U.S. Southern Command Joint Surgeon/Combatant Command Surgeon Panel UNCLASSIFIED Items to convey 50 yr Anniversary Motto: Partnership for the Americas U.S. Southern Command   Joint Surgeon/Combatant Command Surgeon Panel 3 December 2015 THE OVERALL CLASSIFICATION OF THIS BRIEFING IS: UNCLASSIFIED This is an informational briefing and the content is continuously changing. The charts are designed for discussion at time of presentation, not as stand-alone representation of official USSOUTHCOM policies or positions. UNCLASSIFIED

Force Health Protection SC SG Organization Surgeon Col Cachuela Deputy Mr. Diaz The lines in the org chart connect/align in presentation mode Plans Operations Force Health Protection JIATF-S SG/ Clinical Ops LTC Harvey Lt Col Valles MAJ Hankins LTC Coote

Items to Convey USSOUTHCOM is a joint military command supporting U.S. National Security Interest throughout the West Hemisphere beside our international and domestic partners. Vision and Mission Vision: USSOUTHCOM is a Joint Military Command supporting U.S. National Security Objectives throughout the Western Hemisphere in cooperation with domestic and international partners, in order to foster security, ensure stability, and promote prosperity throughout Central and South America, Caribbean and global community. Pics: First: Marines joint training Second: TX Nat. Guard training Guatemala IABU TF Third: U.S. Honduras Airborne Op Fourth: Joint Planning Commander’s Vision: We are a Joint Military Command Supporting U.S. National Security interests within the Western Hemisphere partnering with domestic and international partners which includes government, military, and Nongovernmental Organizations, to foster security, stability, and prosperity. The Commander’s vision recognizes the important role security plays in ensuring prosperity and stability for millions in the region. We support the President’s vision of a peaceful, secure, and prosperous hemisphere.   Commander’s Mission: Although there is extremely low probability of inter-state conflict in this hemisphere, as a Combatant Command, U.S. Southern Command must remain prepared to conduct full-spectrum military operations to defend the United States and to project U.S. military capability if necessary. We realize we cannot impose security, stability, and prosperity on our own; we must achieve it through, by, and with our partners throughout the Americas and the Caribbean. SOUTHCOM is also responsible for providing contingency planning, operations, security cooperation activities as well as force protection for U.S. Military resources at these locations, and for ensuring the defense of the Panama Canal. NOTE: defined by the National Security Strategy, Unified Command Plan, and United States Code or law which prescribes our force structure and specific missions we perform. (Source) Title 10, Chapter 6, Section 162-164. Mission: USSOUTHCOM is prepared to conduct joint and combined full-spectrum military operations within the AOR, in order to support U.S. national security objectives and interagency efforts that promote regional security cooperation. 3

Dependencies & Areas of Special Sovereignty Items to Convey Regional diversity Importance of region to the US A Diverse Region JAMAICA Central America Belize Guatemala El Salvador Honduras Nicaragua Costa Rica Panama South America Dependencies & Areas of Special Sovereignty Anguilla: (UK) Aruba: (Netherlands) Cayman Islands: (UK) Curacao: (Netherlands) Falkland Islands: (UK /*) French Guiana # Guadeloupe # Martinique # Mayotte # Montserrat (UK) Saint Barthelemy (France) Saint Martin (UK) Sint Maarten (Netherlands) Turks & Calcos Islands (UK) Virgin Islands, British (UK) * also claimed by Argentina # departments of France not a dependencies, included on list for convenience of user Andrean Ridge Bolivia Colombia Ecuador Peru Venezuela Southern Cone Argentina Brazil Chile Paraguay Uruguay Area of Responsibility (AOR) 1/6th of earth’s surface (7.2M mi2 of land) 31 countries 15 Dependencies & Areas of Special Sovereignty Demographics 476+ million people 170+ million Portuguese speakers 45+ million indigenous peoples Economics 9 of 19 U.S. FTAs include AOR nations ~ 10% of U.S. trade ~ 30% of U.S. energy imports > $38 billion in remittances Cultural Ties U.S. has the 2nd largest Spanish-speaking population in the world (37 million people) Estimated U.S. will be 30% Hispanic by 2050 Antigua and Barbuda Jamaica St Kitts and Nevis Barbados St Lucia Cuba St Vincent & the Grenadines Dominica Dominican Republic Suriname Trinidad & Tabago Grenada Guyana Haiti Caribbean General Kelly is 1 of 6 geographic combatant commanders. He has responsibility for all U.S. military activity within the boundary shown on the map in blue colored line. His Area of Responsibility includes Central America, South America, and the Caribbean with the exception of the Bahamas and Puerto Rico. Mexico is NOT in USSOUTHCOM’s Area of Responsibility but there is close coordination between us and U.S. Northern Command due to linkages between Central America, Mexico, and the United States. Chile Honduras Colombia Nicaragua Costa Rica *Panama Dominican Republic Peru El Salvador Guatemala Free Trade Agreements *Awaiting implementation There are just under a ½ a billion people living in this region. The predominate languages in Central and South America are Spanish and Portuguese, but through the Caribbean English, Creole, and Dutch are also spoken. The indigenous population in Latin America is estimated at around 40 to 50 million people, or 8 percent to 10 percent of the region’s overall population. The United States’ economy is tightly woven with the countries of the region with 9 of our 19 Free Trade Agreements in place and one more awaiting implementation (Panama). Once implemented, 50% of all FTA will be with regional countries. These agreements are mutually beneficial to our countries and help to cement economic gains that many countries have experienced in recent years. Energy imports are significant—nearly 85% of our coal and 18% of our crude and petroleum are drawn from regional countries (Natural gas is <3%). Remittances from the U.S. are a significant revenue source for many of these countries. Recent data shows that the region receives roughly $38 billion in remittances with between 70% - 80% (or >$28 billion) originating in the United States. In multiple countries, remittances account for more than 10% of the countries’ GDP (mostly Central America) Culture traditions originate from both the indigenous population and from the waves of immigrants through the centuries: Spanish, Portuguese, Dutch, British, French, slaves from Africa, and labors from Italy, Germany, the U.S. and Asia. With increased interdependence and immigration, our countries remain connected economically, socially, and culturally. Latin America, the Caribbean, and the U.S. share common interests and security concerns. 4

Our Priorities Promoting regional security cooperation Items to Convey Quickly highlight our priorities that enable us to support U.S. and PN National Security Objectives Our Priorities Promoting regional security cooperation Pics : 1st: Camp VI 2d: Army Marksmanship training 3rd: Special Ops prejump 4th: Joint Planning Top Right: Bottom Right: Maritime Expeditionary Security Squadron, Panama Canal Detainee Operations Supporting U.S. and Partner Nation National Security Objectives Countering Transnational Organized Crime Gen. Kelly recognizes the important role security plays in ensuring prosperity and stability for millions in the region. And without cooperation between our domestic and international partners we could not progress towards the Command’s priorities of: Detainee Operations, Counter Transnational Organized Crime, Build Partner Capacity, Planning for Contingencies.   Build Partner Capacity Planning for Contingencies Cooperation with domestic and international partners 4 10

SC SG Priorities 1. Protect the health of our force 2. Provide health leadership 3. Plan for contingencies 4. Build partner military’s medical Internal defense FHA/DR PKO 5. MIL CIV: Promote peace, security, and health 6. Epidemic disease prevention, detection, response (mil and civ) 6

Force Health Protection: Job 1! FHP and medical waiver guidance annual updates Affects all Service Members and DoD civilians in our AOR Pre-selection guidance--deployers, TDY, TAD, or PCS Largest “down range” populations JTF-GTMO in Guantanamo Bay, Cuba JTF-B in Soto Cano, Honduras Comalapa, El Salvador; Curacao; SCOs; TDY Area of responsibility care: TRICARE Latin America and Canada - International SOS (ISOS) Patient movement: Commercial air ambulance for day to day small numbers PM planning critical piece of all our contingency planning

Theater Campaign Plan Support Commander’s Theater Campaign Plan (TCP) TCP derived from National Security Strategy, National Military Strategy and Global Employment of the Force (GEF) TCP broken down into Intermediate Military Objectives (IMOs) IMOs have effects and priority countries identified Effects have associated measurement plans: Measures of Effectiveness (MoEs)—”Are we doing the right thing?” Components develop Component Support Plan (CSP) and SCOs have Country Campaign Plans to support TCP BOTTOM LINE: Unified effort through organized activities in prioritized countries

Medical Strategy Shape health engagements Prioritize Synchronize Focus health-related activities Liaison USG/Int orgs: USAID, OFDA, UNOCHA, PAHO, WHO, CDHAM, DIMO, DMRTI, CDC, GEIS, USUHS, USAPHC, ICRC, NAMRU 6 Provide resource oversight Manpower Funding USAID: US Agency for International Development OFDA: US Office of Foreign Disaster Assistance UNOCHA: United Nations Office for the Coordination of Humanitarian Affairs PAHO: Pan-American Health Organization WHO: World Health Organization CDHAM: Center for Disaster and Humanitarian Assistance Medicine DIMO: Defense Institute for Medical Operations DMRTI: Defense Medical Readiness Training Institute AFRIMS: Armed Forces Research Institute of Medical Services GEIS: Global Emerging Infectious Systems USUSH: Uniformed Services University of the Health Sciences USAPHC-P: US Army Public Health Command-Provisional 9

This concludes my brief pending your questions. We are constantly evaluating and assessing our activities and outcomes and providing modifications where needed to attain specified national security objectives in our AOR. Although our resources may be limited, our commitment to the region endures; The Caribbean, Central and South America regions are vital to the continued and future security of the United States and our Partner Nations. USSOUTHCOM will continue as the partner of choice, fostering the development and reinforcement of regional relationships to support multilateral cooperation, security, stability, and prosperity in the Americas. USSOUTHCOM looks forward to fostering and promoting the enormous capabilities within our common home, the Americas. This concludes my brief pending your questions. 10