DAR ES SALAAM, Tanzania – A Nebraska Air National Guard officer spearheaded the first-ever Tanzanian medical readiness exercise as part of the larger multinational training event, Justified Accord 26. U.S. Air Force Lt. Col. Angela Ling transformed a long-standing state partnership between Nebraska and Tanzania into a tangible demonstration of operational readiness, bolstering medical capabilities and strengthening international collaboration. The exercise, a key component of U.S. Africa Command’s largest East Africa exercise, focused on preparing medical professionals for the challenges of providing care in austere environments.
The medical readiness exercise took place between March 2-12, 2026, at Lugalo General Military Hospital in Dar es Salaam and Msata Military Training Base. This collaborative effort leveraged the Nebraska-Tanzania State Partnership Program, bringing together U.S. And Tanzanian medical personnel to train side-by-side, share expertise, and enhance long-term cooperation in healthcare delivery. The focus was on providing practical, adaptable, and resource-efficient medical care, directly improving readiness for potential large-scale combat operations or humanitarian crises.
Lt. Col. Ling, assigned to the 155th Medical Group, 155th Air Refueling Wing, Nebraska Air National Guard, orchestrated the historic mission. She strategically sourced medical specialties from both U.S. Army and Air Force units within the Nebraska National Guard, as well as active-duty personnel, to create a cohesive joint team. Crucially, the exercise wasn’t dictated by what resources were readily available in Nebraska, but rather by a careful assessment of the specific needs and desires of Tanzanian partners. “We collaborate with the host nation about the types of specialties they prefer,” Ling explained. “It’s not just what Nebraska has available, it’s what they need and desire, and then how do we improve readiness by fulfilling their needs.”
Building on a Decade of Experience
Ling’s commitment to global health extends back to her 2009 deployment to Afghanistan, where she earned the affectionate nickname “Mama Ling” from locals while providing medical care to children. Commissioned in 2007, she spent 12 years on active duty as a registered nurse and nurse practitioner before transitioning to the Nebraska National Guard in 2019, seeking geographic stability for her family. This transition coincided with the onset of the COVID-19 pandemic, which dramatically reshaped her responsibilities and propelled her into large-scale operational planning.
By September 2020, Ling was leading all COVID-19 operations for the state of Nebraska at the direction of the governor, overseeing testing, vaccinations, and the establishment of alternate care facilities. This experience proved pivotal, solidifying her evolution from a clinical provider to a seasoned operational planner. “In the National Guard, I have been able to do more things than I ever could have imagined,” Ling said.
Beyond her military duties, Ling also holds a leadership position at the University of Nebraska Medical Center Global Center for Health Security, where she manages disaster health response grants. This institutional knowledge is invaluable when designing medical engagements in resource-constrained environments. Since 2022, she has been instrumental in planning similar medical readiness exercises in both Rwanda and Tanzania, demonstrating a growing commitment to strengthening healthcare infrastructure across East Africa.
Leveraging Technology for Improved Tracking
The Tanzania exercise also marked the debut of a modern technology designed to enhance the measurement of medical readiness operations. Justified Accord 26 was the first time the Medical Currency Application for Readiness Tracking 2.0 (MCAT 2.0), a cloud-enabled medical tracking platform developed by the U.S. Air Force, was utilized in an Army-led military exercise. It was also the first time this capability was deployed in Africa. The modular system allows medical providers to log patient encounters, procedures, diagnoses, and clinical hours directly through a mobile interface, providing real-time data and improving the assessment of training effectiveness.
International exercises like Justified Accord require extensive coordination and the cultivation of trust between partner nations. Ling emphasized that interoperability and host-nation requirements are paramount, even amidst logistical complexities. The resulting joint medical team is carefully constructed to integrate capabilities that directly address Tanzanian priorities.
A Partnership Built on Trust and Shared Responsibility
Establishing this initial medical engagement in Tanzania is intended to foster shared responsibility and empower African partners to take the lead in regional security efforts. The State Partnership Program is designed to build relationships that endure beyond short-term training rotations. Consistent communication and collaboration are essential for establishing the trust necessary for a rapid and effective response to crises. “The relationship takes more than one engagement,” Ling said. “It builds over multiple visits as you secure to understand and trust each other.”
For Ling, the Tanzania exercise represents an early success story for the Nebraska-Tanzania partnership, highlighting the increasing role of National Guard planners in strengthening global military cooperation. She believes that dedicated planners, clinicians, and National Guardsmen are instrumental in transforming strategic agreements into tangible, real-world readiness. “This fills my cup,” Ling said. “Having the opportunity to plan these missions brings me a lot of joy.”
Justified Accord 26, led by U.S. Army Southern European Task Force, Africa (SETAF-AF), was hosted this year in Djibouti, Kenya, and Tanzania. The exercise aimed to increase multinational interoperability, prepare regional partners for United Nations and African Union missions, and enhance the readiness of the U.S. Joint force. More details about the exercise are available from the U.S. Army.
Looking ahead, the Nebraska National Guard and Tanzanian partners will continue to refine their collaborative efforts, building on the foundation established during Justified Accord 26. Future engagements will focus on expanding the scope of medical training and addressing emerging healthcare challenges in the region. The next scheduled review of the State Partnership Program is slated for December 2026, where progress and future goals will be assessed.
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