CHITRÉ, Panama -- CHITRÉ, Panama – In a quiet procedure room at Hospital Gustavo Nelson Collado, U.S. Air Force gastroenterologists are working shoulder-to-shoulder with their Panamanian counterparts, exchanging techniques while cutting through a long list of patients who had been waiting years for specialized care.
For many in this region, the wait for treatment has stretched one to two years, with just one gastroenterologist serving two provinces and nearly 200,000 people. The arrival of U.S. medical teams through AMISTAD 2025 has brought both immediate relief for patients and lasting lessons for providers on both sides.
The U.S. gastroenterology team is composed of two Air Force gastroenterologists, two technicians, and two Language Enabled Airman Program (LEAP) members providing translation assistance—ensuring the procedures run smoothly and collaboration stays seamless.
“Many of these patients have been waiting one to two years to receive care,” said U.S. Air Force Lt. Col. Micheal Brazeau, 88th Healthcare Operations Squadron gastroenterologist. “Normally the doctor here does 14 endoscopy cases a week in between his other work. Between the two of us, we’re doing 20 a day, which is making a big dent in the backlog.”
Beyond numbers, the environment has required flexibility.
“We’ve had to adapt to working in a limited-resource environment,” Brazeau explained. “They don’t have snares or traps for the scopes, so we’ve been using gauze instead. It works, and it’s taught us new ways to accomplish procedures when we don’t have all the equipment we’d normally rely on.”
That adaptability connects directly to military readiness. “I deployed to Afghanistan in 2016–2017, and this feels very similar,” Brazeau added. “You learn to adapt and still deliver safe care.”
He also noted that working side by side with Panamanian staff has changed the way his own team approaches procedures.
“Every provider has different techniques,” Brazeau said. “For example, we introduced a ‘time out’ before each procedure—verifying the patient’s name, date of birth, and what we’re about to do. That wasn’t standard here before, but now the whole team, including the nurses, has adopted it. That’s been rewarding to see.”
For the Panamanian gastroenterologist Dr. Walter Bernal, the partnership has been equally valuable.
“I’ve been working here for seven years, and I’m the only gastroenterologist serving two provinces,” Bernal said. “Working with the AMISTAD team has been a very good experience. They’ve been teaching us their techniques for handling patients, and it’s helped us think about how we can improve our own care and raise our standards.”
He highlighted how critical the partnership is in reducing patient wait times.
“The backlog is very large,” said Bernal. “Having the U.S. team here has allowed us to reduce it in a meaningful way. Their support helps us increase the number of cases we can complete, and decreases wait times for our patients. My hope is that this partnership will continue so we can help even more people.
“Everyone on the U.S. team has been very friendly,” he said. “The name of the exercise means friendship, and I’ve really seen that in our work together.”
Looking ahead, Walter sees the collaboration as more than just a short-term boost.
“I especially want to thank them for their support in treating complex conditions, including colon lesions and other difficult cases,” Bernal said. “At the end of this mission, I hope the impact will be lasting—not only reducing our backlog but also showing how the United States and Panama can work together to strengthen healthcare for our people.”
For the U.S. Airmen, the feeling is mutual.
“Working with the Panamanian doctors and technicians has been very good,” Brazeau said. “We’ve compared health systems, discussed cases and shared strategies. It’s honestly been a seamless process and has been rewarding to work side by side.”
As the mission continues, the blend of collaboration, cultural exchange and operational readiness underscores the deeper purpose of AMISTAD 2025: providing care today while strengthening relationships and resilience for tomorrow.