Royal Netherlands Army Sgt. 1st Class Reinier Hakvoorb, top right, explains medical evacuation procedures to Djiboutian, Sudanese and Rwandan service members during exercise Cutlass Express 2013 at the Port of Djibouti in Djibouti Nov. 13, 2013. Cutlass Express is a U.S. Africa Command-sponsored, Navy-led exercise designed to improve cooperation among participating nations in order to increase maritime safety and security off East Africa.