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" (From left to right) U.S. Army Sgt. Christina McGrath (front), Sgt. Alfred Sevilla (front), Spc. Oliver Gaborno (back), and Spc. Amit Subedi (back), mental health specialists at Tripler Army Medical Center (TAMC) use a litter to transport a patient with simulated injuries to a casualty collection point during a mass casualty exercise at the TAMC mountainside helipad, as part of Rim of the Pacific (RIMPAC) exercise 2018. The purpose of the full scale exercise at TAMC is to prepare the hospital to effectively respond to a natural disaster by synchronizing efforts with government and private sector agencies statewide. Twenty-five nations, 46 ships, five submarines, about 200 aircraft and 25,000 personnel are participating in RIMPAC from June 27 to Aug. 2 in and around the Hawaiian Islands and Southern California. The world's largest international maritime exercise, RIMPAC provides a unique training opportunity while fostering and sustaining.