MFH in Sudan: An Interview with Dr. Tom Catena

Dr. Tom Catena is the Medical Director at MMH and for several years was the only doctor there. Dr. Catena’s commitment to serving the people in the Nuba Mountains is unwavering and his selfless and heroic efforts have been significantly acknowledged internationally. Recently, he spoke with MFH Development Director, Dick Weisberg, to discuss the current situation in Sudan and the clinics we support there.

Q: Please describe the urgent need for the clinics that Medicines for Humanity is supporting.

Tom Catena (TC): The Nuba Mountains region is one of the most remote places in the world. The level of healthcare here is way below anywhere else in Africa. When you visit these communities there is absolutely nothing. It is a six hour walk just to get a Tylenol. There are no health facilities, there are no pharmacies. Outlying clinics bring healthcare closer to the people. This is having a significant impact.

Q: What is the relationship of the clinics to the hospital?

TC: We are the main referral hospital in a very isolated and remote region. Outlying clinics are located near remote villages where people live. They are the focus of the hospital’s outreach program. A few of our hospital staff visit each clinic once a month to bring medicines, provide training for Community Health Workers, and provide support. Any seriously ill patients are brought back to us here at the hospital.

Q: What kind of services do the clinics provide?

TC: They provide a multi-pronged approach to basic healthcare and outpatient services. For example, if someone contracts malaria or they have minor pneumonia, you can go there and be treated for that. Most of the clinics include antenatal services, so pregnant mothers can be examined and evaluated there. Also, most offer immunizations.

Q: What is the role of the Community Health Workers that support these clinics?

TC: Recruiting and training of Community Health Workers (CHWs) is a big part of our outreach program. Our team provides the training. CHWs go out to the villages and present health topics. They talk about basic hygiene, how you recognize if your child has an illness like pneumonia or diarrhea. They reinforce the need to come to the clinic, and they explain home remedies that can be used safely.

Q: How large is the population in the Nuba Mountains?

TC: I would estimate that population to be 1.5 million people.

Q: And that population is growing?

TC: Our area is somewhat at peace right now because the rebels that are in control of our area are not entering into this current conflict very much. The rest of the country is in chaos and civil war. A lot of people have fled, and many have come to the Nuba Mountains. I would estimate an influx of 60,000 to 80,000 new arrivals recently. So, the need is even greater because of this influx of refugees and internally displaced people.

Q: What are the top preventable illnesses that cause child deaths in Nuba?

TC: Measles, pneumonia, gastroenteritis, and malaria. Measles can be prevented with a vaccination. We started getting Pneumococcal vaccines and that should make a big impact. Gastroenteritis can be prevented if there is clean drinking water, and death can be averted if a child gets to the clinic early for help. The key for malaria is also early treatment with anti-malarial tablets. There is hope that a vaccine to prevent it is coming soon.

Q: What are the biggest unmet needs to lower maternal and child deaths?

TC: It’s two things: access to medicines and basic healthcare, and access to a trained health professional. They go hand in hand. We are trying to address both needs through the outreach program. We recently started a school and we are educating a whole generation of clinical officers and midwives. We have 19 clinical officers that we are training to function like Physician’s Assistants at the clinics. They will have quite a few skills and should be able to handle most health issues. They won’t do surgery; they won’t provide high level medical care. If someone comes in with malaria, a child comes in with pneumonia, a child comes in with gastroenteritis, an adult comes in with a musculoskeletal complaint or with tuberculosis, they should be able to identify those illnesses and either treat them or refer them properly to the hospital.

We also started training midwives. We have thirty in our first class, and they will graduate in three years. When those midwives graduate, a few will work here at the hospital, but most of them will be out at the outlying clinics providing antenatal care, delivering babies safely, and providing some postnatal care.

Q: How do you see the future in Nuba?

TC: Sudan is not a stable place. Despite what is going on around us, we are determined to keep moving ahead, getting people trained, and pushing to expand our services, both here at the hospital and at the clinics. We are getting there slowly but surely. We have a adopted a “can do” attitude. The people in this region don’t get down about the harsh realities, they just stay steady. I think that is how they’ve been able to cope with uncertainty over so many years. They say, “If we hear about peace, we don’t get excited. If we hear about war, we don’t get too depressed.” It’s just how life is. We just keep going ahead. We are here, we must survive and keep pushing ahead. I have adopted that attitude from the people here. Life is unpredictable. So, you do what you can, and you keep moving forward.

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