PUERTO PRINCESA, Palawan, Republic of the Philippines -- Though not officially started, Exercise Balikatan 2012 is already doing something different this year than its past 27 iterations. This year, several agencies, including the U.S. Army Pacific partnered together to host a medical symposium in Palawan on April 10 for over 250 medical and veterinary care practitioners.The full day medical symposium brought together public, private and military practitioners for an exchange of knowledge in an effort to enhance access to health care in the villages around Puerto Princesa. To make the symposium a reality, it took the cooperation from all stakeholders, with the U.S. Agency for International Development (USAID) sponsoring the forum, said Philippine Dr. Gloria Balboa, regional director, Center for Health Development, Region IV-B."This [symposium] is a medical outreach activity to the medical personnel of the city [Puerto Princesa] and awareness building for the health workers and community leaders," said Balboa."We are going to leave behind knowledge that is enduring and lasting, rather than just medicine."In years past, Exercise Balikatan, a bilateral exercise between the Armed Forces of the Philippines and the United States military, which is designed to enhance interoperability between the two partners, had medical and veterinary outreach clinics as part of its humanitarian civic assistance projects. These clinics brought services to those that might not otherwise have access to medical and veterinary care. However, these clinics had limitations, said U.S. Navy Capt. David A. Lane, force surgeon, U.S. Marine Corps Pacific."They [outreach clinics] are short in duration, not integrated with the host nation health care system and there's poor ability for us to follow up with patients we see", said Lane. "Many of the conditions are chronic conditions that a short duration visit like that can't really address."This year's change to focus on education is a "knowledge cascade," where there are two efforts, complimenting each other. The medical symposium engages primarily the medical and veterinary professionals. While in the villages, there is an effort to educate the para-medical workers through rural health work training, said Lane.According to Lane, planning and coordination for BK12's medical mission started, as it normally does with medical planners at U.S. Marine Forces Pacific, U.S. Army Pacific and the Armed Forces of the Philippines, along with the Philippine National Police. The medical planners are responsible for all facets of the medical and veterinary outreach clinics to include dental and vision. Unlike years past, the medical planning team invited USAID to participate in planning and shaping the goals of this year's BK12, as USAID has an existing and valuable relationship with the community."The Office of Health of USAID was contacted by Capt. David Lane," said Helen J. Hipolito, project development specialist, Office of Health, USAID. "Since we already work with the Office of Health and there will be medical missions, we decided to help."The Office of Health provided a critical role in making the medical symposium a reality. It did this by coordinating with stakeholders in and around Puerto Princesa. Coordination involved stakeholders at all levels from the Center for Health Development, the regional office of the Department of Health, the Puerto Princesa City Health Office, leaders from the villages around Puerto Princesa, public and private health care providers and many others."Our task really is coordination, because we really are the people in the field who know those who are working in Puerto Princesa, as far as health is concerned," said Hopilto.The medical symposium was a balikatan, meaning "shoulder to shoulder," effort. There were lectures from both Philippine and U.S. medical experts on a variety of topics. After the plenary session, the symposium broke into three different sessions: medical, veterinary and dental.The medical session offered topics from both Philippine and joint U.S. medical practitioners and sanitation experts, including a U.S. Army doctor, dentist and veterinarian from various units around the Pacific Rim. Among the nine topics discussed, Philippine experts presented four topics, U.S. military personnel presented three and non-governmental organizations presented two.The dental breakout session also featured a "balikatan" effort between Philippine and U.S. experts. The Philippine dentists demonstrated a technique to fill a cavity that did not require drilling or anesthetic, something new to their U.S. counterparts. During the veterinary breakout sessions, several topics were covered, including the prevention and identification of rabies, a disease not uncommon within the animal population in Palawan.Among the 252 attendees, 164 were civilians from the Puerto Princesa area and the remainder were Philippine and U.S. military personnel from the medical field.BK12 officially begins on April 16, 2012, although the HCA portion of the exercise started on March 12 with engineering projects, which consisted of building five schools near Puerto Princesa. The construction projects are now over 50 percent complete. The medical and veterinary outreach clinics will offer nine days of services to a variety of locations throughout the island of Palawan. There will also be five training sessions for rural health care workers, each session training more than 50 workers, in an effort to grow medical capacity within the local villages.