Dr. Le Cao Dai, one of Vietnam's top experts on the health effects of Agent Orange, first encountered American military herbicides when he ran a field hospital for the North Vietnamese Army along the Ho Chi Minh Trail. American planes would fly low over the forest canopy and release a cloud of chemicals. Within days, the leaves would begin to fall, forcing Dr. Dai to move his hospital deeper into the forest for concealment. Only later did he come to believe that the spraying had done long-term health damage to Vietnamese soldiers and civilians.
That belief is shared by leading Vietnamese doctors who were interviewed on a recent trip through Vietnam. None would hazard a guess to this writer as to how extensive the damage had been, but one was later quoted in the Vietnamese press as asserting that some 70,000 Vietnamese are now suffering from illnesses caused by Agent Orange.
The evidence to support these beliefs is weak, for it is a sad irony of the Vietnam War that those most likely to have been affected by the spraying -- the Vietnamese themselves -- have been the least effectively studied.
The United States has put enormous effort into assessing possible harm to American soldiers but found only limited damage, perhaps because most soldiers had relatively little contact with the chemicals during their short tours of duty. Meanwhile, the Vietnamese troops directly under the spray and civilians who lived in the sprayed areas for years or moved in later, have been studied primarily by Vietnamese scientists whose results are not generally accepted by scientists from more advanced nations.
American herbicides, of which the most prominent was Agent Orange, were widely dispersed to defoliate trees over supply routes, clear away brush from roadsides, riverbanks and base camps, and kill food crops that sustained guerrilla bands. More than 10 percent of the land area of South Vietnam was sprayed at least once, and some areas were sprayed repeatedly.
The herbicides themselves would generally dissipate within weeks but would leave behind a toxic contaminant, dioxin, that was inadvertently created during the manufacturing process.
Journalists who inquire about Agent Orange are routinely taken to "peace villages" to see malformed children, to an exhibit on health consequences at the medical school in Hanoi or to a collection of malformed fetuses at an obstetrical hospital in Ho Chi Minh City. All three sites make a powerful case that there is appalling illness in Vietnam, but all fall short of demonstrating that Agent Orange was the culprit. The birth defects, cancers and other illnesses that the Vietnamese attribute to Agent Orange can be caused by a wide range of factors, and Agent Orange may not be prominent among them.
The epidemiological and laboratory studies that offer the best hope of teasing out answers are difficult for even the most advanced scientific countries to perform. Vietnamese studies that purport to find excess cancers, birth defects and other illnesses in soldiers and civilians from areas that were sprayed are discounted by Western experts for lack of stringent methodology.
Vietnamese and American scientists once started a collaborative research effort, but it fell apart three years ago when Vietnamese authorities confiscated research samples before they could leave the country. Now, however, the Vietnamese and the American Embassy in Hanoi are both suggesting a joint study of the effects of the herbicides. The U.S. National Academy of Sciences has been asked to consider whether it is feasible to do a study so long after the spraying, in a nation where health records and disease measures are notoriously incomplete.
The research seems well worth doing, if it is technically feasible. An authoritative study would add to the growing literature on the health effects of herbicides and dioxin, could help the Vietnamese decide how to allocate scarce health resources and might shed additional light on the effects of Agent Orange in American veterans. Most compelling of all, it might finally close one of the festering wounds from the Vietnam War.
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