Fireside Chat with Dr. Tom Catena

Full Transcript

Watch the Fireside Chat

Jenelle Blackmon
Welcome, everyone, to the Fireside Chat with Dr. Tom Catena. We are excited for you to be here today. African Mission Healthcare is focused on transforming healthcare throughout Africa. Today, I have the honor of introducing AMH’s board chair, co-founder, and one of the largest donors supporting African Mission Healthcare and all of the work that Dr. Tom does. Mark Gerson will be our facilitator for this conversation, and he will introduce our panelists. Mark, I turn it over to you.

Mark Gerson
Thank you, Jenelle, and thank you, everyone, for joining us—particularly after the flight-related schedule change from last week. It is my great pleasure and honor to be here with everyone today, and particularly with my co-founder at African Mission Healthcare and its CEO, Dr. Jon Fielder, and with Dr. Tom Catena.

Most of you know John and Tom, but I’ll give a brief introduction before we begin. Tom graduated from Brown University in 1986 as an All-American football player, went to Duke Medical School, became a Navy flight surgeon, and then devoted his life to serving the poor in Africa with his medical skills. He began in Kenya and then moved to the Nuba Mountains, where he has now been for almost 20 years.

We’ll talk about Tom’s work in the Nuba Mountains, what he’s done to date, and especially what is happening on the ground right now. If anyone has questions or comments, please put them in the chat. I can see them here and will ask them.

John and Tom, welcome to this AMH session, where we’re going to learn about Tom, the importance of his work, and the critical importance of everyone’s support.

Tom Catena
Thanks, Mark. And thanks, everybody, for joining us today. I know it’s Saturday and many of you have been watching college football, so we hope to make this enjoyable and informative. Thank you for joining us.

Mark Gerson
I’d rather watch if we were in the ’80s when you were playing—but it’s not, and you’re not.
So, Tom, why don’t we start with this: describe a day in the life of Tom Catena in the Nuba Mountains.

Tom Catena
Well, there really is no “typical” day, but here’s what a normal one might look like. I usually get up around 5:30 in the morning. I haven’t needed an alarm for over 20 years—I just wake up. My wife and I sleep with our youngest child, Vinnie (Vincent Moses), who is a year and a half old. Francis, who is 8, is our other adopted son. Both boys are amazing.

Once everyone is up, we take Vinnie outside for his morning routine. We take off his diaper, he does his business, and we cheer him on—he loves it. After breakfast with my wife, I head down to the hospital around 6:45. At 7:00, I’m in the chapel for morning prayers until 7:30, followed by daily Mass with our hospital chaplain, a Nuba priest.

At 8:00 we begin ward rounds, which last until about 1:30 p.m. We make rounds with clinical officers (similar to PAs), clinical officer interns, our three new doctors, nurses, and midwives. We cover maternity, female ward, male ward, children’s ward, the ICU, and we also see patients from the leprosy and TB ward.

Mark Gerson
How many patients do you see in that time?

Tom Catena
We get through 300 to 400 patients during morning rounds. We move quickly, but we always try to address each patient’s issues, especially new ones. After rounds, we go to the minor operating room for minor surgeries: setting broken bones, draining abscesses, managing miscarriages. We often have one or two C-sections in the morning as well. Then we review X-rays, then head to the outpatient clinic, where I see around 50 patients. I finish around 6:00 or 6:30 p.m., read messages, respond to emails, and finally go home.

At night, I’m on call. Clinical officers handle routine problems—malaria, pneumonia, things they’re fully capable of. But for surgical issues, labor complications, or any case beyond their scope, they call me, and I go in to help.

Mark Gerson
You were trained as a family medicine doctor. How did you become the primary surgeon for 3 million people? What surgeries do you do?

Tom Catena
When I got to Kenya in January 2000, I quickly realized that to practice medicine in Africa, you must do surgery. I was apprenticed to missionary doctors and Kenyan surgeons who trained me extensively. I ended up doing as much—or more—surgery than a U.S. general surgery resident.

A typical surgical day in Nuba might include:

  • C-sections
  • Pediatric surgeries like shunts for hydrocephalus
  • Pediatric hernias
  • Wilms tumors (common)
  • Adult hernias, hydroceles, hysterectomies
  • Amputations
  • Laparotomies for tumors or bowel obstructions
  • Trauma: gunshots, stabbings

We are the only surgical hospital for roughly 3 million people, including many from South Sudan and even northern Sudan.

Mark Gerson
Let’s talk logistics. How do you get drugs and equipment to such a remote place?

Tom Catena
Logistics is one of our top challenges. Because of the civil war, we can’t access anything through Khartoum. Everything must come from Nairobi or Juba. African Mission Healthcare (AMH) is our logistics lifeline. We place a year-and-a-half–long order for everything we need. AMH manages procurement, compares prices, buys supplies, arranges transport, loads trucks, and coordinates the long route through Kenya, Uganda, and South Sudan, all the way to us.

Jon Fielder
Sometimes we even rely on river transport down a tributary of the Nile when roads are impassable. Cold-chain items must be flown. Emergencies—like this year’s cholera outbreak—require special shipments.

Mark Gerson
Let’s talk about staff training. Tom, you’ve built incredible training capacity.

Tom Catena
When we arrived in 2008, we had 15 local staff; the one with the highest education had finished 8th grade. No one in the SPLA-controlled region had completed high school. We immediately began sending people out for training. Over the years, we’ve sent about 90 staff to train as doctors, nurses, midwives, clinical officers, anesthetists, an eye surgeon, lab techs, pharmacists, and OR technicians.

Eventually we realized: why not train them ourselves? So we opened a training school. Three and a half years ago we enrolled our first class. We just graduated 19 clinical officers, who are now doing internships with us. They will staff the 19 clinics we support.

Mark Gerson
What can a clinical officer do?

Tom Catena
A lot. They’re comparable to medical officers and can treat:

  • Malaria
  • Pneumonia
  • TB
  • HIV
  • Hypertension
  • Diabetes
  • Heart failure (stable cases)

They refer more complex surgical, obstetric, or advanced medical cases. Clinical officers are the cornerstone of healthcare in much of East Africa.

Mark Gerson
And it costs $7,500 total to train one?

Tom Catena
Correct—$7,500 for all three years.

Jon Fielder
And each one will see around 80,000 patient visits in their career.

Mark Gerson
Tom, you’ve mentioned the need for Nuba surgeons.

Tom Catena
Yes—we urgently need trained Nuba surgeons. We have three Nuba doctors now and more in medical school. Our goal is to send one or two of them to Kenya in January for a 5-year surgical training program under Dr. Bill Rhodes. Over time, we want a full team: surgeons, pediatricians, and more.

Mark Gerson
John, what’s the order of operations for building healthcare where none exists?

Jon Fielder
You start with basic public health: immunizations, clean water—where possible. Then you develop strong hospitals capable of handling pneumonia, injuries, appendicitis, births. Once the hospital is strong, you push quality outward: clinics, midwives, clinical officers. Tom’s hospital oversees 19 clinics, and better trained staff dramatically improves healthcare access.

Tom Catena
Nuba is extremely undeveloped. No roads. No transportation. No electricity. No running water. No toilets. For villagers, access is an enormous barrier. We need clinics equipped with supplies, staffed with trained people. And—a major issue—a huge unmet need for surgery exists across Africa.

Jon Fielder
Hundreds of millions in Africa need surgery now. Only a tiny percentage receive it. About 20% of preventable deaths in Africa are related to surgical conditions. Building surgical capacity means building systems: electricity, backup power, clean water, anesthesia, trained scrub techs, equipment, and trained surgeons.

Mark Gerson
Tom, you have an engineering background. How do you use it?

Tom Catena
Before we had a real engineer, running the physical plant was my biggest anxiety—bigger than clinical work. Without reliable power, water, and functioning equipment, nothing happens. Every day something would break: water supply, power, fires, pumps. That all fell to me. Now we have an engineer, Chris Lowe, who is a genius. He’s saved us thousands of dollars and months of downtime by repairing lab equipment and infrastructure. He keeps us functioning.

Mark Gerson
Let’s talk budget. About $3.5 million per year?

Jon Fielder
Yes—about $3.5 million in 2026.

Tom Catena
And that includes everything:

  • A 485-bed referral hospital
  • 19 clinics
  • A clinical training school
  • Salaries
  • Construction
  • Food for 9,000 inpatients (and caregivers)
  • Ophthalmology
  • Dental
  • TB
  • Leprosy
  • Physical therapy
  • Prosthetics workshop
  • Cholera isolation ward

We see about 300,000 patients per year. We do around 1,200 major surgeries and 2,000 minor ones annually.

Mark Gerson
Let’s talk about your faith. How has serving in Africa shaped your lived experience of faith and community?

Tom Catena
I’m a Catholic lay missionary. That’s why I’m there. Without daily prayer and Mass, I would have left long ago. The work is too psychologically difficult without faith. When things became dangerous, our group of missionaries decided to stay. Running away would not be a good witness of the faith we profess.

Mark Gerson
What about the current conflict?

Tom Catena
Sudan has been independent for 70 years and has been in civil war for about 56 of those years. The most recent conflict began in April 2023. Initially our region was not involved, but SPLA-North has now joined the fighting. We expect renewed conflict when I return next week. It’s not stable.

Mark Gerson
Let’s talk about maternal care and the BMOC centers.

Tom Catena
Hope is a Christian virtue—and as I learned last night, also a Jewish one. We cannot stop because of conflict. We will keep training, keep improving.

We are upgrading clinics into Basic Emergency Obstetric and Neonatal Care (BMOC) centers.
Why? Because 90% of women deliver at home—with disastrous results. Nuba and South Sudan have some of the highest maternal and neonatal mortality rates in the world.

BMOC centers:

  • Staffed by trained midwives
  • Equipped for safe deliveries
  • Capable of treating miscarriages
  • Able to manage bleeding after birth
  • Able to provide IV antibiotics
  • Able to perform vacuum deliveries
  • Able to refer complicated cases rapidly

We will graduate 29 midwives in June. This is transformative.

Mark Gerson
If funding comes in, care in Nuba will expand far beyond what was imaginable even 10 years ago.

Tom Catena
Yes. We’ve renamed our hospital: Mother of Mercy Referral and Teaching Hospital. We want to be the referral hospital not only for the Nuba Mountains, but for greater Sudan, especially as other health infrastructure collapses. We need more surgeons and specialists. We are building that capacity now.

Jon Fielder
A viewer from Nuba asked about emergency transport from remote areas like Farrish. Transport is a huge challenge. Tom has placed ambulances and plans for more tuk-tuk ambulances for remote clinics. It can take years to implement, but progress is being made.

Tom Catena
Exactly. Transport is lifesaving and we’re building a hub-and-spoke system with tuk-tuks and ambulances. It takes time, drivers, fuel, security—but we’re committed.

Mark Gerson
A viewer writes: “Dr. Tom, thank you for all you do…” She saw you in Addis Airport but was too shy to say hello.

Tom Catena
Please—say hello next time!

Mark Gerson
A question about cataract surgery: Can you do outreach in Darfur?

Tom Catena
Cataracts are a clouding of the lens leading to blindness. Sun exposure and age are major factors. We trained a clinical officer, Caesar, to become an eye surgeon. He is now the eye surgeon for the entire region. Dr. Jim Guzak from Washington has been coming to assist. Darfur outreach is not possible right now because of the war, but one day we hope to send Nuba medical missionaries to other regions.

Mark Gerson
What about anesthesia availability?

Tom Catena
We have three trained nurse anesthetists and are training more. Our setup is simple: an Oxford Miniature Ventilator with halothane and manual bellows. But our team can anesthetize everyone—from 3-pound babies to elderly patients—with remarkable skill.

Mark Gerson
Your U.S. travel has gone smoothly despite nationwide delays.

Tom Catena
It’s a miracle. This tour took over a year to plan. I was worried the government shutdown would cancel flights. But every event has gone smoothly. Tonight’s event with you, Mark, is my last—and I can walk there.

Mark Gerson
Let’s discuss partnership among AMH, Sudan Relief Fund, and CMMB.

Jon Fielder
These three organizations are the primary sponsors of Tom’s hospital. AMH handles most procurement and logistics, CMMB manages fuel, and SRF works with Samaritan’s Purse on transport. We brought governance best practices from Nuba to another hospital in Western South Sudan.

Tom Catena
In 2017, major institutional donors pulled out abruptly. These three organizations saved us. Without them—and without individual donors—the hospital would have closed seven years ago.

Mark Gerson
Tom, what advice do you and John have for students interested in medical missions?

Tom Catena
Discern carefully. Spend time in prayer. Choose a field you love—don’t pick something only because you think it’s useful for missions. You might be doing it for 30 years. After training, try a one- or two-month placement first. Don’t start in a war zone. Try Kenya or Uganda.

Jon Fielder
Long-term relationships matter. Many of the best volunteers return yearly. They build trust, understand the culture, and contribute meaningfully.

Mark Gerson
A viewer writes a beautiful prayer of gratitude for Tom and John. Thank you. Tom, John—your effectiveness, your stewardship, the way donations turn directly into lives saved—it is extraordinary.

$25 a month funds a surgery. $50,000 funds a BMOC center serving 20,000 mothers and babies over five years. Thank you for enabling donors’ dollars to go further than we ever imagined possible.

Anyone can follow up at the African Mission Healthcare website. We’re all partners in this work. Tom often says, “Without donors, I’d be working with Band-Aids.”

It is the privilege of a lifetime to partner with both of you.

Jenelle Blackmon
On behalf of African Mission Healthcare, thank you for joining us today. Thank you to Mark, Tom, and John for the incredible work you do. As noted in the chat, there are ways to support Dr. Tom and the efforts in Sudan.

Edited for Clarity