CIS-13: What Peru did when Continuing Promise 2013 was cancelled and how the U.S. supported
By Dialogo November 15, 2013
Engineers from the Peruvian Peace Keeping and Disaster Response Engineering Company inaugurated a science laboratory for an elementary school servicing 2,500 students ages 6-16, culminating four weeks of training in preparation for an upcoming milestone deployment in 2014. The science laboratory in Talara, Peru represents the final chapter of the Peruvian Government’s “Campaña Inclusión Social Talara 2013” (CIS-13), a mission that replaced the U.S. Southern Command’s (SOUTHCOM) scheduled deployment the USNS COMFORT, a humanitarian civic assistance mission known as Continuing Promise 2013 (CP-13), in which free medical services were offered aboard the hospital ship as well as in local medical centers in the towns along its route. For several months the northern coast of Peru eagerly prepared to host the USNS COMFORT, a familiar visitor to Central and South American shores that last visited Peru in 2010. After months of careful preparation to include meetings and medical patient screening, news of CP-13’s cancellation in late April due to the U.S. Government’s sequestration disappointed many Peruvians. The cancellation was particularly troubling for Talara, a province known for its sharp contrast of wealthy petroleum companies and the poor living next to them. Continuing Promise, for many Peruvians became known as “Promesa Incumplida” or Broken Promise. As the Peruvian government scrambled to find an alternative, SOUTHCOM prepared to support Peru through the Humanitarian Assistance Program (HAP), which actively supports the Peruvian government with assistance in building disaster response capability and delivering carefully targeted humanitarian assistance to troublesome emergency zones and regions in-country. Although the mission the Peruvians eventually crafted for Talara did not come bundled on a hospital ship anchored a mile out to sea, the Peruvian version delivered valuable assistance with similar CP-13-type elements: Disaster Response Subject Matter Expert Exchanges (SMEEs), a disaster response field exercise, a five-day medical capability mission (MEDCAP), and an engineering capability development mission (ENCAP). When the dust settled, over 600 Peruvian personnel from the local, regional and nation levels participated in various SMEEs and 5,000 patients received medical care. In addition, the Peruvian government delivered two small construction projects and a myriad donations ranging from small kitchens to scholarships for the under-privileged. SOUTHCOM supported the effort with $350,000 towards the purchase of construction materials, medical supplies, personnel deployment and logistics support. Navy Forces South sent ten medical personnel and five engineers. Uniformed Services University of Health Sciences (USUHS) sent eight medical professionals and six students. Twelve additional personnel participated in the Disaster Response SMEEs from Army Southern Command, Defense Threat Reduction Agency, U.S. Army Corps of Engineers and U.S. Southern Command. Other U.S. agencies also collaborated; USAID/OFDA sent four observers and a guest lecturer, and the Peace Corps volunteered six translators. In all, the U.S. foot print at any given moment included around 50 personnel while the Peruvians numbered around 300 – a much more favorable optic for the Peruvian government than CP-13’s 1,000 U.S. and 200 Peruvian. CIS-13 was a trailblazing and unique mission for Peru and likewise for the U.S. in its evolving supportive role. It was the first time the Peruvian Ministry of Defense organized and executed a humanitarian aid mission of this complexity and magnitude, doing so in less than 90 days. From the U.S. perspective, CIS 13 made a lot of sense not only from a geo-political standpoint, but also a financial one. Although Peru is a country accustomed to receiving foreign aid instead of providing it, it is also a country attempting to forge a new identity after two decades of continued economic growth. Peru desires to become a partner nation instead of an aid recipient, which is exactly the bilateral relationship the U.S wants to foster. Peru has consolidated its democratic rule and is looking to play a greater role in the region. For Peru’s leadership, delivering governance to areas outside of Lima is not only a priority for national sovereignty but also for prestige. Despite its many challenges, CIS-13 was a better fit for Peru than CP-13 for the following reasons: The Peruvians took ownership of the mission, it was tailored to Peruvian requirements, and most importantly, it was less costly to support. A key lesson to take away is that a small, yet consistent, U.S. footprint throughout the planning process gave the Peruvians confidence to take ownership of the plan and execute it. A larger U.S. contingent would have overshadowed the Peruvian efforts and made them turn to the U.S. when things became difficult. This sensation of control and comfort provided by a small U.S. foot print gave the Peruvians the flexibility to plan to the level of their resources instead of trying to meet a particular U.S. standard. One of the most valuable takeaways was the subject matter engagements between the U.S. doctors and the Peruvian medical students. Representing the younger generation of doctors, the Peruvian medical students were eager to learn best practices whereas an older Peruvian doctor, with his own practice in Lima and accustomed to doing things a certain way, may not. That young Peruvian medical student could become a future surgeon in a Peruvian hospital or choose to come to the U.S. to continue his/her education. It’s worth contrasting the price of this type of targeted engagement with engagements that emphasize sheer volume of surgical procedures, especially in the context of developing a long-term Peruvian medical capability. The Peruvian medical students who were initially invited to participate and act as translators ended up being the most valuable part of the medical exchange. COL John E. Atwood, a U.S. Army cardiologist, was so enthused about his engagement with the medical students that he took the time to write the Security Cooperation Office a letter in which he would recount, “Angel David Cueva Parra (Peruvian medical student) functioned as both an interpreter and diagnostician at the level of a physician…he made a great contribution to my ability to work effectively and efficiently.” Exchanges such as these further highlight that some of the highest impact activities of any humanitarian mission (CIS-13 included) are not expensive at all. Missions like CIS-13 are a good fit for countries like Peru: a country attempting to forge a new identity and now capable of providing aid. CIS-13 was a Peruvian-led and tailored mission that delivered a tremendous impact at a fraction of the cost of CP-13.
The National University of Piura is a true cauldron of future professionals. Itâ€™s Medical School is accredited, from which Angel David Cueva Parra is graduating, who is currently focusing on his specialty studies.