How to Run a Hospital in a Warzone: Tom Catena, Missionary Doctor
In June 2011, a 16-year-old girl in Sudan alerted hospital staff that she was experiencing painful back spasms and having trouble swallowing. She already had survived being hit by a barrel bomb and the pain of having her arm amputated. Then hospital staff realized she had developed tetanus. “It was horrifying,” said Tom Catena, MD. “We put her in isolation and I had to walk by her room every day. Every time I came by that room, I’d hear her screaming with pain.” With the help of Dr. Catena and his team, she survived.
More than 75 students, faculty and staff from the Boston University School of Medicine (BUSM) community crowded into a classroom on Jan. 30 to listen to Dr. Catena, Chair of the Aurora Humanitarian Initiative (Aurora) and founder of the Mother of Mercy Hospital in Sudan’s war-ravaged Nuba Mountains.
The seminar, which was sponsored by BU’s Armenia Medical Partnership Program, “How to Run a Hospital in a Warzone: Localizing Humanitarian Action,” focused on the challenges of running a hospital in a war-torn region. Dr. Catena spoke of the importance of empowering people on the ground to make decisions about the allocation of aid. “I want to get you interested in global health [and] show you what is possible with your training as a medical student.”
An American surgeon, pediatrician and obstetrician/gynecologist, Dr. Catena has been the only doctor since 2007 permanently based in the region, which has a population of more than a half million people. In 2008 he founded Mother of Mercy Hospital, the only major hospital in the Nuba Mountains, where he now treats up to 400 patients daily.
BU President Emeritus Aram V. Chobanian, MD, introduced Dr. Catena as a recipient of the $1.1 million Aurora Prize for Awakening Humanity, which he was awarded in 2017 for his humanitarian work. He was appointed Aurora’s inaugural Chair in December 2018, a position he maintains in parallel with his ongoing responsibilities as Medical Director for Mother of Mercy Hospital.
Aurora was founded on behalf of the survivors of the Armenian genocide to honor the selfless actions of those who helped them. “That rings home because both of my parents were survivors [of the Armenian genocide] as well as both of my late wife’s parents,” said Dr. Chobanian. Aurora, an organization that works to inspire people to take action and uplift others in lesser circumstances, also has ties to Boston University. Two of the founders of the organization, Neubar B. Afeyan and Vartan Gregorian, served on BU’s Board of Trustees.
Dr. Chobanian described how Dr. Catena was one of the few medical workers with an international aid organization that stayed behind after the South Sudanese Civil War broke out in the region. Since the conflict began in December 2013, at least 50,000 people have been killed and an estimated quarter of South Sudan’s population has been displaced, according to figures from the United Nations. A report released by Amnesty International in September 2018 showed that during the war, South Sudan’s military forces systematically raped women, murdered civilians and carried out large-scale looting. “I can say that we’re all in awe of you, Tom. The kind of work that you’ve done brings out the very best of what medicine is all about. It’s a pleasure to have our students see what can be done in one’s lifetime.”
Dr. Catena is on call 24 hours a day, seven days a week. There is no electricity or running water in the area where he and his team work and only some parts of Mother of Mercy Hospital are powered by solar energy. “This is a part of the world that has never really known peace. It’s chaotic, but you can still do a heck of a lot with limited resources.” During the seminar, Dr. Catena showed photos of patients he’s treated, including those with goiters, tumors and leprosy, a disease which is very common in the Nuba Mountains. “My wife is from the mountains and her mother has leprosy,” said Dr. Catena. “We’ve had to amputate all her fingers over time.”
While Dr. Catena shared several stories of patients with positive outcomes, he also shared stories of those who were not as fortunate. As the body of a young girl killed by shrapnel in her abdomen was displayed on one of the slides, he said, “I’m showing you this not to scandalize you, but to show you the effects of war and what that is.”
A discussion with attendees followed his presentation. “How do you have resilience of spirit when you’re constantly being bombarded with what’s around you?” asked a student.
“It’s very difficult. You get despondent,” answered Dr. Catena, a Catholic missionary doctor. “For me I have to draw on my faith. I’m there for a reason. I’m there to serve God by serving the people and I take this quite seriously. I’m there to do the best that I can. Let me just do what I can do and see how God can work in the lives of the people here.”
Toward the end of the discussion, Dr. Catena highlighted the vitality of those who he’s worked with and treated for more than a decade. “These people are incredibly tough and strong. They’ve been suffering for so many years and have put up with so much more than I ever will. That gives you a lot of strength to keep on pushing ahead.”
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