KATHMANDU, Nepal-Soldiers, Airmen, Seamen and Marines assigned to U.S. Indo-Pacific Command worked together with more than 300 civilian and military disaster response professionals from 14 countries in Kathmandu for the Nepal Pacific Resilience Disaster Response Exercise and Exchange (DREE) 25-28 Sep. 2018.The civil-military disaster preparedness and response initiative is co-hosted by the Nepali Army, Nepal Ministry of Home Affairs and the United States Army Pacific. The theme for this event was "Unity of Effort IV," this being the fourth iteration of the exercise.During the four-day exercise, participants worked through a disaster scenario in reaction to a mega earthquake that was developed to examine Nepal's legal and regulatory framework, policies, procedures, organizational setup, tactics and response techniques. Also, while working closely together, relationships are built and strengthened between the U.S. and Nepali Army, and other disaster response stakeholders in the region. The multinational, multilateral, joint-exercise consisted of subject matter expert exchanges, table top evaluations, and functional exercises focused on mass casualty simulations, search and rescue operations, camp management, engineer planning, communication planning and disaster response.Lt. Gen. Mamanta Raj Kunwar, Chief of Staff, Nepali Army, was on hand at the closing ceremony, 28 Sep. and remarked on how effective this year's DREE was, "Coordination among various agencies, preparedness to execute responsibilities at different levels effectively, and professionalism and commitment displayed by participants in their respective capacities were highly commendable. This exercise has clearly highlighted the importance of regional and international support, urgency to open lines of communication, requirement of greater aerial assets and an effective mechanism to provide concurrent support to the victims across the region at all times."One of the main aspects of this year's exercise was testing the Tribhuvan International Airport's Disaster Response Plan. During the Table Top Exercise, disaster responders conducted evacuation procedures, search and rescue operations, casualty evacuations, cargo management and pavement repair. TIA is the only international airport in Nepal, and if the facility were to be rendered inoperable during a major quake, it would be difficult to get equipment and aid into the country.While the majority of the planners were working out of tents at the Valley Division Headquarters, medical personnel were busy at the Shree Birendra Hospital practicing mass casualty management as ambulances and helicopters delivered the injured from disaster operations from 13 locations across the city.Maj. Gen. Timothy M. McKeithen, deputy commander for the National Guard, USARPAC, was on hand to review the training and stressed the importance of building relationships early and need for continuous training and preparation."Let us not forget that a natural disaster can strike anytime, anywhere, and any place. Mother nature does not respect borders. This event has done an incredible job deconflicting the synchronization needed to support our nations," said McKeithen. "Multinational response has proven to be the most effective way to save lives when responding to crisis. By sharing our experiences, our expertise, techniques and best practices we all improve our ability to respond quickly and effectively, because ultimately this is about saving lives and minimizing human suffering in areas struck by disasters."This exercise is one of many held every year by USARPAC under the Pacific Resilience umbrella.Pacific Resilience is USARPAC's main platform to engage, partner and prepare in a "whole of government" approach using both the military and civilians to plan and execute events. It utilizes medical, engineering, HA/DR and other related activities to implement, corroborate, and exercise plans, equipment and personnel against a variety of emergency scenarios that continuously impact the Indo-Pacific region. Pacific Resilience is based on sharing best practices and lessons learned across the HA/DR spectrum to enhance all parties' ability to respond and recover from an emergency situation. It is designed to grow and reinforce capacity through Table Top Exercises, Command Post Exercises and Field Training Exercises that simulate reality, identify procedural gaps, and practice techniques required for efficient and collaborative response. It is anchored on HA/DR operations and the integration of all first responder communities. It practices how militaries support civilian authorities during disaster situations, the reception and dissemination of foreign humanitarian assistance and the strategic communication required to successfully execute emergency management plans. It does all of these things in full partnership between civilian and military institutions.Starting in 2019, the exercise will be held annually instead of semi-annually as it had been done. The planning for next year's exercise is scheduled to begin in a few months.