PUERTO BARRIOS, Guatemala (Oct. 29, 2022) Lt. Cmdr. Mark Sariano, a registered operating nurse assigned to the hospital ship USNS Comfort (T-AH 20), observes a Guatemalan child prior to his hand surgery aboard the ship off the coast of Puerto Barrios, Guatemala, Oct. 29, 2022. Comfort is deployed to U.S. 4th Fleet in support of Continuing Promise 2022, a humanitarian assistance and goodwill mission conducting direct medical care, expeditionary veterinary care, and subject matter expert exchanges with five partner nations in the Caribbean, Central and South America. (U.S. Navy photo by Mass Communication Specialist 2nd Class Juel Foster)