Air Force focuses on future of Indo-Pacific alliances, Agile Combat Employment Published July 15, 2022 By Kelley Schlitt U.S. Air Force International Health Specialists FALLS CHURCH, Va. (AFNS) -- The Cope North 2022 exercise in Guam marked a decade of Indo-Pacific security cooperation between Japan, Australia and the United States, and an opportunity to modernize training for the future. Cope North tests how well medics from the three nations operate during challenging scenarios, and to strengthen partnerships. “Large exercises like Cope North provide an opportunity to prepare for future missions that will require us to work seamlessly with partner nations,” said Lt. Col. Cherielynne Gabriel, Pacific Air Forces International Health Specialist team lead. “We have to practice using each other’s equipment and communicating under difficult circumstances, to be ready to save lives when it counts.” Agile Combat Employment Knowing that future contingencies will be unlike the past, International Health Specialist coordinators focused on integrating Agile Combat Employment concepts in the exercise. ACE doctrine, which was approved in December by Air Force Chief of Staff Gen. CQ Brown, Jr., emphasizes sustaining a competitive advantage in a contested environment. ACE decentralizes command and control in a situation where communication is interrupted, and higher-level support is limited. It empowers Airmen and increases the speed of maneuvering dispersed assets and personnel. Decentralization helps address the challenges of operating across a vast ocean dotted with islands. Agreements with partner nations to share resources aids in developing a network that can continue working together or independently if one or more of its components is disconnected. “To put ACE into practice during the exercise, the United States operated the main hub on Guam while the Royal Australian Air Force operated two spokes on other islands with expeditionary medical support facilities,” said Lt. Col. Nelson Pacheco, international health specialist and Cope North 2022 lead medical planner. “Each of the treatment facilities would be able to continue patient movement operations in the case of losing support from the main hub.” U.S. Air Force Staff Sgt. Jaime Vergara, 36th Operation Medical Readiness Squadron paramedic, and U.S. Air Force Tech. Sgt. Alyssa Simon, 36 OMRS independent duty medical technician, provide medication for a patient aboard a French CN-235 aircraft for a trilateral medical evacuation response training during Cope North 22 at Andersen Air Force Base, Guam, Feb. 9, 2022. Alliances and partnerships are crucial to strategy by providing a durable, asymmetric strategic advantage. (U.S. Air Force photo by Staff Sgt. Aubree Owens) Photo Details / Download Hi-Res U.S. Air Force and Royal Australian Air Force members load a medical patient onto a RAAF aircraft for a trilateral medical evacuation response training during Cope North 22 at Andersen Air Force Base, Guam, Feb. 9, 2022. Alliances and partnerships are crucial to strategy by providing a durable, asymmetric strategic advantage. (U.S. Air Force photo by Staff Sgt. Aubree Owens) Photo Details / Download Hi-Res U.S. Air Force members from the 36th, 673rd and the 374th Medical Group treat medical patients onboard a French CN-235 aircraft for a trilateral medical evacuation response training during Cope North 22 at Andersen Air Force Base, Guam, Feb. 9, 2022. Cope North provides an optimal environment to improve possible opportunities for long-term advancement of our shared interests. (Courtesy photo) Photo Details / Download Hi-Res The tools medics use must also work in disconnected locations. For the first time in Cope North, medics used the Battlefield Assisted Trauma Distributed Observation Kit. BATDOK, developed by the Air Force Research Laboratory’s 711th Human Performance Wing, is a smartphone application that assists medics in collecting vital signs and helps guide them when delivering care. “BATDOK is a powerful tool to support adoption of Agile Combat Employment concepts,” Pacheco said. “Even when communication is down, it still provides medics with access to customized, digitized medical standard of care guidelines and procedures when they need it most. Our partner nations were interested in further adoption and integration of this innovative technology that can enable [medics] to function beyond the capabilities of their primary specialties.” ACE emphasizes developing multi-capable Airmen with multiple qualifications or skillsets. This is one example of how ACE is supporting Joint All Domain Operations, a warfighting blueprint that leverages integration of forces and flexibility. Cross-functional teams enable a more agile force with a smaller footprint to maintain continued operations. Agility and flexibility of Airmen is also important during patient movement where medics must adapt and take advantage of “vehicles of opportunity” to transfer a patient from the point of injury to receive emergency medical treatment. To put this into practice, medics conducted a casualty evacuation on an aircraft not used during Cope North before. “Medics encountered an unfamiliar partner nation aircraft that is not usually dedicated to patient movement. This provided an opportunity to practice casualty evacuation in a real-world type of scenario,” Gabriel said. “Military medics must be flexible and capable enough to collaborate in unusual and unplanned ways.” Cope North’s Future Because of Cope North’s value in executing the combatant command campaign plan, planners are increasing expeditionary medical activities in future iterations by broadening scenarios to expand Critical Care Air Transport interoperability and working with the special forces community to leverage their latest equipment and procedures. In addition, planners aim to expand multinational participation as regional allies and partners transition from observers to participants. “Investing in our partnerships in the Indo-Pacific is essential to implement Agile Combat Employment,” said Col. Susan Moran, Pacific Air Forces command surgeon. “In times of crisis, the United States does not respond alone. Our network of alliances and partnerships remain the backbone of global security. Together we are stronger.” Moran stressed that Cope North is not just an exercise, but a rehearsal. “We value multi-lateral exercises such as Cope North to validate our … team’s readiness. We appreciate the opportunity to learn from and with our partners as we continue to advance our medical capabilities. Together our goal is to deter aggression, maintain stability, and ensure a free and open Indo-Pacific.” Cope North is an annual large-force employment, aerial-combat and humanitarian assistance and disaster relief exercise, designed to improve partner nation cooperation, boosting readiness of the participants to conduct contingency operations together. Australia was added as a participant in 2012, and medical observers from 13 countries attended in 2022.