I get text messages and WhatsApp images in follow-up from fellow surgeons,” he said. ” ‘This patient’s doing well … here’s a video of him walking after we did surgery.’ For me, as a physician and surgeon where my primary job is to take somebody who’s unable to do something and then make them potentially able to do something again, the biggest indicator of success is getting that feedback from others, the surgeons that I worked with.” 

In Latin America, HEART 22 Mission Focused on Vision, Partnerships

Posted on October 31, 2022 by George McGinn

In Latin America, HEART 22 Mission Focused on Vision, Partnerships
Oct. 31, 2022 | By C. Todd Lopez
Last month, airmen and soldiers from Joint Task Force-Bravo, Soto Cano Air Base, Honduras, concluded a more-than-month-long operation in Guatemala and Honduras meant to improve not just eyesight, but also the relationships and partnerships between U.S. military medical doctors and Latin American doctors. 

The HEART 22 operation — which stands for Health Engagements Assistance Response Team — began in July in Honduras and ran all the way up to early September, finishing in Guatemala. During the operation, dental, orthopedic and ophthalmologic professionals from around the U.S. military partnered with local medical professionals in both nations to provide care for citizens there, and build enduring partnerships .

This was about skills transfer and partnerships. We’re hoping to establish relationships here, since this is the central Mecca of ophthalmology training for Central America.” 
In Guatemala City, for instance, a handful of uniformed ophthalmologists from around the U.S. military worked together with skilled ophthalmologists and ophthalmology residents from around Latin America to perform critical eye surgeries, including corneal transplants and cataract surgery at the Guatemala National Ophthalmology Unit, also called UNO. 

At the clinic, U.S. military medical professionals weren’t just reducing backlogs of patients or treating patients that might not otherwise get treated. Instead, they were developing and strengthening peer-to-peer relationships between U.S. military and Latin American ophthalmologists, while sharing professional knowledge, said Air Force Lt. Col. (Dr.) Richard Townley, an ophthalmologist who participated in HEART 22 and is stationed in Alaska. 

“This was about skills transfer and partnerships,” Townley said. “We’re hoping to establish relationships here, since this is the central Mecca of ophthalmology training for Central America.” 

The UNO clinic in Guatemala City is well-known by ophthalmologists throughout Latin America and has become a choice location to complete their residency training. This means that U.S. military ophthalmologists participating in HEART 22 had plenty of opportunity to meet some of the residents and form relationships that might be useful later during other operations in Latin America. 

“When we want to go to any remote region, we may be able to entice them to partner with us or they will have contacts in those locations to partner with,” Townley said. 

Having those partnerships is important, Townley said, because when the U.S. military wants to go into a country on a medical mission, advance coordination with local medical providers ensures the most successful mission possible. 

“As Americans, we sometimes see an area of need, and we want to immediately fix it without taking everything into consideration,” Townley said. “On the civilian side, they would sometimes go into an area and see there’s a lot of blind people do a mission there. But if you do it without actually getting to know what resources are there already, if there’s any specialists there already, you can actually do more harm than good.” 

Even when good work is being done, Townley said if medical treatments such as eye surgery are done without working closely with resources already available in a region, it’s possible to undermine the fragile economies in place that might support doctors already there. It’s also important that if U.S. medical doctors go into an area to do work, they ensure those patients will have access to any follow-up care once the U.S. doctors depart. Without making sure that follow-up care is available, then doctors might be doing more harm to those patients than good. 

Also, a benefit of HEART 22 is that when U.S military ophthalmologists work with Latin American counterparts, everybody learns something, Townley said. For U.S. military ophthalmologists, that meant learning how to work with less than what’s expected back in the U.S. while still being successful. That’s a skill that’s important anytime the military goes into combat. 

“It exposes us to situations where we may have to work with less,” he said. “It’s important to know if there other ways of doing things and how do people with resources work in a resource-constrained environment.” 

In a peer-to-peer conflict, Townley said, the U.S. might not have the air superiority necessary for providing medical personnel with the supplies they expect. 

“What I see in this environment, is that it helps us learn other techniques, and how to utilize our resources more fastidiously so that we can potentially reuse stuff, know what we can get away with and what we can’t, and safely,” he said. “I’ve learned new techniques that I wasn’t aware of, that we don’t need in the U.S., because we don’t necessarily have as advanced diseases. But I’ve learned ways of sterilization that are more efficient.” 

In Latin America, Townley said, ophthalmologists are more likely to perform manual small incision cataract surgery, or MSICS. The MSICS procedure is faster and less resource-intensive than the more traditional cataract surgery ophthalmologists in the U.S. are used to. The technique is popular in developing nations because it doesn’t require as much equipment or supplies. In Guatemala and Honduras, he said, American ophthalmologists were able to become more familiar with the technique, which he said is a good thing. 

“In the military, we want to make sure as many ophthalmologists are exposed to this as possible,” he said. “By doing more of these missions we can keep our ophthalmologists more current and ready for deployment.” 

The U.S. medical providers brought a knowledge exchange to their counterparts as well, Townley said. For example, neuro-ophthalmology is not something they had in Guatemala, and Townley said it was something he knew could be useful. 

“We actually brought a neuro-ophthalmologist with us on our team to teach them one-on-one,” he said. 

Spotlight: Helping Hands

The UNO clinic director, María L. Ruíz-Rodríguez, said in the past she knows that U.S. military doctors have come to offer only medical services, as a kind of humanitarian mission. And while she said she, the doctors at her clinic, and other clinic stakeholders appreciate the effort, it’s not how they like to do business. 

During this first iteration of HEART, she said, things were different. She said early in the planning there was a focus on partnering and education rather than on just performing work. That was a welcome change, she said. 

At the clinic, she said, there are residents from all over Latin America, including Peru, Ecuador, Colombia, Mexico, Honduras and El Salvador. 

“The students come here and study … we have had people from everywhere,” she said. “It’s better to come and teach these kids new techniques, because they’re going to go back to their countries and they’re going to replicate it there. So, you’re just not the patients. During a surgery, you are the doctor, the technologist and other people they’re going to work with in the future.” 

Another thing the U.S. military brought to Guatemala through HEART 22 was the promise of a new electronic patient records system for the UNO clinic, which Ruíz-Rodríguez said will change things dramatically. 

The records room at the clinic is stacked high with thousands of paper records. And around the clinic, wherever patients are, their paper records must go with them so doctors can refer to them and update them. 

Implementation of electronic records will save a lot of time for doctors, Ruíz-Rodríguez said, which means they can spend less time filling out paperwork and spend more time seeing patients. She said she expects the clinic will be online with the new system by January. 

Air Force Staff Sgt. Brian C. Russell, an ophthalmic technician stationed at Lackland Air Force Base, Texas, was one of the handful of enlisted medical personnel who participated in HEART 22. He’s been in the Air Force for nine years now and has deployed in his career field to Afghanistan. He’s also completed a humanitarian mission to Panama. 

In Guatemala and Honduras, he said, his role is to assist medical providers with their work, set up equipment and order supplies. 

While both American military and Latin American ophthalmologists learned from each other during HEART 22, Russell said he learned as well, including about operating in an environment that’s not as well-resourced, and also with new techniques. 

“There’s been a whole slew of knowledge exchange between not only our docs, but also the doctors here teaching our doctors different methods of surgery that we don’t normally do back home,” he said. “Back at Lackland we don’t see as many trauma-related eye injuries. I’ve had experience with those before, but here we’re just seeing more. It’s more common here. That helps me as a technician learn how to assist in different procedures that we don’t normally see.” 

In terms of supplies, he said, not everything they’d have at home made it down to Guatemala or Honduras — and that’s a learning experience as well, he said. 

“There is a lot of utilizing the resources that we have and kind of making do with what we have,” he said. 

The HEART 22 mission kicked off in Tegucigalpa, Honduras in mid-July and completed the mission in early September in Guatemala. About 50 U.S. military medical professionals and support personnel form both the Air Force and the Army participated in the operation. 

HEART 22 Strengthens Partnerships in Central America

Posted on October 31, 2022 by George McGinn

A light shines into the eye of a man during an eye exam.

HEART 22 Strengthens Partnerships in Central America
Oct. 31, 2022 | By C. Todd Lopez
Last month, airmen and soldiers from Joint Task Force-Bravo, headquartered at Soto Cano Air Base in Honduras, concluded an operation where they led and supported medical professionals from the U.S. military on a unique dual-nation effort to provide dental, orthopedic and vision care to hundreds of Guatemalans and Hondurans. 

While JTF-B is headquartered in Honduras and regularly engages in medical operations there, the HEART 22 — which stands for Health Engagements Assistance Response Team 2022 – operation was different in at least two ways. First, HEART 22 was much larger than what JTF-B typically engages in. The event lasted longer, involved more participants, and covered two nations. 

I think the message that we send throughout the region is that we are the enduring partner of choice.”

The HEART 22 operation was also unusual in that it wasn’t exclusively a “humanitarian” event, but rather a partnership activity.  

“Joint Task Force-Bravo is involved in a lot of medical operations in Latin America,” said commander, Army Col. Phillip B. Brown Jr. “But HEART 22 was different in that it was longer, it was in two nations, it covered a lot more ground, and it involved a lot more partnering with doctors already in the region than what the JTF normally does.” 

Brown said a recent JTF-B surgical readiness medical mission in Belize was indicative of some of the smaller missions the task force is typically involved in. 

“They were partnered alongside with Belize physicians,” he said. “They were doing procedures, they were working primarily gallbladder surgeries, and hernias, and stuff like that. So, you have six people from JTF-B and they did about 14 procedures during that two-week period.” 

The HEART 22 mission was different in scope, he said. 

“They were in Honduras for approximately four weeks,” he said. “You have anywhere from a medical staff underneath JTF-B from 30 to scale up to 50. So, a lot more U.S. staff involved in it. They’re working in a larger-scale hospital — Hospital Escuela was one of them, which is one of the primary hospitals in Honduras. And then in Guatemala, a similar situation.” 

The number of procedures performed, and the number of patients seen was also greater. Between Honduras and Guatemala U.S. doctors saw about 1,000 patients, said Brown. 

“That’s a pretty big impact,” he said. ” I think for me, it’s a good tie into how the Southcom commander asks us to engage in the region and strengthen partnerships.” 

The biggest indicator of HEART 22’s success, Brown said, is that requests are coming in to do it again, and that the American and Latin American doctors involved have built professional relationships they want to continue to develop.

“What we want to do is essentially do more HEART missions across the region,” Brown said. “When we talk to our partner nations, they want it. It’s valuable to them. So, it’s not the caseload. What makes HEART valuable is the cooperation and the partnership at the provider level and at the staff level.” 

One example of that, he said, is that he witnessed an ophthalmology procedure where an American doctor and a Guatemalan doctor were working together to heal a patient with cataracts. Both professionals were bringing their expertise to the table and sharing with one another, Brown said. 

Another example, Brown said, is that during HEART 22, U.S. military providers conducted medical training classes with the medical residents — which has impact across more than just Guatemala and Honduras. 

“These are medical residents, not just from Guatemala or Honduras, but also from Mexico, also from Nicaragua — these are areas where we definitely have partnerships across the Southcom region,” said Brown. “That’s another sort of outsize impact for HEART.” 

Medical missions like HEART 22 are about more than just providing medical care for civilians in partner nations in Central America. They are also about showing those partner nations that the United States is dedicated to the partnerships it forms, Brown said. 

“I think the message that we send throughout the region is that we are the enduring partner of choice,” Brown said. “From these medical missions that have a very positive impact … it’s a repeatable medical mission, whether it’s a large-scale HEART or some of the smaller-scale things the JTF does, it demonstrates that we’re valued, that we’re trusted, and that we’re the enduring partner of choice throughout the region.” 

Brown is new to JTF-B. So far, he said — especially with what he’s seen on HEART 22 — he’s been impressed with the unit he’s become a part of. 

“I’m extremely proud of them,” he said. “As the new guy coming in, you just don’t really know how your command works and who’s who and who performs at what level. It’s been incredibly impressive at every turn, at every detail. Every component of the HEART mission has been professionally executed. Everywhere they’ve gone they’ve represented the United States very well. They’ve represented the Department of Defense very well and certainly Southcom and Joint Task Force-Bravo.” 