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HO CHI MINH CITY — It’s time for the afternoon meal at the “peace village” ward in Ho Chi Minh City’s Tu Du Hospital, and staff members wheel carts of milk and porridge into the rooms where 58 children — ranging from newborns to teenagers — are staying.

The children suffer a range of birth defects: Some have unformed limbs, others are mentally handicapped. Two infants have grotesquely enlarged heads.

The staff at the hospital are reluctant to say what these patients have in common, but Vietnamese scientists and government officials believe the children — along with perhaps hundreds of thousands of other Vietnamese — are victims of the massive amounts of Agent Orange herbicide that U.S. forces dumped on South Vietnam during the Vietnam War.

Dr. Hoang Dinh Cau, chairman of the government-supported National Committee for Investigation of the Consequences of Chemicals Used in the Vietnam War, or 10-80 Committee, has studied the effects of Agent Orange on Vietnamese people for two decades. Cau is not as circumspect as the staff at Tu Du Hospital in discussing the use of the herbicide, which contained dioxin, a contaminant one Western researcher called “the most toxic chemical discovered by mankind so far.”

“We have recognized many kinds of birth defects associated with dioxin,” he said, opening up a book with photographs of Vietnamese civilians identified as Agent Orange victims. Several of the photos depict badly deformed infants.

The U.S. military used 19 million gallons of herbicides — including more than 11 million gallons of Agent Orange — between 1962 and 1971 during Operation Ranch Hand. Intending to destroy forest cover used by Viet Cong guerrillas and, to a lesser extent, crops thought be useful to the insurgents or their sympathizers, U.S. forces sprayed defoliants over 14 and 18 percent of South Vietnam.

A 1965 confidential memo by one Agent Orange manufacturer, Dow Chemical, described the dioxin in the herbicide as “exceptionally toxic.” In 1969, studies in the United States found that dioxin caused birth defects in mice and rats. Two years later, Washington halted Agent Orange spraying.

In the 1970s, the dioxin-containing chemical in Agent Orange, known in scientific shorthand as 2,4,5-T, was banned in the U.S. and a number of other nations as evidence mounted linking it to disorders in lab animals.

Today, Vietnamese researchers, as well as some of their Western colleagues, believe that the nearly 166 kg of dioxin that the U.S. military introduced to South Vietnamese ecosystems created a public-health nightmare from which Vietnam has yet to escape. Vietnamese scientists believe the dioxin contamination has caused not only birth defects, but also a variety of other illnesses and disorders, including respiratory cancers, heart problems and diabetes.

Pilot surveys conducted by Vietnamese researchers in December 1998 found that between 800,000 and 1 million Vietnamese had Agent Orange-related health problems, according to a report released last year by Dr. Le Cao Dai, executive director of the Agent Orange Victims Fund of the Vietnam Red Cross.

Vietnamese researchers most likely will never be able to arrive at reliable estimates of how many people died as a result of Agent Orange. Cau, however, said research conducted by the 10-80 Committee suggested that about 15 percent of those who had been born with Agent Orange-related birth defects were already dead.

“It’s been almost 30 years since the United States stopped using Agent Orange. The most serious patients have already died,” he said.

Cau’s 10-80 Committee — named because it was founded in October 1980 — was the first Vietnamese organization to attempt systematic research into the effects of Agent Orange. Cau said the North Vietnamese government had tried studying the mysterious herbicides the U.S. was using as far back as 1965, but lacked the resources and knowledge to do so effectively. “The North Vietnamese Army never used Agent Orange, so they had no experts to study about it,” he said.

Vietnamese researchers now know that the dioxin from Agent Orange continues to affect Vietnamese born long after the war because it moves up the food chain, accumulating in higher concentrations as it goes.

According to Dai’s report, 85 to 90 percent of the dioxin burden in Vietnamese comes from contaminated food. After an area was sprayed, the report explains, the dioxin from Agent Orange contaminated organic matter in soil as well as river and lake mud. Animals, fish and shrimp then ingested some of the soil and mud and became contaminated. Humans, in turn, were exposed to dioxin when they consumed contaminated animal, fish or shrimp products.

Dioxin reaches human fetuses through the mother’s placenta. After the mother gives birth, she can pass dioxin to her newborn through her breast milk.

Testing for dioxin is a painstaking and costly procedure, and is difficult to carry out even in nations far wealthier than Vietnam. One dioxin test costs between $500 and $715 in Vietnam, adding up to expenses that can quickly bust the budgets of Vietnamese researchers.

Since the mid-1980s, Western scientists have assisted Vietnamese researchers in conducting tests to measure dioxin levels in soil and river mud, in the food supply, and in human fat, blood and breast milk.

According to this research, people living in sprayed areas and Northern Vietnamese who served in the South during the war have higher levels of dioxin in their bodies than those who have always lived in unsprayed areas in the North. A study of human fat tissue in 1984-85 found that dioxin levels in people who lived in sprayed areas of southern Vietnam were 10 times higher than in people living in the north.

A 1988 World Health Organization study comparing levels of dioxin in breast milk worldwide found that nursing South Vietnamese women had significantly higher levels of the contaminant in their breast milk than their counterparts in Hanoi and in industrial countries. Breast milk from one heavily sprayed area had a level of dioxin eight times higher than samples taken from Hanoi, and almost five times higher than samples taken from the U.S.

According to Dai’s report, more recent tests have shown that dioxin levels in the environment and human tissues “have decreased over time,” while “dioxins in commonly used foods [have] returned to normal.”

Dai wrote in his report that areas around former U.S. airbases remain dioxin hotspots. His concerns about base sites are predicated partly on a 1998 environmental assessment of an area around a former U.S. Special Forces base in Aluoi province.

That research, conducted by a Canadian-based environmental consulting firm and Vietnamese researchers, constituted “the first systematic environmental assessment of residual dioxins” in Vietnam, according to David Levy, a scientist involved in the Vietnam study who also serves as vice president for Hatfield Consultants Ltd.

In one area around the site of the former base, “dioxins are present in duck fat and fish fat at high levels,” Levy said. “Similar concentrations in Canada trigger a regulatory response, for example, food consumption advisories, closure of commercial fisheries.”

Levy said the Hatfield research points to the need for further study of areas around former U.S. military installations in South Vietnam. “There should be carefully designed epidemiology and environmental impact studies carried out adjacent to the former U.S. base sites where Agent Orange was handled, perimeter-sprayed, and possibly buried,” he said.

The U.S. thus far has not wanted to have anything to do with research into the connection between Agent Orange spraying and health problems among Vietnamese. The U.S. government has also questioned the accuracy of Vietnamese studies on Agent Orange.

But U.S. Defense Secretary William Cohen, in Vietnam last month, expressed U.S. willingness to do joint research on Agent Orange.

Also last month, at a congressional hearing on federal research on the effects of Agent Orange on U.S. veterans and their families, Joel Michalek, the Pentagon’s senior principal investigator for the Ranch Hand study on Agent Orange, said he supported conducting research in Vietnam.

“Of course, if you’re going to look for people who are exposed, that would be the place to go,” he said in response to a question from Rep. Bernard Sanders of Vermont. “And to see evidence of concern over there and a counting of individuals with adverse effects should motivate more research.”

U.S. veterans who served in Vietnam are eligible for compensation for a range of 10 different health problems that the federal government recognizes as being linked to Agent Orange exposure, including Hodgkin’s disease and respiratory and prostate cancers. Veterans whose children have spina bifida may also receive benefits.

Last month, the U.S. Air Force released a study that demonstrated a link between Agent Orange exposure and diabetes and heart disease. Vietnamese scientists had already claimed to have found such links.

Levy said Vietnam, with the contrast between the unsprayed North and sprayed South, “provides what may be the best natural laboratory in the world” to study links between exposure to the herbicide and health problems.

“In terms of epidemiology, both prospective studies, similar to the U.S. Air Force Ranch Hand study, and retrospective studies, similar to those carried out by Vientamese medical scientists, should be carried out,” he said. “The research will be challenging, as witnessed by the huge effort required to draw a causal linkage between smoking cigarettes and lung cancer.” Cau of Vietnam’s 10-80 Committee is not too optimistic about the possibility of establishing causal links that would measure up to Western scientific standards. “A long time has already passed,” he said. “Mitigation of Agent Orange effects on human health and the environment are the goals now.”

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