ACCRA, Ghana - Ghanaian and U.S. participated together July 14 in a joint noncommissioned officer-led promotion ceremony at Burma Camp, Accra, Ghana for Staff Sgt. Jennifer Shook, of the U.S. Army National Guard.The ceremony was just one example of the many times the NCOs of both armies have already worked together during the bilateral MEDFLAG 11. Beginning July 11, MEDFLAG 11 is a bilateral exercise between the U.S. and Ghana armed forces through 10 days of collaborative training and sharing of medical expertise, as well as joint humanitarian civic assistance in local communities.“I actually feel very privileged to have gotten promoted here,” said Staff Sgt. Jennifer Shook, a native of Lehighton, Penn., and an intelligence sergeant for the 405th Brigade Support Battalion.Most National Guard are promoted at their unit’s armory or a similar location, and few have the opportunity to be promoted overseas with troops from a partner army in formation.In addition to the promotion, Command Sgt. Maj. Marcus Jackson, the senior enlisted Soldier of the 405th BSB, also presented his challenge coins to three company sergeants major of the Ghanaian army.Warrant Officer 2 Victor Awauah-Boateng, a communications officer and a company sergeant major in the Ghanaian army, was chosen in recognition of his role in an upcoming peacekeeping mission to the country of Côte d'Ivoire.“The way we go about our [ceremonies] is very different,” he said. “I’m very happy to be recognized,” he added.Warrant Officer 2 Antony Kumi, a communications officer from the western region of Ghana, explained what a Ghanaian promotion ceremony entails.Instead of a standing formation, participants remain seated while the newly promoted troops march in alongside their spouses. The troops are toasted, and the commanders also address the spouses during the ceremony.There is a saying that behind every successful man is a good woman, said Kumi.The commanders publicly recognize the support spouses have given to their soldier over the years and commend them for their dedication.Even though there are differences between them, the U.S. and Ghanaian NCO corps are still much the same. Both corps are referred to as the “backbone of the army.”During MEDFLAG, many NCOs have instructed various classes related to the medical field.“They’ve been doing marvelously well,” said Sgt. Richard Acheampong, a nurse at the 37th Military Hospital and a native of Cape Coast, a city in the central region of Ghana. “It’s not easy to control a crowd of people.”The classes are in preparation for several days of joint humanitarian civic assistance. The medical staff of MEDFLAG 11 will hold basic medical, dental and veterinary clinics to treat the local populace.“The Ghanaian Corps are great,” said Jackson, a resident of Chicago, Ill. “Both [the U.S. and Ghana] have differences, but together we’re going to get the job done.”Kumi explained that it’s important for NCOs to be prepared for the future and ready to “take over.”“Old hands will never stay on,” he said. “They [NCOs] should all try to be inquisitive. That’s important as an NCO. Whatever task is given, do it with your heart and mind.”“I look forward to being a mentor and leader to junior , and I look forward to sharing ideas with the Ghanaian NCO corps,” said Shook.A key program in the United States’ efforts to partner with the government of Ghana, MEDFLAG 11 is the latest in a series of exercises involving U.S. military forces and African partner militaries with the aim of establishing and developing military interoperability, regional relationships, synchronization of effort and capacity-building.