BIEN HOA, Vietnam — In the southern Vietnamese city of Bien Hoa, the provincial government office keeps a list of people who have been affected by Agent Orange, which was stored here during the war between North Vietnam and the U.S.-backed South Vietnamese republic. On the list accessed by Devex, most of the people are disabled — a result of exposure to the contaminant dioxin, which is found in Agent Orange and persists in the city’s soil nearly half a century after the war’s end.
Do Trung Thanh is one of them. The 42-year-old’s limbs refuse to straighten, and his back is curved, making it impossible to move. For the last 30 years, his family has placed him in a metal cage-like enclosure, designed such that Do’s body is encapsulated, with only his head free for movement. He cannot speak and only uses head gestures to communicate. Twice a day, his mother feeds him a meal of rice.
“There are people who have been affected by dioxin and need special care. This will need a lot more resources, and we need them now.”
— Nguyen Thi Lan Anh, director, Action to the Community Development Center“We didn’t know why he was born this way. Then some NGOs raised a voice and all the children born with disabilities were tested by the government. Turns out, he had dioxin traces in his blood,” Do’s mother, Le Thi Anh, told Devex. She hasn’t received any support to help her care for her son, and NGOs working on disability rights haven’t reached out to her, she said.
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Bien Hoa Air Base was the primary Agent Orange storage and handling site during the war and is the largest remaining hot spot of dioxin contamination in Vietnam — and, arguably, in the entire world. Le knows this but says she’s not aware of any project meant to treat the dioxin.
In December, almost 45 years after the end of the war in 1975, the United States Agency for International Development announced that it had launched dioxin cleanup operations at the air base and signed an agreement to implement a $65 million program to support people with disabilities in Vietnam.
The operation follows a similar cleanup undertaken at the former Danang air base in 2012, which cost $110 million and took six years to complete. For the remediation project in Bien Hoa — expected to cost $300 million over a 10-year period — USAID will rely on lessons learned in Danang.
Stakeholder involvement
In 2016, USAID, in partnership with the government of Vietnam, completed an assessment of dioxin contamination at the Bien Hoa Air Base. The assessment identified almost 500,000 cubic meters of dioxin-contaminated soil and sediment in need of remediation — almost four times the volume that was treated at Danang International Airport, the site of the city’s former air base.
“USAID and the government of Vietnam have determined that Danang was a success not only in terms of dioxin remediation, but also in terms of our countries' bilateral relationship and capacity building in Vietnam. [An] independent evaluation took a holistic view of the project which produced several things to consider at Bien Hoa,” Christopher Abrams, director of the environment and social development office at USAID/Vietnam, told Devex in an email interview.
The independent evaluation conducted at the end of the Danang project pointed out several areas for improvement — including process tweaks, changes in health and safety plans, and the need to incorporate long-term maintenance into the Vietnamese government budgets upfront. It recommended improving the process of removing the contaminated soil and moving it to a safer zone, known as demobilization.
Specifically, the evaluation called for an improved communications plan “to encourage greater involvement of stakeholders.”
The report also stated that if USAID had characterized the soil more appropriately in the beginning, it would have had fewer problems in dealing with excess volumes of contaminated soil — thereby reducing expenses incurred to resolve unforeseen issues. The evaluation scored “communications among all parties” the lowest among six criteria for meeting stakeholder expectations. Interviewees in the government of Vietnam stated that there were no procedures on communications or any detailing how and when to share information among project participants, the report revealed.
“The remediation of dioxin, particularly in high concentrations is a complex endeavor and it is critical that complex information can be communicated in ways that government policy makers and community members can understand, particularly when it comes to understanding risk and the fate and transport of dioxin in the environment,” Abrams said.
Responding to the evaluation, Abrams outlined steps that will be taken at Bien Hoa. “There will be ongoing community stakeholder engagement workshops, where USAID and the Ministry of National Defense hold ‘Town Halls’ to discuss the current status of the project, the latest information, and planned next steps. These meetings also provide an opportunity to hear resident concerns and adjust operations as necessary,” he told Devex.
Exposure to dioxin
Addressing the health and safety of workers involved in the remediation effort is another area of concern highlighted in the evaluation report. The report stated that the project took blood samples of workers before, during, and after the cleanup project. It noted that the results of the blood samples were not made available but, in a few cases, the dioxin levels in the workers’ blood were higher at the end of the project, suggesting that there was exposure.
The report also recommended that USAID help improve communication by supporting the Vietnamese government’s Office 701 — the Office of the National Steering Committee on the Settlement of Post-War Unexploded Ordnance and Toxic Chemical Consequences — in developing a program-specific communication plan.
As the USAID’s focal point for dioxin remediation in the Bien Hoa Air Base area, Office 701 provides a platform for the U.S. government to communicate the impact of its war legacy programming and help achieve the strategic objective of overcoming these legacies.
Health spending
Experts say the U.S. government has fallen short of its commitments to address the disabilities caused by Agent Orange.
In Feb. 2019, a Congressional Research Service report raised questions about how USAID has utilized appropriated funds for health-related assistance to areas contaminated with Agent Orange. “By May 2017, USAID had obligated less than two-thirds of the appropriated funds for FY2011-FY2017. The funds have generally been used for disability assistance programs regardless of the cause of the disability, rather than for both health and disability programs targeting populations residing near Agent Orange/dioxin ‘hot spots,’” the report says.
Michael Martin, a specialist in Asian affairs and author of the CRS report, said that he will be watching the Bien Hoa project to see if health assistance is disbursed in a timely manner this time around.
“The funds meant for environmental causes have been utilized fairly effectively, and the use of funds meant for health has been slower. There is concern in the congressional community that these funds should be utilized in a timely manner,” Martin told Devex. While the U.S. Congress had made clear that the funds were meant specifically for those affected by Agent Orange, the administration of President Donald Trump instead used the funds on “program awareness and not on programmatic assistance,” he said.
Martin said the idea of providing assistance poses policy and legal challenges. Unlike the presumptive exposure policy for U.S. veterans of the war, former military officials and civilians in Vietnam are not covered by any U.S. medical benefits. “The State Department is concerned that it will set a precedent for the U.S., and hence there is a reluctance in the face of legal liability,” he said.
Support for NGOs
Across Vietnam, civil society groups have been demanding more funding specifically for Agent Orange victims.
“We get funds for working with disabled people, but we know that around us, there are people who have been affected by dioxin and need special care. This will need a lot more resources, and we need them now,” Nguyen Thi Lan Anh, director of the Action to the Community Development Center, told Devex.
“We cannot wait for another 40 years, it will be too late,” she said.
