The sounds of agony filled the air near the wooded back lot of the Central Armed Forces Hospital, or CAFH, in Ulaanbaatar, Mongolia, as an interpreter encouraged accident victims to ‘ham up’ their performances during mass casualty response training, as part of Operation Pacific Angel 14-4 Mongolia.

The Mongolian armed forces soldiers-turned-actors tested the readiness of Mongolian civil military physicians and nurses, during a scenario that represented the culmination of a training event with U.S. Air Force medical subject matter experts.

"We try to make these scenarios as real as possible for the students," said Master Sgt. Victoria Grey, the enlisted medical SME for mass-casualty response training during PACANGEL 14-4. "When they do go out to treat the patients we have moulaged, they know that they need to be treating the most injured first."

The exercise helped cultivate common bonds and fosters goodwill between the U.S., Mongolia and regional nations by conducting multilateral humanitarian assistance and civil military operations at locations like the CAFH.

The CAFH, founded in 1921, provides medical and health care services to all Mongolian armed forces, activity-duty, retired, veterans and their families.

"Despite the cultural hurdles that we knew we'd expect, it's funny how medicine is an international language," said Maj. T.J. Bonjour, an emergency medicine physician assistant and medical SME instructor.

With patience, persistence and the help of Mongolian translators', Air Force members worked seamlessly with surgeons, cardiologists and a wide variety of nurses and technicians to help teach organizational and communication skills.

"This course mainly centered on mass casualty management and emergency center preparedness," Bonjour said. "Their system already has a robust (structure) in place, and I think we facilitated furthering the progression of their system."

The training will allow the CAFH to provide better medical services to those who need it, said Mongolian armed forces Maj. Battumur Batmunkh. The training will also allow the hospital to prepare other first responders for mass causality situations.

As the students eagerly ran toward the mock tragedy, the atmosphere tested the skills learned, which could one day save lives.
"Pretty much for us, communication was the key," Grey said. "They are not all from the same unit, so they had to come together as a team, communicate well and help each other out."