At a remote military post just outside of Montevideo, Uruguay, a team of military service members, 40 strong, worked to provide urgent medical care to mock casualties strewn throughout an open field. Though its members hail from two different countries and speak different languages, the team works together as one cohesive, proficient unit. Were it not for their different uniforms, one would barely notice they serve two different nations on two different continents. This was the scenario as U.S. and Uruguayan military forces conducted a tactical combat lifesaver course subject matter expert exchange Sept. 15-19 at the Uruguayan army's 14th Airborne Infantry Battalion headquarters in Toledo, Uruguay. Led by U.S. Army South, the course focused on tactical combat casualty care guidance and casualty evacuations under fire. "The training has gone really well this week," said Staff Sgt. Robert Hogeland, the clinical operations noncommissioned officer in charge at Army South's medical directorate. "The camaraderie was established early on. We come from similar backgrounds in the military; we have quite a bit in common with these people and it has been really good." U.S. Army South, the Army service component command for U.S. Southern Command, conducts subject matter expert exchanges and professional development exchanges with partner nation armies throughout its area of responsibility in Central and South America and the Caribbean to strengthen relationships, support theater security cooperation and build partner nation capacity. This particular course started with classroom instruction on vital skills such as checking a casualty for wounds, treating for shock, applying tourniquets, inserting an oropharyngeal airway and administering IVs, and culminated with a mock scenario filled with realistic-looking "casualties" elaborately made up to appear to have serious wounds and injuries. "Passing on medical information is crucial," said Hogeland. "If there's a better way of doing things you need to pass that along; it's your duty to do so." The U.S. team consisted of four non-commissioned officers from Army South's medical directorate and two senior enlisted Navy personnel from the Navy Medicine Training Support Center based at Joint Base San Antonio-Fort Sam Houston, Texas. The Uruguayan contingent was comprised of 34 military personnel representing its army, air force and marine corps. The U.S. medics gained a majority of their real-world experience through multiple combat missions in Afghanistan and Iraq. On the other hand, the Uruguayan military mostly participates in UN Peacekeeping missions, the larger groups in the Democratic Republic of the Congo and Haiti, as well as responding to emergency situations such as natural disasters and airplane crashes within its own nation. "Tragedies happen everywhere, especially natural disasters," said Hogeland. "You'll see the exact same things in peace time that you'd see in war such as penetrating trauma, blunt trauma and stuff like that." "We more commonly use our medical procedures in a peacetime environment," said Uruguayan Air Force Capt. Fabrizio Ruiz, one of 13 members of Uruguay's elite pararescue team. "But you can apply the same procedures that you apply in war time in peace time because they are very similar." Despite the differences in their backgrounds, the transfer of knowledge is vital to their success in saving lives. "This exchange is very productive because (our U.S. counterparts) applied it every day in combat," said Ruiz. "This training benefits us a lot because we can apply it during our UN deployments. Personally, for the air force and for the pararescue men who are here, in our everyday work we can apply all these things to become more efficient at saving lives." Sgt. 1st Class Efrain Perez, the plans and operations training noncommissioned officer in charge at Army South's medical directorate, said he was impressed with the Uruguayan service members and that the U.S. participants gained valuable knowledge throughout the week. "They were very advanced in what they knew and they were very enthused," said Perez. "We'll share what we've learned from them with our Soldiers (back home)." Hogeland reiterated the point and said "it's important that we come here and do these subject matter expert exchanges because training with partner nations makes me more diverse and makes me a better medic. It helps us think outside the box for new ideas." The medics appeared to become more comfortable with their newly-acquired skills as they made their way through the course and assessed the mock casualties. "This training builds confidence," said Hogeland. "We showed them a few things like how to improvise tourniquets, hemorrhage control, splinting, and applying traction on a litter. They grabbed that stuff because they know they're going to have to use that in the future." Ultimately, strengthening relationships with partner nation armies through these types of exchanges will have lasting effects on the peace and stability of the region. "The friendship is important for us because we can stay in contact in the future," said Ruiz. "If I ever have any doubts about any new procedures that come out we can communicate with each other and share information. Because of this friendship we can stay in contact in the future." Working side-by-side, on a personal level is effective in building relationships and strengthening bonds, said Hogeland. "When you're interacting with them we build a bond," said Hogeland. "For example, we were practicing movements of carrying casualties and the physical interaction with them went really well. I carried someone and accidentally fell over and we were all laughing about it. We conducted a competition with those movements later and it was just like training with my Soldiers back home. It's motivating when camaraderie is built." U.S. Army South will continue ongoing execution of SMEEs and PDEs with partner nation armies throughout the AOR. This will ensure the U.S. Army continues to strengthen its relationship with partner nation armies, allowing the opportunity for all attendees to develop knowledge, capabilities and support for lasting security and stability.