CAMP O’DONNELL, Philippines - Hawaii National Guard medical professionals completed their fourth annual Tactical Combat Casualty Care (TCCC) exchange with partners from the Armed Forces of the Philippines (AFP) at Camp O’Donnell May 18-30.
The Subject Matter Expert Exchange (SMEE), facilitated by the Department of Defense National Guard Bureau State Partnership Program, helped 85 medical and non-medical personnel develop critical life-saving skills.
For the first time, an AFP instructor corps was qualified through the training to teach follow-up courses, a significant step toward developing a standardized medical training curriculum aligned with U.S. standards.
The training was tailored to support AFP participants at the Peacekeeping Operations Center, which is responsible for preparing personnel for United Nations peacekeeping missions, with a focus on stabilizing volatile regions through the use of military strength.
“This initiative has been greatly enriched by the collaboration between the Peacekeeping Operations School, the Peacekeeping Operations Center and Subject-Matter Experts from the Hawaii National Guard through the Joint United States Military Assistance Group-Philippines,” said Philippine Army Maj. Gen. Pedro C. Balisi Jr., Armor Pambato Division commander. “Their invaluable insights and shared commitment to advancing combat casualty care have deepened the training experience, fostering an exchange of best practices that will elevate our operational capabilities to new heights.”
The two-week SMEE was divided into two five-day programs. From May 18-22, Hawaii National Guard staff trained 36 AFP nurses and training managers as TCCC instructors, equipping them to deliver future courses. The 20-module curriculum covered topics such as hemorrhage control, airway and breathing management, shock recognition, hypothermia prevention, eye injuries, fractures, burns and wound treatment. Training included lectures, hands-on practice and videos, culminating in a mass casualty field exercise on the fifth day to validate instructor readiness.
From May 26-30, the newly certified AFP instructors taught 49 members of the AFP’s Quick Reaction Force (QRF), including Army Rangers, infantry, artillery and combat engineers, with Hawaii National Guard medics evaluating their performance. The QRF acquired critical combat life support skills, ensuring readiness for potential deployments in peacekeeping and combat operations. The week ended with another mass casualty exercise, testing participants’ ability to practice their skills in realistic combat scenarios.
Each week’s field training exercise FTX replicated combat zone stresses, with participants assigned roles as patients, medics, security teams or litter teams navigating complex terrain.
The multinational instructor team incorporated intense simulated stressors, such as explosive charges and patients inflicted with photo-realistic injuries while under attack from a hostile ambush, giving the students a sense of multidirectional chaos. This immersive approach rigorously tested TCCC skills, honing trainees’ ability to deliver rapid, life-saving responses under the heat of a contested battle space.
“One of the most critical lessons TCCC imparts is conditioning medics to keep treating patients under extreme pressure,” said U.S. Air Force Maj. Sanders Sandoval, 154th Medical Group Detachment 1 TCCC officer-in-charge. “Amid the chaos of gunshots, IEDs [improvised explosive devices] and intense yelling, we saw high performers staying focused, treating patient after patient. In combat, you get one shot to save a life, and that’s the standard we train for—operators who never freeze, who seize every moment to save as many lives as possible.”
TCCC, a cornerstone of military medical training, emphasizes combat life support techniques to address life-threatening injuries before patients are relocated to a hospital. It covers Care Under Fire, Tactical Field Care and Tactical Evacuation Care, enabling medics and non-medical personnel, such as infantry and combat engineers, to significantly reduce fatalities in conflict zones.
This milestone event highlighted the Hawaii National Guard’s dedication to mutual learning and interoperability with the Armed Forces of the Philippines, equipping participants with essential combat life support skills for both combat and peacekeeping missions.
“Marking 25 years of the Hawaii-Philippines State Partnership,” Sandoval said, “we are committed to fostering a sustainable model for medical training and evacuation capabilities. Through shared goals, our leaders and warfighters strive to grow together, aspiring to integrate advanced TCCC techniques into standard operating procedures to prepare for future challenges.”
By certifying AFP instructors and training the Quick Reaction Force, this TCCC Subject Matter Expert Exchange strengthened the partnership, fostering trust and advancing a shared vision of readiness for United Nations peacekeeping and regional security, ensuring both forces are prepared to save lives in high-pressure environments.