Tom Catena, an American missionary doctor, has been living since 2008 in the Nuba Mountains of Sudan, a land of horrors where families sometimes cower in caves to avoid aerial bombings by the Sudanese government. Rebels of the Sudan People's Liberation Army-North (SPLA-N), who are fighting for greater autonomy from the government in Khartoum, control much of the countryside, while government forces occupy the towns and prowl the skies. Hundreds of thousands of civilians have fled.
Villagers who remain scatter at the sound of Antonov cargo planes. From these aged aircraft, Sudanese air force personnel drop crude bombs through open hatches, hoping to hit something below. Catena treats the wounded, as well as the sick and the malnourished. Patients walk for many days to get to his overcrowded Mother of Mercy Hospital. He is the only trained doctor in a rebel-controlled area roughly the size of Austria.
Recently, "Dr. Tom," who got his medical degree at Duke University, was on a very rare home leave to the United States. We met for lunch at a sandwich shop on Second Avenue in Manhattan, where Catena seemed overwhelmed by the number of soft drinks and juices on offer. In college, he played football and weighed 230 pounds. Now he's a gaunt 48-year-old, weighing 155 pounds. Over chicken paninis and apple juice, he spoke about life in one of the most isolated and troubled regions on the planet.
Foreign Policy: You wake up in the morning in the Nuba Mountains. What do you see, smell, hear?
Roosters. I stay on the hospital grounds in a Catholic guesthouse, a little cinderblock building. I don't have an alarm, but wake up around 5:00 or 5:30. The roosters are crowing. We've got chickens all over the compound. Sometimes donkeys are braying and cows are mooing.
We have a couple of priests living there and they say mass everyday at 6:30. So I get up, walk out of the back gate of the compound, cross a dry riverbed to the fathers' compound where there's a small chapel. Usually a couple of the sisters are there, maybe a couple of the people from the area, and we have a mass from 6:30 to 7:00. When mass is over, the sun is up a bit. We have a very small breakfast, maybe some coffee and bread. Then I go to the hospital at quarter-past-seven and start the rounds.
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FP: People in the West might have an idea in their heads of what a hospital is, and it might differ from what you're talking about.
It's one floor, shaped like a U, made of hand-carved stones from a quarry in the hillside. We have about 300 beds, and distinct wards, but with the overflow of patients now there are beds in the corridors, beds outside on the veranda. We have beds in a large tent, and in other makeshift tents, spread out all over the place.
We usually have 350 patients, two to three children to a bed. When I left last week, we had 124 kids in the children's ward alone, in maybe 50 beds. There is never enough bed space.
FP: Does the hospital have electricity and running water?
During the day we run solar. We have maybe 12 solar panels and 16 solar batteries. We run the day-to-day operations off that solar bank. As a backup, we also have a 25-kilowatt generator. We're already on our second set of batteries [in four years], and they're expensive. About $8,000 for a full set.