Monday, April 6, 2009

Agent Orange (dioxin)

For me, the topic of Agent Orange is hard to talk about. Being Vietnamese, I want to say that Agent Orange is outrageous and how dare the US just release gases on soil that is not theres. They wanted to destroy crops and fields but how many lives have they destroyed? It's disgusting for a country to claim it wants to fight for freedom, democracy, and the improvement of people's lives when it's simultaneously hiding bombs and releasing gases to physically and mentally injure soldiers and civilians alike over the short-term and the long-term. Although I never researched the topic, I also never questioned it. Agent Orange is bad, and there are victims with chronic cancers and birth defects out there because of the US's careless actions. Then I learned that it wasn't that simple.

When I was studying abroad in Vietnam, one of my study abroad classmates visited Friendship Village, which is a place that takes care of victims of Agent Orange. There, she saw mentally and physically disabled adults as well as the affected children and grandchildren of Agent Orange victims. However, she found it hard to believe that all the people there are Agent Orange victims. She knew that chemicals can affect one's children if their parents are infected, but she couldn't believe that the chemicals' effects can be passed to grandchildren as well. Her opinion was that some of the children there were just naturally disabled and housed there to increase funding. That was the first time I questioned my biases and whether Agent Orange actually had the effects that I assumed it had. Was that really the chemical that created all those cancers or birth defects? Was it a coincidence? How many people were really affected and what are those effects?

Then last semester, I took microbiology, and my professor said that the effects of dioxin on humans are very uncertain. We know for sure it can cause chloracne (hardcore blemishes on the face), and then the other effects like spina bifida (birth defect) and cancers have mixed study results, so no one is really sure.

But so many people claim they have been affected, and it's so hard to ignore anecdotes when they were there and I was not. Who am I to say anything? I have no idea! I know long-term exposure to gaseous chemicals can affect people, and signs may not show today, but someday they might. In my epidemiology class, long-term exposures and their health effects (chronic diseases) are hardest to link together because it doesn't happen over night. It's hard to identify. It's not like an allergy where you eat something, and then within a few hours you're completely red and itchy.

Science can't back up that dioxin has caused all those mental and physical disabilities that sprang up afterwards, but honestly, it's nearly impossible to MEASURE this unless you have tons of funding for years and years of research and/or expose people to a large dosage like in the war again and wait years? It's so hard to know and study. Research has its limitations. Not everything can be researched with accuracy. Even if it could be, people are so different. Some people with the same level of exposure won't develop symptoms while some will and they won't all develop the same symptoms. Furthermore, these people might not even be in the same areas anymore. This includes American war veterans, Vietnamese war veterans, civilians that lived near affected areas. BUT, just because it's hard to research and prove DOES NOT mean it didn't create physical and mental long-term effects, birth defects, and genetic mutations (which might be able to affect grandchildren). And disabilities are not just diabilities on their own. In the context of a family or in the perspective of a caregiver, it becomes even harder.

Dioxin is totally controversial.

I once read something that people who don't read the news are not informed, and people who read the news are misinformed...haha. It's so hard to know anything when there is so much mixed information out there.

I was sent this speech about Agent Orange from my Vietnamese teacher in Vietnam. I thought I'd share:

District of Columbia Vietnamese Students Association

Panel Discussion

A Growing Vietnam: The Economy and Civil Society

American University, Washington, DC

March 4, 2009

Charles R. Bailey, Director

Ford Foundation Special Initiative on Agent Orange/Dioxin

Good evening.

We are talking about the overlap of Vietnam’s economy and civil society this evening. During the ten years I lived in Hanoi I was responsible for some 95 million dollars in grants to Vietnamese organizations in areas like development finance, sexuality and reproductive health, social sciences, media, arts and culture, and international relations. So I look forward to contributing from this experience in the Q&A afterwards. But underlying all of this—the economy, the society, the government—is some unfinished business from a long ago war. That unfinished business is the current health crisis in Vietnam which stems from the US use of military herbicides in that war. I am referring to the Agent Orange legacy of the Vietnam War.

During the 1960s, the US used Agent Orange and other military herbicides to destroy the forests and crops over about ten percent of the area of central and southern Vietnam. This is the same size as New Jersey. Agent Orange carried with it dioxin, a persistent chemical poisonous to creatures like us in very small amounts. So while this dioxin has historical origins in the US conduct of the war, it is still a problem today—exposure to dioxin is strongly associated with chronic ill health and even more notably, with increased numbers of children born with severe and often multiple disabilities.

Two groups of Vietnamese are at risk because of exposure to dioxin: First, soldiers on both sides and civilians, people who were in the sprayed areas during the 1960s and their children and grandchildren. And second, people who today live in communities close to several former US military airports which are contaminated with dioxin. People in these communities continue to be exposed, primarily through the food chain.

I became involved with the Agent Orange legacy shortly after I arrived in Vietnam in 1997. However, Agent Orange proved to be so sensitive that it was hard to find people willing to accept grants to work on it. This was highly unusual to me in my experience as a grant maker! A kind of breakthrough occurred in 2003 when we were asked to support SAIS here in Washington and the Institute of International Relations in Hanoi for a conference on the future of the US-Vietnam relationship.

The conference leaders decided to organize the discussion starting with easy things and then moving on to the more difficult. So we first talked about trade and economic growth, then we moved to regional security —the relationships among Vietnam, China and the US. By the second day of the conference it was time to move to the most difficult subjects— the legacies of the war: the overseas Vietnamese and their relationship to their country of origin, unexploded ordnance and Agent Orange. Agent Orange was way out on the end of this spectrum, sensitive, unattended to, but clearly important.

It turns out that Agent Orange is not only a sensitive subject but it’s also very controversial. The controversy is of two sorts. At the abstract, scientific level—just how is it that dioxin in the body leads to early death in those exposed and congenital disabilities in their children? The controversy is also at the practical level—the diseases and disabilities linked to dioxin also can have other causes. So how do you identify specific Agent Orange survivors? And should you single them out?

The government of Vietnam estimates some three million Vietnamese, the majority children and young adults, are Agent Orange victims.

The US government claims there is no causal linkage and these victims’ health problems must have other causes. At the same time, thanks to a law passed in 1991, the US government provides compensation and healthcare to some half million Vietnam War veterans for more than a dozen cancers and birth defects associated with Agent Orange exposure during their wartime service in Vietnam. For children of veterans, spina bifida is recognized as linked to their parents’ exposure to herbicides. For the children of female veterans only, an additional 18 birth defects and childhood disabilities, including cleft palate, congenital heart disease and club foot are recognized as service-related.

So in fact, this legacy, the Agent Orange legacy, is both the dioxin itself and the fact that Vietnam and the United States were not able to reach common ground on this issue for many decades.

Two approaches have emerged over the last few years—legal and political/technical.

The legal approach is a class action suit which the Vietnam Association of Victims of Agent Orange filed in US federal court in New York in 2004. Plaintiffs claim damages against 37 US chemical companies which manufactured dioxin-contaminated Agent Orange in the 60s. However the district and appellate courts ruled that the Association’s legal arguments did not merit a trial and last Monday the Supreme Court refused to hear their appeal.

The political/technical approach only began to unfold in November 2006 when President Bush, in Hanoi on an official visit, committed the US to help Vietnam clean up dioxin contaminated soil at former US military airports. However the Bush administration did not provide the funds to do this. Subsequent progress in the bilateral dialogue has been led by the US Environmental Protection Agency and its counterpart in Vietnam, Committee 33 of the Ministry of Natural Resources and the Environment.

The Ford Foundation role in all this has been that of a neutral party working with both sides—the government of Vietnam and the government of the US. We bring people together who might not otherwise talk, we fund confidence building projects for which there is no other donor, and we seek to mainstream this issue in the US. We also support the US-Vietnam Dialogue Group on Agent Orange/Dioxin, a bi-national committee of prominent citizens working together on solutions.

We have mobilized $17 million so far for such solutions. This is $9 million in direct Ford Foundation grant making and $8 million contributed by the Government of Vietnam, the Bill and Melinda Gates Foundation, Atlantic Philanthropies and the US Fund for UNICEF. Two thirds of our grants fund direct services to Vietnamese families struggling to cope with a disabled child or young adult.

I’m also pleased to say that last October 29th the US government announced its first grants in this area-- $1 million to three US NGOs for social services for people with disabilities in the city of Danang. These are the first disbursements out of a $3 million allocation for dioxin clean-up and health programs in Vietnam which the Senate inserted in the 2007 Appropriations Act. The Senate has placed a second $3 million in the 2009 appropriations bill.

As I mentioned, the precise link between exposure to dioxin and disability is disputed. So we have taken an inclusive approach—aiming to assist all who are disabled. There are 85 million people in Vietnam and about 13 million of them are living with disabilities. Of these 13 million, the disabilities of some three million are linked to exposure to dioxin.

One should never underestimate the destructive power of physical and mental disability not only on the individual but on her or his family. When a family member becomes chronically ill or disabled or is born with disabilities, the family expenses go up, family income drops and the family finds itself on the fast elevator to the bottom of the society where they join families still stuck below the poverty line. Disability leaves people more vulnerable, especially women and children. So, the challenge of the Agent Orange legacy of the Vietnam War is to focus resources—funds and expertise—to ensure healthy families, and more particularly, to ensure opportunities for people with disabilities in Vietnam to maximize their capabilities and live with self-confidence and self-respect.

I have to say though, despite this progress, it’s still a fragile situation and continues to depend utterly on the actions and commitment of a pretty small number of people, most of them in this town. We need more people to join us, people like you.

The people and government of Vietnam think a solution to the Agent Orange/dioxin issue is important and certainly long overdue. They are looking for a solution which directly benefits the affected people, their families and their communities. They also feel that this issue is the last remaining barrier to fully normal relations between the US and Vietnam.

For these reasons, we Americans need to get reacquainted with Vietnam, to pay attention to Vietnam.

Thank you.

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