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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."
Kala-azar itself was not the only problem. One day a patient who had gone mad threw a spear through another man's chest. Seaman operated and saved the man's life. Then she and De Wit operated on a man so riddled with tropical ulcers that his bones were exposed.
There were other crises. Hesselink had just taken off at sunset from the small airstrip at Nimne, not far from Duar, when he got a radio call from Seaman asking him to return and pick up a woman having complications in childbirth. "I told her it was crazy. It was too late. We would crash," says Hesselink. "She made me do it anyway." After picking up the woman and Seaman in Nimne, Hesselink flew in the dark to Ler, where there was better equipment. As the plane approached the field, the Nuer lit fires along the runway. After being treated, the woman gave birth to twins. When Hesselink flew back to Nimne with the newborns, he was greeted by cheering crowds.
By late 1995, it looked as though the epidemic in southern Sudan was beginning to wane. Seaman and the MSF staff had treated about 19,000 patients, principally by administering daily injections of Pentostam. Keeping track of up to 1,400 patients at a time, most of whom were unable to read, required the creation of a massive card-filing system and the training of a competent local staff. Family members were taught to fill syringes to lines marked with tape and then to administer the doses themselves. "Jill Seaman has treated more cases of kala-azar than anyone else in the world," says Dr. Robert Davidson, senior lecturer in infectious and tropical diseases at the Imperial College of Science, Technology and Medicine in London. "She has personally dealt with more than 10,000 cases."
Once treated, a patient is likely to remain immune to the disease. But the price of stopping the epidemic, which amounted to more than $1 million a year poured in by MSF-Holland, has been high in human terms as well. Of 70 Nuer and Dinka nurses trained by Seaman and the other MSF doctors, more than 75% have come down with kala-azar themselves. Five lost children to the disease.