A Japanese doctor evaluates a volunteer with a simulated head wound during the Big Rescue Kanagawa exercise in Atsugi, Japan, Sept. 1, 2026. (Jonathan Baez/Stars and Stripes)
ATSUGI, Japan — U.S. and Japanese medics confronted language barriers and differing medical practices this week as they treated dozens of casualties from a mock magnitude 8.2 earthquake during a large-scale disaster drill southwest of Tokyo.
About 40 U.S. service members joined more than 1,000 Japanese doctors, firefighters and other emergency responders Tuesday for Big Rescue Kanagawa 2026 at Kanagawa Prefectural Disaster Prevention Center, about six miles southwest of Naval Air Facility Atsugi.
The annual exercise included damage control, firefighting and rescue drills, while U.S. participation focused largely on a mass-casualty scenario in which volunteers with simulated injuries were triaged, treated and evacuated.
“The more we exercise and learn together, the more trust we build,” Capt. Joshua Miller, director of U.S. Naval Hospital Yokosuka, said during the exercise. “[It’s] just learning the different systems and how we’re going to operate in crisis – because you don’t want to learn it during crisis.”
Inside the center’s gym, Japan Self-Defense Forces personnel maneuvered through the crowded room carrying victims on stretchers and delivering them to treatment stations based on injuries ranging from minor head wounds to severe burns.
At one station, a U.S. Army medic struggled to relay directions to his Japanese counterparts even with a translator present. By the time the next patient arrived, however, the process was noticeably smoother.
The difficulty illustrated one of the exercise’s primary purposes, said Petty Officer 1st Class Matthew Werneke, a hospital corpsman at Yokosuka.
“[This drill] stresses our communication with them, which is pretty helpful because during a disaster management scenario, it’s going to be crazy, and communication is going to be very hard,” he said.
U.S. and Japanese medics assess a simulated casualty during the Big Rescue Kanagawa exercise in Atsugi, Japan, Sept. 1, 2026. (Jonathan Baez/Stars and Stripes)
Japan Ground Self-Defense Force soldiers stabilize a simulated casualty during the Big Rescue Kanagawa exercise in Atsugi, Japan, Sept. 1, 2026. (Jonathan Baez/Stars and Stripes)
A volunteer shows off a simulated compound fracture during a U.S.-Japan disaster-response exercise in Atsugi, Japan, Sept. 1, 2026. (Jonathan Baez/Stars and Stripes)
Japan Ground Self-Defense Force soldiers carry a casualty actor as a medic performs triage during U.S.-Japan disaster-response exercise in Atsugi, Japan, Sept. 1, 2026. (Jonathan Baez/Stars and Stripes)
Dr. Mako Kitazono of Showa Medical University said communication was difficult at times, but American and Japanese responders shared the same objective of saving patients. The exercise mostly mirrored everyday hospital work, she said, but with additional complications.
Some procedures have already been designed to bridge the language gap.
Navy Capt. Teresa Allen, surgeon for the Yokosuka-based U.S. 7th Fleet, pointed to two large triage sheets accompanying each casualty. The American and Japanese forms use identical layouts, allowing responders to quickly interpret information even when they cannot read the other language, she said.
The training also gave both sides a chance to compare equipment and medical practices.
Allen and Air Force Col. Graham Warden, commander of the 374th Medical Group at Yokota Air Base in western Tokyo, said U.S. forces are interested in adopting some Japanese practices, including color-coding personnel and medical supplies.
Meanwhile, Japanese medical officials are studying how the U.S. military supplies blood to forces operating far from established medical facilities, Miller said.
“[Japan is] very reliant on the Japan Red Cross for all their blood supply, but that’s not going to work for … remote island issues and other things,” he said. “So, they’re looking to learn more about the way U.S. military does blood supply.”
For Werneke, the greatest benefit was building relationships before they are needed in an actual emergency.
“We’re not completely isolated from the rest of the U.S., but we are pretty far away” he said. “So, it’s just kind of great we’re able to be here and build that relationship in case we ever experience a real-world disaster.”
A previous version of this story incorrectly identified Petty Officer 1st Class Matthew Werneke as Matthew Wernicke.
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