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Seaman To Present Gorgas Lecture, June 10

By Karen Leighty

This year's Gorgas Memorial/Leon Jacobs Lecture will be presented by Dr. Jill Seaman, a pioneering physician who worked for 9 years in Southern Sudan as a Médecins Sans Frontières (Doctors Without Borders) volunteer. Her talk, "Epidemic Kala-azar in Sudan: Tragedy and Treatment," will be given on Wednesday, June 10 at 4 p.m. in Wilson Hall, Bldg. 1.

In 1988, Seaman accompanied a medical team sent to an isolated community in Sudan, where the population was being ravaged by kala-azar (visceral leishmaniasis), a disease not previously seen in the region. This parasitic disease, transmitted by sand flies, is almost invariably fatal if left untreated.

In spearheading a treatment program against this epidemic, Seaman not only saved thousands of lives, but also developed new techniques and procedures that could be applied in other field situations where basic facilities and supplies, including food, are lacking.

Dr. Jill Seaman, a pioneering physician who worked in Southern Sudan as a Médecins Sans Frontières (Doctors Without Borders) volunteer, will deliver the 1998 Gorgas Memorial/Leon Jacobs Lecture at NIH.

Bombings in the immediate vicinity -- as a result of the Sudanese civil war -- contributed to the medical challenges. Flights of supplies into the area were so limited that Seaman and her team often had to choose between food and medicine. The doctors decided at one point that if the patients were starving, they themselves would eat less. Treatment of kala-azar requires a 20-day course of injections of a potentially toxic drug, during which each patient must be carefully monitored. Patients typically walk for days to reach the clinic, which consists of a tent surrounded by a huge encampment of patients, their families, and sometimes the cattle that the families had to tend for the treatment period. Seaman monitored up to 1,400 kala-azar patients at a time, while also coping with health issues more common to the villagers: measles and meningitis outbreaks, spear wounds, and complicated pregnancies.

The symptoms of kala-azar are persistent fever, enlarged liver and spleen, and wasting. While a blood test can be used for diagnosis, it is very inexact because the lack of refrigeration causes the testing antigen to shift in the fluctuating temperatures. The only method for confirming diagnosis is a bone marrow or spleen biopsy, which, under field conditions, is not undertaken lightly. Seaman is working on a diagnostic field test kit that is less cumbersome.

It is unlikely that patients would undergo the pain and discomfort involved in diagnosis and treatment without complete trust in the doctor. This trust may well derive from the affection Seaman has for these people, their language and tribal culture. The chief of one village announced that he has named many of his daughters "Jill" -- and is planning to give the name to his future sons. Such connectedness may be why Seaman's clinic became one of the most sustained of the MSF programs.

Originally from Moscow, Idaho, Seaman earned her B.A. at Middlebury College in Vermont. She received her medical degree from the University of Washington School of Medicine at Seattle in 1979 and studied at the London School of Tropical Medicine, where she earned her diploma in tropical medicine and hygiene in 1989.

During the 1984-1985 Ethiopian famine, she worked for the International Refugee Committee as a physician in a makeshift refugee hospital and also at a therapeutic feeding center. It was this experience that inspired her to further her training in tropical medicine. She had previously been working in Bethel, Alaska, for the regional Indian Health Service, where she served as a general medical officer for a 50-bed bush hospital. She received a PHS citation for this work in 1986. In 1994, the British Royal Society of Tropical Medicine and Hygiene awarded her the Donald MacKay Medal, which recognized outstanding work in tropical health in rural areas.

As a result of her extensive community service, Time magazine profiled her work in 1997 in a special issue devoted to medical heroism.

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