When Caethe Goetz was diagnosed with multiple myeloma, a rare form of bone marrow cancer, at age 49 in 2003, both she and her doctor were perplexed.

The disease affects only 20,000 Americans a year, typically African-American males in their late 60s. Goetz’s family has no history of cancer.

However, when her doctor learned she was a former U.S. Marine, he thought he might have found the answer to the mystery. Since multiple myeloma is one of the 14 diseases that the U.S. government recognizes as related to contact with the toxic defoliant Agent Orange, he speculated that the roots of her illness came from her military service.

“He questioned if I had been exposed to Agent Orange and suggested I do an intake exam,” Goetz told The Japan Times. “I did the exam, but discounted it as I was unaware of any exposure to Agent Orange outside Vietnam.”

After the results of the tests suggested Goetz had indeed been exposed to dioxin, she was even more confused because she had never stepped foot in Vietnam — at the time the only country where the Pentagon admitted it had used the defoliant.

But then Goetz recalled she had spent the year between 1975 and 1976 at Marine Corps Camp Foster in Okinawa. At the time, according to Goetz, the sight of military personnel spraying herbicides along the perimeter fence of the base was common.

“The fence line was devoid of vegetation. When I walked past it, there was a pungent smell and I would get a headache. One time there was a breeze and some of the mist blew onto me.”

As well as inhaling the dioxin-laced defoliant, Goetz also worries that she may have come into contact with Agent Orange through Camp Foster’s water supply. She was pregnant at the time and her physician advised her to stay as hydrated as possible.

“So I drank copious quantities of the local water.”

To Goetz, the evidence seemed to indicate she had been exposed to Agent Orange while in Okinawa, so she filed a claim for compensation with the Veterans Affairs Department — the U.S. body in charge of helping former service members with their health care costs.

In May 2010, Goetz’s claim was rejected. The VA stated that “a review of the DoD (Department of Defense) documentation showed no use, testing, or storage of tactical herbicides such as Agent Orange at any location on Okinawa.”

The VA denial is identical to hundreds of others issued to sick American veterans who have claimed exposure to Agent Orange in Okinawa during the 1960s and 1970s. All but one of these applications has been rejected by the VA.

The sole exception was a former marine truck driver who received compensation in 1998 for prostate cancer that he asserted was the result of transporting Agent Orange to Okinawa Island’s northern jungles between 1960 and 1961. However, previous VA decisions do not set precedents, so Goetz was unable to cite the 1998 ruling to support her claim.

Due to the VA denial, Goetz was confronted with monthly medical bills of $1,400 to pay for the oral chemotherapy treatments recommended by her doctor. In 2010, she testified before California State Assembly and Senate committees about her struggle to meet these bills.

“The costs were so great I maxed out every single credit card. Finally, I had no choice but to stop the oral chemo and go to an IV (intravenous) medication, which was not effective. We shouldn’t have to make a life or death choice based on costs.”

A veteran, who was at Camp Foster between 1972 and 1973, said he witnessed the use of Agent Orange as a weed killer at his camp.

“I witnessed on many occasions the Okinawan groundskeepers spraying defoliants around the buildings and refrigeration units at my barracks and others on Camp Foster,” said the former sergeant, who asked to remain anonymous due to fears that speaking to the media would harm a claim for compensation that he recently submitted to the VA.

The former service member is currently suffering Type-2 diabetes that he believes was caused by exposure to Agent Orange on the base.

According to the testimony of other veterans gathered by The Japan Times, the use of Agent Orange as a localized weed killer was commonplace on American bases in Okinawa, where it was difficult to keep the fast-growing vegetation under control.

Raymond Adams, a marine stationed on the island between 1973 and 1974, said, “We routinely sprayed the runway at MCAS Futenma at the wing equipment and support group. It burned my skin. But it kept the grass down and moreover kept the ‘habus’ (venomous snakes) away.”

The Pentagon itself recognizes that Agent Orange was used in this manner on U.S. bases in Thailand until 1975.

However, just Friday, the Foreign Ministry announced that the Pentagon once again denied allegations that the U.S. military ever stored or used the defoliant in Okinawa before its reversion to Japan.

Meanwhile, Goetz’s fears that her cancer may have been caused by drinking the local water raises worries that Camp Foster’s water supply was contaminated with Agent Orange.

Though it is not certain where exactly the defoliant was used, Wayne Dwernychuk, an environmental scientist, explained, “Dioxin contamination may not necessarily be isolated and restricted to the immediate area of original contamination.”

Dwernychuk served as chief scientist for 12 years with Hatfield Consultants, a Canadian firm at the forefront of investigations into Agent Orange poisoning on former U.S. bases in Vietnam.

“Seepage into the ground occurred throughout these bases. Due to rains and erosion, contaminated soil was transported through drainage pathways into lakes. Therein, the particulates settled on the lake bottoms and were also flushed out of the lakes into other waterways,” he said.

Between 1994 and 2006, Hatfield Consultants identified more than 20 potential dioxin hot spots in Vietnam over two decades after the U.S. military had pulled out. The contaminated sites included Da Nang Air Base, where dioxin levels in the soil were more than 30,000 times normal and the toxin was discovered in the blood of local residents and the breast milk of mothers.

U.S. government scientists and the companies who manufactured Agent Orange, including Monsanto and Dow Chemical Co., still cast doubts on links between dioxin and disease. But most independent health experts are sure — even in volumes as infinitesimal as two parts per trillion, dioxin exposure can cause cancer and birth defects.

The impact on the children of those exposed is particularly worrying for Goetz. The daughter she was carrying while pregnant in Okinawa has been experiencing life-long leg and back disorders possibly related to spina bifida occulta — another disease the VA recognizes as related to Agent Orange exposure.

As for Goetz, her struggle with multiple myeloma goes on.

“I have exhausted all the available current therapies, and my kidneys were in danger of failing in June,” she said. Goetz is soon scheduled to undergo a stem cell transplant, but her doctors give the operation only a 50 percent chance of success.

Goetz, however, is determined to keep fighting for the VA to recognize that she came into contact with Agent Orange as a marine at Camp Foster.

“The powers that be just don’t know me. I won’t give up and go away. I just hang in there until the end. And it isn’t just about me — it’s about every other vet who was exposed on Okinawa.”