Craig Bonnema always wanted to be a doctor. He couldn’t go directly into medicine when he joined the Navy, so he served as a flight officer for eight years before attending the Uniformed Services University in Health Sciences in Bethesda. He is a board-certified anesthesiologist based out of the naval hospital in Pensacola, deployed now as the command surgeon in Camp Lemonier, Djibouti.

In this volatile area of northeastern Africa and Yemen, the Combined Joint Task Force-Horn of Africa focuses its efforts on improving conditions to keep extremist ideology from getting a foothold among the people. Six years ago this month, terrorists attacked the USS Cole in Aden Harbor, Yemen, killing 17 sailors and injuring many others. The vessel was recommissioned in 2002.

Bonnema spoke recently with Tribune correspondent MyLinh Shattan about his medical role in the mission. He has completed half his tour and looks forward to a reunion with his wife and three children.

Tell us about your assignment. As command surgeon I coordinate all the medical activities for CJTF-HOA, which includes 13 nations. The area is roughly the size of the continental United States. We take care of troops that are assigned here in Djibouti and the medical assets deployed out with units. I’m the senior physician and I also go on the missions.

In Yemen as part of a medical exchange mission, I taught anesthesiology to Yemen physicians. We operate in the preconflict phase by trying to improve conditions for people who live in this part of world so they’re less likely to be exploited by extremists. Yemen is significant. It’s trying hard to enter the 21st century, but it’s still a tribal country – almost medieval in their attitudes and customs. We’re trying to expose them to American medicine. They’re starved for that.

And some areas, where it’s kind of the “Wild West,” folks still carry rifles and it’s a fertile ground for extremists. We’re focusing attention in these very areas.

The U.S. government has invested $5 million in a hospital – its infrastructure, building, equipment. They have staff but they don’t have the same level of training.

There are 70-80 medical personnel in the U.S. military here. That’s not a lot, but by making relatively smaller investment in people and resources at this early stage, we get a lot of benefit instead of waiting for terrorists or extremists to step in.

What else does the medical mission involve? Aside from the training missions, the other things are short term; we do medical civil action programs. We fill up a couple vehicles with personnel and medications and go out and open the tailgate.

We’ll do that for two, three, five days and see up to a thousand patients a day.

It’s really the longer-term things that interest us. We have people here who drill wells, bring fresh water to villages, schools and health clinics. Navy Seabees [construction battalion workers] are here building these clinics and schools or renovating existing structures. These things will last long after our deployment.

What’s the state of the health care system? There’s a wide range of the quality of medical care. In the capital town of Sana’a, the hospital is essentially on the same level of care as the United States. Once you’re outside of a major metropolitan area, you have quickly decreasing quality care available.

What’s the reaction to Americans? Everyone has been very open, warm, generous. In Yemen our embassy staff told us to be careful. I was a little apprehensive. By the time I was finished, I was feeling very comfortable. Everyone was so happy, glad to see me. Because I was a physician, and an American physician, I got a lot of respect

How do you deal with more challenging areas? There are two countries that don’t welcome us, Somalia and Eritrea. They’re very closed societies. We’re constantly looking for opportunities to help.

One example with Somalia: With the conflict there, refugees come across the Somali border. The first case of polio in Kenya since 1993 was found, and it was a 3-year-old Somali refugee girl. We’re exploring opportunities for ways we might be able to have an impact with that, whether it’s a vaccination effort or our participation to try to stem the outbreak of polio.

We want to help Africans help Africa. In the end, they’re the ones who are going to make this work, like the saying: Give a man a fish, he eats for a day; teach him to fish and he eats for a lifetime.

How does this mission compare to your deployment to Iraq? I was in Central Command for Operation Iraqi Freedom on the hospital ship Comfort, taking care of presumed U.S. casualties for the invasion of Iraq, and we were not supposed to take care of civilian patients. But it ended up that 80 percent were Iraqis, and a number of those were women and children. We didn’t deploy with a pediatrician.

On day three of the war, we got our first pediatric patient, a 12-year-old boy who had a gunshot wound to the head. Thank goodness we had a critical care specialist who had a pediatric background. He was worth his weight in gold.

We’re physicians and we’re going to treat anybody that comes our way, whether they’re bad guys, good guys, civilians or anybody else. My experience on the Comfort – you can’t replicate that trauma experience anywhere else in the world. It gives you a lot of confidence in how to deal with all sorts of lesser things.

Have you abated terrorism in the region? How do you evaluate that? Remember the USS Cole bombing? There hasn’t been something of that level. It’s hard to prove that’s the impact we’re having.

Does your mission have an impact? I’d say that there are a couple levels of impact. We go out in uniform, we’re recognized as Americans, so we impact each individual we interact with. On a larger level, it’s just being recognized for doing something. For instance, in Yemen, the local TV station took footage and aired our mission that night. Just to have it heard that an American physician was in their country, visiting and trying to help.

What attracted me to come here … we are the action element for this mission, unlike in Iraq where [medicine is] a supportive role. It’s one of those jobs you can feel proud and good telling family and friends about – making an impact on the world, where people appreciate what you’re doing. And what could be better than helping people in this part of the world?

Tribune correspondent MyLinh Shattan can be reached at mylinh@mylinhshattan.com.