Friendship, or "amistad" in Spanish, brought more than 20 National Guard medical professionals from throughout the U.S. to Paraguay, but this is more than a cultural exchange. The seasoned practitioners are sharing thousands of hours of clinical experience with Paraguayan medical professionals while also offering care to locals during Exercise Amistad 2026.
The annual training event — which includes rotations in both Paraguay and the Dominican Republic this year — is tailored to the host nation's needs. Guardsmen from Arkansas, Colorado, Iowa, Massachusetts, Rhode Island and Utah are taking part in the exercise in Asunción, Paraguay, June 15-26.
The overall goal is to deliver care while strengthening partnerships and exchanging expertise in real-world conditions.
"It is absolutely incredible to watch a U.S. joint medical operations team come to a country they may have never been to and operate in multiple locations," said Air Force Lt. Col. Peter Mudge, commander of the Arkansas Air National Guard's 188th Medical Group, and mission commander of the Paraguay portion of the exercise. "They are doing all this with teammates and all foreign partners they have never met, with a common goal of providing world-class medical care in whatever situation they are given. They are, plain and simple, amazing."
The guardsmen and their Paraguayan partners are melded into four teams to provide aid at clinics selected by Paraguay's Ministry of Health, each of which sees an average of about 100 patients a day. This year's event focused primarily on optometry and audiology services but also included dental and family care.
"Audiology and optometry definitely impact people's lives," Mudge said. "You can see it on people's faces when they get glasses or hear better than they ever have in their lives. Seeing the brightness on their face is just an incredible experience."
Army Maj. Meghan Hart, a physician assistant assigned to the Massachusetts Army National Guard medical detachment, echoed Mudge's enthusiasm.
"It's a special mission that we have, being able to treat the local community where they're resource-limited, so we're able to bring a little bit of outside support to them," she said. "But we're also able to see our impact almost immediately, and that's the most rewarding thing."
Although providing care in South America was new to many of the team, interacting with patients is what most of them do in their civilian careers.
Serving in the guard allows soldiers like Army Capt. Brad Daniels-Demers to be a nurse practitioner part time with the Massachusetts Army National Guard and work full time in a hospital as a nurse practitioner on the civilian side.
"I think the guard has a particular advantage, because not only do we have our military-trained skill set, but we also have civilian career skills," he said. "So, when we match those things together, not only do we offer a variety of knowledge, but we can offer more to the local community."
For the Massachusetts National Guardsmen, working with Paraguayans is familiar territory. The state has a 25-year partnership with Paraguay through the War Department National Guard State Partnership Program. The program pairs guard elements with partner nations for mutual training and subject matter expert exchanges.
Although the exercise is not an SPP event, it builds on foundations developed through the program and mirrors its focus on exchanging best practices. It also enabled guardsmen to mentor Paraguayan medical students working alongside them in the clinics.
Air Force Lt. Col. Kirk Drennan, an optometrist assigned to the Utah Air National Guard's 151st Medical Group, who is also fluent in Spanish, said the ability to communicate without a translator increased his ability to provide care and also improved his working relationship with his Paraguayan counterpart.
"Hopefully that translates into perpetual care, where they can go on to treat more and more [patients], and we can snowball this into bigger and greater things," he said.
Drennan's snowball effect is already coming to fruition, with the next phase of the exercise scheduled to bring guardsmen to the Dominican Republic later this summer.
Exercise Amistad is just one of many exercises and operations guardsmen participate in globally.
"Our soldiers and airmen gain invaluable experience working alongside trusted partners, sharing expertise, strengthening readiness and building relationships that enhance security," said Air Force Gen. Steve Nordhaus, chief of the National Guard Bureau.