The following article is apart of a series about a U.S. Navy humanitarian mission I observed this August and September.

A view of Yulu, Nicaragua from a Marine CH-53 helicopter.

(Puerto Cabezas, Nicaragua): It was in 1857 on the Mosquito Coast where an American Adventurer named William Walker and his motley crew of filibusters made their second attempt to usurp power during the British Protectorate period. Since 1860, the peoples of the Mosquito Coast have enjoyed relative independence, when the British relinquished control and allowed it to operate as a semi-Autonomous Region to Nicaragua proper. However, American intervention in the region would remain inextricable in the near future. During the 1890's, U.S. firms acquired plantations by the Escondido River and controlled the main commercial hub in Bluefield. During the long era of American political and economic intervention (1909-1934), industry displaced many Mosquito Indians from their lands. It wasn't until the American backed Somoza military dynasty firmly held rule that the Mosquito Indians realized de facto autonomy. A non-political community, the Mosquitos favored the Somocista's laissez-faire policy relative to the Atlantic Coast, despite the region's underdevelopment and high levels of poverty.

Whether its confronting direct or indirect hemispheric challenges, the ever malleable Monroe Doctrine that remained during the protectorate cycle is not dead, as many analysts dispute, rather it's currently in the process of adjusting to new obstacles as America continues to master its sphere of influence. Conversely, Juan Montecinos of Counterpoint Magazine, argues that Latin America has moved on. Forgotten by Washington, whose interest is virtually occupied in as strategic war in the Middle East and the African war on poverty, Latin America has found its own way independent of the conditional economic prescriptions that arrived with the "consensus." While inflammatory rhetoric continues to exist from the likes of Hugo Chavez and Daniel Ortega about the hegemonic super power to the North, U.S. influence in the region won't diminish in the near future. The re-launching of the 4th Fleet and Operation Continuing Promise, for its part, counters those specific claims of diminishment. The USS Kearsarge's mission on the Atlantic Coast of Nicaragua, and its subsequent missions are certainly not an extension of the aforementioned early U.S. intervention, whether it be from Walker's swash buckling exploits or the era of military protection of American investments. One cannot discount the larger purpose for hemispheric re-engagement of our neighbors, but equally one can't remain dismissive of the philanthropic ethos contributed by the collective altruisms of the sailors, airmen, soldiers, and marines aboard.

"Vital presence is actual absence," Marine Lt. Colonel Bentley articulated as a contributing element of Operation Continuing Promise. In laymen's terms, as a facet in the currently successful pacification of Iraq, the U.S. military is apportioning greater use of its time, resources, and manpower for the practice of humanitarian assistance and population security as opposed to the application of kinetics, that is the use of conventional combat operations. Bentley pointed to the MAGTF (Marine Air Ground Task Force) as a fundamental change in U.S. policy: "what MAGTF has done is set up U.S. presence by regional specialization. We are showing a concern for the security of Latin America, and we get training so we are not walking into anything new." While I'm certainly not privy to the intelligence briefs in the officer's wardroom, it is worth noting that advance teams had been sent to Nicaragua in preparation for medical and engineering sites on the Atlantic Coast.

A joint military construction battalion restored the community well in Yulu.

Many homes in Yulu are built on stilts to protect from recurring floods.

The Mission in Yulu is an appropriate testament to the U.S. military's pre-planning. An outskirt of the principal city of Puerto Cabezas, the Navy's ace team targeted the village as a point of urgency. As one looks out from the decaying Moravian Christian Church at the head of the village, they will notice the Miskito's continuing deference for communalism that is attached to their inherent indigenousness. Destroyed by last year's Hurricane Felix, homes are nothing more than ad-hoc bungalows raised by stilts under which floodwaters can pass. Land remained un-parceled, anemic livestock graze wildly where bare foot children play soccer. According to Captain Greg Langham, a veterinarian augmentee with the United States Public Health Service, such conditions have serious medical consequences: "when it rains, cow feces carrying e-coli can be carried to the town's water source, causing people to become sick." Along with vet-techs, Captain Langham and his associate Army Captain Ellen Landis launched a process of what can ostensibly be called preventive medicine from a public health stand point. Cows, chickens, horses, and pigs were all given vitamins and de-worming medicine, as well as vaccinations against parasites and fatal diseases such as anthrax, rabies, and liptosporosis. The Navy's construction battalion also installed a cover and pump on the community's well, along with 2,000 gallons of sodium chloride so its people could have reliable and uncontaminated water. But the main obstacle appeared to be the traditional lifestyle choice of the Yulu residents. According to Captain Langham, the lack of private property and holding livestock in common makes it hard to "quantify" and evaluate the condition of the cattle, but steps can be made to "interrupt the cycle" which can be a potential contributor to individual sickness. During one such mission Captain Langham participated on the West Coast of Nicaragua in 2007 and described as a "success story", cattle inevitably showed signs of shedding the e. coli virus. Captain Langham also explained that another by-product of the mission addresses economic concerns. If the cattle are unhealthy when brought to inspectors, they will ultimately reject it and the community won't earn any income from the sale of the animal.

Cows are routinely tied around trees to control for immunization.

Army Corps vet-techs immunize a calf.

Veterinarians USPHS Captain Greg Langham and Army Captain Ellen Landis.

U.S. Sailor with children at Yulu. Many of the children were assisting in the animal immunization process.

I saw the medical consequences of communal living first hand when I observed U.S. Navy Lt. Cmdr. and Medical doctor Nathan Uberhoeler treating patients at Yulu's medical site. He explained the basic medical problems in a two step process. "Step one," Uberhoeler said. "There is no access to anti-inflammatories or anti-biodics, so basic problems progress. "Step two," since there is no access to physicians, the people have nobody to treat them when "they get eggs and worms in their bowels." Uberhoeler treated one girl that had a common rash on her arm that persisted for months. Another girl had headaches that caused her to have blurred vision, and a weak looking man had such intense headaches that it caused his nose to bleed. Augmenting U.S. forces, Canadian medical officer Maximillian Callaghan saw prevalent cough and fever among the community's children over the three days he was at the Yulu site. "It's a close knit community, so viruses pass as the children play."

Navy Lt. Cmdr. Nathan Uberhoeler treats a young patient in Yulu.

I sensed the feeling that America's servicemen and women wanted to do more than just execute health and humanitarian diplomacy on the Atlantic Coast. And they did. But with limited time and resources, medical prescription, minor surgeries, and health education occupied the majority of patient care. However, the USS Kearsarge's triage center, adjacent to the ship's hangar bay, was open for limited major surgeries. Along with surgeons from Operation Smile, U.S. military personnel helped to repair numerous children with cleft lips (cheiloschisis) and palates (palatoschisis), and the elderly were treated for cataracts. On my way back to my state room one afternoon, Navy Lt. Cmdr. Tim Shoppe, a trained pediatrician, stopped to talk to me and appeared visibly encouraged because a man with a large tumor on his back was cleared to board the ship via helicopter. One nurse told me that these surgeries, however minor, have great effect, enhancing the quality of life for those hampered and embarrassed by their disfigurement.

In conjunction with military personnel, Operation Smile treated local children aboard the Kearsarge for cleft lips and palates.

As noted above by the restoration of Yulu's water source, The  USS Kearsarge also carried construction battallions (CB's) to rebuild key infrastructure in the aftermath of last year's Hurricane Felix. Captain Thomas DeFazio, an Air Force engineer and OIC (officer in charge) of the on the CP08 engineers, headed the rebuilding of school rooms at Juan Comenius High School and Rubén Dario Elementary, as well as constructing portable classrooms at the city's government compound. He and his team also worked to repair the city's electric sources so schools and other social services could meet their vital power needs.

Military CB's repairing a makeshift classroom at Rubén Dario Elementary.

What I found admirable about DeFazio's team was that they weren't content to just work on the sites allocated to them by the Ace Team, instead going out and finding more of the city's vital needs. Rubén Dario Elementary was one of those sites. As I walked with him through the school, he showed me a small shelter that he re-constructed so children could resume their studies in the overcrowded school. He also noted that he wanted to embark on an ambitious plan to fix the community's plumbing system. Except the problem lied in the troubling conditions of the source near the central Nancy Bach Hospital; he wasn't going to put his men at risk as they would have to dig through syringes and other forms of bio-waste.

Children play on a jungle gym built by military CB's in the revitalized Municipial Park at Puerto Cabezas.

Air Force engineer Captain Thomas DeFazio pictured during the rain-soaked closing ceremonies, also at the Municipal Park.

The USS Kearsarge Choir sings for congregates at a local Moravian Church in Puerto Cabezas.

I have never observed the CB's so enthusiastic during the mission than when they saw children on the swing sets and jungle gyms they constructed in city's Municipal Park. It was a re-awakening of sorts. The CB's also painted and re-landscaped what used to be a haven for "drunks and gangsters" as one Nigerian born sailor working on the project put it. There was a similar sense of idealism in the community relations project lead by Navy Chaplain Quinn O'Bannon, a young Protestant Minister who hails from Starkville, Mississippi. I was fortunate to join his group after I was bumped off an earlier manifest to Nancy Bach hospital earlier one morning. O'Bannon was accompanied by an all black Navy choir who would sing gospel tunes to the central Moravian Church in Puerto Cabezas. The Chaplain himself gave an extemporaneous and vividly diplomatic sermon inspired by Mathew 14, verses 13-21 at the request of the Parish priest, Father Sarmiento:

We might be different countries, but we are all in Jesus's family.

Eight months ago, I went to Israel, and I and some sailors walked where Jesus walked, and went to a town on the Sea of Galilee, called Copernium.

At Copernium, we went to a church where I saw a picture on the ground of 4 loafs of bread and 2 fishes. The church was built in the same town where the 4000 were fed.

It was a moving experience to walk where Jesus was. It's one of my favorite Bible stories.

We went on this mission to do what Jesus taught. We made a difference by helping a lot of people.

Even though the government was cooperative, we the people cooperate on a different level.

Jesus showed us how he would give himself for us, and we are still eating from that fish and bread.

This is what we learned in Israel and we learned more in Puerto Cabezas

Because the people welcomed us, we feel as one family.

We are the fish and the bread, we have the gift to build.

He gives us these gifts, so we can help others.

Help us remember Jesus, and that he gives us gifts.

Let us be the fish and bread for each other.

Let us hope that the gifts given are for the glory of God.

We thank you again for welcoming us with open arms and allowing us to be here today.

Navy Chaplain Quinn O'Bannon gives a sermon to the Moravian congregation.

O'Bannon's words were spoken with an undoubted cadence of sincerity, but dually interesting was the strategic goal of using a religious forum to advance political communication and American values to a people who have animus to their own central government. It was clear they not only appreciated the medical aid, but cherished American presence as an act of love. As we left the church and boarded the buses, locals touched and hugged the humanitarians. Their next stop: Colombia.

USS Kearsarge commander, Commodore Frank Ponds meets the congregation.

Two local women at the Moravian church. Their home was destroyed by last year's Hurricane Felix.

Yulu locals watch as the military humanitarian force takes off by helicopter.

Some Quick Thoughts About Colombia

Afternoon skyline of Santa Marta, Colombia from the USS Kearsage.

(Santa Marta, Colombia): There were some on the ship that believed that the level of despair in Colombia didn't match Nicaragua, and because of strong relations with the Uribe government, our presence in the Andean country was entirely political. From my limited time there, it's true that Colombia had a more robust economic infrastructure. The Santa Marta beaches adjacent to port boasts luxury resorts, restaurants, and bon-fire gatherings that feature traditional Cumbia music. The local hospitals were fixed with a plethora of doctors, nurses, and in-house pharmacies. But beyond the façade of the major commercial hubs of the Magdalena Department, the surrounding area can be characterized as nothing less than squalor. La Palmira Village, for example, is a slum composed of displaced victims of the FARC (Revolutonary Forces of Colombia), a leftist paramilitary group that has terrorized the population and engaged the government in a decade's long war. But with FARC elements dwindling in recent years, La Palmira now seems like a cycle of collective ineptitude and environmental circumstance. Shelved flat against a fishing lagoon (which is the main staple of the local economy), tropical storms are a daily flood threat to the sludge filled streets. Lack of plumbing and running water left the foul stench of human waste. Because of no organized way to dispose of material waste, trash builds up on the shores and around people's homes. Every 12 days a truck with a hose attached to the back drives through town, giving each person 1 gallon of water for all of their bathing, drinking, and cooking needs. Many people were obviously unhealthy and in serious pain.

The mired streets of La Palmira Village.

Garbage fills the shores of the lagoons.

Lagoon fishers struggle to get back to shore during a tropical storm.

Medical doctor and Navy Lieutenant Sugat Patel treats a man paralyzed from the waist up.

Before the Americans showed up to work on medical and building projects, the people at La Palmira became self-motivated to clean their facilities and pick up trash. But these spurts of motivation are all too common, explained one woman. She continued to explain that the people sometimes attain the good-sense to work together, but become jaded and disinterested aftertime. Lack of pride often gives rise to bandits from adjacent villages to exploit their non-cooperation and plunder their homes; it becomes a vicious cycle.

A local police station in Santa Marta tallies killed and captured members of the FARC.

Nevertheless American efforts in Colombia were similar to Nicaragua. The U.S. Navy and their augmentees set up medical sites and pharmacies for general, optical, and dental care. Operation Smile continued cosmetic surgery on the triage deck of the Kearsarge, and the construction battalion worked on building playgrounds, strengthening decaying foundations, and installing a water tank for communal use.

Traditional Colombian Cumbia band at a Magdalena hospital entertaining U.S. forces.

A group of Naval Chief Petty Officers pose in front of the hospital. The chiefs were assisting on construction projects.

View of the Sierra Nevada Mountains in Departmento Magdalena, Colombia.

Sunset view from a Santa Marta beach.

As for me, when I wasn't observing the goodwill, I was seeking shelter when the tropical storm dawned in the late afternoon, and when sunny outside, I enjoyed the beauty of Magdalena. My last night in Santa Marta, I spent on the popular El Rodadero beach with Navy special security forces and Canadian augmentees. But I had to leave because the Kearsarge was forced to divert its course from Panama to Haiti. It was late that summer when Gustav was inflicting his wrath.

U.S. Military humanitarian forces call it a day in Colombia, and load up the LCU for the trip back to the USS Kearsage.