Residual Dioxin in Viet Nam
American advisors in Viet Nam during the early days of U.S. intervention there often complained about the ability of Viet Cong warriors to hide within the jungle fastness of the land where they could not be seen. As early as 1961, Walt Whitman Rostow and Robert McNamara discovered that army chemists were experimenting with powerful herbicides, based upon a compound of 2,4-D and 2,4,5-T laced with dioxin. McNamara and Rostow believed use of this defoliant in Viet Nam might solve the problem of guerrilla lairs. Tons of this substance were sent to Viet Nam in different color-coded barrels; each color striped on a barrel designated a separate strength or compound. The most commonly used was shipped in orange containers, and thus the phrase "Agent Orange" passed into the English language. Beginning in January 1962, the Kennedy administration ordered the Air Force to dump defoliants on selected areas of the Ca Mau Peninsula, the southernmost region of that Asian land. C-123 aircraft made thousands of such sorties in this program which was designated "Ranch Hand." Pilots chuckled that their motto was, "Remember! Only you can prevent forests." They soon turned thousands of acres of jungles and rice paddies into mud wallows.
In 1964, President Lyndon Johnson ordered an increase in the use of herbicides for defoliation and crop reduction. If the enemy could not eat, neither would he be able to fight. The Air Force willingly complied. In 1966, Ranch Hand planes sprayed 850,000 acres of jungle. In 1967 they dumped the deadly powders on one and a half million additional acres. Army helicopters were equipped with special tanks and nozzles and sprayed around the perimeters of fire support bases to keep killing zones free from obstacles. The same lands were repeatedly sprayed as the tough jungle vegetation tried to reclaim its own. Even in generally quiet and safe locations, American troops regularly ducked under cover to avoid low-flying helicopters as they buzzed about their business of spraying the ubiquitous ground cover. In their hooches at eventide, these soldiers had to shake powder residue from herbicide sprayings out of their blankets before climbing into bed.
Warnings of the possible dangers to humans from contact with such herbicides were made known at least as early as the administration of Richard Nixon. His science adviser, Dr. Lee A. DuBridge, called Nixon's attention to a 1969 National Institute of Health report claiming that high dosages of 2,4,5-T caused stillbirths and malformations in mice. Yet by 1970, 200,000 gallons a month of Agent Orange were being used in Viet Nam. Some suggested substituting Agent White, but it was more expensive and persisted longer in the soil, increasing the possibility of long-term ecological damage.
Defense Secretary Melvin Laird considered curtailing the use of such herbicides, but General Creighton Abrams, commander in Viet Nam, and his boss, Admiral John S. McCain, Jr., Commander-in-Chief, Pacific, as well as Admiral Thomas H. Moorer, acting Chairman of the Joint Chiefs of Staff, reaffirmed the necessity for its use. General Earle G. Wheeler, Chairman of the Joint Chiefs, added his voice to those of his colleagues. Ending defoliation would take away from the military its ability to expose enemy encampments, storage depots, and main supply routes. Despite that pressure, David Packard, Deputy Secretary of Defense, announced that use of Agent Orange was to be suspended. Planes of the Seventh Air Force flew their last defoliation sortie on 7 January 1971, although they continued to spray crops. (Later there was at least one unauthorized use of Agent Orange in the provinces of Quang Tin and Quang Ngai to defoliate base perimeters and to destroy crops.)
Official figures indicate that the planes of Operation Ranch Hand ultimately poured nineteen million gallons of chemical poison on over twenty percent of the entire land area of the Republic of South Viet Nam; nearly six million acres. President Nguyen Van Thieu announced that herbicides had destroyed twenty percent of his nation's forests. An additional 150,000 acres were destroyed in Laos and an uncounted number in Cambodia. One and one-third million gallons of unused Agent Orange were retrieved from South Viet Nam by April 1972, to be stored with an additional 850,000 gallons that had not yet been sent to Asia from depots in the U.S.
Department of Agriculture standards for the use of herbicide spraying with the U.S. limited the average concentration of dioxin to one-half to one part per million. Agent Orange contained two to four times that allowable amount. The compounds were finally destroyed on 3 September 1977 aboard a ship in the North Pacific, equipped with special furnaces for destroying toxic substances. The cost was eight million dollars. To the last, military chiefs maintained that here was little or no danger to human beings from use of such herbicides.
In 1970, a four-man task force composed of scientists from the American Association for the Advancement of Science went to Viet Nam to investigate the long-term effects of Agent Orange but were kept from having access to necessary data by the military. Their preliminary report, issued 30 December 1970, indicated little forest regrowth even after three and more years. Bamboo had spread to reclaim forest floors where once hardwoods had grown. Coastal mangrove swamps were destroyed, nearly all trees dying after one spraying, not expected to return to their former state for at least a hundred years. Thirty-six percent of all mangrove forests were gone. Records were inadequate, they said, to conclude that herbicides caused birth defects, but they noted that it had been the civilian population rather than enemy troops who had consumed nearly all the food sprayed under the crop destruction program.
And there the matter of defoliants rested for me until 1988 when, at long last, the government of the Socialist Republic of Viet Nam finally gave me permission, after four years of requests, to visit that country and to travel its length and breadth, talking with people at all levels and photographing whatever I wished. I was a colonel in the Army Reserve, a professor of military history at the University of South Florida, and the author of nine books. As a youth I had resisted church-sponsored service as a missionary in foreign lands. That trip to Viet Nam caused me, a man nearing sixty years of age, to reconsider that youthful decision!
During that March trip, I requested a visit to Tu Du Obstetrical and Gynecological Hospital in Sai Gon, for I had heard from others of a sad and mysterious exhibit kept there within a locked room. I wanted to see it for myself. I already knew that medical needs in Viet Nam are immediate and drastic. Its citizens are generally vitamin and protein-starved. Intestinal parasites and malaria are endemic. Polio, diphtheria, and other diseases afflict a large proportion of the population.. Many people suffer from what their physicians believe may be the after-effects of American use of defoliants, for the residue of that outpouring of herbicide has entered the food chain. In that land of problems, Tu Du and other hospitals fight a lonely battle.
Tu Du is a primary health care facility of 750 beds serving the women of sixteen southern provinces around the former capital city of the southern republic--and there I came into first-hand contact with what may be the after-effects of Agent Orange. Founded over fifty years ago, the present physical plant, located inside a walled compound, consists of three pleasant buildings constructed during the French occupation in 1937, in 1965 while U.S. forces were beginning their build-up, and in 1985, after unification. Oleander bushes dot the courtyard and that day blooms hung in profusion from the branches. It provides care without cost. In 1987, hospital physicians examined 1,800,781 women who needed maternal care and delivered 17,002 infants. The institution is divided into four sections: gynecology, obstetrics, neonatology, and family planning.
Upon our arrival on Thursday, 24 March 1988, my interpreter, Le Hong Lam, and I were met by a delegation consisting of a man, Professor Dr. Bui Sy Hung, Director of Tu Du, and two women: Professor Dr. Nguyen Thi Ngoc Phuong, Chief Gynecologist, and Dr. Le Diem Huong, Chief Pediatrician and the head of neonatology--all assembled to greet their western visitor. We seated ourselves in a nearby conference room, plain and starkly utilitarian. On the long table around which we gathered, however, sat a beautiful flower decoration which I admired while we were served refreshments: tea and small bananas. The director gave a few words of welcome and then excused himself for urgent business elsewhere, leaving Dr. Le Diem Huong in charge of our visit.
A woman of about fifty, she had the face of a saint and the dedication of a missionary. She was a woman comfortable with herself and her work. As I listened to my interpreter translate her words, I watched her kind eyes and careworn expression and was impressed by her inner strength. She spent some time on her briefing and then gave me a tour of the hospital.
Tu Du faces unique problems. The sixteen provinces from which it draws the bulk of its patients also happen to be those which received the largest amount of defoliants used in Viet Nam during the period when U.S. military forces fought there. Dr. Huong believes dioxin is now in the food chain in that area, an inextricable part of all the water and meat and vegetables the inhabitants there consume. American soldiers came in contact with defoliants for one year (unless they extended their time in Viet Nam--an option exercised by only a few men). For the Vietnamese, the land is theirs for life, with all the dangers that continued exposure may bring to them.
Neonatology, the area Dr. Huong knows best, contains 150 beds reserved for difficult and premature births. During 1987, the hospital supervised the delivery of seventeen thousand babies of which 30 percent were either difficult or premature. In areas north of the 17th parallel, she said, the incidence of such problems is much less significant. An example: 18 percent of births at the hospital were premature; for Sai Gon, the incidence was only 12 percent. For all of the south, the figure was 10 percent, and for Viet Nam as a whole, 8 percent.
Birth defects are common. I was shown several premature infants huddled in their outmoded incubators, and saw tiny babies with gross cleft palates, marked with absence of limbs or ears, hydrocephalic--all abandoned by their horror-stricken mothers. One sweet premature baby girl lay in her incubator, a picture of beauty until a nurse turned her and I saw that she had been born without a left shoulder and left arm. Another with a dismaying cleft palate lay nearby.
In 1987, Dr. Huong told me, forty infants suffered from neural tube defects, forty from cleft palate, thirty-two from malformation or absence of arms or legs, and every year since 1975 the hospital has been the site of five or more conjoined ("Siamese") births. I visited with one such twin, seven year old Nguyen Viet-Duc, born at Gia Lai-Kontum on 25 February 1981. Abandoned by their mother when she realized what she had delivered, Viet-Duc had since remained at the hospital. They were conjoined at the pelvis: one anus, one penis, one urinary tract, one bladder, two kidneys, three legs--two of them tiny and stick-like--that rose from the pelvic area; the other twisted and atrophied, and separate torsos. On 22 May 1986, Viet fell prey to acute anencephalopathy and by October of that year had lost cerebral cortex and reaction functions. He suffered from constant respiratory and urinary infections. Since Viet had no sensations when eating, his food often diverted into his trachea. He remained hydrocephalic, comatose and ill; his system pouring poisons into his twin. Duc, on the other hand, was lively and bright, but increasingly subject to illnesses given him by his twin. Dr. Huong spoke of her hopes of interesting a team of foreign physicians in coming to Viet Nam to operate on Duc-Viet. (I again visited Tu Du in December 1988 and found that the previous September a group of Japanese physicians had performed the surgery. Both twins still survived, although there was no hope for the vegetative one; Viet was near death, kept alive only by extraordinary measures. Duc--who for the first time in his life now had mobility in a wheelchair--smiled and told me that one day he hoped to become a soccer goalie.)
Every two or three days, physicians at Tu Du deliver another deformed fetus. Dr. Huong ushered me into a large room, perhaps twenty-five feet long by fifteen feet wide, its walls covered with floor to ceiling shelves. Other, free-standing shelves filled much of the floor space. Everywhere were two-and-a-half gallon, formalin-filled Bell jars, in each of which floated an aborted or full-term fetus. The hospital administration had, for a time, ordered all such specimens to be preserved for later scientific tissue studies, but has not done so of late because of lack of funds to purchase even so cheap a material as formaldehyde. Many were genetic monstrosities: twinned or triple conjoined, hydrocephalic, some covered with cancerous growths, their eyes staring blankly through the glass at sights they would never see. Dr. Huong, who spoke French, waived her hand at the shelves of grossly deformed beings and sadly told me in that language, "They're not babies. They're monsters." And they were. The genetics of one fetus had gone so awry that its genitals were growing out of the middle of its face! The Vietnamese wonder whether this great incidence of deformity has not been heightened by the toxic poisoning of their land during the war from the widespread use of defoliants.
Tu Du does more. It also cares for women suffering from hydatidiform mole and choriocarcinoma. The former causes a woman to believe she is pregnant, but it is not a fetus inhabiting her body but rapidly developing cysts within the uterus. The latter is an extremely rare, very malignant neoplasm of the uterus. It can happen to women of any culture, but usually strikes them in their fourth or fifth decade or even later, and in the West, this malignancy is regularly cured through chemotherapy. Ninety-two percent of such patients in America, for example, are still alive five years after the disease has been detected, unless it has metastasized to the brain, while in Viet Nam it is simply and inevitably fatal, for Viet Nam has little access to chemotherapy drugs. In all countries of southeast Asia, choriocarcinoma accounts for one of every two thousand female patients. In southern Viet Nam, that figure doubles and for the sprayed areas the figure is six per cent or higher.
In the thirteen provinces around Sai Gon, young women of eighteen and nineteen fall prey to this cancer--and there are no chemotherapy medicines to save them. I visited their ward of sixty beds which normally contains between eighty and ninety patients. Some women lay two to a bed. Many of these sad creatures simply lie there passively waiting to die; their cancers had metastasized to their lungs and elsewhere even after removal of their uteruses. Most had not been told that further efforts were hopeless, but their expressions showed they knew they would die soon.
Somewhere on the grounds that day, impressed with her work, I told Dr. Huong, "Vous ete la mére Thérèsa de Ho Chi Minh Ville." She looked blank, either because of my French pronunciation or because she had not heard of Mother Theresa or her work in Calcutta and elsewhere. When I explained, she disclaimed any accolade, saying she was not worthy of such an honor--a most Mother Theresa-like response.
As I took my leave, Dr. Huong told me that many had come as visitors to Tu Du, listened gravely to her and even sometimes promised to send help. She had not heard from them again, she remarked, without any trace of rancor or bitterness. I did not say so aloud, but inwardly pledged myself to help. Upon my return to the U.S., in company with my accountant, my lawyer, a Vietnamese friend who works in the public health sector in California, and a Thai businessman I had met, I formed "American Medical Help for Viet Nam." We were fortunate. On my second trip to Viet Nam in December 1988, I took with me nearly a ton of donated medicine and supplies, twenty-two boxes worth approximately $25,000 and distributed the material between Tu Du Hospital and another I had visited earlier in the north--the Institute for Protection of the Mother and the Newborn in Ha Noi (Professor Dr. Duong Thi Cuong, Director).
Other non-governmental agencies have also pledged themselves to provide aid to Viet Nam despite obstacles placed in our way by various agencies of the U.S. government acting on orders of successive American presidents: Ford, Carter, Reagan and Bush--they have all obstinately refused to allow direct aid or shipment of goods to Viet Nam. After all, that nation had the temerity to defeat us in combat. In the meantime, while we passively wait for such agencies to change their policies, thousands upon uncounted thousands of Vietnamese die unnecessary, slow and lingering deaths--many of them due to our poisoning of their soil. Most caught in the coils of that persevering compound were once citizens of the Republic of South Viet Nam--our ally in the fight against the government in the north. In April 1975 their land was occupied by troops of the People's Army of Viet Nam, their government collapsed, their leaders fled. They remained behind and have experienced repeated punishment because of where they lived: re-education camps, poverty and inflation, unemployment and health problems linked to our use of herbicides. And we have turned our backs.
Cecil B. Currey is the founder of American Medical Help for Viet Nam, the biographer of Edward Lansdale, and the author (under the pseudonym of Cincinattus) of Self-Destruction.