U.S. Congressional Hearing on Agent Orange Victims Assistance

Dr. Nguyen Thi Ngoc Phuong

Speech at the Public Hearing Subcommittee on Asia, the Pacific and the Global Environment House Foreign Affairs Committee

by Dr. Nguyen Thi Ngoc Phuong, Head of Women’s Health Department, Ho Chi City Medical University

Our forgotten responsibility: What can we do for the victims of Agent Orange

The Honorable Chairman Faleomavaega, Congress members, Ladies and Gentlemen,

First of all, I would like to extend my sincere thanks to Chairman Faleomavaega and the Subcommittee for organizing this Hearing on “Our forgotten responsibility: What can we do for the victims of Agent Orange.” I am pleased to have this opportunity to discuss the legacy of Agent Orange/Dioxin and how we can work together for the victims, in general and in Viet Nam.

I am testifying in my capacity as a medical doctor who has been working for nearly 40 years in a big obstetrics-gynecology hospital in Ho Chi Minh City – Tu Du hospital – where more than 45,000 babies are born a year – among them, about 2 % who are deformed.

Forty years ago, when I was an intern, I delivered for the first time in my life, a severely deformed baby – it had no brain and limbs. It was horrible for me, I was nauseas, vomiting and shaking. And how was the scared young mother? She was in shock when she saw her baby. Then she cried for many hours; many days. She thought she had committed some unforgivable mistake and was being punished by God. You can imagine how much she suffered!

Since then, every day or two, I have witnessed such birth defects and mother’s sufferings. But, for many years, I didn’t know what caused these tragic events.

After 1975, many American Vietnam Veterans came to Tu Du hospital and asked about birth defects and cancers related to toxic chemicals sprayed over the Southern part of Viet Nam during wartime. I began looking for documents written on the spraying of toxic chemicals and happened to run across a report about this subject published by the US National Academy of Sciences in 1974.

Only then, did I realize that the deformed babies I delivered might have a causal relationship to the toxic chemicals that the US Air Forces repeatedly sprayed over my country – on a large scale – for more than 10 years! With my colleagues, I started to study the problem.

The spraying of Agent Orange and other toxic chemicals covered not only inland and mangrove forests, but also crop lands and people in villages!

More than 20 million gallons of toxic chemicals containing more than 366 kg of Dioxin were sprayed over the land and people of Viet Nam. Only one billionth of a gram of Dioxin can cause cancers, birth defects, miscarriages, etc.  Dioxin is the most toxic man-made chemical substance in terms of its effect on human-beings. The spraying of these toxic agents (Agent Orange, Blue, White, Purple, Green, Pink, etc.) destroys the environment, and biodiversity, causing annual natural casualties such as flooding.  It is a cruel destroyer of all life in my country.

While the suffering caused by Agent Orange is widespread, I would like to tell you primarily about the effects on the health of exposed people, among whom are my patients.

Many studies published in international scientific journals such as Chemosphere (UK), Journal of the American Public Health Association and documents of the annual international Dioxin Conference have established a link between Agent Orange/Dioxin and cancers, abnormal pregnancy outcomes such as miscarriages, fetal death in-utero, neonatal death, birth defects, etc.

Recently, a joint Vietnamese- Japanese study on 47,000 veterans showed that the percentage of reproductive problems, birth defects and some other diseases is higher in the Agent Orange/Dioxin victims than in the non-exposed group.

In 1983, during the first international conference on “Long term Consequences of Herbicides and Defoliants used in Viet Nam during the wartime on Nature and Human Health” held in Ho Chi Minh city, scientists from 22 countries, including the US, recognized that the incidence of 5 categories of birth defects is abnormally high in Viet Nam as compared with the other countries in the world and in the region.

In 1970, the breast milk of mothers living in sprayed areas, analyzed by biochemists in the US,  had more than 1500 picrograms of dioxin, many thousands of times higher than that in the US, Japan, Canada and the standard level allowed by WHO.  Breast milk analysis done by laboratories in Canada and Germany still shows a very high dioxin level.

Because of this, victims are increasingly millions of innocent newborn babies breastfed by their exposed mothers. The half-life of dioxin in the human body is much longer than in the environment. So, dioxin may exert its effects over many generations of Vietnamese people!

The analysis of human fatty tissues of people exposed to Agent Orange in Viet Nam always indicates high dioxin levels.  The dioxin found in their bodies is 2,3,7,8 tetrachloro-dibenzo para dioxin – the form of dioxin that exists only in Agent Orange (and other agents like Agent Green, etc.)

Recently, in and around at least 3 hot spots which are former US Air Bases and where the toxic agents were stored, we discovered that dioxin remains at dangerously high levels and continues to contaminate the environment and local food sources, continuing to cause harmful effects on human health.

Susan Berresford, former President of the Ford Foundation, Convener of the US – Viet Nam dialogue group on Agent Orange/Dioxin, has recognized: “A worryingly high number of birth defects, cancers and other diseases have now been seen in American veterans and their families, as well as in many Vietnamese veterans, civilians, their offspring and those now living in the affected areas.”

Admiral Zumwalt, whose son, an American Vietnam Veteran, died of cancers and whose grandson was born with birth defects, after analyzing many studies on Agent Orange/Dioxin, made a statement before the Subcommittee of Human Resources of the US Congress in June 1996 saying that “the unique right decision the members of the US Congress can make is to recognize that Agent Orange/Dioxin can cause a wide range of diseases, illnesses and birth defects. So that, the American Vietnam Veterans should be correctly compensated”

And, in 1985, the American Vietnam Veteran’s lawsuit against the chemical companies that produced Agent Orange was settled out of court for 180 million USD.

The US government has also been making payments to the American Vietnam Veterans and their offspring for 13 diseases and defects recognized as consequences of dioxin exposure during the period of time they served in Viet Nam. But, despite the expenditure of billions of dollars, there is not enough being done to alleviate their suffering and we support their struggle to achieve justice!

Ladies and Gentlemen,

Victims of Agent Orange/Dioxin in Vietnam are the most heavily exposed to dioxin in the world.  Commensurately, their suffering is also the most severe. The victims and their families face extremely difficult living conditions due to their illnesses and birth defects – consequences of Agent Orange/Dioxin exposure. The Vietnamese government, people, and particularly, the Vietnam Association for Victims of Agent Orange/Dioxin, and other NGOs in Viet Nam have done a lot to support those affected, materially and morally. But, due to our limited financial resources, we can not fully meet their needs, much as we hope to.  The victims who suffer from cancers are dying every day. They can not wait any longer for justice!

Since 2002, the US government has started to recognize the severity of the problem and to assist our clean up efforts with some millions USD.

Some NGOs like the Ford Foundation and US veterans’ groups are pioneering in the clean up efforts and in helping the victims. We highly appreciate their assistance. However, they, too, have limited resources.

Therefore, I would like to propose that you and your colleagues in the Congress continue the efforts of the US NGOs and veterans in acting decisively to heal the wounds of war for Vietnam’s more than 3 million Agent Orange victims by doing the following:

1. Allocate sufficient funds for the urgent environmental remediation of hot spots where the US Air Forces stored toxic chemicals as well as for helping victims of Agent Orange/Dioxin and their families to receive appropriate health care, rehabilitation, education, vocational training and job creation and social services to meet their needs.
2. Require the chemical companies who manufactured Agent Orange to recognize their responsibility.

The American Public Health Association in its 2007 policy statement on Agent Orange recognized the responsibility of the US government and chemical companies to alleviate the harm caused by their use of Agent Orange/dioxin in recommending that,

 “… the US government and involved chemical companies provide resources for the disabled… provide medical and nursing services for those harmed by Agent Orange; develop community support organizations, including health care and educational and chronic care services… for American and Vietnamese people harmed…[and] remediate or attempt to clean up those areas of in Vietnam that still contain high levels of dioxin.” (APHA Policy # 20075)

I hope that this very first hearing on Agent Orange convened by the subcommittee on Asia, the Pacific and the Global Environment will provide the US Congress and the US public with a better understanding of the severity of the suffering facing the victims of Agent Orange/Dioxin as well as the entire Vietnamese people. Support from the Congress for swift and effective actions to help victims of Agent Orange/Dioxin are of crucial importance in building mutual understanding between our two countries. It will usher in a new chapter of peace and solidarity between the peoples of our two countries.

Thank you for your attention.

The Vietnam Association for Victims of Agent Orange/Dioxin

Statement for the Hearing Record

Introduction:

The Vietnam Association for Victims of Agent Orange/dioxin welcomes the opportunity to submit a statement for the hearing of the Subcommittee on Asia, the Pacific and the Global Environment of the House Foreign Affairs Committee on Our Forgotten Responsibility: What Can We Do for Victims of Agent Orange.  We thank the Chairman, The Honorable Eni F.H. Faleomavaega, for his leadership in holding this hearing and his dedication to the cause of justice for Agent Orange victims in Vietnam, the United States and globally!

VAVA – Speaking for Vietnam’s Agent Orange Victims:

The Vietnam Association for Victims of Agent Orange (“VAVA”) is the organization representing all three million Vietnamese victims of Agent Orange and other related chemical agents (for example, Agent Purple, Blue, White, Pink, Green, etc.)  Established in 2003, VAVA has chapters at the national, provincial, district and commune levels. At present there are VAVA chapters in 50 provinces and hundreds of districts and communes.  VAVA’s work includes, among other things. encouraging victims of Agent Orange in overcoming the difficulties of daily life, providing aid and services to victims, their families and their communities and raising public awareness.

VAVA is, first and foremost, the voice of the victims, representing them and providing expertise and advice on their behalf with the Vietnamese government and in international forums.  VAVA maintains relations with supporting groups in many countries.

Many VAVA leaders and members are victims of Agent Orange and suffer from a variety of illnesses and disabilities as a result of their contact with the deadly chemical Dioxin contained in Agent Orange. 

Many Vietnamese families have lost their loved ones. Many others have given birth to severely disabled babies whose lives are doomed from birth.  Yet, Vietnam’s Agent Orange victims live with dignity and hope.  They are doing everything possible to make their lives better and to contribute to their society.  Through VAVA, they are organizing for mutual assistance – helping each other to develop new and innovative ways of taking care of disabled children, developing income generation projects for families struggling under the burden of several sick and disabled members and raising funds for housing, training and education.

In partnership with VAVA, the Vietnamese government is providing monetary and social assistance to Agent Orange victims throughout the country and working to clean up a number of toxic hot spots where Dioxin has remained in the land and water.  The Vietnamese people are involved in helping Agent Orange victims through donations from individuals, organizations and businesses.  Thousands of students, veterans and workers are engaged in volunteer activities. From the provision of monthly financial aid to the construction of treatment and rehabilitation centers and environmental remediation, VAVA is leading in improving the lives of three generations of Agent Orange victims.

The Needs of Vietnam’s Agent Orange Victims

The suffering of Vietnam’s Agent Orange victims cannot be alleviated without much greater resources than the people and government of Vietnam can provide.  Agent Orange victims live in nearly every province in Vietnam.  They are veterans of the Peoples Army of Vietnam, the National Liberation Front and those forces served in alliance with the United States during the war.  They are civilians and, increasingly, they are children born after the end of the war. 

People who were exposed to dioxin laden Agent Orange endure many life threatening and chronic diseases and disabilities — from cancers, reproductive disorders, immune deficiency, endocrine deficiency and nervous system damage.  Several generations of the children and grandchildren of those directly exposed suffer from developmental and physical disabilities including terrible birth defects.  

One of the saddest results of Agent Orange is the death of infants in utero, many with horrific malformations.  Numerous families cannot give birth to children or give birth to several children with serious birth defects.  Despite universal prenatal care, most of hospitals in Vietnam have not had sufficient effective equipments to test pregnant women for birth defects. Families, many of whom have two, three or even four members who are afflicted are the poorest in Vietnam.

Caring for severely disabled children prevents many parents from being able to work and many exhaust their savings looking for viable treatments.  As the first generation of those exposed to Agent Orange ages, children and grandchildren with crippling disabilities face a future without caregivers. These children will need lifetime treatment and assistance in the activities of daily living.

Many areas of Vietnam have centers for treatment, rehabilitation and housing of Agent Orange victims, but there are not enough facilities for the number of victims who need them.  They also lack sufficient medical and rehabilitation equipment and other resources.

In areas where Agent Orange was heavily sprayed or stored during the war by the U.S. military, contamination of the environments results in continuing exposure of civilians to Dioxin.  In a number of “hot spots” such as Da Nang, Bien Hoa and A Luoi, Dioxin remains in the lakes and the soil and continues to cause illnesses to the residents who eat foodstuffs thereof.

Even those far from our country are not immune from the ravages of Agent Orange exposure during the war.  Vietnamese Americans, many of whom have been in the U.S. decades, also suffer the effects of Agent Orange although their situation has received virtually no attention.

Justice for Vietnam’s Agent Orange victims

Because the effects of Agent Orange are a public health and environmental tragedy for the Vietnamese people, the Vietnam Association for Victims of Agent Orange/Dioxin is seeking justice for the millions of Agent Orange victims we represent. 

The American Public Health Association recognized the serious public health consequences of Agent Orange for Vietnam in a 2007 policy statement recommending that, “the US government and involved chemical companies provide resources for services for the disabled in areas where dioxin victims are concentrated; provide medical services and nursing services for those harmed by Agent Orange; and develop community support organizations, including health care and educational and chronic care services and medical equipment to care for American and Vietnamese people harmed; including additional services as they are identified.”

During the war, between 1961 and 1971, approximately 72 million liters of herbicides, including 49.3 million liters of Agent Orange containing more than 360 kg of Dioxin were sprayed multiple times over 5.5 million acres in the southern and central areas of Vietnam. 

Agent Orange was made by several U.S. chemical companies, including Dow Chemical and Monsanto and was sold to the United States government.  These companies sold Agent Orange which contained Dioxin as a by-product of the manufacturing process.  Despite knowing that the Dioxin content could be eliminated or drastically reduced by using better manufacturing methods, the companies put profit over human health by continuing to produce a product with elevated Dioxin levels.

U.S. military personnel who handled or sprayed Agent Orange have suffered from similar ailments and disabilities as Vietnamese victims.  As a result of a lawsuit against the U.S. chemical manufacturers, in 1984, U.S. veterans received a settlement of $180 million dollars.

Due to the efforts of U.S. veterans and their supporters, the U.S. Congress passed the Agent Orange Act of 1991, which awarded service connected disability benefits to Vietnam veterans exposed to Agent Orange and suffering from certain medical conditions.  A U.S. Government Accounting Office report, published in 2005, estimated yearly payments to 160,000 veterans with the four most common illnesses related to Agent Orange exposure at approximately $1.52 billion in disability compensation and $56 million in medical care.

Other governments — New Zealand, England and Australia — have also awarded compensation to their veterans who were similarly exposed.  In 2006, a South Korean Court ordered Dow Chemical and Monsanto and other companies, to pay more than 63 million dollars to 6,795 Korean Agent Orange victims and their relatives. Recently, the Canadian government, which sprayed Agent Orange in Gagetown, Canada, has approved a compensation package of 26 million dollars for the 4,500 people affected.

The Vietnam Association for Victims of Agent Orange/Dioxin shares the pain of Agent Orange victims in the U.S. and in other countries.  VAVA wholeheartedly supports justice and compensation for ALL victims of Agent Orange!

Vietnamese Agent Orange victims have been the subject of the most intensive spraying of Agent Orange in the world.  VAVA believes that the corporations, that manufactured the Agent Orange without regard to the health consequences, and the U.S. government, which used it, are responsible for helping to alleviate the tragic effects of this toxic chemical upon the land and people of Vietnam. 

We are thankful for the assistance and aid given by U.S. veterans groups and humanitarian organizations!  Many veterans have built and equipped clinics and rehabilitation centers, donated wheelchairs, volunteered their time and contributed funds.  These kind hearted American people have taken the lead in extending a hand of friendship to Vietnamese victims.
However, the U.S. chemical manufacturers have yet to follow the lead of the American people.

They have denied any responsibility for their toxic product.  VAVA brought suit in federal court against these companies under U.S. and international law.  The case was dismissed by the Court of Appeals and a petition for hearing en banc is currently pending in this Court of Appeals.

Last year, for the first time, the United States Congress appropriated $3 million, “for environmental remediation of dioxin storage sites and to support health programs in communities near those sites.”  This is a positive step in healing the wounds of war for Agent Orange victims. 

Vietnamese Agent Orange victims living near these “hot spots” are eagerly awaiting for the truly significant contributions from the U.S side to make a real difference in their lives.  VAVA hopes that the funds will be allocated according to the needs of the victims, in a direct and effective manner, and will be happy to assist in coordination.

Conclusion

The needs of Vietnam’s Agent Orange victims are great and time is running out.  Fifty years since Agent Orange was sprayed over the people and land of Vietnam this human tragedy continues unabated.  Those who survive seek redress for the anguish that is befalling several generations of their offspring.  They hope that the forgotten responsibility will now be remembered and acted upon!

The Vietnam Association for Victims of Agent Orange/Dioxin earnestly hopes that the United States Congress and government will continue to provide assistance to Vietnam’s more than three million Agent Orange victims. We believe that providing such assistance as will enable our members to significantly improve their lives is an important part of the improving relations between our two countries. We believe that helping the victims and remediating the environmental effects of Agent Orange is in accordance with the humanitarian tradition of the American people.

VAVA looks forward to working with this Committee and with all of the members of Congress to address this issue in the future.

Arnold Schecter, MD, MPH

Professor, Environmental and Occupational Medical Sciences
University of Texas School of Public Health, Dallas Regional Campus,
Dallas, Texas

I am a Professor of Environmental and Occupational Health Sciences at the University of Texas, Dallas Campus, and have done public health research on Agent Orange and dioxins in Vietnam, Laos, and Cambodia since 1984 on 25 occasions. My research  is almost exclusively on dioxins which are the toxic contaminant of Agent Orange. I have also done research on Agent Orange and American Vietnam veterans.

Our findings, working with Vietnamese, German, American, Canadian and Finnish scientists, show  that the dioxin contaminant of Agent Orange, the most toxic of the dioxins, 2,3,7,8-TCDD or TCDD, is still present in some areas of Vietnam in soil, sediment, food, wildlife and people. Most of Vietnam is free of Agent Orange contamination but elevated levels in food have produced high levels in blood and milk of some Vietnamese, from current food intake, not only from Agent Orange sprayed in the past.

Although the health or epidemiology research from Vietnam on cancer and birth defects is not considered conclusive by Western scientists, it has been shown from other studies that dioxins are toxic and can cause, in sensitive people and when the amount of exposure is high enough, cancer, immune deficiency, nervous system damage including lower IQ and emotional problems, endocrine disruption including diabetes, thyroid problems, sex hormone disorders, liver damage, reproductive and developmental pathologies, and death from heart attacks in highly exposed workers.

There is no doubt that certain parts of Vietnam are still contaminated with dioxin from Agent Orange and that there are an unknown number of people living in Vietnam who have elevated levels of dioxin,  All persons in the world now have some contamination with the synthetic compounds known as dioxins. In general, the higher the dose the more illness, so it is likely people are sick, have been sick and will continue to become
sick from dioxin in Agent Orange.

We have documented elevated dioxins in Vietnam in over 100 articles published in the Western scientific literature, usually with our Vietnamese scientific colleagues such as Dr. Nguyen Thi Ngoc Phuong of Tu Du Hospital, Dr. Le Cao Dai (now deceased), Dr. Hoang Trong Quynh, and others.

Dioxin left over from Agent Orange is one of many serious health problems in Vietnam in the past and presently and will continue to be a health problem until its location in people and food is mapped out and food contaminated with dioxin is no longer consumed.

People potentially exposed to dioxins should be provided preventive medical and primary medical care with regular monitoring, and specialized care when indicated. They are at higher risk for disease than people not exposed to dioxin from Agent Orange. Although “the dose makes the poison”, that is, the more dioxin the more health damage, even small exposures above background can be harmful to the health of sensitive persons, including exposed fetuses, the young, elderly and sick persons.

I refer you to my book, Dioxins and Health, 2nd Ed, Arnold Schecter and Thomas Gasiewicz, Eds, John Wiley and Sons, Piscataway, NJ, 2003, for further information about health damage which can be caused by dioxins.

If I can be of any further help, please do not hesitate to contact me.

Sincerely yours,

Arnold Schecter, MD, MPH
Professor of Environmental Sciences
Univ. of Texas School of Public Health, Dallas