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The trilateral exercise demonstrated enduring strategic alliances forged through collaborative medical operations crucial for saving lives across the vast Pacific. Freedom Edge’s ship-to-ship medical evacuation, blood tabletop exercise, and replenishment at sea activities showcased groundbreaking logistics coordination and operational trust between all three nations.
“This unique opportunity provided our nations the chance to trilaterally validate our joint exercise life cycle planning and medical procedures with real world assets, confirming our nations’ commitment to cooperation in the region,” said Lt. Col. Afua Boahema-Lee, joint medical planner for U.S. Indo-Pacific Command.
“It was an honor to participate in the trilateral Freedom Edge Exercise together with ROK and Japan military medical leaders,” said Col. Eric Swanson, command surgeon for United States Forces Korea. “The blood tabletop training exercise and maritime patient evacuation were the first ever for this alliance, and we see this as a great first step and a tremendous opportunity for building and strengthening our joint and combined interoperability and multinational partnerships.”
First-Ever Blood Tabletop Exercise Among Japan, Korea and U.S.
Japan, Korea, and the U.S. conducted a blood tabletop exercise aiming to establish how the three nations would collectively manage blood resources across borders in times of crisis. During the TTX, participants shared technical knowledge, fostering a space where they could openly discuss, learn, and build trust regarding the handling of critical blood products.
More importantly, the TTX built trust through transparency. The three nations created a foundation upon which they could operate together in future crises, particularly when blood products are a critical lifeline for combat forces.
Replenishment at Sea (RAS): The Backbone of Lifesaving Operations
Japan, Korean and U.S. ships sustained Freedom Edge and the medical training activities by executing a Replenishment at Sea evolution. A RAS is a complex operation that involves replenishing ships with fuel, supplies, and medical resources without returning to port. This exercise provided the logistical groundwork necessary to conduct the medical evacuation at sea.
Trilateral Ship-to-Ship Medical Evacuation: First of its Kind
Freedom Edge 2025 marked the first time Japan, Korea, and the U.S. conducted a trilateral ship-to-ship, air medical evacuation.
The medical evacuation exercise tested the ability of trilateral crews to coordinate patient care under real-world conditions with the added complexity of operating at sea. The mission was a high-pressure test of procedural trust, requiring all three nations to work together seamlessly.
A Japan Self-Defense Force helicopter landed on a Republic of Korea Armed Forces ship to pick up a Korean service member role-playing as a casualty. The JSDF evacuated the patient to a nearby JSDF ship equipped with increased medical capability. U.S. military medical service providers diagnosed and treated the patient throughout the evacuation.
“We look forward to continuing to build this collaboration and extending Korea’s international partnerships for military medicine,” said Col. Kim Young Shin, command surgeon for the Combined Forces Command. “This was an outstanding trilateral engagement and an opportunity for Korea and Japan to engage in medical logistics, discuss blood sharing, and execute a patient evacuation for the first time.”
“This was a first step, not a final step. The trilateral blood discussions we started here will shape the way we fight together tomorrow and ensure that our forces never face a shortage of care on the battlefield,” Boahema-Lee said.