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There was no shortage of causes for emotional stress. The Ler
vicinity was bombed twice by government forces, once on
Christmas Day in 1989 while Seaman was still there and once
after she had moved to Duar. She got news of the second bombing
by radio from a pilot evacuating all but two expatriates from
Ler. Then the radio went dead. "You felt kind of isolated," she
says. Khartoum continued bombing civilian targets in rebel
territory in the south in 1990.
The rebel forces were not much better. In November 1991, they overran Ler, and Seaman watched as rebel troops moved through Duar on their way to battle. "You saw near naked men running past with guns and artillery," she says. "We could hear gunfire in the distance." By then the team had 1,400 patients in Duar and 600 more in Ler. MSF decided to evacuate Duar. As the plane was preparing to take off, Seaman was still writing instructions for the Nuer staff to run the hospital alone. She expected bitterness at the desertion and even physical attack. Instead the Nuer sacrificed a cow to thank her for her work. They named Seaman Chotnyang, or "brown cow without horns," because they knew she hated violence. "When the Nuer give you the name of a cow," says Hesselink, "you know that you have done something right and that they think you are pretty exceptional." The departing team left behind an emergency radio. For three months, Francis Galiek, a male Nuer nurse who had lost his family to kala-azar, ran the operation. Seaman and her colleagues later returned, but subsequent battles for control of the region made more plane evacuations necessary. At Duar, while she tried to cope with simultaneous outbreaks of meningitis and measles, at least 900 patients were also suffering from kala-azar. Each time she had to leave, she could not exorcise the images. "I kept seeing thousands of people standing at my tent, saying, "I am dying, Jill. What do I do?'" While Seaman and De Wit were spending two weeks climbing Mount Kilimanjaro in 1994, the long period of strain suddenly caught up with Seaman: she realized she could no longer sleep in a room alone. She took a four-month leave in the U.S. but afterward returned to Africa. Her biggest problem was a sense of helplessness. "I remember someone saying, 'Don't worry. Jill is here,'" she says. "But I still couldn't do anything." In fact, she was trying to do just about everything. "She didn't just treat patients," says Marilyn McHarg, the current country manager for MSF-Holland in Nairobi. "She designed the protocols and the system for the treatment."
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