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# Malaysia hosts, Sultan opens Indo-Pacific Medical Health Exchange 2023

By Sgt. 1st Class Timothy Hughes18th Medical Command

More than 580 medical-military leaders representing 24 nations from the Indo-Pacific region converged on Kuala Lumpur, Malaysia, for Indo-Pacific Military Health Exchange 2023 from September 26-29, 2023.IPMHE is a biannual-multilateral health engagement that allows medical professionals to exchange and share information amongst Allies and partners to discuss shared issues and concerns, and enhance regional interoperability.“The multilateral collaboration enhances our preparedness and readiness to respond to future pandemics, natural disasters, crisis, or conflict,” said U.S. Indo-Pacific Command Surgeon Jeffrey Bitterman, who was the co-host and is a captain in the U.S. Navy.The theme for the Malaysian hosted and U.S. Indo-Pacific Command sponsored military exchange was “achieving health solutions through diversity and inclusivity.”In his opening remarks, Perak Ruler Sultan Nazrin Shah, who is also the colonel-in-chief of the Royal Medical and Dental Corps said, "the growing number of adverse climate-related events such as floods, fires, hurricanes, landslides, and storm surges, together constitute another area of non-traditional health-related security threats.”In recognition of military forces increasing roles in humanitarian response efforts, Shah said, “military forces and their healthcare operations are increasingly being called on in this context, both to respond to immediate emergencies and their aftermath, and to contribute to prevention and preparedness, and to building resilience.”Nearly 30 general and breakout sessions were available for the attendees to attend with topics ranging from “Innovating and Improving Prehospital Combat Casualty Care” to “Health Challenges in Military Unique Environments” as well as “Global Partnerships During Disaster Responses.”While giving a keynote address about building strong ties towards a more secure and prosperous Indo-Pacific, U.S. Army Pacific Command Surgeon Maj. Gen. Paula Lodi, who also serves as the commanding general of 18th Medical Command, reminded the officers and noncommissioned officers “the future of armed conflict is characterized by large scale ground operations where all domains will be contested.“This operating environment will complicate health care delivery, particularly in the areas of command and control, patient evacuation, and logistical resupply,” said Lodi. “This will all be compounded by increased lethality that we know is expected to generate unprecedented numbers of casualties.”Like many of its counterparts, the U.S. Army has begun modernization efforts in its medical efforts.“Two noteworthy efforts towards command and control capacity are the maturing of the Department of Defense Health Agency as a strategic enabler and as a combat support agency, and the operationalization of the theater medical command,” Lodi said.“Defense Health Agency provides a medically ready force ... to combatant commands in both peacetime and and wartime,” she continued.The multilateral countries' militaries had similarities as well as differences in its systematic approaches in how it practiced medicine.One example is the U.S. Department of Defense designates its medical processes, equipment and responsibilities between each of its service branches. On the other hand, Malaysia has a singular military health system, which serves its entire armed forces.“There are so many opportunities,” said U.S. Air Force and Space Force Surgeon General Lt. Gen. Bob Miller. Partnering with our Indo-Pacific nations in regards to how do we respond to training events, how do you respond to natural disasters, how do you respond to things like [COVID-19]?“It is a broad spectrum of issues that we need to be prepared for and that’s also a focus of this meeting: learning some of the success stories from others, what some of our partner nations do better than we do, and ensuring what we can bring to the table.”A key event during the 4-day military exchange was the ceremonial handover of two mobile Role 2 surgical/critical care systems and a Role 3 field hospital from the USINDOPACOM to the Malaysians military.“It was initially a 5-year plan,” said Bitterman, “however, the expeditionary capability was delivered and set up by the Malaysian Armed Forces in only 18 months – culminating in a ceremony and field demonstration on the final full day of IPMHE 23.“The rapid deployment of this capability is a true testament to Malaysia’s commitment to increase disaster response capacity and capability within the region,” he said.The Indo-Pacific region host “ring of fire” nations and is considerably one of the most hotly challenging regions of the world due to various-unpredictable natural and manmade disasters ranging from climate change and ring of fire activities as well military and economic threats from those attempting to disrupt the balance of international norms and the freedom of navigation throughout the Indo-Pacific.Although it is riddled with its own challenges requiring intraregional assistance, it is not uncommon to extend humanitarian aid to other parts of the continually interdependent global stage.U.S. Charge d’affaires, a.i. Manu Bhalla, the deputy chief of mission at U.S. Embassy Malaysia, said, “this mobile intensive care unit capacity strengthens or civilian-to-military relationship and provides opportunities for us to work together to address humanitarian crises in Malaysia and around the world – as he reflected on the unit being used to assist Turkey during its recent humanitarian relief crisis following a devastating earthquake.“It is a fantastic example of how our partnership benefited vulnerable populations affected by crises in far regions of our globe,” said Bhalla.The significance of hosting the event was not lost on the minds of several Malaysian Armed Forces Health Services members.In addition to expressing pride in having her native country host IPMHE 2023, MAFHS Dr. (Maj.) Menaha Subramaniam, who specializes in primary care and field medicine with the Royal Medical Corps and Dental Corps said, “IMPHE was a very good and eye opening experience for me. We kind of learned a lot of things related to military medicine. From the many topics that were discussed, for me personally, I was more interested in vector borne disease related matters and also telemedicine. There was a lot of engagement between countries – it was great, I got to learn a lot of things!”The next IPMHE is scheduled to be hosted by Japan in 2025.“As the IPMHE flag was symbolically passed to Japan as the hosts for IPMHE 2025,” said Bitterman, all of our international partners recognize the importance of becoming more interoperable and leveraging the strengths of our diversity and inclusivity to enhance regional capacity and disaster response capability.“Indo-Pacific Command looks forward to working side-by-side as co-chairs to assist Japan in planning and executing another successful multilateral engagement in 2025,” he said.

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