U.S. Army Lt. Col. Peter O’Connor, an ear, nose and throat surgeon and chief of surgery at Landstuhl Regional Health Center (RHC), Germany, assists Rwanda Defence Force Maj. Jonathan Bukuru, an ear, nose and throat doctor, while preforming a tonsillectomy at the Rwanda Military Hospital (RMH) in Kigali, Rwanda, Nov. 28, 2018. O’Connor was at RMH participating in a weeklong subject matter expert exchange alongside U.S. military medical personnel assigned to Combined Joint Task Force- Horn of Africa and Landstuhl RHC. (U.S. Navy photo by Mass Communication Specialist 2nd Class Timothy M. Ahearn)

U.S. Army Maj. Dionicia Russell, a public health nurse assigned to the 403rd Civil Affairs Battalion functional specialty team, assigned to Combined Joint Task Force-Horn of Africa (CJTF-HOA), Camp Lemonnier, Djibouti, presents a leadership seminar at the Rwanda Military Hospital (RMH) in Kigali, Rwanda, Nov. 27, 2018. Russell was at RMH participating in a weeklong subject matter expert exchange alongside U.S. military medical personnel assigned CJTF-HOA and Landstuhl Regional Health Center, Germany. (U.S. Navy photo by Mass Communication Specialist 2nd Class Timothy M. Ahearn)

U.S. Army Lt. Col. Peter O’Connor, an ear, nose and throat surgeon and chief of surgery at Landstuhl Regional Health Center (RHC), Germany, and U.S. Army Lt. Col. Delnora Erickson, a radiation oncologist and officer in charge, 403rd Civil Affairs Battalion functional specialty team, assigned to Combined Joint Task Force-Horn of Africa (CJTF-HOA), Camp Lemonnier, Djibouti, review a print of a patient’s computerized tomography scan at the Rwanda Military Hospital (RMH) in Kigali, Rwanda, Nov. 27, 2018. O’Connor and Erickson were at RMH participating in a weeklong subject matter expert exchange alongside U.S. military medical personnel assigned to CJTF-HOA and Landstuhl RHC. (U.S. Navy photo by Mass Communication Specialist 2nd Class Timothy M. Ahearn)

Amb. Peter Vrooman, U.S. Ambassador to Rwanda, listens during a meeting at the Combined Joint Task Force-Horn of Africa (CJTF-HOA) East Africa Security Forum (EASF) at Camp Lemonnier, Djibouti, Dec. 13, 2018. The EASF provides opportunities for CJTF-HOA and interagency leaders to assess and align efforts, and develop synchronized courses of action that support common goals. (U.S. Navy photo by Mass Communication Specialist 1st Class Nick Scott)

Irvin Hicks Jr., foreign policy advisor (POLAD) for Combined Joint Task Force-Horn of Africa (CJTF-HOA), addresses U.S. diplomats and joint service personnel at a meeting during the CJTF-HOA East Africa Security Forum (EASF) at Camp Lemonnier, Djibouti, Dec. 13, 2018. The EASF provides opportunities for CJTF-HOA and interagency leaders to assess and align efforts, and develop synchronized courses of action that support common goals. (U.S. Navy photo by Mass Communication Specialist 1st Class Nick Scott)

U.S. Air Force Capt. Tyler Brin, director of protocol for Combined Joint Task Force-Horn of Africa (CJTF-HOA), addresses U.S. diplomats and joint service personnel at a meeting during the East Africa Security Forum (EASF) at Camp Lemonnier, Djibouti, Dec. 13, 2018. The EASF provides opportunities for CJTF-HOA and interagency leaders to assess and align efforts, and develop synchronized courses of action that support common goals. (U.S. Navy photo by Mass Communication Specialist 1st Class Nick Scott)

Amb. Peter Vrooman, U.S. Ambassador to Rwanda, takes notes during a meeting at the Combined Joint Task Force-Horn of Africa (CJTF-HOA) East Africa Security Forum (EASF) at Camp Lemonnier, Djibouti, Dec. 13, 2018. The EASF provides opportunities for CJTF-HOA and interagency leaders to assess and align efforts, and develop synchronized courses of action that support common goals. (U.S. Navy photo by Mass Communication Specialist 1st Class Nick Scott)

Amb. Donald Yamamoto, U.S. Ambassador to Somalia, addresses U.S. diplomats and joint service personnel at a meeting during the Combined Joint Task Force-Horn of Africa (CJTF-HOA) East Africa Security Forum (EASF) at Camp Lemonnier, Djibouti Dec. 13, 2018. The EASF provides opportunities for CJTF-HOA and interagency leaders to assess and align efforts, and develop synchronized courses of action that support common goals. (U.S. Navy photo by Mass Communication Specialist 1st Class Nick Scott)

U.S. Army Maj. Ivette Blanco-Padilla, dental officer in charge, 403rd Civil Affairs Battalion (CAB), Combined Joint Task Force-Horn of Africa, Djibouti, gives a medical book to a student during a ceremony at the Djibouti Nursing School, Dec. 10, 2018. More than 30 students completed a semester-long medical English discussion group, facilitated by the 403rd CAB, which serves as a language laboratory where students develop practical linguistic and rhetorical skills through relationship building and information exchange. (U.S. Air Force photo by Tech. Sgt. Shawn Nickel)

U.S. Army Lt. Col. Delnora Erickson, an oncologist assigned to the 403rd Civil Affairs Battalion (CAB), Combined Joint Task Force-Horn of Africa, Djibouti, presents a certificate of completion to a Djibouti Nursing School student during a ceremony at the Djibouti Nursing School, Dec. 10, 2018. More than 30 students completed a semester-long medical English discussion group, facilitated by the 403rd CAB, which serves as a language laboratory where students develop practical linguistic and rhetorical skills through relationship building and information exchange. (U.S. Air Force photo by Tech. Sgt. Shawn Nickel)

Djibouti Nursing School students, faculty and guests listen to opening remarks by Amb. Larry André Jr., U.S. Ambassador to Djibouti, during a certification ceremony held by the 403rd Civil Affairs Battalion (CAB), an Army Reserve unit assigned to Combined Joint Task Force-Horn of Africa, Djibouti, Dec. 10, 2018. More than 30 students completed a semester-long medical English discussion group, facilitated by the 403rd CAB, which serves as a language laboratory where students develop practical linguistic and rhetorical skills through relationship building and information exchange. (U.S. Air Force photo by Tech. Sgt. Shawn Nickel)

U.S. Navy Capt. Thomas S. Wall, chief of staff for Combined Joint Task Force -Horn of Africa post with his deputy, U.S. Air Force Lt. Col. Michael Mansfield and secretary, U.S. Army Capt. Shannon Hernandez before participating in the annual Grand Bara race. Nearly 200 members of CJTF-HOA ran alongside 2,500 Djiboutian, Chinese, and coalition service members and civilians during the 15k (9.3 mile) race across a stretch of Djibouti’s Grand Bara Desert, Dec. 13. (U.S. Army photo by Capt. Olivia Cobiskey)

Task Force Alamo, a U.S. Army Reserve unit from Texas, gathered before the race. Nearly 200 members of Combined Joint Task Force – Horn of Africa ran alongside 2,500 Djiboutian, Chinese, and coalition service members and civilians during the 15k (9.3 mile) race across a stretch of Djibouti’s Grand Bara Desert, Dec. 13. (U.S. Army photo by Capt. Olivia Cobiskey)

A runner approaches a kilometer marker during a 15-kilometer run through the Grand Bara Desert in Djibouti. Hosted by the French Foreign Legion, nearly 200 members of Combined Joint Task Force – Horn of Africa ran alongside 2,500 Djiboutian, Chinese, and coalition service members and civilians during the race across a stretch of Djibouti’s Grand Bara Desert, Dec. 13. (U.S. Army photo by Capt. Olivia Cobiskey)

Runners compete in the 36th annual Grand Bara 15K race in the Grand Bara Desert, Djibouti. Nearly 200 members of Combined Joint Task Force – Horn of Africa ran alongside 2,500 Djiboutian, Chinese, and coalition service members and civilians during the race across a stretch of Djibouti’s Grand Bara Desert, Dec. 13. (U.S. Army photo by Capt. Olivia Cobiskey)

Hosted by the French Armed Forces 5th Combined Overseas Marine Battalion the Grand Bara race honors the long history of the French relationship with Djibouti. Participants in the race follow a 15-kilometer line of rocks in the Grand Bara desert, which the Foreign Legion used to make its Soldiers paint as punishment. Nearly 200 members of Combined Joint Task Force – Horn of Africa ran alongside 2,500 Djiboutian, Chinese, and coalition service members and civilians during the 15k (9.3 mile) race across a stretch of Djibouti’s Grand Bara Desert, Dec. 13. (U.S. Army photo by Capt. Olivia Cobiskey)

A U.S. Soldier poses for a photo with an officer in the Chinese military after exchanging patches. Nearly 200 members of Combined Joint Task Force – Horn of Africa ran alongside 2,500 Djiboutian, Chinese, and coalition service members and civilians during the 15k (9.3 mile) race across a stretch of Djibouti’s Grand Bara Desert, Dec. 13. (U.S. Army photo by Capt. Olivia Cobiskey)

U.S. Navy Petty Officer 2nd Class Morgan Cushing (left), U.S. Navy Chief Petty Officer Michael Williams (middle) and U.S. Navy Petty Officer 1st Class Stephen Jacquet, Coastal Riverine Squadron 8, Combined Joint Task Force-Horn of Africa, Camp Lemonnier, Djibouti, watch a possible threat while conducting surveillance from a Rigid Hull Inflatable Boat during an armed security escort in the Gulf of Tadjourah, Dec. 7, 2018. Coastal Riverine Squadron 8 conducts force protection of strategic shipping and naval vessels operating in the inshore and coastal areas, anchorages and harbors, from bare beach to sophisticated port facilities. (U.S. Air Force photo by Tech. Sgt. Shawn Nickel)

U.S. Navy Sailors from Coastal Riverine Squadron (CRS) 8, Combined Joint Task Force-Horn of Africa, Camp Lemonnier, Djibouti, pilot Rigid Hull Inflatable Boats while en route to provide armed escort to the fleet replenishment oiler USNS Henry J. Kaiser (T-AO 187), in the Gulf of Tadjourah, Dec. 7, 2018. Coastal Riverine Squadron 8 is a hardware-equipped, intelligence, surveillance, reconnaissance embedded, deployable asset that provides centralized planning, control, coordination and integration of its boat and security platoons. (U.S. Air Force photo by Tech. Sgt. Shawn Nickel)

U.S. Navy Petty Officer 2nd Class Morgan Cushing (left), U.S. Navy Chief Petty Officer Michael Williams (middle) and U.S. Navy Petty Officer 1st Class Stephen Jacquet, Coastal Riverine Squadron 8, Combined Joint Task Force-Horn of Africa, Camp Lemonnier, Djibouti, watch a possible threat while conducting surveillance from a Rigid Hull Inflatable Boat during an armed security escort in the Gulf of Tadjourah, Dec. 7, 2018. Coastal Riverine Squadron 8 conducts force protection of strategic shipping and naval vessels operating in the inshore and coastal areas, anchorages and harbors, from bare beach to sophisticated port facilities. (U.S. Air Force photo by Tech. Sgt. Shawn Nickel)

The fleet replenishment oiler USNS Henry J. Kaiser (T-AO 187) is in view behind a Coastal Riverine Squadron 8, Combined Joint Task Force-Horn of Africa, Camp Lemonnier, Djibouti, Rigid Hull Inflatable Boat during an armed security escort in the Gulf of Tadjourah, Dec. 7, 2018. Coastal Riverine Squadron 8’s anti-terrorism and force protection missions include harbor and homeland defense, coastal surveillance and special missions. (U.S. Air Force photo by Tech. Sgt. Shawn Nickel)

U.S. Navy Petty Officer 1st Class Alexander Weigel, engineer under instruction, Coastal Riverine Squadron 8 (CRS 8), Combined Joint Task Force-Horn of Africa, Camp Lemonnier, Djibouti, mans a security post on a Rigid Hull Inflatable Boat (RHIB) while en route to provide armed security escort in the Gulf of Tadjourah, Dec. 7, 2018. Each RHIB team in CRS 8 is made of up a diverse group of U.S. Navy Reserve Sailors with different skills and backgrounds, which aids in protecting U.S. and partner interests in the East Africa combined joint operations area. (U.S. Air Force photo by Tech. Sgt. Shawn Nickel)

U.S. Navy Petty Officer 2nd Class Morgan Cushing, coxswain in training, Coastal Riverine Squadron 8, Combined Joint Task Force-Horn of Africa, Camp Lemonnier, Djibouti, pilots a Rigid Hull Inflatable Boat (RHIB) while providing an armed security escort in the Gulf of Tadjourah, Dec. 7, 2018. Coastal Riverine Squadron 8 conducts force protection of strategic shipping and naval vessels operating in the inshore and coastal areas, anchorages and harbors, from bare beach to sophisticated port facilities. (U.S. Air Force photo by Tech. Sgt. Shawn Nickel)

U.S. Navy Sailors from Coastal Riverine Squadron (CRS) 8, Combined Joint Task Force-Horn of Africa, Camp Lemonnier, Djibouti, pilot Rigid Hull Inflatable Boats while en route to provide armed escort to the fleet replenishment oiler USNS Henry J. Kaiser (T-AO 187), in the Gulf of Tadjourah, Dec. 7, 2018. Coastal Riverine Squadron 8 is a hardware-equipped, intelligence, surveillance, reconnaissance embedded, deployable asset that provides centralized planning, control, coordination and integration of its boat and security platoons. (U.S. Air Force photo by Tech. Sgt. Shawn Nickel)

Amb. Michael Raynor, U.S. Ambassador to Ethiopia, presents thoughts after a briefing titled “Triggers of Regional Instability” during the East Africa Security Forum (EASF) at Camp Lemonnier, Djibouti, Dec. 11, 2018. The EASF is an annual opportunity for CJTF-HOA and interagency leaders to sync, assess and align efforts to develop synchronized courses of action that support common goals. (U.S. Air Force photo by Tech. Sgt. Shawn Nickel)

Amb. Deborah Malac, U.S. Ambassador to Uganda, listens to a briefing titled “Triggers of Regional Instability” during the Combined Joint Task Force-Horn of Africa (CJTF-HOA) East Africa Security Forum (EASF) at Camp Lemonnier, Djibouti, Dec. 11, 2018. The EASF is an annual opportunity for CJTF-HOA and interagency leaders to sync, assess and align efforts to develop synchronized courses of action that support common goals. (U.S. Air Force photo by Tech. Sgt. Shawn Nickel)

Amb. Donald Yamamoto, U.S. Ambassador to Somalia, presents a briefing titled “Triggers of Regional Instability” during the Combined Joint Task Force-Horn of Africa (CJTF-HOA) East Africa Security Forum (EASF) at Camp Lemonnier, Djibouti, Dec. 11, 2018. The EASF is an annual opportunity for CJTF-HOA and interagency leaders to sync, assess and align efforts to develop synchronized courses of action that support common goals. (U.S. Air Force photo by Tech. Sgt. Shawn Nickel)

Amb. Peter Vrooman, U.S. Ambassador to Rwanda, listens to a briefing titled “Triggers of Regional Instability” during the Combined Joint Task Force-Horn of Africa (CJTF-HOA) East Africa Security Forum (EASF) at Camp Lemonnier, Djibouti, Dec. 11, 2018. The EASF is an annual opportunity for CJTF-HOA and interagency leaders to sync, assess and align efforts to develop synchronized courses of action that support common goals. (U.S. Air Force photo by Tech. Sgt. Shawn Nickel)

Amb. Larry André, U.S. Ambassador to Djibouti, addresses U.S. diplomats and joint service personnel during a meeting at the Combined Joint Task Force-Horn of Africa (CJTF-HOA) East Africa Security Forum (EASF) at Camp Lemonnier, Djibouti Dec. 12, 2018. The EASF provides opportunities for CJTF-HOA and interagency leaders to assess and align efforts, and develop synchronized courses of action that support common goals. (U.S. Navy photo by Mass Communication Specialist 1st Class Nick Scott)

Stephen Banks, Deputy Chief of Mission to Eritrea, listens during a meeting at the Combined Joint Task Force-Horn of Africa (CJTF-HOA) East Africa Security Forum (EASF) at Camp Lemonnier, Djibouti Dec. 12, 2018. The EASF provides opportunities for CJTF-HOA and interagency leaders to assess and align efforts, and develop synchronized courses of action that support common goals. (U.S. Navy photo by Mass Communication Specialist 1st Class Nick Scott)

U.S. Army Maj. Gen. James D. Craig, left, commanding general, Combined Joint Task Force-Horn of Africa (CJTF-HOA), listens to a briefing titled “Triggers of Regional Instability” during the East Africa Security Forum (EASF) at Camp Lemonnier, Djibouti, Dec. 11, 2018. The EASF is an annual opportunity for CJTF-HOA and interagency leaders to sync, assess and align efforts to develop synchronized courses of action that support common goals. (U.S. Air Force photo by Tech. Sgt. Shawn Nickel)

U.S. Army Brig. Gen. Miguel Castellanos, deputy commanding general - Somalia, Combined Joint Task Force-Horn of Africa (CJTF-HOA), presents thoughts after a briefing titled “Triggers of Regional Instability” during the East Africa Security Forum (EASF) at Camp Lemonnier, Djibouti, Dec. 11, 2018. The EASF is an annual opportunity for CJTF-HOA and interagency leaders to sync, assess and align efforts to develop synchronized courses of action that support common goals. (U.S. Air Force photo by Tech. Sgt. Shawn Nickel)

U.S. Army Maj. Gen. James D. Craig (center), commanding general, Combined Joint Task Force-Horn of Africa (CJTF-HOA), listens as U.S. Army Brig. Gen. William Zana (right), CJTF-HOA deputy commanding general, addresses U.S. diplomats at a meeting during the CJTF-HOA East Africa Security Forum (EASF) at Camp Lemonnier, Djibouti Dec. 12. The EASF provides opportunities for CJTF-HOA and interagency leaders to assess and align efforts, and develop synchronized courses of action that support common goals. (U.S. Navy photo by Mass Communication Specialist 1st Class Nick Scott)

U.S. Department of State and interagency officials attend a briefing titled “Triggers of Regional Instability” during the Combined Joint Task Force-Horn of Africa (CJTF-HOA) East Africa Security Forum (EASF) at Camp Lemonnier, Djibouti, Dec. 11, 2018. The EASF is an annual opportunity for CJTF-HOA and interagency leaders to sync, assess and align efforts to develop synchronized courses of action that support common goals. (U.S. Air Force photo by Tech. Sgt. Shawn Nickel)

British Army Col. Simon Butt (center), Combined Joint Task Force-Horn of Africa plans and policy director, observes a moment of silence during a ceremony honoring the late U.S. President George H.W. Bush at Camp Lemonnier, Djibouti, Dec. 5, 2018. (U.S. Navy Photo by Mass Communication Specialist 1st Class Nick Scott/released)

U.S. Marine Master Sgt. A.J. Benvie, assigned to Combined Joint Task Force-Horn of Africa, calls a formation to attention during a ceremony honoring the late U.S. President George H.W. Bush at Camp Lemonnier, Djibouti, Dec. 5, 2018. (U.S. Navy Photo by Mass Communication Specialist 1st Class Nick Scott/released)

Joint forces from Combined Joint Task Force-Horn of Africa stand at parade rest during a ceremony honoring the late U.S. President George H.W. Bush at Camp Lemonnier, Djibouti, Dec. 5, 2018. (U.S. Navy Photo by Mass Communication Specialist 1st Class Nick Scott/released)

U.S. Army Brig. Gen. William L. Zana (left), deputy commander, Combined Joint Task Force-Horn of Africa, speaks during a ceremony honoring the late U.S. President George H.W. Bush at Camp Lemonnier, Djibouti, Dec. 5, 2018. (U.S. Navy Photo by Mass Communication Specialist 1st Class Nick Scott/released)

Joint forces from Combined Joint Task Force-Horn of Africa gather around the flagpoles at Camp Lemonnier, Djibouti, during a ceremony honoring the late U.S. President George H.W. Bush at Camp Lemonnier, Djibouti, Dec. 5, 2018. (U.S. Navy Photo by Mass Communication Specialist 1st Class Nick Scott/released)

U.S. Army Brig. Gen. William L. Zana (center), deputy commander, Combined Joint Task Force-Horn of Africa (CJTF-HOA), returns the salute of British Staff Sgt. David Donovan (left), assigned to CJTF-HOA during a ceremony honoring U.S. President George H.W. Bush at Camp Lemonnier, Djibouti, Dec. 5, 2018. (U.S. Navy Photo by Mass Communication Specialist 1st Class Nick Scott/released)