Exercise Big Rescue Kanagawa 2026 Strengthens Bilateral Disaster Medical Readiness

Sept. 9, 2026 | By Daniel Taylor, U.S. Naval Hospital Yokosuka |

Sailors assigned to the U.S. Navy Medicine Readiness and Training Command Yokosuka, Japan, joined U.S. and Japanese military, government, medical and emergency response organizations for Exercise Big Rescue Kanagawa 2026, Sept. 1, at the Kanagawa Prefectural Comprehensive Disaster Prevention Center and Fire Academy in Atsugi City, Japan.

USNMRTC Yokosuka contributed doctors, hospital corpsmen, Japanese fellows and translators to a tri-service U.S. medical team. The team integrated with other War Department emergency responders and Japanese medical partners to rehearse patient reception, bilateral triage and treatment, casualty movement and coordination across military and civilian medical systems.

Big Rescue Kanagawa is a large-scale, multiagency disaster-response exercise jointly organized by Kanagawa Prefecture and Atsugi City. It brings together Japanese and U.S. military, medical and emergency response organizations to practice coordinated rescue and medical operations.

USNMRTC Yokosuka sailors and American Red Cross Yokosuka volunteers applied moulage — makeup and materials used to simulate injuries — to role players before the mass casualty scenario. American Red Cross Yokosuka volunteers also served as role players, creating realistic conditions for medical teams to assess injuries, prioritize treatment and move patients.

Translators and Japanese fellows helped U.S. and Japanese participants communicate throughout the exercise. Their support allowed medical teams to exchange information, coordinate care and work through differences in language, procedures and medical practices before a real emergency occurs.

"Exercises like Big Rescue Kanagawa are about more than validating procedures — they are about building the relationships and trust that make a coordinated response possible," said Nikolai Kerry, emergency manager, USNMRTC Yokosuka. "By training alongside our U.S. joint partners and Japanese allies, we strengthen the communication, teamwork and shared understanding needed to provide timely care when communities need us most."

Japanese Prime Minister Sanae Takaichi attended the exercise with Defense Minister Shinjiro Koizumi, Kanagawa Gov. Yuji Kuroiwa and other local officials. The delegation observed rescue, medical and emergency response demonstrations conducted by participating organizations.

Army Maj. Gen. James Dooghan, commanding general of U.S. Army Japan, met with the prime minister on behalf of the department teams participating in the exercise. U.S. Army Japan participated alongside the Japan Ground Self-Defense Force, Navy and Air Force, highlighting capabilities U.S. forces in Japan can provide in support of disaster-response operations.

USNMRTC Yokosuka's command triad also attended the drill to observe the command's sailors working with Japanese medical partners and other War Department responders during the medical response scenario.

"Seeing USNMRTC Yokosuka and U.S. Navy Medicine Readiness and Training Unit Atsugi personnel work through a complex scenario reinforced the value of training as one Navy medicine team," said Navy Capt. Joshua A. Miller, commanding officer, USNMRTC Yokosuka and director, U.S. Naval Hospital Yokosuka. "Every rehearsal builds the confidence and habits that allow us to respond with purpose when it matters most. That is what it means to be ready, steady and together."

104th Fighter Wing Strengthens Regional Medical Readiness With Multiday Emergency Decontamination Course

June 8, 2026 | By Air Force Airman 1st Class Ellen Ozkaptan, 104th Fighter Wing |

The Massachusetts National Guard's 104th Fighter Wing Medical Group enhanced regional medical readiness by hosting the Air Combat Command Emergency Decontamination Course at Barnes Air National Guard Base in Westfield, Massachusetts, June 1-6, marking the first time the Air National Guard has hosted a remote training team for this course.

The multiday training brought together more than 70 airmen from Region 1 and other regions, including the 103rd Airlift Wing, 114th Fighter Wing, 150th Special Operations Wing, 158th Fighter Wing and 161st Air Refueling Wing. Through two iterations of the course, participants completed hands-on instruction in equipment setup, personal protective measures, patient handling and full-scale decontamination operations.

Patient decontamination, or PT Decon, is a 19-person unit type code designed to decontaminate patients before they enter a medical facility during chemical, biological, radiological or industrial contamination events. The capability is essential for protecting medical staff, maintaining facility operations and stabilizing victims before they receive further care.

"The importance of [emergency management decontamination training] is the ability to safeguard a medical facility in the event of having to support victims [who] come in with contamination," said Saulo Ugarte, the course lead instructor. "The purpose is to teach these medical teams the process of setting up and decontaminating victims prior to going inside a medical facility in order to ensure that the staff inside is protected, as well as the facility itself. The PT Decon course extends beyond contamination removal."

"The second part [of the PT Decon course] is ensuring that we do lifesaving situations; for example, stabilizing the victims and making sure they're stabilized through the process in order to get the medical needs they need in a clean facility after they've been decontaminated," Ugarte said.

For the 104th Fighter Wing, hosting the course represented a significant milestone in both capability and readiness.

"This is the first time that the guard has ever done the remote team," said Air Force Chief Master Sgt. Timothy Mutti, senior enlisted leader assigned to the 104th Fighter Wing Medical Group. "The Air National Guard Medical Training Division was here the last two days evaluating to see if it was up to par. Overall, it went really well."

Bringing the course to Barnes Air National Guard Base allowed multiple units to train together, strengthening regional interoperability. The collaboration also tested the airmen's abilities to operate under the demands while in full protective gear.

"My favorite part from this course is the teamwork that is involved, not only in putting it together, but the barrier of communications and how we work around that," said Air Force Senior Airman Malachi Paiz, an aerospace medical technician assigned to the 150th Special Operations Wing. "You have limited communications when having the hazmat on. It's hard to hear, and you have to communicate in different ways, such as hand signals, touching, just trying to be creative in a chaotic environment."

Aside from the technical challenges, airmen had the opportunity to build relationships outside of their units and gain a better understanding of their shared mission.

"I think meeting all the other people [who] came from the other bases was the best part of the course," said Air Force Airman 1st Class Meledith LeBron, a bioenvironmental engineer specialist assigned to the 104th Fighter Wing. "You get so used to the people [who] you're with, then you meet other people and you realize we're all doing the same thing, and we all know what we're going through."

The 104th Fighter Wing wanting to network and build relationships contributed to the decision to host the training locally.

"It was about getting the region fully trained," Mutti said. "Hosting it [at the 104th Fighter Wing] meant we could get a large portion of units trained at once."

Throughout the course, instructors guided airmen through realistic scenarios using operational equipment. The final day featured a capstone event with simulated patients, requiring teams to demonstrate communication, coordination and technical proficiency under pressure.

"The airmen are doing a really good job with what time they've had," said Brandy Tarala, a course instructor. "Everybody steps in, and you don't even have to tell them. They say, 'OK, what can I do?' The teamwork makes the process go a lot more efficiently. We don't get that all the time, because not everybody [who] takes this class wants to be here."

The course also supports broader goals within the 104th Medical Group to strengthen team cohesion and ensure deployable capability.

"My overarching goal is bringing our readiness back to where we need to be for the medical enterprise," Mutti said. "But my interior goal is team building, ensuring the 19-person team works together, understanding each other's strengths and building confidence."

As the week concluded, leaders emphasized the importance of continued regional collaboration and recurring training opportunities.

"If we can get the region ready, we will be a better asset," Mutti said.

By hosting the ACC Emergency Decontamination Course for the first time, the 104th Fighter Wing strengthened its medical readiness posture, expanded regional capability and ensured that airmen remain prepared to respond to contamination events in any environment.