ZIGUINCHOR, Senegal — When U.S. Army Capt. Nicholas LeBeau stepped into the operating room, he expected a routine uterine fibroid removal procedure. As surgeons removed fibroids from a Senegalese woman’s uterus, the number kept climbing far beyond what had been anticipated.
By the time they reached nearly 30, medical personnel watched as each fibroid was placed not into a sterile metal dish, but into a half-cut plastic water bottle. The procedure highlighted how medicine is practiced differently in environments with limited resources.
For LeBeau, the moment was surprising.
“In a large-scale combat environment, you’re not always going to have everything you need,” said LeBeau, a nurse assigned to the 86th Infantry Brigade Combat Team, Vermont National Guard,. “Being able to adapt and still provide care – that’s critical.”
LeBeau and his colleagues from the Vermont National Guard are currently participating in a Medical Readiness Exercise (MEDREX) as part of African Lion 26. Running from April 25 to May 8, the exercise brings together U.S. Army medical professionals and Senegalese Armed Forces healthcare providers to strengthen medical readiness and interoperability while they operate in expeditionary environments.
LeBeau’s experience underscores how training in these conditions directly prepares medical forces for large-scale combat operations.
Throughout the exercise, he observed Senegalese providers adapt everyday items for medical use. From repurposing materials to reusing sterilized equipment, these approaches are driven by necessity and grounded in experience.
“They find a way to make it work when they don’t have the same equipment we do,” LeBeau said. “It’s not about doing things the way we’re used to. It’s about using what’s available to take care of the patient.”
The training spans multiple facilities across the region, including Ziguinchor Regional Hospital, Hospital De La Paix and a local military hospital. There, medical professionals from Austria, Italy, the United States and Senegal work side-by-side, treating patients while exchanging knowledge and techniques shaped by their respective environments.
Executed by the U.S. Army Southern European Task Force, Africa (SETAF-AF), the medical exercise prepares U.S. military health professionals to deliver care outside traditional clinical settings while strengthening partnerships with African allies.
LeBeau worked alongside multinational partners, including Italian Army Capt. Simone Campani, an emergency room physician. Their shared experience demonstrates how practicing medicine in Senegal differs significantly from the conditions they face at home.
“The conditions here are very different from what we see in Italy,” Campani said. “It challenges you to adapt and approach medicine in ways you wouldn’t normally consider.”
Alongside U.S. and Senegalese forces, medical personnel from the Italian Army and Austrian Armed Forces participated in the exercise, building readiness through shared experience and collaboration.
The MEDREX provides an opportunity to learn how to operate effectively in constrained environments while strengthening professional relationships across nations.
LeBeau and his multinational partners know these experiences will sharpen their readiness for the demanding conditions they may face in combat. They’ll also carry forward the memory of simple, resourceful solutions like using a half‑cut water bottle as a surgical tray.
African Lion 2026 (AL26) is U.S. Africa Command's largest annual joint exercise, designed to strengthen collective security capabilities of the U.S., African nations and global allies. Co-led by U.S. Army Southern European Task Force, Africa (SETAF-AF) from April 20 to May 8, 2026, and hosted in Ghana, Morocco, Senegal, Tunisia, AL26 involves over 5,600 personnel from more than 40 nations, using innovation to drive partner-led regional security.