Building Trust Through Shared Expertise

Story and photos by Staff Sgt. Elliot Boutin, 157th ARW Public Affairs

A joint New Hampshire National Guard medical team conducted an aeromedical exchange with its state partners in Praia, Cabo Verde, from May 20 to 22.

The exchange was coordinated through the NHNG-Cabo Verde State Partnership Program, the three-day collaboration with the Cabo Verde Armed Forces Medical Unit and personnel from the Ministry of Health focused on en-route patient care, triage, prolonged field care and medical readiness in an archipelagic environment.

The Republic of Cabo Verde consists of a chain of 10 volcanic islands located off the western coast of Africa.

“Being in Cabo Verde to see what barriers exist and talk through them is invaluable,” said Maj. Kimberly Steinhagen, a nurse assigned to the 157 th Medical Group’s Critical Care Air Transport Team. “We have access to different equipment and supplies, so to be able to see and touch what they have and together make a plan on the best way to implement it is essential.”

Steinhagen was one of five airmen and three soldiers who made the roughly 14-hour trip from Boston on commercial aircraft. The exchange included classroom discussion and a hands-on practical using the country’s one C-12 aircraft.

“The most difficult obstacle for any team is time to wheels up with the patient,” Steinhagen said. “Running scenarios to improve the process is helpful to practice to decrease the time of patient movement.”

Participants compared processes, asked questions and discussed how each organization approaches medical readiness within its own mission requirements, geography and available resources.

“Our role is to assist with sharing the procedures that the Army practices in the pre- hospital care continuum,” said Staff Sgt. Zackari Lepicier, a health care noncommissioned officer assigned to the New Hampshire Army National Guard Medical Detachment. “Army medicine focuses heavily on point-of-injury and illness care. We train with great focus on prolonged field care and resource management.”

The airmen, whose aeromedical platform is the KC-46 Pegasus, focused on planning, en-route care and the coordination required to move patients safely by air.

“Air Force personnel offer different perspectives to the guidelines we both share,” Lepicier said. “This diversity of knowledge helps to paint a complete picture of the goals of tactical combat casualty care.”

The engagement gave New Hampshire personnel an opportunity to learn from Cabo Verde’s unique set of patient care challenges. “We learn how we can do the same mission with less and how to maneuver more efficiently,” Steinhagen said.

Maj. Nilson Fernandes, bilateral affairs officer for the NHNG-Cabo Verde state partnership, ensured the learning was mutually beneficial.

“There was open communication, a willingness to share expertise, and confidence in each other’s capabilities,” he said. "That kind of trust is built over years of partnership and is what allows us to operate effectively together.”

NHNG and Cabo Verde established a state partnership in 2022 under a Department of War initiative that pairs state National Guards with a nation’s military, security and disaster response agencies. At the time, it represented the 16th state partnership between the U.S. and African nations.

Much of the fledgling union has focused on aviation operations and medical care. In early 2024, flight paramedics from the 238th Medevac Company taught a workshop on basic first aid to Cabo Verde military and first responders as part of a month-long field exercise. Later that year a leadership team from the Cabo Verde military visited the 157 th Air Refueling Wing in Newington and Army aviation in Concord for a three-day familiarization.

In addition to sharing best practices, the partnership supports broader U.S. government priorities by strengthening relationships with a strategically important transatlantic ally, said Mark Weinberg, chargé d’affaires for the U.S. Embassy in Cabo Verde.

Weinberg held an office call with the NH team, stressing they serve as a visible extension of U.S. policy.

“We don’t care for people from a conference call or a conference room,” Steinhagen said. “There is no AI equivalent to patient care or transport. You gain knowledge from a classroom, but you gain experience from being hands on, working side by side.”