GAROUA, Cameroon -- As the sun begins to peek over the horizon, a 10-person Army medical team from the 212th Combat Support Hospital makes its way through the thick morning fog at Ramstein Air Base, Germany, mostly in silence. Some of the team members boarding the waiting C-130 Hercules aircraft have already been to the African continent, but for most, this is their first real Army mission and their first time going to Africa.

"I'm nervous. A new place, new people, something different -- it always gives me a bit of anxiety," said Army Spc. Kess Houck, an operating room technician with the 212th Combat Support Hospital, taking in her surroundings right after touching down Aug. 5 at the military airstrip here. The team was supporting U.S. Army Africa-led Medical Readiness Training Exercise 17-5, which was held at the Military Hospital of Garoua. This exercise was the fifth and final such exercise in the 2017 series.

Unlike previous iterations this year that U.S. Army Africa facilitated on the African continent, this one allows the team to live on an established contingency location and work in northern Cameroon, outside of the partnered country's capital. The lodging placed the soldiers in a field setting and simulated a deployed environment. For the team, field life is familiar.

"We spend a lot of time in the field, working as a unit and setting up a combat support hospital that is able to perform surgeries in no more than 72 hours," said Army Capt. Charmayne Pope, an operations officer for MEDRETE 17-5 and a company commander for the 212th Combat Support Hospital. "That's the mission of a CSH. We are a tailorable rapidly deployable surgical treatment facility with inpatient capacity."

SETTING UP

Landing on an airstrip, the group took in the difference in terrain and temperature. Escorted off the flight line by members of the local U.S. task force and transported to a green tent with six cots lining each side, each team member methodically chose their personal spaces for the next two weeks. Assessing how to make the tight quarters more functional, some strung up 550 cord, a versatile 7-strand nylon paracord, while others put up "privacy walls' to accommodate the mixed-gender living conditions.

While setting up their lodging is a familiar task for members of this unit, they were not required to set up their own hospital facility in an austere environment. This exercise enabled them to work at a partnered nation's established and alternatively resourced medical facility, shoulder to shoulder with their Cameroonian counterparts.

The U.S. group, ranging in age, gender and professional skill level, was equipped with a full surgical and emergency medical team supported by administrative personnel. The experienced personnel balanced the neophytes and increased the training possibilities available to the team. Each junior professional paired up with senior team members throughout the exercise, and the twosome then partnered with Cameroonian medical staff.

Skilled, but less experienced team members were deliberately chosen to participate because of their potential to positively influence the future of their career field, Pope said.

"We invested in the Army's future. We chose certain people to allow them to continue growing in their field," she added.

ESTABLISHING RELATIONSHIPS

Being the first MEDRETE U.S. Army Africa has facilitated in this region, the team concentrated on establishing professional and personal relationships with their Cameroonian counterparts to set the stage for future collaborations. Throughout the two-week exercise, the team rotated personnel through the different areas of the hospital -- emergency room, operating room, patient wards and clinics -- to offer them a deeper understanding of the processes and an opportunity to interact with all the Cameroonian army medical staff.

The MEDRETE team's junior medic was able to observe a routine surgery the U.S. surgical team and their Cameroonian counterparts performed together. The young soldier entered the operating room wearing borrowed green scrubs and watched as the surgeons and technicians worked together.

"It was my first time in an actual operating room," Army Pfc. Jason Macha said. "Watching our team members partner with the Cameroonian staff was very interesting to watch. I didn't realize how tedious surgery was, and it was an opportunity I was glad to have."

More seasoned members of the team also witnessed things they hadn't seen before. Emergency room physician Army Maj. (Dr.) Warren Johnson, who is 10 years into his career, saw two separate pathologies that he hasn't witnessed before: bilateral kidney stones severe enough to cause renal obstruction and gestational transfer of malaria.

"A mission like this opens eyes," Pope said. "It exposes my medical personnel to different environments, allowing them to see treatment of patients with different techniques, with less equipment, and challenges them to provide the same level of care with less."

The gained knowledge of different treatment processes and exposure to an alternatively resourced environment benefits the American soldiers in their individual medical capacities, said Army Capt. Matthew Veith, a critical care nurse.

"[The exercise] has offered our team the chance to gain knowledge on how our allies and partners do business," he added. "There are some obvious differences and some obvious challenges. … I was honored to be a part of this mission, and working with their team only strengthens the Army medical capabilities and readiness in the future."