By Chris Arsenault, Al Jazeera English

When Hillary Clinton, the US secretary of state, visited Vietnam on Thursday she extolled the country’s “unlimited potential” and strong trade relations with the US. But the words must have rung hollow for Ngyuen Ngoc Phuong, who has seen his potential destroyed by American chemical poisoning.

Phuong, 19, was born long after the US cut and run from the Vietnam war, evacuating its last remaining personnel by helicopter from the roof of its Saigon embassy in 1975.

But the results of that war, which officially ended 35 years ago, affect every aspect of Phuong’s life.

The young man has severe physical deformities, and like an estimated three million Vietnamese, he suffers from exposure to Agent Orange, a toxic chemical U.S. forces sprayed during the war to defoliate the dense jungles Viet Cong rebels used for cover.

In its manufacture, the chemical was contaminated with TCDD, or dioxin, “the most toxic substance known to humans,” according to an investigation in the journal Science.

Dangers known

In his book Agent Orange on Trial published by Harvard University Press, Peter Schuck reported that companies who manufactured the defoliant knew “as early as 1952” that deadly dioxin had contaminated the chemical.

Between 1962 and 1971, the U.S. military sprayed an estimated 80 million litres of Agent Orange and other herbicides on Vietnam, the journal Nature reported in 2003.

“I met one family of victims with four blinded children, no eyes – period,” Dr Nguyen Thi Ngoc Phuong, a Vietnamese researcher, said in a 2007 interview.

In a now declassified report for the US department of veterans affairs, Admiral ER Zumwalt Jr wrote that Dow Chemical and other manufacturers knew Agent Orange exposure could cause “general organ toxicity” and “other systematic problems” as early as 1964.

These and other studies show that the American military, and the chemical companies who serviced it, were well aware of the dangers posed by the chemicals on the general population.

On this front, Agent Orange elucidates an alarming trend in modern warfare, particularly counter-insurgency fighting: civilians and the environment tend to be main casualties.

Brutality clearly defined World War I and II and previous conflicts between standing armies, but soldiers usually made up the majority of the dead.

Poisoning civilians

From the jungles of Vietnam to the plains of Sudan, Iraq’s cities to the Afghan mountains, civilians now bear the highest cost for wars not of their making.

“In Vietnam it was chemical [weapons] … Agent Orange and napalm,” Len Aldis, secretary of the Britain-Vietnam friendship society, told Al Jazeera.

“In Iraq, Kosovo, [and] Afghanistan the U.S., U.K. and NATO have used depleted uranium, cluster weapons … and drones that are controlled from military bases in the US.”

These conflicts tend to continue even after the wars officially end. “We did a number of soil samples and followed [dioxin contamination from Agent Orange spraying] though the food chain into ponds, to fish, into ducks and then into humans. We found it in children who had been born long after the war ended,” Dr Wayne Dwernychuck, who led the first team of western scientists to study the long-term affects of spraying in Vietnam, said in an interview.

“We concluded the only way they could be contaminated is through food and nursing,” he said, referencing his 1994 study.

Former US military bases including Bien Hoa, Phu Cat and the infamous Danang are the worst sites of present day contamination.

“We have been working with Vietnam for about nine years to try to remedy the effects of Agent Orange,” Clinton said at a press conference in Hanoi.

Since 2007, the US congress has appropriated $9m to help Vietnam clean up contaminated areas and for related health activities, or an amount roughly equal to the cost of 12 Tomahawk cruise missiles.

Wounds still remain

In June, a joint panel of US and Vietnamese policymakers, citizens and scientists estimated the cost of a proper clean-up and rehabilitation for the sick at $300m.

“The war is over but the wounds from the war still remain in many areas of Vietnam,” Nguyen Van Son, a member of Vietnam’s National Assembly, said during the report’s launch in Hanoi.

Vietnamese civilians are not the only ones suffering from exposure. Veterans in the US, Canada and beyond also have histories with the chemicals.

In 1984, US veterans reached an out-of-court settlement for $180m with companies who produced the chemicals, including Monsanto and Dow Chemical.

Remarkably, Dow maintains that there is no evidence to link Agent Orange to illnesses from US veterans and Vietnamese civilians. The Institute of Medicine (IOM), the pre-eminent scientific authority in the US when it comes to setting government policy, links exposure to a raft of conditions including cancers, diabetes and spina bifida. Like their American counterparts, Vietnamese victims have tried to gain justice in US courts, but after a series of cases, the U.S. Supreme Court refused to hear their case in 2009.

However, American conservatives were some of the first to recognise the moral quagmire around giving pensions and other benefits to US veterans and not Vietnamese civilians, even though both groups were poisoned by the American government and the companies who provided it with chemicals.

‘Difficult to rationalise’

It is “difficult to rationalise why [American] Vietnam vets are compensated for Agent Orange exposure but Vietnamese civilians shouldn’t be,” Steve Milloy, a scholar at the Cato institute, wrote in a commentary for Fox News.

During her visit, Clinton criticised Vietnam for jailing rights activists and censoring the Internet and urged the single party, nominally communist state to “strengthen its commitment to human rights.”

However, in the broader schema of rights, Vietnam’s transgressions against courageous lawyers and journalists seem positively minor compared to three million destroyed lives: children born missing eyes, grossly elongated heads or misshapen legs where their arms ought to be.