http://www.chicagotribune.com/health/agentorange/chi-agent-orange-dioxindec17,0,2121785,full.story

AGENT ORANGE: PART 5 OF 5

Agent Orange’s lethal legacy: Defoliants more dangerous than they had to be

Papers show firms didn’t act on data to reduce toxicity

Malia Nobriga from Hawai’i was interviewed by Democracy Now! at the Copenhagen Climate Change action where 100,000 people marched outside while the states debated inside.  The issue of climate change, rampant development, energy consumption and degradation of the environment is now reaching an irreversible tipping point for the planet, with the poor and indigenous peoples taking the brunt of the impact. This is an environmental justice issue.  In the future, more and more wars will be fought over resources, unless there are dramatic shifts in the world economy.

http://i2.democracynow.org/2009/12/14/indigenous_leaders_at_the_frontline_of

Indigenous Leaders at the Front Line of Climate Change, at the Front of the Historic Climate March in Copenhagen

On Saturday, over 100,000 people marched in Copenhagen calling on world leaders to agree to a just climate policy. Leading the march was a delegation of indigenous leaders from communities on the front lines of climate change. Democracy Now!’s Anjali Kamat and Elizabeth Press speak to indigenous activists at the march and at the Danish National Museum.

AMY GOODMAN: This is Climate Countdown. We’re broadcasting live from Copenhagen in our exclusive two-week series on the climate talks. I’m Amy Goodman.

On Saturday, over 100,000 people marched in Copenhagen calling on world leaders to agree to a just climate policy. Leading the march was a delegation of indigenous leaders from communities on the front lines of climate change.

Democracy Now!‘s Anjali Kamat and Elizabeth Press spoke to indigenous activists at the march and at an earlier event at the Danish National Museum.

FIU ELISARA: Well, I’m Fiu Elisara from Samoa, a small country in the Pacific. I’m here in Copenhagen, because as small island countries, the whole issue of climate change is an issue of life and death for many of our peoples and indeed our countries. And as indigenous peoples, too, it’s a huge issue for us, because a lot of the solutions that are being proposed in Copenhagen are all terrible, flawed solutions that would not do anything about the objectives of the climate change convention about curbing climate change and stopping emissions. But they are, in fact, making the problem worse.

And it’s really sad to see that there is no political will to actually make it work, and instead of cutting greenhouse gas emissions and the commitments made by the developed countries, they are in fact now shifting the responsibility to us, who have contributed very little or nothing to the whole problem, and yet we really are at the forefront of the impacts, the negative impacts.

MALIA NOBREGA:Aloha kakou. My name is Malia Nobrega, and I’m from the island of Kauai in Hawaii, which is, unfortunately, an illegal part of the United States of America. For me, back home on Kauai, my family, we’re salt producers. And it’s the last place in the islands of Hawaii that continue to make salt in this traditional way. And we’re seeing the disappearance of our land, which—where we can produce salt.

PROTESTERS: Leave the oil in the soil! Leave the oil in the soil!

ROBBY ROMERO: My name is Robby Romero. I am from the Apache and Pueblo territories of the Southwest, Turtle Island. And I’m here because I think it’s vital that indigenous peoples’ voice is part of the global conversation, especially when it comes to climate change. I believe that everything new is hidden in the past and that indigenous peoples are the first to be impacted. They live at the point of impact and are the first to experience the ruin and unnecessary desecration of land and life. And it’s their wisdom, along with modern science—it’s going to take both—to lead us into a time of healing. And if the indigenous voice is not included in the negotiations here at COP15, it will be a major, major mistake.

JOHNSON CERDA: My name is Johnson Cerda. I am a Quechua Indian from the Ecuadorian Amazon, and I grew up in the rainforest. Now we are here because we understand that climate change—in the climate change negotiation, we need at least to put our voice first. Second, we want to insert some safeguards for indigenous peoples. And the third thing is that we need to also say here that we have knowledge, and we can share our knowledge.

SARIMIN BOENGKIH: My name is Sarimin Boengkih, and I come from a small island in the Pacific region called New Caledonia. We are losing land. With losing land, we lose identity. We lose our sovereignty on food. We lose our culture. We lose our languages. So it is very important for us, for the future generation, that the world leaders listen to us, take into account our rights, and sign a good long-term, binding agreement.

MALIA NOBREGA:Well, we’re hearing that what will come out of Copenhagen is a six- or seven-page political statement. I think at this point, for the indigenous caucus, we want to at least have a few sentences within this whole document that will recognize and respect our indigenous rights, because that will create the framework for any future negotiations.

GUNN-BRITT RETTER: My name is Gunn-Britt Retter. I’m working for the Saami Council Arctic and Environmental Unit. I am from a small town on the northeast coast of Norway called Unjárga, or Nesseby. And I’m a Coastal Saami. It’s not only the climate change that’s a challenge to us, but also the national state’s mitigation efforts. So we don’t only see—as the Arctic Ocean opens up, we don’t only see a race for the oil and gas resources, which also impacts our lands; we also see a race for green energy and windmills and water power plants and nuclear plants actually impacts our land, as well. So the mitigation measures are as big a challenge as climate change in itself.

PROTESTERS: Fight for justice! Fight for justice! Fight for justice!

FIU ELISARA: Unfortunately, they are now proposing a whole lot of geo-engineering solutions, so-called solution techno-fixes, to the problem. And we are—we are really looking at that with a huge concern, because the Pacific Ocean now is being targeted for ocean fertilization. And that has never been tested. And we are concerned that the languages here does not even address the whole issue of relevant and appropriate technologies. And the fact that, you know, developed countries are trying to integrate intellectual property rights into technology makes it unaffordable and inaccessible for people like ourselves in the Pacific.

PROTESTERS: Climate justice! Climate justice! Climate justice!

JOHNSON CERDA: In relation to our contribution, we have, as I said, knowledge, but the problem is that, here, most of the countries, they believe that they have the knowledge. Also organizations, you know, NGOs, they are saying that “We want to go to train the communities to understand what is climate change.” We feel the climate change. We know what’s climate change.

PROTESTERS: ¡El pueblo unido, jamás será vencido! ¡El pueblo unido, jamás será vencido!

FIU ELISARA: We are saying that climate is going to be the economic crisis. It’s going to cause economic crisis. It’s not only affecting our peoples, small island countries, the Pacific and indigenous peoples of the world; it’s already knocking at the doors of the rich countries. And if they don’t do anything about it, and if they don’t heed the caution of the scientists, if they don’t heed the spirit of Bali to do real solutions and to address climate change, unfortunately, the whole world and Mother Earth is—it’s going to be, you know, the end—it’ll be the end of all of us.

ROBBY ROMERO: I think that what we do now, or fail to, in this moment will be humanity’s defining legacy.

AMY GOODMAN: That report by Anjali Kamat and Elizabeth Press, indigenous leaders on the front lines of climate change, on the front lines of the climate protest.

This third article in a series about Agent Orange from the Chicago Tribune looks at the toxic legacy in Vietnam.  The indiscriminate suffering caused by the chemical should clearly mark this as a chemical weapon, a ‘weapon of mass destruction’.   The U.S. is now using depleted uranium weapons which have also been suspected as causing many health problems for troops and residents of war zones in Iraq and the Balkans.

Go to the Chicago Tribune website for the full series, photos, video, maps and graphics.

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http://www.chicagotribune.com/health/agentorange/chi-agent-orange3-dec08,0,1119071,full.story

AGENT ORANGE: PART 3 OF 5

Agent Orange: Birth defects plague Vietnam; U.S. slow to help

U.S., Vietnam split over whether defoliants used in war are to blame

By Jason Grotto Tribune reporter

December 8, 2009

DONG NAI PROVINCE, Vietnam – Part 3 of a Tribune investigation finds that the role of defoliants in Vietnam’s high rate of birth defects remains a contentious question decades after U.S. spraying missions ended.

The sun beats down on Dao Thi Kieu’s straw hat as she hunches over thin strands of bright green rice plants, pulling them from beds submerged in muddy water and replanting them elsewhere.

These are the same paddies Kieu tended as a teenager during the Vietnam War, and she still remembers the planes that came in the mornings to spray Agent Orange and other defoliants while she worked.

“I was about 16 when I saw the planes flying overhead, and I saw the spraying until I was married,” said Kieu, 58. “It smelled like ripe guava. No trees could survive. It made my clothes wet.”

Her vivid memories are supported by data from spraying missions analyzed by the Tribune, which show at least seven sorties that dispensed nearly 13,000 gallons of defoliants passed over Kieu’s fields.

Since then, the story of Kieu’s life can be told with simple, heartbreaking math. She had eight children. Seven of them were born with severe deformities. Of those, five died before age 8. She also lost her husband, who served in the U.S.-backed South Vietnamese army, to cancers associated with herbicide exposure.

Decades after the Vietnam War ended, the most contentious question surrounding the use of defoliants by the U.S. military is the impact on the health of untold numbers of Vietnamese.

At the heart of the controversy is the suspected link between the herbicides and birth defects in Vietnam, where more than 5 out of every 100 children are born with some form of physical or mental abnormality, a fourfold increase since the start of the war, according to Vietnamese scientists.

The U.S. government spent $13.7 billion last year on disability payments for more than 1 million Vietnam veterans, many of whom were exposed to herbicides. Millions more have been spent compensating veterans’ families whose children were born with birth defects. But U.S. officials bristle at acknowledging connections between the defoliants and illnesses in Vietnam.

Since the countries normalized relations in 1995, Congress has allocated at least $125 million to fight HIV/AIDS in Vietnam, whose infection rate ranks 67th worldwide. About $46 million has been provided to help Vietnamese who lost limbs from unexploded bombs dropped by the United States.

Yet, since the war ended 35 years ago, Congress has set aside just $6 million to assist Vietnam with herbicide-related issues, despite evidence that large numbers of civilians in the south — people in whose name the war was fought — were exposed to defoliants that have since been outlawed in the U.S.

Private philanthropies — including the Ford Foundation, the Gates Foundation and Atlantic Philanthropies — have provided nearly three times more money than the U.S. to help the Vietnamese overcome health and environmental damage brought on by the herbicides.

During the war, U.S. officials assured the Republic of Vietnam that the defoliants were harmless. The South Vietnamese government, in turn, sought to convince its citizens that the chemicals were safe. Vietnamese soldiers went so far as to douse themselves in the chemicals and even drink them with water, according to documents from the National Archives.

“Civil servants and cadres explain to the people there the harmlessness of the defoliation by spraying defoliant on the body and water and drinking it before the people,” said an October 1963 report from the South Vietnamese government.

Like U.S. soldiers, Vietnamese citizens used empty herbicide barrels for showers and barbecues. Believing the chemicals were harmless, South Vietnamese soldiers often sold empty barrels containing as much as five gallons of herbicide residue to civilians in such places as Da Nang and Bien Hoa, government records state.

But many of the compounds weren’t safe. They were contaminated with the most toxic man-made chemical known, the dioxin TCDD. The contaminant was an unintended byproduct of the manufacturing process used by U.S. chemical companies to produce an ingredient found in Agents Orange, Purple, Green and Pink — compounds that made up more than 65 percent of the nearly 20 million gallons of herbicides released in Vietnam.

Scientists have tied dioxin to more than a dozen illnesses, including cancer, Parkinson’s disease and crippling congenital disorders.

“I never met a hormone system that dioxin didn’t like to disrupt,” said Dr. Linda Birnbaum, director of the National Institute of Environmental Health Sciences and a leading dioxin expert. “It has widespread effects in nearly every vertebrate species at nearly every stage of development.”

Early warnings

As a young obstetrician during the war, Dr. Nguyen Thi Ngoc Phuong brought hundreds of healthy babies into the world in Tu Du Hospital, home to Vietnam’s largest maternity ward, in Saigon, now Ho Chi Minh City.

Then, in 1968, two years after U.S. forces expanded the use of herbicides by millions of gallons, Phuong said she delivered a baby born without a brain or a spinal cord.

In the next few months, she said, she delivered dozens of infants with equally severe deformities, three or four a week — babies born with organs on the outside, with no arms, no legs, no eyes.

“It was very horrible for me and my colleagues,” she said, her voice cracking as she wiped away tears. “The first case happened on my duty. I didn’t show the mother because I was afraid she would go into shock. But the father and other family members demanded to see, and it was horrible.”

Finally, she went to friends who wrote for one of the Saigon newspapers. Stories of birth defects linked to the U.S. war in Vietnam soon began to emerge, sparking a bitter controversy that continues today.

The U.S. military ended the herbicide program, known as Operation Ranch Hand, in 1971 after a study for the National Institutes of Health found that a chemical in some of the compounds caused birth defects in laboratory animals. Soon after, the U.S. surgeon general halted the domestic use of the chemical, known as 2,4,5-T. Later it became widely known that 2,4,5-T was contaminated with a highly dangerous form of dioxin, TCDD.

A diabolical toxin that attaches itself to the fat cells of humans and animals, TCDD can remain in the body for decades. Scientists think that once present, it binds with cell proteins known as Ah receptors, which can then trigger a series of molecular events that affect cellular growth, potentially leading to cancer and other illnesses. Researchers also hypothesize that dioxin’s impact on the receptors can alter the regulation of genes, leading to changes in a person’s DNA.

Multiple genetic and environmental factors can affect a person’s reaction to TCDD, and scientists say health effects depend on genetic predisposition, the manner and amount of exposure and other factors that researchers haven’t fully figured out.

In the case of birth defects, dozens of experiments show that laboratory animals exposed to TCDD have higher rates of birth defects, with dose and timing affecting risk. In humans, scientists have found some correlations between exposure and defects but have yet to prove a cause-and-effect relationship. Animal research suggests that the chemical can affect reproduction by corrupting sperm and interfering with hormones that regulate the development of fetuses.

The U.S. Department of Veterans Affairs in 2003 began providing disability compensation to the children of female Vietnam veterans if they suffer from any of 18 birth defects — including the first deformity Phuong encountered four decades ago, known as anencephaly.

Male veterans’ children are compensated for one defect: spina bifida, a condition in which some vertebrae in the spine are not fully formed, leading to a host of difficulties including paralysis, fluid in the brain, bowel control problems and learning disabilities.

Figuring out how and why children are born with birth defects remains painfully complicated. There can be multiple factors at play, many of which are never known, making the job of isolating one culprit difficult, if not impossible.

What is becoming clear, however, is that people — especially women — who are exposed to even trace amounts of TCDD, which scientists measure in parts per trillion, have a higher risk of bearing children with birth defects.

Conflicting views

The controversy over Agent Orange’s impact in Vietnam stands at the crossroads of science and politics, a messy affair rife with hard feelings and stubborn assumptions on both sides.

Birth defects are the most emotionally charged part of the disagreement, with some Vietnamese claiming nearly every child born with a deformity is a victim of Agent Orange, while U.S. officials demand definitive proof that defoliants are to blame for any birth defect.

“The Vietnamese authorities, particularly at the local level, tend to lump all of these birth defects together and talk about them being related to Agent Orange,” said Michael Marine, the U.S. ambassador to Vietnam from 2004 to 2007. “At the same time, I didn’t think the U.S. side was tackling this with enough vigor. It was politically toxic to deal with.”

As evidence of the large-scale impact of the herbicides, the Vietnamese point to a study by Columbia University professor emeritus Jeanne Stellman, published in the peer-reviewed journal Nature, that estimated 2.1 million to 4.8 million Vietnamese civilians were exposed to the chemicals during the war.

Still, some U.S. officials view accusations that the defoliants caused widespread birth defects in Vietnam as a centrally controlled propaganda campaign founded on scant scientific evidence.

“We believe the (Vietnamese government) will never permit research that in any way might discredit its two-decade long propaganda campaign, i.e., Agent Orange/dioxin is to blame for a huge range of serious health problems — especially birth defects and mental retardation,” said a 2003 memo from the U.S. Embassy in Hanoi.

U.S. officials point to a host of other possible reasons for the high rate of congenital deformities, including malnutrition, a lack of iodine in the diet of pregnant mothers, even alcoholism.

Much of the contentious political rancor is captured inside Tu Du Hospital, which cares for dozens of children with some of the most severe deformities. Many were abandoned at birth and spend their days studying and playing while undergoing physical therapy and other treatments to overcome their disabilities.

The hospital and the children treated there have become symbols of Agent Orange’s lingering impact, even though in many cases little is known about whether and how their parents may have been exposed.

In 1968, Phuong and her colleagues began collecting dozens of fetuses and deformed babies who did not survive, storing them at Tu Du in large jars filled with formaldehyde. Foreign news reports about the herbicides often feature images of the jars, again despite a lack of hard evidence about what caused the deformities.

As the Tribune conducted interviews overseas, it was clear that some Vietnamese citizens are quick to blame the defoliants for health problems even when documenting exposure is difficult or the facts make direct exposure impossible. Some who said they were exposed didn’t join the military until long after the spraying missions had ceased; others operated in areas where little or no spraying took place.

Still, the Tribune saw many children at Tu Du and elsewhere in Vietnam who suffer from birth defects and illnesses that science has linked to dioxin exposure. In many cases, data on wartime spraying missions supports their parents’ stories of exposure to herbicides.

Parents’ burdens

Tram Thi Shu has a 6-year-old son, Ho Cong Duc, who looks more like he’s 6 months old. His blue veins are visible beneath his translucent skin. The boy is thin and pale; his breathing is raspy and labored. Shu believes his illnesses, as well as her daughter’s seizures, are due to her exposure to defoliants.

“I remember seeing the plane fly over the back of my head,” said Shu, 43, who grew up in Quang Nam province. “After it left, all of the leaves from the trees fell down. We were wet because of the spray. I don’t remember exactly how many times it happened, but my mother said it was at least three times.”

Data from spraying missions in Quang Nam show nearly 24,000 gallons of Agent Orange and 21,000 gallons of Agent Blue — which contained arsenic — were sprayed within two miles of Shu’s village.

“I am very worried for my son,” Shu said. “If I can live longer than him, it will be OK. But if I pass away, I don’t know who will take care of him.”

And then there’s Dao Thi Kieu, who has lost a husband as well as five children.

Her husband, Lam Ba Trung, served in the U.S.-backed South Vietnamese army along the 17th Parallel in Quang Tri province, where U.S. and South Vietnamese forces sprayed more than 700,000 gallons of herbicides to destroy enemy crops and defoliate dense jungles.

He died in 2004 at 60 after a seven-year battle with lung and throat cancer, illnesses the Institute of Medicine and the U.S. Department of Veterans Affairs link to defoliants used during the war.

Like many Vietnamese citizens, Kieu and her husband spent years blaming themselves for their children’s suffering.

“We thought that maybe we had done something bad in a past life,” she said, her voice beginning to break. “That’s why my husband became a vegetarian.”

Almost every day, Kieu rises at 3 a.m. to care for her two surviving disabled daughters, Lam Kim Lien, 39, and Lam Ngoc Huong, 35.

Without the benefit of physical therapy, neither is able to walk, talk or even hold a spoon. Their misshapen, skeletal bodies and cropped hair make them look much younger, while their gaunt, expressionless faces reflect lives spent on a small wooden bed covered with a straw mat.

The couple’s only healthy child, Lam Ngoc Nhan, 20, was born after Kieu and Trung waited 10 years to try again, an important detail considering dioxin levels are cut in half in human beings after about 7 1/2 years; the chemical also passes out of the body as mothers breast feed.

Kieu tends her rice paddies until dusk and then returns home to bathe and feed Lien and Huong. A diminutive woman with an iron resolve, Kieu is well-respected in her village for struggling through hardships, giving her a sense of pride amid all the pain.

But her strength melts away as she speaks about the difficulties she faces and her hopes for the future.

“I don’t know what to say. To find justice?” she said, tears streaming from her dark eyes. “I lost five children and a husband. I have two children with disabilities. There are days when I come back from work, and I am so tired I cannot lift up my children.”

jgrotto@tribune.com

Copyright © 2009, Chicago Tribune

The Chicago Tribune ran a powerful series of articles on the toxic legacy of the U.S. military’s use of Agent Orange in Vietnam.  The nightmarish health effects have haunted generations of Vietnamese and U.S. soldiers and their families.   As a main staging base for air operations in Vietnam, Guam is also heavily contaminated with Agent Orange.    There is a shameful link to Hawai’i as well.  Agent Orange was secretly tested in Hawai’i by University of Hawai’i agricultural researchers. Although the defoliant was a military project, research programs were funded through the Department of Agriculture.   Two UH workers who were drenched with Agent Orange as they guided aerial spraying of the agent later became seriously ill and died.  They were unsuccessful in their lawsuits for compensation.    Retired UH journalism professor Bev Keever and her students helped to uncover this shameful episode.   A UH agricultural research area on Kaua’i is contaminated with Agent Orange.

Agent Orange was one of the deadly products of the classified U.S. biological and chemical weapons program caleld Project 112/Project SHAD.   It involved the testing of nerve gas in the Waiakea forest on the Big Island and the release of biological ‘simulants’ on O’ahu.

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http://www.chicagotribune.com/health/agentorange/chi-agent-orange1-dec04,0,6366546,full.story

AGENT ORANGE: PART 1 OF 5

Agent Orange’s lethal legacy: For U.S., a record of neglect

Poisonous defoliants still exact a toll in U.S., Vietnam

By Jason Grotto and Tim Jones Tribune reporters

December 4, 2009

Part 1 of a Tribune investigation finds that U.S. officials have neglected a lasting problem even as the health fallout has spread. Complete coverage >>

In central Indiana, two sisters struggle through another day, afflicted by a painful condition in which their brains are wedged against their spinal cords. They are in their 30s, but their bodies are slowly shutting down.

Thousands of miles away, amid the rice paddies of Vietnam, a father holds down his 19-year-old daughter as she writhes in pain from a seizure brought on by fluid in her skull, which has been drained four times in the past four years.

“The doctors said that they were sorry, but they could not cure her,” the father says. “They told me I should take her home and that she would pass away very soon.”

These women come from different cultures, from nations separated by more than 8,300 miles. Their fathers fought on opposite sides of the Vietnam War, but they are linked by the stubborn legacy of Agent Orange and other defoliants sprayed by the U.S. military decades ago.

Contaminated with dioxin, a chemical now considered the most toxic ever created by man, the defoliants are linked to a higher risk of multiple cancers, birth defects and other conditions that are contributing to a dramatic increase in financial compensation for U.S. veterans and their families.

Service-related disability payments to Vietnam veterans have surged 60 percent since 2003, reaching $13.7 billion last year, and now account for more than half of such payments the U.S. Department of Veterans Affairs provides to veterans of all wars. The average compensation payment for Vietnam vets is 41 percent higher than that for World War II veterans and 35 percent higher than for those who served in Korea. Those disability checks do not include the billions spent on health care for Vietnam veterans.

The price tag is only expected to escalate as scientists learn more about the effects of dioxin, as veterans are stricken late in life and as the children of veterans discover they are sick. In September, three more diseases were added to the list of illnesses for which the VA provides compensation — an expansion the agency estimates will affect roughly 200,000 veterans and cost billions of dollars annually.

Meanwhile, untold numbers of Vietnamese — including many who weren’t even alive during the war — also suffer from maladies associated with the defoliants. Tens of thousands more are at risk today from dioxin that remains in the environment at dozens of former U.S. military bases.

Yet in the 30 years since Agent Orange was recognized publicly as a potential health threat, the federal government has established a record of neglect.

U.S. veterans seeking compensation for their illnesses face delays and a maddening bureaucracy. Adding to their frustration, the federal government never has gotten to the bottom of Agent Orange’s full impact, failing to follow through on requests for large-scale studies on how defoliants may have affected veterans’ health.

In Vietnam, children sing songs of the devastation caused by Agent Orange and government officials wonder how the U.S. can avoid fully addressing the health and environmental havoc wreaked by the chemicals, even as the two nations foster stronger trade and military ties.

Since the countries normalized relations in 1995, Congress has allocated just $6 million for herbicide-related issues in Vietnam, even though Vietnamese officials say addressing them will take tens of millions. The Ford Foundation, a philanthropic organization that has made Agent Orange a focus, has provided $11.7 million.

With assistance from the Fund for Investigative Journalism, the Tribune spent a month traveling to eight provinces throughout Vietnam, conducting nearly two dozen interviews with civilians and former soldiers who say they were exposed to the defoliants.

The newspaper used a database of every spraying mission, mapping software and a GPS device to help corroborate their stories. And in the U.S., the paper researched thousands of pages of government documents and traveled to the homes of veterans to gauge the impact and measure the cost in both dollars and human misery.

Some scientists remain skeptical that Agent Orange and other defoliants directly cause diseases. But with hundreds of independent studies completed in the years since the war ended, there is strong evidence that people exposed to the herbicides have a higher risk of contracting illnesses such as soft tissue sarcoma and non- Hodgkin’s lymphoma. The number of medical conditions linked to the defoliants continues to grow.

The lingering controversy over the herbicides on both sides of the Pacific Ocean provides a sobering reminder of the often unforeseen consequences of war at a time when the country is fighting protracted conflicts in Iraq and Afghanistan.

“We do not know the answer to the question: What happened to Vietnam veterans?” said Jeanne Stellman, an epidemiologist who has spent decades studying Agent Orange for the American Legion and the National Academy of Sciences. “The government doesn’t want to study this because of international liability and issues surrounding chemical warfare. And they’re going to win because they’re bigger and everybody’s getting old and there are new wars to worry about.”

A deadly defense

The U.S. military began spraying herbicides in South Vietnam in 1961, as the Cold War raged and America seemed beset on all sides by the threat of communism. Vietnam, a sliver of a country hugging the South China Sea, was split in half, with communists controlling the north. Led by nationalist leader Ho Chi Minh, the communists sought to reunite the country by toppling the U.S.-backed Republic of Vietnam in the south.

The greatest asset of the armies fighting the U.S. may have been the landscape of South Vietnam. Triple-canopy jungles cascading down mountainsides, patchworks of rice paddies and dense forests covered a battlefield where the line between enemy and civilian was often blurred.

The verdure allowed North Vietnamese forces to harass, resupply and melt back into the thick vegetation while surviving on food grown by local supporters.

The U.S. countered with chemical defoliants aimed at destroying the natural fortresses protecting the enemy. Over 10 years, U.S. and South Vietnamese forces released nearly 20 million gallons of herbicides in Southeast Asia, enough to blanket Lake Michigan four times. The vast majority of the missions took place in South Vietnam, but border areas in Cambodia and Laos were also sprayed.

Though Agent Orange was the most widely used herbicide, there were actually a half-dozen “agents,” including White, Blue, Purple, Pink and Green. About 65 percent of them were contaminated with TCDD, a highly toxic form of dioxin, while more than 1 million gallons of Agent Blue contained arsenic.

The U.S. military stopped using Agent Orange in 1970 after a study for the National Institutes of Health showed that a chemical found in some of the compounds caused birth defects in laboratory animals. Soon after, the U.S. surgeon general halted the domestic use of that chemical, a dioxin-tainted compound known as 2,4,5-T.

Some limited spraying continued in Vietnam for another year, but only with agents that did not contain dioxin. The herbicide program, known as Operation Ranch Hand, stopped in 1971, four years before the war officially ended.

‘We’re a mess’

Nearly four decades later, on a quiet street in Brownsburg, Ind., Carrie Price-Nix and Amanda Price Palmer have resigned themselves to a life of prolonged fatigue and permanent disability. They’ve had 41 surgeries between them in the past 20 years, including five brain operations, two spinal cord surgeries and one hysterectomy.

Their father, Stephen Price, was an Air Force mechanic who served at the U.S. air base in Da Nang in 1967. Even today, the site is contaminated with levels of TCDD that are as much as 365 times higher than what the World Health Organization deems safe.

Price died in April 2008 after fighting leukemia, diabetes and chloracne, all of which are associated with the herbicides used in Vietnam. He began receiving full disability compensation from the VA in 2005, after waiting two years for his claim to be approved.

His daughters both have Chiari malformation, a structural defect in the base of the brain associated with spina bifida, which the VA recognizes as a defoliant-related birth defect in the offspring of male veterans.

Price filed a claim with the VA for Price-Nix in July 2002. Three and a half years later, she was approved for partial compensation. By that time, her bladder had shut down, and her father was dying.

Palmer, who has similar health problems, has spent six years seeking compensation from the VA. “They’re waiting for you to die,” her sister said. Last week, the agency denied Palmer’s claim, ruling her illness is not related to spina bifida.

The deterioration of Palmer’s abdominal muscles forces her to remove her feces manually. Price-Nix has a pacemaker-like device to regulate her bowels and must catheterize herself daily.

“We’re a mess,” Palmer said jokingly. Then the sisters began weeping as they pondered the reality that there is no recovery from their conditions.

See video of the sisters discussing their family’s health issues

Far away from Brownsburg, in central Vietnam’s Quang Binh province, Do Thi Hang, 19, suffers from symptoms similar to the sisters’. She has regular seizures caused by the fluid that accumulates in her brain. She can’t walk and has trouble controlling her bowels.

Her parents have never been given a specific diagnosis because of Vietnam’s underdeveloped health care system, but Hang’s ailments mirror those of people suffering from spina bifida.

As a soldier fighting the U.S., Hang’s father, Do Duc Diu, 58, was stationed for four years at an abandoned U.S. air base called A So, located in a valley where parts of the Ho Chi Minh Trail wound along the Laotian border. U.S. and South Vietnamese forces sprayed more than 400,000 gallons of herbicides in the Aluoi Valley, formerly known as A Shau.

New studies show that areas where the U.S. military stored chemicals on the A So air base are still contaminated with dangerously high levels of TCDD.

Since the war ended, Diu and his wife, Pham Thi Nuc, have had 15 children. Twelve died before the age of 3, all from illnesses similar to Hang’s, Diu said. Their small graves sit atop a sandy hill behind Diu’s home where he goes nearly every day to burn incense.

“I can say that I have no future, no happiness,” he said.

See video of Diu’s family at home in Vietnam

Invisible wounds

The compensation U.S. veterans now receive for herbicide-related illnesses was gained only after a long, hard-fought battle in which the lines between science and politics were often blurred.

Part of the problem was that veterans were returning home with invisible wounds. Their fight to receive recognition and compensation for their war-related illnesses, including post-traumatic stress disorder, opened the door for veterans of all wars.

“The better care that troops get now is owed to their Vietnam brothers,” Stellman said.

New scientific studies, dogged investigations into political interference in government-sponsored studies and a $180 million settlement in a veterans’ class action suit against chemical companies paved the way for the Agent Orange Act of 1991.

Among other provisions, the legislation created a list of “presumptive illnesses” for which Vietnam veterans could be compensated. It directed the National Academy of Sciences to review studies on the chemicals found in the herbicides and, every two years, recommend additions to the list. Diseases or birth defects are recommended if exposure to defoliants is more likely than not to increase a person’s risk.

Since then, the VA has added 15 diseases as well as 17 birth defects in the children of female veterans.

But veterans groups say as many as a dozen more illnesses could be associated with the herbicides, as could numerous birth defects in the offspring of male vets.

One reason for the slow pace in adding diseases is that the VA relies on outside research on workplace exposure and industrial accidents instead of conducting a broader epidemiological study on veterans, which Congress first asked for in 1979. For years the agency said it could not study the impact of the herbicides on veterans because it had no way of measuring their exposure.

But that excuse is no longer valid, according to Stellman, professor emeritus at Columbia University‘s school of public health.

With her husband, Steven, an epidemiology professor, she compiled a comprehensive database on spraying missions and used it to develop an exposure model that has twice been blessed by the Institute of Medicine, an independent panel of medical experts whose recommendations on health policy help guide the VA’s decision-making.

The VA said in 2003 it would take the model under advisement. The agency is still evaluating it.

“I’m surprised that it hasn’t been pursued more energetically,” said Dr. David Savitz, a physician at Mount Sinai School of Medicine in New York City who chaired the institute’s review panel.

In September, the VA announced a broad, three-year study on Vietnam veterans’ health, but it won’t look specifically at defoliants like Agent Orange. Coming more than three decades after the war ended, the plan has many veterans believing the government is simply waiting for them to disappear.

“The mantra of the VA is delay, delay, delay until they all die,” charged Paul Sutton, a Vietnam veteran and former chairman of Vietnam Veterans of America.

Retired Army Gen. Eric Shinseki, now the secretary of veterans affairs, has acknowledged the adversarial relationship between the VA and former soldiers. A Vietnam veteran who was wounded in combat, Shinseki has vowed to be more of an advocate for those who serve the country.

Members of Congress say much of the foot-dragging on studying Agent Orange is tied to the bottom line.

“I don’t think they really want to know the answer,” said Rep. Bob Filner, D-Calif., chairman of the House Veterans Affairs Committee. “The (financial costs) would be so high that they’d scare the hell out of everybody.”

Jason Grotto reported from Vietnam; Tim Jones reported from Indiana.

jgrotto@tribune.com

tmjones@tribune.com