PEARL HARBOR, Hawaii (AP) — The U.S. Navy is spending more than $20 million each year sending ships to poorer nations in the Asian-Pacific region to provide cataract surgery, dental fillings and other medical care.

The Navy and its sailors are more often recognized for sending aircraft carriers to help troops in Afghanistan, fighting pirates off the Somali coast or intercepting ballistic missiles in missile defense tests off Hawaii. But the U.S. Pacific Fleet and analysts say the humanitarian missions are key to promoting U.S. national security, with relatively low costs even during a time of shrinking budgets.

Adm. Cecil Haney, commander of the U.S. Pacific Fleet, said the missions strengthen relationships with other countries.

"You're building trust, bonds, and how to communicate," Haney said in an interview at his Pearl Harbor headquarters. "We give it a fancy term, interoperability — it's more than just technology. It's cultural. It's this business of building trust with like-minded nations."

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