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Armed with the results of these early surveys, Seaman was determined to set up central operations in Duar. Hesselink, as MSF's country manager, disapproved. He claimed he would never be able to get a plane in to evacuate the staff if local trouble broke out between Sudan's warring factions. Seaman went over Hesselink's head, appealing to MSF's managers in Holland. Hesselink was furious, but he eventually admitted that setting up camp in Duar was sensible. Still he warned Seaman that if she ran into trouble, she might have to walk out on foot.
The flights into Duar were often spaced as much as six weeks apart, and cargo on the planes was so limited that although there were food shortages in the area, the staff frequently had to decide between food and medicine. "We saw patients' relatives losing weight because they were giving their food to sick family members," says Sjoukje De Wit, a Dutch nurse who became Seaman's sidekick. The doctors decided that they could eat less as long as the Nuer were starving.
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?'"