Joint Task Force Bravo, Honduras –
A mass casualty subject matter expert exchange and partner nation capacity building exercise took place as part of Panamax Alpha Phase II, Sept. 6 through Sept. 12, 2025.
In a joint effort, the Ministry of Health, U.S. Embassy, Panama Social Security Fund (CSS), National Aeronaval Service, Panama National Police, and the State Border Service worked together to test their ability to rapidly deploy Panamanian Emergency Medical Team level one capabilities for disaster response in collaboration with the U.S. military- Joint Task Force-Bravo and U.S. Southern Command.
The joint training was used to enhance interoperability of U.S and Panama authorities in the deployment of emergency services and to validate the inclusion of mass casualty events into future Panamax exercises.
“I would consider this our crawl phase,” shared Air Force Lt. Col. John Camacho Ayala, air advisor/international health specialist, U.S. SOUTHCOM Command Surgeon’s Office and lead planner for this collaborative event. “This is our first time working together on something like this, so together we will decide if it’s something we want to incorporate into future iterations of Panamax.”
17 mobile hospital modules, ten of which were donated by U.S. SOUTHCOM through the Humanitarian Assistance Program (HAP) during the pandemic, were set up during the first three days of the exercise which took place behind the Sistema Nacional de Protección Civil (SINAPROC) headquarters.
Set up consisted of 35 people, led by Lic. Brian Avila, paramedic, Panama Social Security Fund (CSS), who described his experience using the mobile hospital modules, “We tested these during the COVID pandemic, helping hospitals respond in the Central provinces and Chiriqui province, to increase the capacity of the CSS. We also supported Costa Rica by sending one of the modules to increase service capacity, where we installed 40 beds for the CSS of Costa Rica.”
Areas of treatment provided by these mobile hospitals can include gynecology, pediatrics, triage, communicable and noncommunicable diseases, Chemical, Biological, Radiological, and Nuclear (CBRN) disasters and a morgue as well as administrative areas dedicated to support and communications.
Dr. Gabriela Romero, emergency medicine, Hospital Irma de Lourdes Tzanetatos, led the medical portion of the exercise and shared her perspective on the benefit of the joint training, “The objectives of these exercises are to show response capacity of the CSS and the Panamanian entities when facing any accidents like chemical spills, epidemics, etc.”
She continued, “It’s important to share and increase knowledge and improve response capacity, as well as improve quality of care for different events.”
Day four could arguably be considered when the fun really started as 20 medical emergency students arrived to start moulage makeup in preparation for the mass casualty execution.
“I’m studying medical emergencies and disaster care…we are currently in a drill where I’m participating as a patient…from this drill I hope to learn how the patients feel because perhaps my role as a paramedic is to treat them but we never get the experience to be in their shoes,” expressed Nicole Pineda, medical student, Universidad Especializada de las Américas, and volunteer.
The teams simulated various scenarios, creating chaotic scenes where ambulances arrived with multiple patients at once, aiming to induce panic similar to a real-world situation. This tested the participants' communication skills and their ability to stay calm under pressure.
“This practical exercise is very important to prepare for emergency or disaster response or also to increase the capacity of the emergency service or caring for mass casualties,” shared Avila, attesting to the importance of the readiness training.
“Practicing with U.S. SOUTHCOM or the U.S. Army helps us to associate and for the U.S. to know the response capabilities of Panama to see how they can support us…and how the equipment donated to us is being adequately used for responding to emergencies, disasters, or for service-related issues by the CSS,” he concluded.
Assisting with the setup and teardown, along with practicing triage using the mobile hospital modules, equipment, supplies, and materials, provided valuable hands-on experience. This ongoing practice ensures that team members are thoroughly trained and well-prepared in the event of a disaster.
“By training side by side with our Panamanian partners building, breaking down, and delivering critical care through a mobile field hospital, we strengthen more than just our capabilities,” said Air Force Maj. Anna Lain, mass casualty exercise officer in charge, Joint Task Force-bravo. “We strengthen trust, resilience, and readiness. Every shared effort makes us faster, stronger and better prepared to face disaster together. Practice today is the promise of a more capable response tomorrow,” she concluded.
Of course, the week would not have been complete without taking a moment to celebrate one another—not just as teammates, but as friends. When Lic Brian Avila reached a personal milestone with his birthday, everyone paused to join in the celebration. We sang “Happy Birthday” in both Spanish and English, shared cake, and enjoyed a moment of connection that reflected the genuine friendships and strong bonds formed throughout the training.