This 2008 photograph depicts U.S. Public Health Service (USPHS), Lt. Cmdr. Gary Brunette, as he was examining a patient in Puerto Cabezas, Nicaragua, during operation Continuing Promise 2008 (CP08). In this case, the patient, a young boy, was seated in his mother’s lap during the exam. Lt. Cmdr. Brunette was deployed aboard the amphibious assault ship, the USS Kearsarge (LHD 3), which was supporting the Caribbean phase of operation CP08, an equal partnership mission between the United States, Canada, the Netherlands, Brazil, Nicaragua, Panama, Colombia, Dominican Republic, Trinidad and Tobago and Guyana.