A Chance to Put the Vietnam War Behind Us

Nguyen Thi Hoang Lang, or “Be Ba,” is 10 years old and already a survivor of cancer. I first met her in 1992 in Ho Chi Minh City (Saigon), when she was 2 years old and had bright shinning eyes. When I saw her again in 1994, she had lost her right eye to cancer at the age of 3. Since then, cerebral palsy has warped and deformed her limbs. It is questionable whether the dioxin in Agent Orange is responsible for her cerebral palsy, but it is highly probable that the tumor that took her right eye was caused by the residual of the defoliant sprayed over areas of South Vietnam during the Vietnam War. Be Ba and other Vietnamese children--and the offspring of affected U.S. veterans--are the most innocent of the innocent of a war that still affects us.

Fortunately, there are developments that may ease the suffering of future generations. The American Red Cross is exploring the possibility of a partnership with the Vietnam Red Cross to support a program providing assistance to disabled Vietnamese, including cases that may have resulted from exposure to Agent Orange. Similarly, the U.S. government is engaged in talks with Vietnam to start a joint research project on the health and ecological effects of dioxins.

Between 1962 and 1971, the United States sprayed some 19 million gallons of herbicide, more than 10 million of which was Agent Orange, over much of South Vietnam, often in multiple sprayings. It ceased spraying the defoliant when reports from the sprayed areas indicated a dramatic increase in miscarriages, cancer and birth defects among the inhabitants, and public pressure mounted. Chemicals found in Agent Orange--2,4-D and 2,4,5-T compounds--were already banned in the United States, except for carefully controlled use on non-cropland.

It had been believed that the chemicals in the soil and food chain would deteriorate over time, but Dr. Arnold Schecter of the University of Texas, who has been studying the problem since 1981, has concluded, along with the Hatfield Consultants Ltd. of Canada, that Agent Orange has contaminated the soil and food chain in the sprayed areas of South Vietnam. (In June of this year, the Environmental Protection Agency declared for the first time that dioxin is a carcinogen).

From 1968 to 1970, I traveled more than 20,000 miles through South Vietnam’s war zones. I visited every major U.S. military evacuation, field and surgical hospital, as well as Vietnamese provincial hospitals and orphanages, sometimes twice, documenting the efforts of the American Red Cross to alleviate human suffering. I occasionally saw birth malformations in children and cancer in older Vietnamese.

Twenty-one years later, I returned to Vietnam and made subsequent trips in 1994-96 and last year, to document suspected Agent Orange cases for the Vietnam Red Cross. It was no longer a war story, but an environmental one and, in many ways, sadder. In Vietnam’s hospitals and orphanages, I saw young people with cancer, children with birth deformities and mental disabilities and other illnesses. This generation’s wounds were inherited from exposed parents and from toxins in what had once been a clean and virgin environment.

The U.S. government has implied that if there were a true epidemic in Vietnam caused exclusively by Agent Orange, all the people in the sprayed areas, Vietnamese and American veterans, would be afflicted with the same ailments. In fact, spina bifida, mental retardation, congenital birth defects and cancer have occurred in nearly a half-million Vietnamese children of sprayed parents. Children of affected U.S. veterans have similar ailments, though on a much lower scale.

But differences in individual genetics, according to Francis Collins, director of the National Human Genome Research Institute, explain why some individuals develop cancer when exposed to environmental agents and others do not. In the case of the Vietnamese, there was no evidence of dioxin in their rural environment before the war. Then they were suddenly exposed to a high concentration of it. Americans, by contrast, have dioxin present in their bodies, but the exposure has been more gradual. The average TCDD (dioxin) levels in human fat tissue in the United States is 7.2, while in the sprayed areas of Vietnam, the average level is an astounding 19.24.

On my last trip to Vietnam, Dr. Nguyen Thi Hoi, vice president of the Vietnam Red Cross, told me that Vietnamese from the sprayed areas of South Vietnam carry a social stigma similar to that of the Japanese who survived Hiroshima and Nagasaki. Like the Japanese, these Vietnamese are considered risky potential spouses because of a fear of birth defects in their offspring.

If the joint Agent Orange study is realized, it would be a long time in coming because of political and economic considerations of both governments. In 1978, Vietnam appealed to the U.S. for war reparations, including Agent Orange injuries, but the U.S. threatened to end negotiations if Agent Orange were even raised as an issue. Then, in 1995, the U.S. began to explore the possibility of a joint scientific research effort, but the Vietnamese didn’t initially respond, presumably fearing the results might have a negative effect on the country’s agricultural exports.

With a joint American-Vietnamese research project will come many distractions in sorting out what health problems can be tied to Agent Orange. For example, many birth defects among Vietnamese children may result from malnouished mothers who didn’t realize they were pregnant until after their first trimester. Furthermore, the pharmacy trade in Vietnam is poorly regulated. People can buy drugs without a prescription. This can result in a pregnant woman taking medication with the potential to harm her fetus. Finally, during the U.S. trade embargo, which ended in 1994, Vietnam resorted to using DDT, a pesticide banned in the United States because it is a proven carcinogen. Rural Vietnamese farmers took few precautions when spraying their crops and used empty pesticide containers to store drinking water. Nevertheless, the incidence of disease and disorder in the sprayed areas is too great to rule out Agent Orange as a factor.

After World War II and the Korean War, the United States helped rebuild the countries its firepower had destroyed. During the Vietnam War, more bombs fell on Vietnam, roughly the size of California, than all the bombs the U.S. dropped during World War II--and the United States walked away when the fighting stopped. That act denied the United States the therapeutic effect that comes from aiding and rebuilding a former enemy.

The Vietnamese-American joint Agent Orange study could well prove that the toxin is not the cause of all the health ailments that plague the Vietnamese. What it will prove, if it goes forth, is that the United States is a nation powerful enough to be gentle, courageous enough to be compassionate. By extending official aid to the Vietnamese to heal this final wound of the Vietnam War, it will heal itself. The Vietnam War will finally conclude in a manner reflecting the compassion, courage and sacrifice of the men and women who served during that war.