A mere 43 steps from the hospital's operating rooms, a small history of the U.S. Army and Chadian partner medical readiness training exercises is kept much like a makeshift museum in the office of an operating room specialist. Photographs, badges, and documents displayed show the unique opportunities and partnership between U.S. Army and Chadian medical personnel.A Chadian officer shares his combined MEDRETE experience with a first time MEDRETE participant during the Medical Training Exercise 18-2 held at the Hopital Militaire D'Instruction over the course of three weeks from April. 6-27.African beats played cadence across the laptop speakers as Dillah Naiwala described Chadian operating room and hospital processes to Maj. Caprice Knight-Johnson, a nurse anesthetist with William Beaumont Army Medical Center, El Paso, Texas. While, Naiwala has participated in many MEDRETE exercises, this is Knight-Johnson's first."Your presence here is helpful," said Naiwala, the surgical operating specialist at Hopital Militaire D'Instruction, speaking about the U.S. Army medical team. "And the patients have also benefited."Knight-Johnson is one of 15 U.S. Army medical professionals participating in MEDRETE 18-2. The training is a combined effort between the Chadian government and U.S. Army Africa and is part of a series of medical readiness training exercises scheduled within various countries in Africa, and serves as an opportunity for the partnered militaries to hone and strengthen their general surgery and trauma skills while reinforcing the partnership between the countries."Comprendre! The lightbulb just came on," said Knight-Johnson, during one point of the half hour dialogue.Sharing their experiences, enabled Knight-Johnson to make a key observation based on a different operational approach involving anesthesia technicians that would prove to enhance the patient flow and to provide stronger understanding between the partnered professionals.Naiwala, a 42-year-old captain in the Chadian military, is a surgical operating specialist who studied in France before becoming responsible for providing practical training for new doctors to the hospital. He is the only person at the hospital capable of filling the position - a job he has held since 2006. It was this job that would ultimately destine his path to intersect with U.S. Army medical personnel.Not only does this year mark the fifth year that the U.S. Army's medical professionals have fostered cooperation with the Chadian military while conducting specific medical tasks during the mutually beneficial MEDRETE exercises, but it also marks Naiwala's fifth year participating in the exercise."He has very good surgery hands," said Knight-Johnson. "Definitely very skilled when working in the operating room."Chadian and U.S. Army personnel conducted more than 150 patient consultations and performed almost three dozen surgeries. These training exercises allow U.S. doctors and nurses to train in an austere environment, to share medical procedures, and to build lasting relationships with Chadian medical professionals."Most of the patients are coming from villages outside N'Djamena," said Naiwala.The operations not only provided life-saving care, but impacted the larger Chadian community by enabling greater access to opportunities for healing and recovery from injuries or illness, said Naiwala.While speaking with U.S. Army personnel present for MEDRETE 18-2, Naiwala proudly shuffled thru photos of previous MEDRETE teams he has worked alongside and the groups of Chadian physicians he has helped to train.Even to this day, he wears a U.S. Army embroidered surgical cap that was given to him during one of the previous exercises. Both being part of the team and participating in all of the Chadian MEDRETEs are things he is equally proud of accomplishing, he said, his smile widening.He said he understands that it takes a team of doctors, nurses, and staff working together and performing their individual roles to bring successful operations.During this year's exercise, Naiwala has already assisted in a wide variety of operations during more than two dozen surgeries, ranging from a partial removal of a thyroid to repairing broken femurs. During MEDRETE 18-2, it is the teamwork and skills of each member that highlight the effectiveness of the partnered operation. But regardless of the surgery, Naiwala can almost always be found side-by-side with physicians and technicians alike in the operating room."We have benefited greatly from working together," said Naiwala.