The solo doctor in Sudan covering an area the size of Austria
'It's been years,' he said. 'I had pulmonary tuberculosis back in 2017…I guess that was the last time I really took some time off.'
Known by locals as Dr Tom, the 60-year-old strives to 'show the love of Christ' through his medical work. 'You do it as a complete service,' he said, adding that his Catholic faith is his 'driving force'.
It's good he has faith, because he is up against it.
With Sudan mired in civil war, more than a million people have fled to the relative safety of the Nuba mountains, piling pressure on its already overstretched healthcare system. There are now four million people living in the region, but only two hospitals to meet their needs.
On top of that, the region is in the grip of a devastating famine, which is stretching Dr Catena's resources to breaking point and creating the most challenging moment for the region since it came under attack in 2011.
Dr Catena has no idea how many people have arrived in the Nuba mountains since fighting broke out in Sudan almost two years ago, but many have risked their lives to reach the Mother of Mercy hospital which he runs – word of its work has travelled far and wide.
'We heard of Dr Tom, they say he has treated millions of people,' said Layla Mohammed, 40, who travelled by TukTuk for five days to reach the hospital for her daughter to be treated for severe malnutrition. 'He's a good man, we love him.'
Dressed in dusty scrubs and a worn-out Brown University t-shirt – Dr Catena studied engineering at the Ivy League school in the 1980s before converting to medicine – he told The Telegraph that the food security situation in Nuba is 'by far the worst it's been'.
In December, famine was declared in at least five areas in Sudan, including the Western Nuba Mountains and Zamzam displacement camp in North Darfur.
Food shortages are so severe that the hospital has been forced to start rationing the high-calorie peanut paste called Plumpy Nut which is used to treat severe malnutrition in children and breastfeeding mothers, said Dr Catena.
Fresh supplies aren't expected until April, he added.
A significant proportion of the patients he and his small team of staff, most of whom are locals he has trained himself, see are suffering from malnourishment as a result of the famine.
While he credits his faith with giving him the strength to keep going, it's a struggle.
Often seeing over 100 patients a day, Dr Catena said he finds it hard to switch off: 'I'm a major insomniac.'
'I'll wake up in the night and I'll start going over an operation that I did…when your brain starts doing that, forget about it. It's really, really hard to sleep,' he said, removing a pair of battered circular glasses to reveal dark rings under his eyes.
'I've had these glasses for 10 years. They're so scratched I have to keep taking them off to see properly!'
Dr Catena lives in a basic brick compound attached to the back of the hospital with his wife Nasima, who is from Nuba, and their two adopted sons: Francis, seven, and Vincent, who is six months old.
There is no mobile-phone signal, there are no paved roads and there is no running water. It's a far cry from the city of Amsterdam in upstate New York, where he grew up as a devout Catholic with his parents and six siblings.
Dr Catena is no stranger to war. In 2011, the Sudanese government dropped more than 10,000 bombs on the rugged mountainous region in a scorched earth campaign against a local rebel group who refused to accept the imposition of Islamic law.
Air strikes hit Dr Catena's hospital and home, and the region suffered under a total aid blockade.
Every other doctor, aid worker and even major international organisations including the United Nations, left as soon as the assault began.
Despite never having treated trauma wounds before, only Dr Catena was left to care for Nuba's three million inhabitants.
'Truckloads of up to a hundred wounded would come. We'd put them on sheets or trolleys in the courtyard, and we just started doing triage,' Dr Catena recalled.
In recognition of his work and bravery in staying behind, delivering babies, treating shrapnel wounds and performing amputations, Dr Catena was awarded the prestigious Aurora prize – the top humanitarian award.
The Telegraph met Dr Catena in January – before the USAID cuts – and he said he was 'happy' Donald Trump is now president.
'I just didn't like the way the country was going. It just seemed we were losing our moral compass,' he said, calling 'uncontrolled immigration' in the US 'complete madness'.
But he said that 'denigrating immigrants is of course wrong', adding that it was incredibly difficult for his Sudanese wife Nasima to accompany him on a recent trip.
Dr Catena thinks that Trump will probably have very little effect on Sudan's civil war. 'He is not engaged,' he said.
'George Bush was the last president interested in Africa, he gave us Pepfar', he said, referring to the landmark HIV/Aids programme.
A Catholic mission hospital, the Mother of Mercy doesn't provide birth control or abortions under any circumstances.
'As a doctor and as a human, you sympathise with people that are in a bad situation, but it is completely forbidden,' said Dr Catena. 'Culturally, in the Nuba mountains, it is an anathema to have an abortion anyway.'
In an effort to offset the dire shortage of medical professions in a region that is largely dependent on poorly paid doctors coming from abroad, in 2022, Dr Catena and a small team opened the St Bakhita Health Training Institute on the hospital grounds.
It's the first institution in the Nuba mountains to provide accredited medical courses – a remarkable offering in an area where most don't finish secondary school – and Dr Catena hopes its graduates will one day be able to carry on his work.
'One of our main goals over the past ten years has been to bring care closer to the people as access to care is such an issue,' he said. 'These new graduates will help to transform health care in Nuba as it will double the workforce in our badly under-resourced region.'
They currently have 19 clinical officer students and 29 midwifery students. By June 2026, they will have a new intake of around 30 nurses and midwives for the three year diploma course.
But even with a solid blueprint for his legacy in place, Dr Catena shows no sign of slowing down.
As if on cue, his pager beeped – a message from one of his students asking him for advice on a surgical procedure – and he was back on his feet and striding towards the operating room.
African Mission Healthcare are the leading supporters of the Mother of Mercy hospital. Click here to read more and support their work
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