Today’s Bloggers’ Round Table gave us the opportunity to interview Adm. Joseph Kernan, Commander, U.S. Naval Forces Southern Command Commander, U.S. 4th Fleet.

The Fourth Fleet was originally created during World War II and assigned mission in the South Atlantic. It was disestablished in 1950. In April 2008 it was reactivated and assigned duties in both the Atlantic and Pacific Oceans and the Caribbean Sea, to include all of Latin America.

Fourth Fleet has no ships. Adm. Kernan is a Navy SEAL. It has responsibilities in two different oceans. This makes for a curious start.

The reality is that Fourth Fleet has as one of its primary tasks the CNO’s direction to build partnerships with friendly nations. To that end, it ran Operation Continuing Promise ’08 this year where both USS Boxer and USS Kearsarge deployed on humanitarian missions in Latin America. Kearsarge came from the Atlantic Fleet and Boxer from the Pacific Fleet and were under Fourth’s control for their missions.

In addition, Fourth Fleet will serve as a training partner for the militaries in the region. Operation Southern Partnership Station will be held in the summer of 2009. It will involve the USS Oak Hill, United States Marines as well as Marines from Argentina, Brazil, Chile, Columbia, Peru and Uruguay. Some of our partner Marines will embark at Mayport, Florida while others will join during the op. Some of the partner nations will also join the command element on board.

Planning at Fourth Fleet includes possible mass migration activities, such as if there were to be another Mariel boat lift. The Fleet is also involved in supporting anti-drug activities and anti-terrorism activities.

Missions such as Continuing Promise are planned to continue indefinitely. The goal is to institutional the Navy’s presence in the region. A recent conference held by the Chief of Naval Operations in Washington with a number of NGO’s involved changing their perceptions of the Navy’s humanitarian assistance role and informing them of the Navy’s capacity to provide a wide variety of support to their work.

Kernan told us that one of the biggest lessons from Continuing Promise for him was the importance of joint / interagency cooperation. This cooperation was vital in the successes achieved during Continuing Promise ’08. He stated that NGO’s are now lining up for inclusion in future Navy humanitarian missions.

One of the most innovative changes to come out of Continuing Promise ’08, according to Adm. Kernan, was a cybermedicine program with a group of doctors in El Salvador. They now have the ability to realtime their surgery to Mayport and obtain advice and consultations with doctors in the United States during their treatment of their patients.

“being involved in this kind of thing and doing this kind of work is what they joined the Navy for”

Boxer is home in San Diego, after successful stops in three Latin American nations. Operation Continuing Promise ’08 was designed to provide medical assistance and education to people in Guatemala, El Salvador and Peru. A contingent of SeaBees were aboard tasked to engage in repair and reconstruction activities at various sites in the host countries. And a load of materials donated by Project Handclasp, books and other supplies, was along to be distributed where needed.

A Bloggers’ Roundtable on June 26 with Navy Capt. Peter Dallman, commander of Amphibious Squadron 5, filled in more of the details. The transcript is here [PDF file].

This was a two month mission, shorter than many that Boxer undertakes. She was staffed with an air detatchment – helicopters, several landing craft, the Naval Construction unit also called SeaBees [ about 60 ], a group [ about 21 ] from the NGO Project Hope, a rotating set of uniformed personnel [ about 15 ]of the US Public Health Service as well as additional military personnel [ about 90 ]. The added military included medical staff, a Marine beach party for landing support and volunteers from several branches of the military.

Materials were bought with some Title 10 funds. About half was purchased in the States with the remainder being bought in the host countries.

The Seabees worked on 8 schools, a church and also two culverts. In the buildings, the work included plumbing, electrical repairs and renovations and some roof repair and replacement.

On the medical side, Captain Dallman reported:

We had 127 total surgeries onboard Boxer, 14,000 total dental procedures, 66 repairs to biomedical equipment in the various clinics and hospitals that we worked at. A lot of this is done by corpsmen that don’t have any parts, no kit, no tool bag, no anything. So I was amazed that they could repair that many.

We saw just under 4,000 optometry patients. We distributed about 3,500 glasses to those patients.

We dispensed nearly 40,000 medications.

We had a veterinarian team, and they saw just under 2,900 animals total. A lot of that was vaccinations and de-worming.

And primary care saw just over 14,000 patients.

So total patients for the 28 mission days was just over 24,000 patients seen. And that results — if you add in the classes, 123 classes, and 18,000 total students for those classes, then that’s a total of 65,000 encounters during the 28 mission days.

Kearsarge will be doing the same sort of mission later in the summer, on the Atlantic side of the continent. Both Boxer and Kearsarge are uniquely qualified to do these types of missions. They can support air operations, landing craft operations and they can carry a significant number of personnel beyond their own crews. They also have a great deal of space to conduct medical procedures and for storage.

These missions are no longer an exception. USNS Mercy is currently in Vietnam having been engaged in an assistance mission in Southeast Asia. The Reagan carrier battle group is providing typhoon relief in the Philippines. The United States Navy with its capabilities and world-wide reach is able to conduct routine and emergency humanitarian assistance operations, saving lives and giving the people of diverse nations a positive view of the United States and its people.

HUACHO, Peru (June 13, 2008) Aviation Maintenance Administrationman 2nd Class Melody Colangeli, assigned to the amphibious assault ship USS Boxer (LHD 4) holds a baby goat while visiting a family goat ranch with a team of Army veterinarians in the Huacho region of Peru during a Continuing Promise (CP) 2008 veterinary civil affairs project. Boxer is deployed supporting the Pacific phase of CP, an equal-partnership mission between the United States, Guatemala, El Salvador and Peru. U.S. Navy photo by Mass Communication Specialist 2nd Class MC2

El Salvador

SONSANATE, El Salvador (May 26, 2008) Lt. Elizabeth Leavitt of the U.S. Public Health Service, embarked aboard the USS Boxer (LHD 4), translates for her colleagues to a Salvadoran man at the Sonsanate landfill during the Pacific phase of Continuing Promise (CP) 2008. U.S. Navy photo by Mass Communication Specialist 2nd Class Brian Gaines

USS Boxer (LHD 4) along with various embarked units and non-governmental organizations (NGO) arrived in Acajutla, May 19 for the second stop of Continuing Promise (CP) 2008.

CP is a collaborative effort between the United States and partner militaries, non-governmental organizations and partner-nation support organizations to build strong partnerships that can be called upon in the event of a regional situation requiring cooperative solutions.

CP’s medical contingent, led by the embarked Fleet Surgical Team (FST) 5, will spend six work days alongside local medical providers at El Salvador’s Miravalle and El Sunza schools providing primary medical care to nearly 6,000 Salvadoran citizens. The team will also spend 10 days at El Salvador’s Sonsonate Regional Hospital performing hospital equipment repairs and holding education and training to hospital staff, while also sharing ideas and experiences on best practices for long-term public health solutions.

While anchored off the coastline, Boxer’s medical facilities will host 10 surgical patients a day across nine days. Surgeries will include cyst and gallbladder removal and minor hernia repair.

United States Navy

SONSONATE, El Salvador (May 19, 2008) Hospitalman Ricardo Perez, Hospital Corpsman 3rd Class Andino Palacio and Emergency Medical Technician Julie Whitis, all assigned to the medical education team embarked aboard the amphibious assault ship USS Boxer (LHD 4) demonstrate cardio pulmonary resuscitation to a group of medical personnel at Sonsonate Regional Hospital during Continuing Promise (CP) 2008. U.S. Army photo by Specialist Brian R. Williams

The Continuing Promise (CP) 2008 medical education team taught basic life support and advanced cardiac life support classes to a group of medical professionals, May 20, at El Salvador’s Sonsonate Regional Hospital.

CP is a humanitarian civic assistance mission teaming American and Salvadoran health care providers and relief capabilities to demonstrate the cooperative partnerships among allies.

The basic life support class included teaching the El Salvadoran medical personnel how to perform basic cardio pulmonary resuscitation (CPR) for adults as well as children.

The advance cardiac life support class was taught mainly to doctors, nurses and hospital workers with more medical expertise because it involves the use of a manual defibrillator.

The team taught a demonstrative class to train the students in the different aspects of advanced cardiac life support. They offered the students hands on-training with life-like mannequins.

“It’s interesting to watch everybody get to do CPR with the mannequins and integrating it with a lot of teaching and instructional tools that we use when we do resuscitation or CPR in a hospital,” said Capt. Luis Orosz, CP 2008 medical contingent commander. “Everybody gets their hands in some of the skills that were taught.”

Partner nations sharing health education through training like this extends the medical care provided by the teams ashore long after Boxer’s Continuing Promise mission leaves El Salvador.

“It’s very important to have knowledge of CPR so that we can help people in an emergency and respond to heal a natural disaster, automobile accident or even an illness,” said Pablo Alberto Cortez Grande, a community family medic.

Most of the students had practicing physician or active nursing levels of experience. They were constantly active in the classes by asking questions and sharing tips during the CPR demonstrations.

“I am very grateful for the classes and the opportunity to learn the most up to date techniques while working side by side with a neighbor and partner nation,” said Cortez. “This is more than an opportunity, it is an honor. We hope this type of work continues. We are very grateful and we would very happily receive any additional training.”

The medical education team consists of medical professionals from Boxer, Project Hope, U.S. Public Health Service and Fleet Surgical Team 5.

United States Navy

ALCAJUTLA, El Salvador (May 19, 2008) Construction Mechanic 2nd Class Roberto Duajardo, Builder 3rd Class Justin Lewis and Steelworker Constructionman William Stimson, dig a hole with an auger to insert posts for new fencing at Canton La Sunza school in El Salvador as part of Continuing Promise (CP) 2008. The three Seabees are assigned to Construction Battalion Maintenance Unit (CBMU) 303, embarked aboard the amphibious assault ship USS Boxer (LHD 4). Army photo by Specialist Brian R. Williams

ACAJUTLA, El Salvador (May 24, 2008) Lt. Cmdr. Phillip B. Creider, Chaplain for the amphibious assault ship USS Boxer (LHD 4), welds sheet metal at the Canton La Sunza school renovation site during Continuing Promise (CP) 2008. U.S. Navy photo by Mass Communication Specialist 2nd Joshua Jarvis

Construction Battalion Maintenance Unit (CBMU) 303, embarked aboard USS Boxer (LHD 4), began renovations at a local school in Alcajutla, May 20, as part of Continuing Promise (CP) 2008.

CP is an equal-partnership mission enabling American and partner-nation civil engineers to share ideas to provide effective infrastructure solutions, while also building on long-term bonds.

The Seabees worked along with the Salvadoran military’s Command of Engineers in a four-day process to begin renovating Canton La Sunza’s school house in Alcajutla.

For most CBMU 303 Seabees, the Continuing Promise mission is the first time working with a partner-nation. However, it is the eigth time for the engineers of El Salvador to be working alongside their American counterparts.

“This is a large community, but we have little space for all the students,” said the school’s principal, Mauricio Torres. “It is a gift from God and a benefit for the children.”

Canton La Sunza is a public school that regularly hosts 400-500 children annually. They currently have 497 students attending, who take classes either in the morning or afternoon in one of seven small classrooms.

The Seabees and partner-nation civil engineers are working together to repair electrical wiring, plumbing, fencing, renovate a kitchen as well as two new sinks and a brand new incinerator to a school that has not been upgraded in 14 years.

“As a principal, I am satisfied. Because of this support, the school will have another face to it; a better face. You won’t see that ugly school that is falling apart,” said Torres. “It will be a new school, and it will captivate the children. They will like coming to school instead of being unmotivated.”

United States Navy

SONSONATE, El Salvador (May 23, 2008) U.S. Public Health Service nurse, Cmdr. Kimberly Elenberg and Army Capt. (Dr.) Karin Potirus, embarked aboard the amphibious assault ship USS Boxer (LHD 4), provide immunizations for two Salvadoran children. U.S. Navy photo by Mass Communication Specialist Seaman Matthew Jackson

ACAJUTLA, El Salvador (May 26, 2008) Hospital Corpsman 2nd Class Linda Grant, embarked aboard the amphibious assault ship USS Boxer (LHD 4), gives a Salvadoran girl a dental exam at the Canton la Sunza school during a Continuing Promise (CP) 2008 community relations project. U.S. Navy photo by Mass Communication Specialist 3rd Class Porter Anderson

ACAJUTLA, El Salvador (May 26, 2008) Lt. Megan Rieman, embarked aboard the amphibious assault ship USS Boxer (LHD 4), gives a Salvadoran girl an eye exam at the Canton la Sunza school during a Continuing Promise (CP) 2008 community relations project. U.S. Navy photo by Mass Communication Specialist 3rd Class Porter Anderson

During the 13-day operation in El Salvador, Boxer’s embarked NGOs and military units worked side-by-side with partner-nation military and civilian professionals to provide medical, dental, optometry and veterinary care along with construction, renovation and small-scale civil engineering projects.

“Our mission was to provide healthcare and construction support,” said the mission commander for CP, Capt. Peter Dallman. “We were able to vastly exceed our goal because of the great support from our Salvadoran hosts.”

Medical specialists from Boxer, Fleet Surgical Team (FST) 5, the U.S. Public Health Service and Project HOPE worked together with Salvadoran medical professionals to conduct nearly 4,000 dental exams and procedures, more than 1,800 optometry exams, 62 surgeries aboard Boxer, provide nearly 8,000 patients primary medical care and filled more than 19,000 prescriptions at several sites in the area.

In addition to treatment, teams also conducted classes on personal and industrial hygiene, the safe preparation of food and water, child development and infant cardio-pulmonary resuscitation.

“The appreciation from the people who were served through the medical and dental selection program was overwhelming,” added Dallman. “There were lots of smiles.”

Seabees assigned to Construction Battalion Maintenance Unit (CBMU) 303 and Navy Mobile Construction Battalion (NMCB) 5 completed projects at three sites including two schools and a main-road repair. The work included major plumbing and electrical upgrages, roof replacement, fence construction, kitchen renovation, replacing doors and windows, painting and landscaping.

United States Navy

Operation Continuing Promise 2008 continues, with the USS Boxer now in Peru. I have more of this series to post but I thought some recent pics would be interesting.

BARRANCA, Peru (June 12, 2008) Tents fill the basketball court of the Guillermo Enrique Billinghurst school in Barranca, Peru where Seabees embarked aboard the amphibious assault ship USS Boxer (LHD 4) have set up a temporary home. Seabees are renovating the school, which is used by more than 1,500 Peruvian students.

HUACHO, Peru (June 11, 2008) Army Capt. Karin Potirus, a veterinarian embarked aboard the amphibious assault ship USS Boxer (LHD 4), examines corn stalks to be used as animal food at a dairy farm during the Pacific phase of Continuing Promise 2008.

HUACHO, Peru (June 11, 2008) Lt. Cmdr. Michael Copeland, embarked aboard the amphibious assault ship USS Boxer (LHD 4), inspects a drinking water reservoir in the City of Sayan in the Huacho region of Peru during Continuing Promise 2008 evaluation of the needs of the community.

HUACHO, Peru (June 12, 2008) Lt. Johnny Cosby, embarked aboard the amphibious assault ship USS Boxer (LHD 4), examines a patient’s eyes at the Huacho Salon Parochial medical site during Continuing Promise 2008.

BARRANCA, Peru (June 12, 2008) Seabees from Construction Battalion Maintenance Unit 303 embarked aboard the amphibious assault ship USS Boxer (LHD 4) install a new roof over the Guillermo Enrique Billinghurst school in Barranca, Peru during Continuing Promise 2008.

HUACHO, Peru (June 12, 2008) Construction Mechanic 3rd Class Harvey Evans, assigned to Construction Battalion Maintenance Unit 303 embarked aboard the amphibious assault ship USS Boxer (LHD 4), cleans windows after performing maintenance at Luis Fabio Xammer Jurado school in Peru during Continuing Promise 2008.