A local boy shows off his notebook during a medical civil assistance project in support of Balikatan 2009 at Paaralang Elementary School in Nakar, Quezon province, Republic of the Philippines, April 21. Civil military humanitarian assistance activities enable Armed Forces of the Philippines and U.S. personnel to get to know each other, train together, and provide assistance in communities where the need is greatest, improving their ability to operate as one team on joint projects.