Project Hope volunteer Sara Joyce, embarked aboard the amphibious assault ship USS Kearsarge, examines the hand of an elderly Nicaraguan woman at a medical clinic at Juan Comenius High School during a Continuing Promise 2008 humanitarian assistance project. Kearsarge is the primary platform for the Caribbean phase of Continuing Promise, an equal-partnership mission involving the United States, Canada, the Netherlands, Brazil, Nicaragua, Panama, Colombia, Dominican Republic, Trinidad and Tobago and Guyana.