The legacy of Agent Orange in Vietnam — and US efforts to make amends

A photo exhibit of Agent Orange victims at the War Remnants Memorial in Ho Chi Minh, Vietnam. Social inclusion for people with disabilities is part of the U.S. Agency for International Development’s country development cooperation strategy in the country. Photo by: ruben i / CC BY

Bobby Muller’s first trip to Vietnam left him paralyzed from the chest down after a North Vietnamese bullet severed his spinal cord while he was leading his platoon up a hill near Con Thien in 1969.

He returned to Vietnam 13 years later in 1981, invited by the Vietnamese government to accompany the first group of U.S. war veterans back to the country where nearly 60,000 U.S. soldiers and an estimated 1 million Vietnamese lost their lives in a bloody war.

Muller recounted the fraught history of post-war U.S.-Vietnam relations on a hot and humid day in June in the café of a Washington, D.C., sports club near his home. He wore a black T-shirt, swore occasionally and punctuated his story with a laugh that rocked his shoulders and head from the stillness of his lower body.

Two issues hung in the air over that first return visit to Hanoi: Americans missing in action and the U.S. government’s use of the herbicide Agent Orange, sprayed in vast quantities across the jungle to eviscerate huge swaths of the forest canopy where Viet Cong soldiers found cover.

“What we expect to do is to make contact with the Vietnamese, to be as persuasive as we can in expressing concern about certain issues like Agent Orange and people missing in action,” Muller told the New York Times in advance of the 1981 trip.

The United States and Vietnam would not normalize diplomatic relations for another 14 years.

A peace activist and the first director of Vietnam Veterans for America, an advocacy group for veterans and their families, Muller hoped this first nod toward constructive dialogue could help both sides move forward on a range of war legacy issues. It would turn out to be an early step in a decadeslong effort to address one of the most painful and controversial legacies of the Vietnam War: mental and physical disabilities apparently caused by exposure to Agent Orange and the contaminant dioxin — disabilities that may be inherited from generation to generation.

USAID’s ‘transformational’ programs

The U.S. government has not officially apologized for its use of chemical defoliants during the war. But today, programs to promote social inclusion for people living with disabilities are a central pillar of the U.S. Agency for International Development’s country development cooperation strategy for Vietnam — accounting for about 20 percent of the USAID country mission’s budget.

USAID Administrator Rajiv Shah was supposed to visit Vietnam and the Philippines this week to inspect the agency’s disabilities programs and highlight the “transformational” role they have played as investments in a bilateral relationship that was for many years torn and poisoned by conflict and its collateral damage. Shah however cancelled his trip to Asia to handle the response to the Ebola outbreak in West Africa.

Since 2007, the U.S. Congress has earmarked millions of dollars for programs that provide, among other things, workforce training to people with disabilities, assistance for families to identify educational opportunities for disabled children and partnerships with businesses that commit to hiring more people with disabilities and showcase their role as productive employees.

Under the guidance of USAID Vietnam’s new annual program statement — and as suggested in Congress’s appropriations language — disabilities programming will increasingly look to cooperation and co-management with local partners to help build local skills, resources and experience around social and workforce inclusion and to ensure programs continue even without U.S. funding. Shah is holding those projects up as examples of how foreign aid can be used both to improve lives and to mend — or strengthen — international bonds.

The lingering effects of Agent Orange, while still a source of pain for many Vietnamese and U.S. veterans, is no longer just a bitter reminder of war’s atrocity but also now a keystone of development cooperation between two former adversaries. But for an issue littered with political minefields and wrapped up in the legacy of a brutal, bitter war, that outcome was hardly a foregone conclusion.

A ‘peculiar’ valley

In March 1998, Charles Bailey, in the first six months of his tenure as head of the Ford Foundation’s new Hanoi office, toured Vietnam’s central highlands with a potential grantee from an agriculture university outside of Ho Chi Minh City. They came upon a valley that, to Bailey — who was trained as a natural resource economist — “looked peculiar.”

The valley appeared as though it was growing back from some kind of disturbance, with occasional land slips scarring the mountains. Bailey learned it had been sprayed with the herbicides collectively known as Agent Orange during the war.

“It sort of clicked,” he said.

The sight of the valley recalled memories of hearing about this U.S. war tactic, and it surprised him that the effects were still in evidence.

“I thought to myself: Why is nothing being done about this? I was thinking of the environmental impact at the time,” Bailey told Devex. “A lot has happened in between, in the intervening 16 years.”

Since then, Bailey, who now directs the Aspen Institute’s Agent Orange in Vietnam Program, and others have worked with a variety of donors to mobilize money for the cleanup of “dioxin hotspots” and for programs to address the impacts on the health of the Vietnamese populations living near and exposed to those heavily contaminated areas. As of June 2014, champions for this issue under the leadership of U.S. Senator Patrick Leahy have helped to rally $140 million for dioxin cleanup and mitigation of the chemical’s apparent negative health effects on those who come into prolonged contact with it.

But for the seven years after he first saw the highland valley where the “peculiar” effects of Agent Orange were so evident, Bailey struggled with a dilemma that is uncommon in the world of development finance: No one wanted to take his money.

“When I went back from that field trip in March 1998 to Hanoi and started asking around, the thing that astounded me was how sensitive it was,” Bailey said. “It was sort of that ultimate remnant of the fog of war … The fog was still thick and swirling in 1998.”

Neither the U.S. nor the Vietnamese government wanted to discuss Agent Orange and its effects, Bailey said, and most other donors did not seem to know about it. In his 33 years of working with the Ford Foundation, he added, this was the only time he had to “hunt around for” and “get people convinced that this would be OK.”

The ‘burr under the saddle’

While the United States and Vietnam have cooperated on a wide variety of other issues, from environmental conservation to energy to HIV and AIDS, Agent Orange has remained “the burr under the saddle of U.S.-Vietnam relations,” Bailey said. The Vietnamese, he noted, are “reminded of it every day.”

U.S. lawmakers and administration officials have, for years, heard complaints from Vietnamese counterparts about the lingering effects of Agent Orange and about the U.S. responsibility to help address those effects.

“A few years ago, you could not have a meeting with Vietnamese officials without them bringing up Agent Orange, regardless of the subject of the meeting,” Tim Rieser, a top aide to Leahy on the Senate Appropriations Committee and one of the most steadfast advocates of funding for war-related disabilities programs in Vietnam, told Devex.

“That has changed,” he noted. “Our goal was always to turn this remaining issue of resentment and antagonism into something that we are working together to solve and I think we have achieved that in large part, but we have a long way to go."

‘Regardless of cause’

The fog of war still clouds issues around the use of Agent Orange — and what responsibility the United States may have to address its effects in Vietnam. Activists, lawyers, veterans and policymakers still argue about how to talk — or not talk — about what the U.S. government is doing to make amends and debates about whether or not there is a direct connection between dioxin and disability still muddy the waters of responsibility.

The U.S. government compensates its own war veterans for a long — and growing — list of health problems that may be connected to Agent Orange exposure. Now, at Congress’ urging, USAID delivers disabilities programs in Vietnam — and almost exclusively in locations that were heavily exposed to dioxin during the war — but the agency does so with the stipulation that assistance benefits persons with disabilities, “regardless of cause.”

Some, like Rieser — who many credit with getting the appropriations language through for the first time in 2007 — have argued that the government’s unwillingness to talk honestly and openly about what happened and about what is being done about it has been an obstacle to fully changing the narrative from one of bitter antagonism to one of cooperation.

"There are increasing examples of how the program has helped people with disabilities who were likely affected by Agent Orange, but that story has not really been told. Very few people are aware of it," Rieser told Devex.

Part of that limitation is wrapped up in the administration’s ongoing reliance on the “regardless of cause” stipulation.

“The program is not a secret, but the administration's reluctance to call it what it is has limited the extent to which the U.S. government is recognized for finally addressing a problem that many people believe we walked away from,” Rieser said.

Not everyone shares that concern.

“There’s no complaint, either from the government of Vietnam or from Vietnamese civil society, on this point,” Joakim Parker, USAID Vietnam mission director, told Devex by phone from Hanoi. Moreover, if the United States was to tie disabilities programs directly to Agent Orange exposure, he said, it could force USAID to “turn away” some disabled populations who currently benefit from the agency’s assistance programs.

From the Vietnamese perspective, he added, USAID’s disabilities programs are related to the lingering effects of Agent Orange, and that the only complaints he hears about the “regardless of cause” stipulation come from abroad.

“I know we have some stakeholders in the U.S. who think [the ‘regardless of cause’ stipulation] hampers things,” Parker acknowledged. “But the fact is … I’ve never been asked to channel the program in a more specific way or to rebrand it.”

While Parker anticipates that the next phase of USAID’s disabilities program will look to expand geographically, assistance so far has focused around Danang, an area highly exposed to Agent Orange and dioxin, one of the so-called “hot spots.” Despite that tight focus, the U.S. government has never explicitly stated that its support is intended for people who were harmed by dioxin exposure, and that is unlikely to change anytime soon.

The disabilities-poverty connection

Vietnam’s disability prevalence rate tops 15 percent, according to a government household living standards survey conducted in 2006, but that number is unevenly distributed, with higher prevalence in poor and rural communities.

That pattern holds true throughout the world. Disability is strongly correlated with poverty, and the causal link between poverty and disability seems to run in both directions: Poorer populations more often encounter the factors that can cause disability, and disabilities can reduce access to services and opportunities that can sustain and grow a livelihood.

That social and professional isolation is exacerbated in many, if not most, societies by the stigma and discrimination that accompanies disability, and Vietnam has particularly struggled to overcome those negative associations, Parker said.

“Vietnam itself is changing. The situation for persons with disabilities is improving,” he added.

USAID is advocating for the country to ratify the U.N. Convention of the Rights of Persons with Disabilities, which looks to establish the full enjoyment of human rights by persons with disabilities and ensure their full equality under the law. Ratification would “open up new opportunities for USAID,” Parker said.

Several of the agency’s current disabilities programs are scheduled to end soon, and that has provided an opportunity to consider how they might be tweaked to achieve greater impact. New disabilities programs will operate under the guidance of the annual program statement, which was revised in June. That document favors more local partnerships and a tighter focus on physical, occupational and speech therapies, Parker added.

“It’s different because our strategy has this inclusion focus and this emphasis on local organizations … In that sense, the disabilities programming will be evolving … in ways that are relevant for Vietnam,” he said, adding that, “the mix of our implementing partners will be quite different over the next few years.”

To earmark or not to earmark?

Development agency leaders and officials are often leery of congressional earmarks — funds set aside by lawmakers to address specific issues. These are often seen as “pet projects” for those with the power in the congressional appropriations process to get them funded. They can deflect resources away from agency-driven, strategic priorities like those identified in a country development cooperation strategy at USAID.

But Parker said that in this case, the issue of whether congressional earmarks for Vietnam disabilities programs help or hinder the agency’s broader goal-setting process is largely an “academic” one.

While USAID’s disabilities programs in Vietnam grew out of the special interest and efforts of a few well-connected individuals with the power to pull congressional purse strings in certain directions — and toward a single, specific cause — the agency has now built its strategy around the inclusion issue.

“Even if the earmarks and directives … disappear,” Parker said, “USAID is now committed to doing this.”

The real challenge, Parker added, is not Congress’ focus on a specific issue, but the risk that appropriators will fail to recognize the need for continued assistance to Vietnam to tackle other priorities. Parker sees a risk that funding to Vietnam that has been funneled through the President’s Emergency Plan for AIDS Relief could recede without being redirected into other critical areas like wildlife trafficking, pollution control and working with civil society organizations to bolster public democratic participation.

Not all of these issues benefit from the presence of emotionally invested champions with the power to find funding for them.

“There are no guarantees when it comes to appropriations,” Parker said.

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About the author

  • Igoe michael 1

    Michael Igoe

    Michael Igoe is a Senior Reporter with Devex, based in Washington, D.C. He covers U.S. foreign aid, global health, climate change, and development finance. Prior to joining Devex, Michael researched water management and climate change adaptation in post-Soviet Central Asia, where he also wrote for EurasiaNet. Michael earned his bachelor's degree from Bowdoin College, where he majored in Russian, and his master’s degree from the University of Montana, where he studied international conservation and development.

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