Innocent victims

By Fred Pearce TO THANH NAM is a victim of phocomelia, a congenital deformity that has left him without legs. But his two feet have grown just the same—attached to the torso where his thighs would normally be. Phocomelia is Greek for “limbs of a seal”. He was born in June 1997 in the village of Nguyen Khe near Hanoi in Vietnam. Doctors believe he is one of a small but growing number of Vietnamese children who are third-generation victims of the toxic pesticides—in particular Agent Orange—that were sprayed over the country by the US Air Force at the height of the Vietnam War 30 years ago. The Americans were trying to destroy the rainforests in what was then South Vietnam to flush out communist Vietcong soldiers, who used the cover of the forests to build bases, move troops and ambush traffic on roads and railways. The baby’s grandfather is To Tiern Hoa. Between 1968 and 1972 he fought the Americans in the jungles of the Aluoi Valley, about 60 kilometres west of the coastal town of Hue. The valley was among the most heavily sprayed areas. He did not himself suffer visible damage from the chemicals, but his first son was later born with a toe missing from his left foot. And then his grandson was born. The history of this family has been tracked by Le Cao Dai, a medical researcher and director of the Agent Orange Victim Fund set up in July by the Vietnam Red Cross. He says there is no proof that the malformations in To Tiern Hoa’s son and grandson are caused by his exposure to Agent Orange, but points out there is no previous history of birth defects either in the family or among people in their village. Nor has the family been exposed to other pesticides or drugs that might cause defects. Le Cao Dai is monitoring a dozen other children with similar conditions that he believes are linked with their grandparents’ exposure to Agent Orange. “To establish scientifically such a relationship we need sophisticated tests that are not available at the moment in our country,” he says. “But after a careful clinical examination and interviews with the family members that show no other causes, we believe the link.” Agent Orange is a mixture of the herbicides 2,4-D and 2,4,5-T. Both chemicals mimic plant hormones and upset the metabolism of growing plants. Concern about the formulation centred largely on the presence of dioxin, or 2,3,7,8-TCDD, an unwanted by-product in the manufacture of 2,4,5-T and one of the most poisonous substances known to science. Dioxin is strongly suspected of being a human carcinogen, linked with both soft-tissue sarcomas and non-Hodgkin’s lymphomas. It is also known to disrupt the body’s hormonal, reproductive and immune systems in a variety of ways. Animal studies have shown that it can feminise males and cause birth defects in their offspring. But the biggest concern is that the damage appears to extend to the human reproductive system, causing fathers to produce damaged sperm. There is currently no evidence that dioxin damages DNA and so causes mutations. So if, as Le Cao Dai believes, it is causing second and third-generation birth deformities, the likelihood is that they are congenital, caused by either the continuing presence of dioxin in the environment and human tissue, or lingering effects on the father’s or mother’s hormonal system. Appalling second-generation birth defects among the children of veterans exposed during the war to Agent Orange and other pesticides have been well documented. According to Professor Hoang Dinh Cau, the chairman of Vietnam’s 10-80 Committee, which investigates the consequences of the use of chemicals during the war, tens of thousands of children are affected. Common symptoms are limbs twisted in a characteristic way or missing altogether, and eyes without pupils. Le Cao Dai and his colleagues have conducted a study of the families of some 1900 veterans, graded according to whether and for how long they served in areas subjected to spraying. Of the 8000 children born to these veterans, the proportion with defects rose from 1.1 per cent born to veterans with no known exposure, to 1.9 per cent for light exposure, 2.2 per cent for moderate exposure and 5.1 per cent for high exposure. The chemicals used to make Agent Orange were widely used on farms and in gardens in the US and Europe in the 1960s. But the concentrations used in Vietnam, at 40 litres per hectare, were 20 to 100 times those employed in normal agriculture. American military aircraft sprayed some 50 million litres of Agent Orange over the country between 1962 and 1971 in a project known as Operation Ranch Hand, which at its peak in 1969 employed 25 aircraft. They doused 1.7 million hectares, often several times over. By the end of the war, a fifth of South Vietnam’s forests had been sprayed with Agent Orange, and more than a third of its mangrove forests were dead. The defoliation was on an unprecedented scale, far exceeding British spraying of jungles during counter-insurgency operations against communists in Malaya in the 1950s. From the start there was concern that Agent Orange was toxic to humans as well as trees. In 1964, the Federation of American Scientists condemned Operation Ranch Hand as an unwarranted experiment in chemical warfare. But the operation continued until a spate of reports in the South Vietnamese press in 1970 and 1971 that Agent Orange was causing birth defects, and research showing that 2,4,5-T caused malformations and stillbirths in mice. Nature has cleansed Vietnamese soils and vegetation of most of the dioxin. In the early 1970s, South Vietnamese fish typically contained 300 parts per trillion (ppt) of the chemical. Today’s levels of less than 1 ppt are still higher than in the north but are similar to those in industrialised countries. But adult humans still harbour higher levels in blood, fat and breast milk. According to Le Cao Dai, the breast milk of women in former South Vietnam who were exposed to Agent Orange in childhood contains 15 to 20 ppt of dioxin. This is only one hundredth the concentration in the breast milk of women in the region in the early 1970s, but remains about ten times higher than in either former North Vietnam or industrialised nations such as the US. Average dioxin levels in fat in the people of Ho Chi Minh City, formerly Saigon, are 19 ppt, compared with 1 ppt in Hanoi and around 7 ppt in the US. War veterans in Hanoi have more dioxin in their fat than their neighbours. Research into the effects of Agent Orange has mostly taken place in the US, where it is highly politicised. Each piece of evidence becomes ammunition in long-running legal battles by American veterans who claim their own health has been affected by handling the chemical. Sceptics, such as Michael Gough, director of science and risk at the Cato Institute, an industry think-tank, deny that there is convincing evidence of long-term health impacts from either dioxin or Agent Orange. The poor state of Vietnamese health services means that there is little systematic data on the lingering effects of these chemicals on the population. But there is plenty of evidence that many of those exposed to spraying have suffered from persistent headaches, depression, nausea and impotence since the war. And then there are the deformed children. Further research is needed to establish the link, but Le Cao Dai and his colleagues are convinced that Vietnam faces the prospect of a new generation succumbing, perhaps in large numbers,
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