Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

Congressional research reportNov 30, 2012

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Vietnamese Victims of Agent Orange and

U.S.-Vietnam Relations

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Acting Section Research Manager/Specialist in Asian Affairs

November 30, 2012

Congressional Research Service

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www.crs.gov

RL34761

CRS Report for Congress

Prepared for Members and Committees of Congress

Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

Summary

Since the end of the Vietnam War in 1975, there has been a gradual warming of bilateral relations

between the United States and Vietnam, culminating in the appointment of the first U.S.

ambassador to Vietnam in 1996 and the granting of permanent normal trade relations (PNTR) to

Vietnam in 2007. Over the last three decades, many—but not all—of the major issues causing

tension between the two nations have been resolved.

One major legacy of the Vietnam War that remains unresolved is the damage that Agent Orange,

and its accompanying dioxin, have done to the people and the environment of Vietnam. For the

last 35 years, this issue has generally been pushed to the background of bilateral discussions by

other issues considered more important by the United States and/or Vietnam. With most of those

issues presently resolved, the issue of Agent Orange/dioxin has emerged as a regular topic in

bilateral discussions.

In the last few years, the United States has shown a greater willingness to fund environmental

remediation activities in Vietnam. Since 2007, Congress has appropriated $59.5 million for dioxin

removal and related health care activities in Vietnam. In 2012, the Senate has proposed providing

an additional $20 million in the Department of State, Foreign Operations, and Related Programs

Appropriations Act, 2013 (S. 3241), but the House of Representatives has not included dioxin

remediation funding in its corresponding appropriations bill, H.R. 5857. The Vietnamese

government and people would like to see the United States do more to provide help for victims of

Agent Orange, as well as assist with the cleanup of other Agent Orange “hot spots.”

According to various estimates, the U.S. military sprayed approximately 11 million-12 million

gallons of Agent Orange over nearly 10% of then-South Vietnam between 1961 and 1971. One

scientific study estimated that between 2.1 million and 4.8 million Vietnamese were directly

exposed to Agent Orange. Vietnamese advocacy groups claim that there are over 3 million

Vietnamese suffering from health problems caused by exposure to the dioxin in Agent Orange.

The people of Vietnam have become increasingly concerned about the issue of Agent Orange.

Various non-government organizations are placing more pressure on the Vietnamese government

to remove the dioxin from the environment and provide better care to the people exposed to

Agent Orange. Some government ministries are comparatively sympathetic to the public concern

about Agent Orange, but other ministries are apprehensive that highlighting the dangers of dioxin

could have undesired consequences for bilateral relations or for Vietnam’s economy.

This report examines various estimates of the effects of Agent Orange on Vietnam’s people and

environment, the history of U.S. policy on the issue, the current cleanup efforts in Vietnam, the

various forms of assistance—including U.S. governmental assistance—provided to people with

medical conditions associated with dioxin exposure, and the implications for bilateral relations. It

concludes with a brief discussion of possible congressional responses to the issue.

This report will be updated as conditions warrant.

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

Contents

Brief History of Post-War U.S.-Vietnam Relations and the Agent Orange Issue ............................ 3

U.S. Government Assistance ........................................................................................................... 7

Assistance Through 2007 .......................................................................................................... 8

Assistance Since 2007 ............................................................................................................... 9

Obligations .............................................................................................................................. 11

The Effects of Agent Orange on Vietnam ...................................................................................... 14

Brief History of the Use of Agent Orange in Vietnam ............................................................ 15

Estimates of Vietnamese Exposure to Agent Orange .............................................................. 16

Amount Used .................................................................................................................... 16

Exposure ............................................................................................................................ 18

Vietnam’s Health Claims ......................................................................................................... 22

Cleanup Efforts .............................................................................................................................. 22

The Dialogue Group’s Plan of Action............................................................................................ 25

Vietnam’s Assistance to the Victims .............................................................................................. 26

Government Support ............................................................................................................... 27

AO Central Payments Programme .................................................................................... 28

Health Insurance Card ....................................................................................................... 28

Agent Orange Day............................................................................................................. 29

U.S. Civil Suit for Compensation ............................................................................................ 29

Vietnamese Americans and Agent Orange .............................................................................. 30

Other Sources of Assistance .......................................................................................................... 30

Vietnamese Non-Governmental Assistance............................................................................. 31

Vietnam Red Cross Fund to Support Agent Orange Victims ............................................ 31

Vietnam Association for Victims of Agent Orange/Dioxin (VAVA) ................................. 31

Charity Events ................................................................................................................... 32

Peace Villages ................................................................................................................... 32

International Sources of Assistance ......................................................................................... 33

The Ford Foundation ......................................................................................................... 33

The United Nation’s Children’s Fund (UNICEF) ............................................................. 35

The United Nations Development Program (UNDP)........................................................ 35

The Bill and Melinda Gates Foundation and the Atlantic Philanthropies ......................... 35

Implications for Bilateral Relations ............................................................................................... 35

Issues and Options for Congress .................................................................................................... 37

Pending Legislation ................................................................................................................. 37

General Issues.......................................................................................................................... 38

Figures

Figure 1. U.S. Trade with Vietnam, 2001-2011 ............................................................................... 6

Figure 2. Map of Areas of Vietnam Sprayed with Herbicides ....................................................... 17

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

Tables

Table 1. Congressional Appropriations for Agent Orange/Dioxin Remediation and

Health-Related Activities in Vietnam ......................................................................................... 10

Table 2. USAID Obligations and Planned Obligations of Agent Orange/Dioxin

Appropriations ............................................................................................................................ 12

Table 3. Non-Vietnamese Sources of Agent Orange/Dioxin Assistance........................................ 34

Contacts

Author Contact Information........................................................................................................... 39

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

ince the mid-1990s, bilateral relations between the United States and Vietnam have become

virtually normalized. The United States has granted Vietnam permanent normal trade

relations (PNTR) status and Vietnam has become a member of the World Trade

Organization (WTO)—two major objectives of the Vietnamese government following the end of

the Vietnam War. As part of the bilateral agreements related to PNTR and WTO membership,

Vietnam has made a number of significant changes in its trade policies, and has increased its

efforts to help the United States recover the remains of U.S. soldiers and civilians who died

during the Vietnam War. The two nations also have expanded their nascent cooperation on

strategic and military issues to the point that Vietnam has emerged as an important partner for the

United States on many issues in Asia.

Although the United States remains concerned about human rights in Vietnam, tensions between

the two nations are comparatively low. However, inside Vietnam, there is a long-standing issue

that could continue to cause friction in the future—the condition of Vietnamese people affected

by Agent Orange and its unintended byproduct, the dioxin 2,3,7,8-tetrachlorodibenzo-p-dioxin, or

TCDD.1 Agent Orange was one of several herbicides that the U.S. military used widely in

southern Vietnam during the Vietnam War. According to U.S. Ambassador to Vietnam David

Shear, “Agent Orange remains among the most sensitive issues in U.S.-Vietnam relations.”2

Over the last decade, there has been a groundswell of concern among the Vietnamese people

about the continuing problems of environmental damage and illnesses associated with Agent

Orange. Some non-governmental organizations (NGOs) in Vietnam are seeking compensation or

assistance from the U.S. government and the manufacturers of Agent Orange. Partially in

response to this rising tide of popular concern, the Vietnamese government has raised the profile

of this issue in various bilateral fora with U.S. officials, including the June 2008 summit between

President Bush and Prime Minister Nguyen Tan Dung.

Vietnam’s government is divided on the issue of whether to seek greater U.S. assistance with the

Agent Orange/dioxin issue. Vietnam’s Ministry of Defense (MOD) and various veterans groups

are among the more vocal advocates of seeking more U.S. assistance. Similarly, the Ministry of

Health (MOH); the Ministry of Labour, War Invalids, and Social Affairs (MOLISA); and the

Ministry of Natural Resources and the Environment (MONRE) would like to see the United

States increase its assistance. However, the Ministry of Agriculture and Rural Development

(MARD) is concerned that by drawing attention to the continued pervasive presence of dioxin in

the Vietnam’s environment, other nations may restrict or prohibit the import of Vietnamese crops,

aquatic products, meats and poultry, and processed foods supposedly for health reasons. Some

officials in Vietnam’s Ministry of Foreign Affairs (MOFA) are also apprehensive that greater

pressure on the United States on the Agent Orange/dioxin issue may have an adverse impact on

other important bilateral issues, such as Vietnam’s application to the U.S. Generalized System of

Preference program or the ongoing Trans-Pacific Partnership (TPP) negotiations.3

For purposes of this report, the term “dioxin” and “TCDD” will be used interchangeably, unless otherwise noted.

Calum MacLeod, “Fifty Years Later, U.S., Vietnam Deal with Agent Orange,” USA Today, November 7, 2012.

For more information on Vietnam’s application to the GSP program, see CRS Report RL34702, Potential Trade

Effects of Adding Vietnam to the Generalized System of Preferences Program, by (name redacted) and (name redac

ted). For information on the TPP negotiations, see CRS Report R42694, The Trans-Pacific Partnership Negotiations

and Issues for Congress, coordinated by (name redacted).

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According to one Vietnamese estimate, there are up to 5 million Vietnamese spanning three

generations who have medical conditions that are purported to be related to exposure to Agent

Orange and similar herbicides—and more importantly, their accompanying dioxin—that the U.S.

military sprayed across much of South Vietnam as part of Operation Ranch Hand.4 The

Vietnamese government and various Vietnamese interest groups have long sought U.S. assistance

with the cleanup of the residual dioxin in Vietnam, as well as financial support to provide medical

treatment to people exposed to Agent Orange. The official U.S. response to date has been to deny

any legal liability and to contest that the medical conditions are related to exposure to Agent

Orange and dioxin. The Vietnamese government and people have objected to these denials given

the level of support provided to U.S. veterans who were presumably exposed to Agent Orange

and the extensive cleanup efforts made at Love Canal, Times Beach, and other U.S. locations

found to have elevated levels of dioxin in the soil.5

In the waning months of the George W. Bush Administration, there were some indications that the

United States was becoming more flexible on this issue—just as the issue has risen in importance

in Vietnam. For example, following President Bush’s November 2006 meeting with President

Nguyen Minh Triet, the two governments issued a joint statement that included the sentence,

“The United States and Vietnam also agreed that further joint efforts to address the environmental

contamination near former dioxin storage facilities would make a valuable contribution to the

continued development of their bilateral relations.”6 The joint statement also indicated that

“President Triet also expressed appreciation for the U.S. Government’s increasing development

assistance to Vietnam and urged the U.S. side to increase humanitarian assistance including

through cooperation on areas such as unexploded ordinance and continued assistance to

Vietnamese with disabilities.”7

In addition, Congress has demonstrated a willingness to provide assistance for both the dioxin

cleanup and humanitarian support for Vietnamese believed to be affected by exposure to dioxin.

In May 2007, the 110th Congress appropriated $3 million to the State Department for the cleanup

of dioxin in and around an ex-military base in Da Nang used as a distribution center for Agent

Orange during the Vietnam War. Some of the funds were to be used to provide medical care for

residents near the ex-military base. The 111th Congress appropriated $3 million in FY20098 and

an additional $15 million in FY20109 for the cleanup and related health activities in Da Nang. In

April 2011, the 112th Congress appropriated $18.5 million as part of Department of Defense and

Full-Year Continuing Appropriations Act, 2011 (P.L. 112-10) for Agent Orange/dioxin

remediation and related health activities in Vietnam, and an additional $20.0 million in the

Consolidated Appropriations Act, 2012 (P.L. 112-74). Additional legislation has been introduced

Operation Ranch Hand was the military code name for the spraying of herbicides from U.S. Air Force aircraft across

much of southern Vietnam, as well as parts of Cambodia and Laos, from 1962 through 1971 in an effort to eliminate

jungle cover for North Vietnamese and Viet Cong forces.

Observation based on various interviews conducted by author with Vietnamese officials and citizens.

“Joint Statement Between the Socialist Republic of Vietnam and the United States of America,” Office of the Press

Secretary, The White House, November 17, 2006.

Ibid.

The details of the appropriate were included in House Appropriations Committee Print, “Division H—Department Of

State, Foreign Operations, and Related Programs Appropriations Act, 2009,” of the Omnibus Appropriations Act, 2009

(P.L. 111-8).

The appropriation of $3 million was specified in H.Rept. 111-366 of the Consolidated Appropriations Act, 2010 (P.L.

111-117) and an additional $12 million was specified in S.Rept. 111-188 of the Supplemental Appropriations Act, 2010

(P.L. 111-212).

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

in 112th Congress that would appropriate funds for Agent Orange/dioxin remediation and related

health activities in Vietnam (see “Issues and Options for Congress”).

Some Members of Congress have also stated that the United States has a “moral obligation” to

the people of Vietnam—many of whom were either allies at the time or were innocent civilians—

to help address the perceived environmental and health problems created by the use of Agent

Orange during the Vietnam War. In April 2008, Senator John McCain said in regards to the Agent

Orange/dioxin issue, “I believe it remains an irritant, and perhaps more than that, for some of the

people of Vietnam. I think we need to continue to address the issue both in compensation for the

victims as well as cleanup of areas that are clearly contaminated.”10

Although both sides appear to be willing to discuss the issue, the legacy of Agent Orange has the

potential to adversely affect U.S.-Vietnamese relations in the future. With other key issues

apparently resolved, Agent Orange has emerged as one of Vietnam’s top concerns. However,

Vietnam’s interest in forming closer economic ties with the United States—such as its formal

request for inclusion in the U.S. Generalized System of Preferences (GSP) program11 and the

ongoing negotiations of the Trans-Pacific Partnership trade agreement12—may once again push

the Agent Orange issue into the background.

For the United States, the recent growth in bilateral trade and U.S. investment in Vietnam is

providing a strong incentive to improve relations with its former enemy. According to many U.S.

manufacturers, Vietnam is one of the more attractive alternative sources to China for a variety of

imported products. Also, some analysts think that friendly relations with Vietnam offer a strategic

counterbalance to the growth of Chinese influence in Asia. In addition, greater assistance with the

cleanup of dioxin in Vietnam and/or aid in providing medical care for dioxin victims may

enhance the image of the United States in Southeast Asia, as well as improve Vietnam’s public

environmental management and health systems. Some observers assert that if the United States

continues to deny the legitimacy of Vietnam’s environmental and health claims—and the

responsibility to help ameliorate the damage caused by Agent Orange/dioxin—it risks causing

harm to its relations with Vietnam, and possibly weakening U.S. soft power in Asia.13

Brief History of Post-War U.S.-Vietnam Relations

and the Agent Orange Issue

From 1975 to about 2000, although the Agent Orange issue was on Vietnam’s agenda, it was

generally pushed into the background.14 There are many reasons for this, including Vietnam’s

Bao Van, “Agent Orange Victims Need More Support: McCain,” Thanh Nien News, April 8, 2008.

For more information on Vietnam’s GSP application, see CRS Report RL34702, Potential Trade Effects of Adding

Vietnam to the Generalized System of Preferences Program, by (name redacted) and (name redacted).

For more about the TPP negotiations, see CRS Report R42694, The Trans-Pacific Partnership Negotiations and

Issues for Congress, coordinated by (name redacted).

There has been considerable criticism of a perceived U.S. neglect of Southeast Asia, and a growth in Chinese

influence in the region. For more information on this issue see CRS Report RL34620, Comparing Global Influence:

China’s and U.S. Diplomacy, Foreign Aid, Trade, and Investment in the Developing World, coordinated by (name r

edacted).

For more information on the history of U.S.-Vietnam normalization, see CRS Report RL33316, U.S.-Vietnam

Relations in 2008: Background and Issues for Congress, by (name redacted).

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desire for greater trade opportunities with the United States, the U.S. desire for a more complete

accounting for U.S. soldiers still listed as “missing in action” (MIA) in Vietnam, Vietnam’s

invasion of Cambodia in 1978, and the rising tide of Vietnamese “boat people.”

In 1975, following North Vietnam’s victory over South Vietnam, President Gerald Ford severed

diplomatic relations and imposed a trade embargo on Vietnam.15 Although Vietnam sought to

normalize relations, it was predicated on the United States honoring President Richard Nixon’s

“secret promise” of $3.25 billion in reconstruction assistance,16 which the United States was

unwilling to do.17 Although President Jimmy Carter signaled a willingness to discuss

normalization soon after his inauguration, the emotional issue of U.S. prisoners of war/missing in

action (POW/MIAs), the migration of Vietnam’s so-called “boat people,” Vietnam’s 1978

invasion of Cambodia (known at that time as Democratic Kampuchea), and Vietnam’s border

conflict with China18 made any significant warming of relations politically impossible. U.S.Vietnamese relations became even more frosty following the signing of a mutual defense treaty

between Vietnam and the Union of Soviet Socialist Republics (USSR) on November 3, 1978.19

These circumstances pushed the issue of Agent Orange effectively off the bilateral agenda despite

Vietnamese efforts to raise the subject.

President Ronald Reagan was generally opposed to any move towards normalizing relations with

Vietnam so long as Vietnamese forces remained in Cambodia and the Vietnamese government

had not provided a “full accounting” of U.S. POW/MIAs.20 In addition, the Reagan

Administration, which repeatedly expressed a skepticism about U.S. veterans claiming medical

problems related to Agent Orange exposure, was generally unwilling to discuss the issue of

Vietnamese nationals with similar medical conditions supposedly caused by Agent Orange

exposure.

Following Vietnam’s withdrawal from Cambodia in 1989, President George H. W. Bush reopened

communication with Vietnam. In April 1991, President Bush announced a U.S. “roadmap” for

normalization of relations that included greater cooperation in locating and returning the remains

of approximately 2,200 U.S. soldiers and civilians who were still unaccounted for at that time.

Vietnam responded by allowing the United States to open an MIA office in Hanoi and offering

President Johnson imposed a trade embargo on the Democratic Republic of Vietnam (North Vietnam) on May 4,

1964, using his authority under the Trading with the Enemy Act of 1917. President Ford extended the embargo to all of

Vietnam on April 30, 1975.

During the peace negotiations for the Vietnam War, then President Nixon wrote a secret letter on February 1, 1973,

to then-Prime Minister Pham Van Dong promising the United States would contribute “in the range of $3.25 billion” in

postwar reconstruction assistance over a five-year period.

In 1976, Congress passed legislation—the International Security Assistance and Arms Export Control Act (S.

2662)—that would have partially ended the embargo on trade with Vietnam, but President Ford vetoed the bill.

Following Vietnam’s invasion of Cambodia, Chinese troops entered Vietnam, precipitating a border conflict. Given

the Cold War politics of the time, the United States was more concerned about maintaining its developing relations

with China than fostering relations with Vietnam.

The Vietnamese-USSR mutual defense treaty was primarily targeted at the People’s Republic of China (China), not

the United States. Both Vietnamese and USSR relations with China had soured during the 1970s, and both nations

perceived a military threat from neighboring China. For Vietnam, the threat was quite real, as China attacked Vietnam

in 1979, in part in response to Vietnam’s invasion of Cambodia.

For more information on the POW/MIA issue, see CRS Report RL33452, POWs and MIAs: Status and

Accounting Issues, by (name redacted).

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greater cooperation and assistance in locating the remains of U.S. personnel. On February 6,

1991, President Bush said,

I am pleased today to sign into law H.R. 556 [P.L. 102-4], the “Agent Orange Act of 1991.”

This legislation relies on science to settle the troubling questions concerning the effect on

veterans of exposure to herbicides—such as Agent Orange—used during the Vietnam era.21

However, President Bush’s approval of assistance for U.S. veterans exposed to Agent Orange did

not extend to Vietnamese veterans and civilians; Vietnamese efforts to discuss the issue were

generally rebuffed by the United States.

President William Clinton built on the general thaw in bilateral relations by signaling the end of

U.S. opposition to Vietnam receiving international financial assistance. On February 3, 1994,

President Clinton announced the end of the U.S. trade embargo on Vietnam. In April 1994,

Congress passed the Foreign Relations Authorization Act, Fiscal Years 1994 and 1995 (P.L. 103236) that expressed the Senate’s support for the normalization of relations with Vietnam. Despite

some congressional efforts to tie normalization to the POW/MIA issue, President Clinton

continued to advance U.S. relations with Vietnam by appointing the first post-war ambassador to

Vietnam in 1996 and signing the U.S.-Vietnam bilateral trade agreement (BTA) in 2000.

Towards the end of the Clinton Administration, the United States signaled an increased

willingness to address the Agent Orange issue. In March 2000, then Defense Secretary William

Cohen pledged greater U.S. cooperation with Vietnam’s Agent Orange problems during a trip to

Hanoi. Eight months later, during President Clinton’s five-day trip to Vietnam, the United States

and Vietnam agreed to set up a joint research study on the effects of dioxin/Agent Orange. In

March 2002, the United States and Vietnam signed a memorandum of understanding (MOU) that

specified future collaborative research on the human health and environmental effects of Agent

Orange and dioxin, as well as created a Joint Advisory Committee (JAC) to oversee such

collaboration.

However, there continued to be clear limits on U.S. willingness to provide assistance. In August

2000, then U.S. Assistant Deputy Under Secretary of Defense Gary Vest traveled to Hanoi for

bilateral meetings on environmental security, which included discussions of the Agent Orange

issue. Following those meetings, Vest stated, “It is very important to emphasize we were not here

to discuss a U.S. government cleanup of contamination.” Vest went on to explain that it was his

understanding that under current international and U.S. law the U.S. military could only

undertake contamination cleanup activities outside of the United States if there is a clear liability

under an international agreement or if specifically authorized by Congress.22

Progress towards the resumption of normal bilateral relations continued during the Bush

Administration. Congress ratified the U.S.-Vietnam BTA in October 2001; the new agreement

went into effect on December 10, 2001. Under the BTA, the United States granted Vietnam

conditional normal trade relations (NTR).23 Vietnam’s conditional NTR status was renewed every

year until December 2006, when Congress passed P.L. 109-432, a comprehensive trade and tax

“Statement on Signing the Agent Orange Act of 1991,” February 6, 1991, as posted by The American Presidency

Project, http://www.presidency.ucsb.edu/index.php.

“US Wants Private, World Role in Agent Orange Plan,” Reuters, August 4, 2000.

Previously known as temporary most favored nation (MFN) status.

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

bill, that granted Vietnam permanent NTR status as part of a wider agreement that saw Vietnam

become a member of the World Trade Organization (WTO) on January 11, 2007.

Following the lifting of the trade embargo and the granting of NTR status, U.S. trade with

Vietnam grew rapidly (see Figure 1). In addition, a rising number of U.S. companies invested in

manufacturing facilities in Vietnam. Between 2001 and 2011, total bilateral trade between the two

nations rose from $1.5 billion to $21.8 billion, according to official U.S. trade statistics.24

Figure 1. U.S. Trade with Vietnam, 2001-2011

(U.S. $ Billions)

2001

2002

2003

2004

2005

2006

Exports

2007

2008

2009

2010

2011

Imports

Source: U.S. International Trade Commission.

Relations between Vietnam and the United States have also improved on matters of national

security. In 2005, the United States and Vietnam signed an international military education

training (IMET) agreement. Since then, a number of Vietnamese military officials have

participated in training programs in the United States, and U.S. naval vessels have been allowed

to make port of call visits to Vietnam. In August 2010, the two nations conducted week-long joint

naval exercises in the South China Sea, as part of the celebration of 15 years of renewed

diplomatic relations. Joint naval exercises were held again in July 2011 and April 2012, off the

coast of Da Nang.

For a general discussion of U.S.-Vietnam economic and trade relations, see CRS Report R41550, U.S.-Vietnam

Economic and Trade Relations: Issues for the 112th Congress, by (name redacted).

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Despite the general improvement in bilateral relations during the Bush Administration, the joint

U.S.-Vietnamese studies of the effects of Agent Orange on Vietnam fell apart among claims of

failure to act in good faith by both parties. In a “sensitive” (but not classified) dispatch of

February 16, 2003, from the U.S. Embassy in Hanoi to the Secretary of State, a State Department

official wrote that the Vietnamese government was unwilling to accept internationally recognized

scientific methods because the results may not support their claims of widespread environmental

damage and severe health effects.25 The Vietnamese government claimed that U.S. officials were

instructed to prevent the completion of the exposure studies by senior government officials. In

March 2005, the United States unilaterally terminated the research project.26

Moreover, the Bush Administration was reluctant to provide direct assistance to people with

health problems related to exposure to dioxin. During an April 2006 trip to Vietnam, then U.S.

Secretary of Veterans Affairs James Nicholson was pressed by Vietnamese journalists to explain

why the United States offered compensation to U.S. Vietnam veterans with Agent Orange-related

medical conditions, but not to Vietnamese veterans and civilians.27 In June 2006, then U.S.

Secretary of Defense Donald Rumsfeld reportedly stated that the United States would not

compensate supposed Vietnamese Agent Orange victims, but would be willing to provide

scientific information and technical advice on the effects of dioxin.28

There have been modest efforts to revitalize joint research on Agent Orange exposure and the

effect of dioxin on the people of Vietnam. These studies frequently involve non-government

organizations (NGOs) in addition to agencies from both the U.S. and Vietnamese governments. In

general, the participation of the NGOs has been welcomed by both the U.S. and Vietnamese

government. The first meeting of the Joint Advisory Committee (JAC) on Agent Orange and

dioxin was held on June 5 and 6, 2006—more than four years after its creation. Since then, the

JAC has met every year.

U.S. Government Assistance

Since the resumption of diplomatic relations, the U.S. government has maintained a

comparatively consistent policy on the issue of Agent Orange/dioxin contamination in Vietnam.

On the one hand, the U.S. government has been willing to offer some assistance with scientific

research to evaluate the extent and severity of dioxin contamination, and, in locations where

serious contamination has been found, provide financial and technical assistance with the

containment and cleanup effort. On the other hand, the U.S. government has repeatedly reiterated

that it “does not recognize any legal liability for damages alleged to be related to Agent

Orange.”29 In addition, the U.S. government has continually questioned the credibility of

Vietnam’s evidence that the dioxin contained in Agent Orange and other herbicides sprayed

during the war are responsible for the various illnesses, health problems, and birth defects

The disclosed text of the dispatch, “Joint Research on Health/Environmental Effects of Agent Orange/Dioxin - An

Assessment of Vietnamese Attitudes,” is available at http://www.ffrd.org/Agent_Orange/Embassy_memo.pdf.

“US Abandons Health Study on Agent Orange,” Nature, Vol. 434, April 7, 2005, p. 687.

“US Won't Compensate Vietnam’s Agent Orange Victims: Official,” Agence France Presse, June 5, 2006.

“US Refuses to Compensate Agent Orange Victims,” Australian Broadcasting Company, June 5, 2006.

“Testimony of Deputy Assistant Secretary Scot Marciel, Bureau of East Asian & Pacific Affairs, U.S. Department of

State,” Subcommittee on Asia, the Pacific, and Global Environment Hearing, Our Forgotten Responsibility: What Can

We Do to Help Victims of Agent Orange?, May 15, 2008.

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

prevalent in the Vietnamese population. For example, then U.S. Ambassador to Vietnam Michael

W. Marine responded to a question regarding U.S. assistance to “Agent Orange victims,” by

saying, “But honestly, I cannot say whether or not I have myself seen a victim of Agent Orange.

The reason for that is that we still lack good scientific definitions of the causes of disabilities …

that have occurred in Vietnam…. We just don’t have the scientific evidence to make that

statement with certainty.”30

As a result, the United States government has demonstrated a willingness to participate in

programs designed to assess, contain, and clean up dioxin found in Vietnam’s physical

environment. However, it has been comparatively reluctant to support or assist programs

designed to address the health problems of Vietnamese nationals attributed to Agent

Orange/dioxin.

To date, Congress has directly or indirectly appropriated $63.4 million for Agent Orange/dioxin

remediation and related health care activities in Vietnam. Of this amount, $3.9 million was

allocated for these purposes by the State Department out of funds appropriated for more general

purposes, such as the Economic Support Fund (ESF). Funding levels were relatively low prior to

2007, but have noticeably increased since then. Most of the appropriated funds continue to be

directed towards environmental remediation, with smaller amounts being provided for “related

health activities.”

Assistance Through 2007

U.S. government assistance was almost exclusively in the form of cooperative efforts to identify,

contain, and remove dioxin contamination related to the spraying of Agent Orange. According to

the testimony of a State Department official before a House subcommittee in May 2008,

examples of U.S.-Vietnamese cooperation on Agent Orange include:

•

The creation of a Joint Advisory Committee (JAC) to review possible joint

activities related to dioxin contamination;

•

Joint workshops conducted by the U.S. Department of Defense and the

Vietnamese Ministry of National Defence to share historical information on U.S.

military operations in Vietnam related to Agent Orange handling and storage;

•

A five-year, $2 million project—involving the U.S. Environmental Protection

Agency (EPA) and the Vietnamese Academy of Science and Technology and the

Ministry of National Defence—to enhance Vietnam’s ability to conduct

laboratory analysis of soil and tissue samples; and

•

$400,000 in financial support from the Department of State and the EPA for

dioxin mitigation planning assistance in Da Nang.

The U.S. government has provided assistance to health-related programs in Vietnam that were

associated with other types of medical conditions, including war-related conditions. For example,

Vietnam is one of 15 “focus countries” and is the only Asian country to receive related assistance

through the President’s Emergency Plan for AIDS Relief (PEPFAR).31 Similarly, the United

Embassy of the United States in Vietnam, “Remarks by Ambassador Michael W. Marine,” press release, February 5,

2007.

For more information about the U.S. PEPFAR activities in Vietnam, see CRS Report RL34569, PEPFAR

(continued...)

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

States—via the Agency for International Development and the Leahy War Victims Fund—has

provided Vietnam with financial support for assistance programs for people disabled by

landmines and unexploded ordnance.32

According to the Department of State, the United States provided $40 million in support for

“mine-action programs” from 1993 to 2007 and $43 million in disability assistance from 1989 to

2007 through the Leahy War Victims Fund. Funding for Agent Orange related projects up to 2007

amounted to $2 million.33 Although the State Department did not provide an itemization of the

use of the $2 million, apparently most of the funds were used for technical and scientific

activities.34 Confidential sources report that all of these funds were expended by U.S. government

officials or their contractors—none of the funds went to the Vietnamese government or

Vietnamese citizens.

The primary forum for U.S. consultation with the Vietnamese government on the issue of Agent

Orange has been the JAC. The first JAC meeting was held in Hanoi on June 5 and 6, 2006, during

which the Vietnamese delegation “proposed to accelerate cooperation” on the topics of

environmental cleanup, care and treatment of dioxin victims, and scientific research. According to

the official minutes of the meeting, the first two topics were deemed “outside the scope” of the

JAC’s activities. At the second JAC meeting—held on August 14 and 15, 2007, again in Hanoi—

the U.S. co-chair stated that JAC was not a “policy making body,” but was a “scientific advisory

committee” created to “provide expert scientific consultation to inform AO/dioxin related

programs in Vietnam.” The third JAC meeting was held September 8-11, 2008, in Hanoi.35 The

meeting focused on various environmental remediation efforts in Vietnam, as well as

presentations from various donor organizations working on the Agent Orange/dioxin issue in

Vietnam. During its third meeting, the JAC agreed to establish two task forces—one to focus on

environmental issue and another to focus on health issues.

Assistance Since 2007

In May 2007, Congress passed the U.S. Troop Readiness, Veterans’ Care, Katrina Recovery, and

Iraq Accountability Appropriations Act, 2007 (P.L. 110-28) that appropriated $3 million for

assistance to Vietnam for environmental remediation of dioxin-contaminated storage sites and to

support health programs in communities near those sites.36 For various reasons, it took over a year

for the State Department to determine how to use these funds.

(...continued)

Reauthorization: Key Policy Debates and Changes to U.S. International HIV/AIDS, Tuberculosis, and Malaria

Programs and Funding, by (name redacted).

For more information about U.S. unexploded ordnance activities in Vietnam, see the U.S. Department of State’s

website, “To Walk the Earth in Safety: The U.S. Commitment to Humanitarian Mine Action,” at http://www.state.gov/

t/pm/rls/rpt/walkearth/2006/68018.htm.

Statement of Assistant Secretary for East Asian and Pacific Affairs Christopher R. Hill, Senate Committee on

Foreign Relations, Subcommittee on East Asian and Pacific Affairs, March 12, 2008.

Personal communications with representative of State Department, April 25, 2008.

There have been two subsequent JAC meetings since September 2008.

For details, see CRS Report RL33900, FY2007 Supplemental Appropriations for Defense, Foreign Affairs, and Other

Purposes, coordinated by (name redacted).

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

After much consultation, the State Department decided that the administration of the $3 million

would be handled by the U.S. Agency for International Development (USAID). Approximately

$500,000 of the initial $3 million was to be budgeted to hire and support a full-time

environmental health and remediation advisor for two years to be posted at the U.S. Embassy in

Hanoi. This position was filled in December 2008.

Half of the $3 million has been budgeted for environmental containment and remediation

planning at the Da Nang airport. Preliminary USAID plans on how to allocate those funds were

approved by the U.S. government and presented to representatives of Office 33,37 Vietnam’s

Ministry of Defense, and the Vietnamese Academy of Science and Technology (VAST).

In February 2009, Office 33 and the United Nations Development Program (UNDP) cosponsored a roundtable meeting on remediation standards and technology.38 Also attending the

meeting were representatives of the U.S. State Department, USAID, and the U.S. Environmental

Protection Agency. During the roundtable, the attendees agreed on two goals—immediate

containment of dioxin-contaminated soil at the three major known “hot spots” (Bien Hoa, Da

Nang, and Phu Cat); and a longer-term goal of dioxin destruction to completely eliminate dioxin

from contained soil and sediment. They also discussed a short list of possible technologies

(including bioremediation) to pilot test at the identified “hot spots.”

Table 1. Congressional Appropriations for Agent Orange/Dioxin Remediation and

Health-Related Activities in Vietnam

(in Millions of U.S. Dollars)

Congress

Public Law

Date Enacted

Total Amount

Environmental

Remediation

HealthRelated

Activities

110th

P.L. 110-28

May 2007

3.0

111th

P.L. 111-8

March 2009

3.0

P.L. 111-117

December 2009

3.0

P.L. 111-212

July 2010

12.0

P.L. 112-10

April 2011

18.5

15.5

3.0

P.L. 112-74

December 2011

20.0

15.0

5.0

112th

Source: CRS research.

Notes: Does not include $3.9 million allocated for these purposes by the State Department out of funds

appropriated for more general uses, such as the Economic Support Fund (ESF).

The 111th Congress appropriated a total of $18 million for dioxin cleanup in Vietnam and related

health services. In addition, the State Department and USAID allocated $1.9 million in

Development Assistance funds for FY2010 for environmental remediation at Da Nang airport.39

In 1999, Vietnam created the Office of National Steering Committee for the Overcoming of the Consequences of

Toxic Chemicals used by the United States in the War in Vietnam—also known as Office 33 or Committee 33—to

coordinate the various programs designed to overcome the various consequences of the use of herbicides during the

war, including environmental remediation and health care assistance for people suffering from diseases associated with

dioxin exposure.

Information in this paragraph from correspondence with U.S. Embassy in Vietnam, March 25, 2009.

U.S. Congress, House Committee on Foreign Affairs, Subcommittee on Asia, the Pacific, and the Global

(continued...)

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

In March 2009, the 111th Congress appropriated $3 million for Agent Orange/dioxin remediation

and health care assistance in the vicinity of the Da Nang “hot spot” in the Omnibus

Appropriations Act, 2009 (P.L. 111-8). In December 2009, Congress passed the Consolidated

Appropriations Act, 2010 (P.L. 111-117), which included $3 million for dioxin cleanup and

related health services in Vietnam. In July 2010, Congress included $12 million in the

Supplemental Appropriations Act, 2010 (P.L. 111-212).

On April 15, 2011, the 112th Congress appropriated in the Department of Defense and Full-Year

Continuing Appropriations Act 2011 (P.L. 112-10) $15.5 million for remediation activities at

dioxin contaminated sites in Vietnam, and $3 million for related health activities—the first time it

explicitly divided the funds between the two uses. An additional $20.0 million was appropriated

by the 112th Congress in the Consolidated Appropriations Act, 2012 (P.L. 112-74), with not less

than $15.0 million allocated for “environmental remediation of dioxin contamination at the Da

Nang and Bien Hoa airports and other severely contaminated sites,” plus not less than $5.0

million for “health/disability activities in areas of Vietnam that were targeted with Agent Orange

or remain contaminated with dioxin.”40 P.L. 112-74 was the first legislation to explicitly

appropriate funds for dioxin contaminated locations other than the Da Nang airport.

The conference report accompanying P.L. 112-74 also endorsed language in a Senate Report

associated with the Department of State, Foreign Operations, and Related Programs

Appropriations Act, 2012 (S. 1601) directing USAID, in consultation with the Senate

Appropriations Committee, the Department of State, the Government of Vietnam, and “other

interested parties” to develop a “comprehensive, multiyear plan” for Agent Orange-related

activities in Vietnam within 180 days of the enactment of the law.41

Obligations

According to information provided by USAID, $16.5 million of the available funds have been

obligated as of June 2012, with plans to obligate an additional $45.1 million (see Table 2). Of the

$16.5 million already obligated, $11.9 million went to environmental remediation and $3.1

million was allocated to related health services. Also included in the $16.5 million in obligations

was $1.5 million allocated to USAID for administration and technical oversight of the

appropriated funds. USAID has plans to obligate $33.4 million for environmental remediation

efforts at Da Nang airport, $8.0 million for “environmental health activities,” $2.3 million for an

environmental assessment of Bien Hoa airport, and $1.4 million for administrative oversight.

Since providing CRS the data contained in Table 2, USAID has awarded an additional $25.3

million in contracts for dioxin remediation, and has announced plans to award $9 million for

health-related activities in dioxin contaminated sites in Vietnam.

(...continued)

Environment, Testimony of Acting Deputy Assistant Secretary Matthew Palmer, Agent Orange in Vietnam: Recent

Developments in Remediation, 111th Cong., 2nd sess., July 15, 2010.

U.S. Congress, Conference Committee, Military Construction and Veterans Affairs and Related Agencies

Appropriations Act, 2012 , Conference Report to Accompany H.R. 2055, 112th Cong., 1st sess., December 15, 2011,

H.Rept. 112-331 (Washington: GPO, 2011).

U.S. Congress, Senate Committee on Appropriations, Department of State, Foreign Operations, and Related

Programs Appropriations Act, 2012, Report to Accompany S. 1601, 112th Cong., 1st sess., September 22, 2011, S.Rept.

112-85 (Washington: GPO, 2011).

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

A portion of the obligated funds have been used by USAID to hire and support a full-time

environmental health and remediation advisor to be posted at the U.S. Embassy in Hanoi, as well

as finance the administrative expenses associated with the project. Most of the funds have been

awarded as grants to non-government organizations to provide services related the project.

Table 2. USAID Obligations and Planned Obligations of Agent Orange/Dioxin

Appropriations

(type and recipient, as of June 2012)

Recipient

Obligated

Planned

Obligation

Environmental Remediation

CDM International, Inc.

$10,542,276

TerraTherm International

$1,336,486

$19,957,238

To Be Determined:

•

Excavation and Construction

$13,400,000

•

Environmental Assessment at Bien Hoa

$2,304,000

Related Health Activities

East Meets West

$500,000

Save the Children

$1,199,980

Vietnam Assistance for the Handicapped

$1,288,408

USAID Global Health Technical Assistance

$103,000

To Be Determined

$8,000,000

Administration and Oversight

USAID

$1,537,449

$1,400,000

TOTAL

$16,507,559

$45,061,238

Source: Information provided to CRS by USAID.

Note: Table does not include contracts awarded after June 25, 2012.

CDM International, Inc. has been the main contractor used by USAID to assess the extent and

severity of dioxin contamination at Da Nang Airport. It was awarded a $1.69 million contract in

2009 to conduct an environmental assessment of the site to determine practical options for the

decontamination of the affected areas around the airport.42 The assessment was concluded in June

2010, and determined that thermal treatment was the most cost-effective method for removing the

residual dioxin from the contaminated soil.43 The total cost of thermal treatment is estimated at

Embassy of the United States, Hanoi, “United States Government Provides $1.69 Million to Prepare for Agent

Orange/Dioxin Removal in Danang,” press release, October 1, 2009, http://vietnam.usembassy.gov/pr100109i.html.

Thermal treatment will use in-situ/in-pile thermal desorption destruction. The contaminated soil will be relocated to

contained landfills to undergo treatment.

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

$43 million. On December 30, 2010, the two governments signed a memorandum of intent (MOI)

for the environmental remediation of dioxin contamination at the Da Nang airport.44

In March 2012, USAID contracted TerraTherm, a Massachusetts-based environmental

remediation company, to design the thermal remediation project to be used at Da Nang airport, as

agreed to in the MOI. In June 2012, USAID awarded two contracts related to the dioxin cleanup

at Da Nang airport. CDM Smith, a Massachusetts-based company, was awarded an $8.34 million

contract for construction management and oversight of the thermal remediation project, in

coordination with Vietnam’s Ministry of National Defence. Incremental funding of $6 million

was made for FY2012, with the balance to be obligated at a later date still to be determined. Tetra

Tech, a California-based company, was awarded a $17.00 million contract for the excavation and

construction components of the project. An initial $13.4 million was obligated at the time the

contract was awarded; the balance will be obligated at a later date still to be determined.

A groundbreaking ceremony for the thermal remediation project was held at Da Nang airport on

August 9, 2012, with U.S. Ambassador to Vietnam David Shear in attendance. In his remarks,

Ambassador Shear stated that the goal is to complete the Da Nang airport cleanup by late 2016.

He also indicated that the two governments would continue their cooperation on cleaning up

dioxin “hot sports” by carrying out an environmental assessment of Bien Hoa airport. In addition,

Ambassador Shear announced a three-year, $9 million health and disability program during the

Da Nang event. An initial $8 million is to be obligated, possibly in FY2012 if the contract is

awarded before September 30, 2012. The remaining $1 million is to be obligated on a yet-to-bedetermined date. As of the date of this report, USAID had not reported any obligations of funds

for this purpose.

The East Meets West Foundation was awarded a $500,000 grant to improve the quality of life for

persons living with disabilities in Da Nang Province, particularly children with disabilities. Funds

were used for medical and social screening for people with disabilities, corrective surgery,

physical therapy and rehabilitation services, scholarships for children with disabilities, and

community-based rehabilitation. Information provided by USAID describes the program as

follows:

Supports improvement of the well being of people with disabilities (PWDs) and children

with disabilities (CWDs) in Danang. Specifically, activities provide: 1) medical and social

scanning for PWDs and CWDs; 2) corrective surgery; 3) physical therapy and rehabilitation

services for non-surgery cases; 4) scholarships to CWDs; 5) the establishment of

community-based rehabilitation units, and 6) training to improve skills of medical personnel

treating PWDs.45

Save the Children was provided a grant in 2009 to expand employment and income-generating

activities for people with disabilities and their families living in Da Nang. Information provided

by USAID describes the program as follows:

Program provides technical assistance to empower people with disabilities (PWDs) with

skills and training to engage successfully in Vietnam’s economic transformation and to lead

productive and self-sufficient lives. PWDs learn how to access services and resources, obtain

U.S. Embassy in Hanoi, Vietnam, “Remarks by U.S. Ambassador Michael W. Michalak,” press release, December

30, 2010.

Text from information provided to CRS by USAID.

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

reliable and gainful employment, start a business, increase their awareness of the demandsupply dynamics of the market and the availability of entrepreneurial services. Activities also

aim to increase the support and engagement of local government, private sector, and

communities to create livelihood opportunities and a disability friendly business

environment.46

The Vietnam Assistance for the Handicapped was provided a grant in 2009 to help people with

disabilities and their families improve their social and economic status and integration, and help

local authorities, health service providers, disabled organizations, and others develop and enforce

programs that increase resources for disability. Information provided by USAID describes the

program as follows:

USAID assistance for people with disabilities (PWDs) in Danang aims to improve their well

being and livelihoods by increasing their integration into society through comprehensive

rehabilitation services and socio-economic support. The program also strengthens the ability

of local service providers and organizations to serve the disabled population. Key activities

include: 1) establishing a model for rehabilitation services and a community-based support

system to increase access to quality services for PWDs; and 2) improving capacity of selfhelp groups to access to health and social services, and economic support.47

The Effects of Agent Orange on Vietnam

Virtually every aspect of the effects of Agent Orange on Vietnam is infused with uncertainty

and/or controversy. There is some question about the amount of Agent Orange and other

herbicides sprayed in Vietnam, as well as the amount of dioxin contained in the Agent Orange

used. It is also unclear exactly where the herbicides were sprayed and the amount sprayed at each

location. Nor is it known who was exposed to Agent Orange and its dioxin, and for what duration

they were exposed. Finally, there is limited information about the long-term effects of Agent

Orange on the environment and people of Vietnam.

The uncertainty and controversies are in part attributable to the general “fog of war.” At the time

the herbicides were used, there was little consideration within the U.S. military about potential

long-term environmental and health effects of the widespread use of Agent Orange in Vietnam.

Similarly, both the South Vietnamese and North Vietnamese governments were not keeping

detailed troop deployment information in anticipation of future claims of health problems

associated with exposure to Agent Orange and dioxin. In addition, after the war ended, many

Vietnamese combatants returned to their home towns, far away from the jungles where they once

were sprayed with herbicides from U.S. military aircraft.

Given that direct information about Agent Orange exposure is not available, the alternative

generally used has been to seek indirect evidence of dioxin exposure. Soil samples taken from

supposedly sprayed and unsprayed locations can be analyzed to determine the amount and extent

to which Vietnam has been contaminated with dioxin due to Operation Ranch Hand. At the same

time, blood and tissue samples can be taken from Vietnamese nationals across the country to

determine how much dioxin is present in their systems. To date, relatively few of these studies

Ibid.

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

have been done, in part because of the cost associated with the research, and in part because of

the political implications of the findings of such studies.

Although the research on the use of Agent Orange and other herbicides in Vietnam—and the

resulting exposure of the people of Vietnam to dioxin—is limited in scale, it is possible to draw a

few tentative conclusions from existing studies. First, numerous areas of southern Vietnam were

sprayed with Agent Orange and other herbicides during the Vietnam War, with widely varying

levels of contamination with dioxin. Some locations were sprayed repeatedly; other locations

only once. Second, millions of Vietnamese were directly exposed to dioxin at the time the

herbicides were sprayed, and millions more have been exposed to dioxin that remains in the soil

and in the sediment of waterways of southern Vietnam.48 Third, blood and tissue studies of

Vietnamese nationals provide some evidence of higher than normal levels of dioxin in the

systems of people presumed to be have been exposed to Agent Orange, but methodological

problems make interpretation of the data difficult and open to debate. Fourth, research in Vietnam

on the long-term health effects of exposure to varying levels of dioxin is limited, making it

difficult to firmly establish the connection between dioxin exposure and a variety of health

problems occurring among the Vietnamese people with unusually high frequency.

Brief History of the Use of Agent Orange in Vietnam

Agent Orange was a chemical herbicide used from 1961 to 1971 by the U.S. military in the then

Republic of Vietnam (a.k.a.—South Vietnam) and portions of the then Democratic Republic of

Vietnam (a.k.a.—North Vietnam) to deny their military enemy cover in Vietnam’s dense foliage.49

An approximately 50-50 mix of two chemicals—2,4,-D (2,4, dichlorophenoxyacetic acid) and

2,4,5-T (2,4,5 trichlorophenoxyacetic acid)—Agent Orange derived its name from the orange

band painted on the side of the 55-gallon drums in which the herbicide was delivered. Agent

Orange was manufactured under Department of Defense (DOD) contracts for military-use in

Vietnam by several companies, including Diamond Shamrock Corporation, Dow Chemical

Company, Hercules Inc., Monsanto Company, T-H Agricultural & Nutrition Company, Thompson

Chemicals Corporation, and Uniroyal Inc.

Agent Orange was one of 15 herbicides used during the Vietnam War, principally as part of

Operation Ranch Hand, the key component of the U.S. military’s overall herbicide program,

Operation Trail Dust.50 Other herbicides used in Vietnam included Agent Blue, Agent Green,

Agent Orange II (a.k.a. Super Orange), Agent Pink, Agent Purple, Agent White, Bromacil,

Dalapon, Dinoxol, Diquat, Diuron, Monuron, Tandex, and Trinoxol. However, Agent Orange was

the most extensively used herbicide during the war.

Dioxin is not water soluble, but an unknown amount of dioxin has washed into the rivers, streams and coastal waters

of Vietnam, and presumably settled into its river and ocean beds.

Operation Ranch Hand was primarily conducted in South Vietnam. However, one of the more heavily sprayed areas

was Quang Tri, along the demilitarized zone (DMZ), which resulted in the spraying of some portions of southern North

Vietnam. The U.S. military also sprayed herbicides in Cambodia and Laos, but information on those programs is not

included in this report.

For brief military accounts of Operation Ranch Hand, see Major William A. Buckingham, Jr., “Operation Ranch

Hand: Herbicides in Southeast Asia,” Air University Review, July-August 1983; and USAF TSGT Dale K. Robinson’s

article from the Air Force booklet, “Air Commando, 1950-1975: Twenty-Five Years at the Tip of the Spear.”

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

A contaminant of the manufacture of Agent Orange (as well as Agents Pink and Purple) was

2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), a dioxin thought to be responsible for most of the

medical problems associated with exposure to Agent Orange. Because TCDD was an unwanted

byproduct, its concentration varied by production run, manufacturer, and the proportion of

2,4,5-T in the formulation. A 1978 General Accounting Office (GAO, now known as Government

Accountability Office) report indicated that a 1971 DOD analysis of its remaining Agent Orange

inventory found TCDD contamination levels ranging from 0.05 to 47.0 parts per million

(p.p.m.).51 Various studies made during and soon after the Vietnam War found lower ranges for

TCDD concentration levels in stockpile samples, ranging from 0.05 to 17.0 p.p.m.52

Estimates of Vietnamese Exposure to Agent Orange

In general, research into the level of Vietnamese exposure to Agent Orange and dioxin has

followed two different approaches. One approach has attempted to determine how much Agent

Orange was sprayed in Vietnam, where and when it was sprayed, and who was in the area when

the herbicide was sprayed. From this data, researchers can then determine the level of exposure to

Agent Orange and dioxin. The second approach examines the amount of dioxin in blood and

tissue samples taken from people in Vietnam, and then infers each person’s level of exposure.

Because of data and other methodological problems, neither approach has been able to provide

conclusive information on the general pattern of Agent Orange and TCDD exposure in Vietnam.

Amount Used

Precise information on how much Agent Orange was sprayed in Vietnam during the war is

difficult to find, though several studies estimate the amount in the range of 11 million-12 million

gallons. A 1978 GAO report states that 18.85 million gallons of herbicide were applied during the

Vietnam War, of which 11.22 million gallons were Agent Orange.53 According to William

Buckingham’s calculations, Operation Ranch Hand sprayed about 19 million gallons of herbicide,

of which 11 million gallons were Agent Orange.54 Dale Robinson reports that Operation Ranch

Hand dispensed between 17.7 million and 19.4 million gallons of herbicide, of which

approximately 10.6 million to 11.7 million gallons were Agent Orange.55 A 2003 study of the

extent of use and distribution patterns for herbicides based on DOD records estimated between

19.3 million and 20.3 million gallons of herbicide were used in Vietnam, of which up to 12.1

million gallons were Agent Orange.56 A study by H. Lindsey Arison found that 19.4 million

gallons of herbicides were used in Vietnam, of which 11.7 million gallons were Agent Orange.57

General Accounting Office, Use of Agent Orange in Vietnam (CED-78-158), August 16, 1978.

See Jeanne Mager Stellman, Steven D. Stellman, Richard Christian, Tracey Weber, and Carrie Tomasallo, “The

Extent and Patterns of Usage of Agent Orange and Other Herbicides in Vietnam,” Nature, Vol. 422, April 2003, for

details.

GAO, op. cit.

Buckingham, op. cit.

Robinson, op. cit.

Stellman, et al., op cit.

H. Lindsey Arison III, “The Herbicidal Warfare Program in Vietnam, 1961-1971, Operations Trail Dust/Ranch

hand,” July 12, 1995, available online at http://www.utvet.com/agentorange2.html.

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

Figure 2. Map of Areas of Vietnam Sprayed with Herbicides

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

Exposure

Data on exposure to Agent Orange for Vietnamese nationals are even more difficult to determine

for several reasons. First, while official records for Operation Ranch Hand are available, it is

difficult to be certain about how much herbicide was sprayed on what locations due to mitigating

combat conditions.58 Second, in addition to the areas intentionally exposed to Agent Orange, an

unknown amount of herbicide was leaked or spilled on military bases.59 Third, it is difficult to

correlate the presence of Vietnamese nationals in exposed areas during or soon after the

distribution of Agent Orange in a location. Fourth, while the average U.S. Vietnam veteran served

for six months in Vietnam, Vietnamese nationals have been living and working in potentially

dioxin contaminated areas for years. Fifth, the scientific tests on soil and tissue samples are

expensive. The typical cost of determining the dioxin level in one person is $1,000. The

Vietnamese government states it lacks the financial resources to conduct comprehensive exposure

studies.

Exposure studies generally fall into two types: (1) estimates of the concentration of Agent Orange

applied or found at studied locations; and (2) tests to determine the concentration of dioxin in the

tissue samples of persons who may have been exposed to Agent Orange during the Vietnam War.

In part because of difficulties in determining where, when and how much Agent Orange was

distributed in different locations in Vietnam, there are also varying estimates on the number of

Vietnamese nationals who were exposed.

Concentrations

A 2005 study of the concentration of Agent Orange distribution in Vietnam determined that an

estimated 1.7 million hectares (4.2 million acres) were sprayed with herbicides containing

2,4,5-T, and by extension, containing TCDD.60 Figure 2 shows the sprayed areas.

According to the Vietnamese government, about 12,000 square miles (9.6%) of the nation was

sprayed with herbicides during the war.61 Over 10,000 square miles were sprayed more than twice

and over 1,300 square miles were sprayed more than 10 times. Sprayed areas are distributed

across much of southern Vietnam, ranging from Quang Tri to the north to Ca Mau in the South.

A 2005 article cited evidence of Agent Orange distribution levels ranging from 185 liters per

hectare (l/ha) to 21,007 l/ha.62 Another study concluded “the residual levels of wartime Agent

Orange dioxin (TCDD) in soils of southern Vietnam are generally at or below background levels

found in industrialized nations of North America.”63 However, several researchers maintain that

According to Stellman, et al., planes on occasion dumped their load of herbicide on non-targeted locations as part of

an evasive maneuver or as the result of a plane crash.

According to several cited sources, DOD records for Operation Ranch Hand record multiple cases of herbicide

leakages or spills at airbases.

Stellman, et al., op. cit.

Ministry of Natural Resources and Environment, Human and Environmental Consequences of Agent Orange/Dioxin

in Viet Nam: Overcoming Activities, pamphlet. The total land area of Vietnam is 125,622 square miles, or a little larger

than the State of New Mexico.

Michael G. Palmer, “The Legacy of Agent Orange: Empirical Evidence from Central Vietnam,” Social Science &

Medicine, vol. 60 (2005), pp. 1061-1070. One liter = 0.264172052 U.S. gallons; 1 hectare = 2.47105381 acres.

L.W. Dwernychuk, T.M. Hung, T.G. Boivin, G.S. Bruce, P.T. Dung, L.K. Son, C.T. Hatfield, N.T. Dung, J.A. Allen,

(continued...)

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

Vietnam’s frequent and heavy rains have probably washed most of the dioxin out of the soil of

Vietnam during the 40-50 years since Agent Orange was sprayed.

There are specific locations where measured TCDD concentrations remain high, despite the

passage of over three decades. The main “dioxin hot spots” are located in and around the military

bases that served as hubs for Operation Ranch Hand, including the airbases at Bien Hoa, Da

Nang, Nha Trang, and Phu Cat. In addition, the A Luoi (or A Shau) Valley, south of Quang Tri and

west of Da Nang, was considered an important segment of the Ho Chi Minh Trail and was

therefore heavily sprayed. The former U.S. military base in the A Luoi Valley has been identified

as another “hot spot.”

One study of Da Nang airbase found soil concentrations of “TCDD toxic equivalents” (TEQ) of

up to 365 parts per billion (p.p.b.)—365 times the international maximum level of 1.0 p.p.b.64

Seventeen out of the 23 soil samples taken at Da Nang airbase exceeded the international

maximum standard.65 A study of soil samples from the Bien Hoa airbase found one sample with a

TEQ concentration at over 1,000 p.p.b.66 By comparison, the maximum concentration of TCDD

found at Love Canal, NY, was 17,200 p.p.b.; at Times Beach, MO, the maximum concentration

was 1,750 p.p.b. Both U.S. communities were evacuated after evidence of dioxin contamination

was found.67

Tissue Samples

Another method of determining exposure levels to Agent Orange and TCDD is to take tissue

samples—usually blood, breast milk, or adipose tissue68—from people who may have been

exposed and compare the presence of TEQ to a control group who presumably were not exposed.

A 1995 study of over 3,200 Vietnamese nationals living in sprayed and unsprayed areas of

Vietnam found elevated TEQ levels for people residing in southern Vietnam and presumably

more heavily exposed to Agent Orange when compared to residents of northern Vietnam who

were less likely to have been exposed to Agent Orange.69 Average blood levels of TEQ were

nearly six times higher among the people from sprayed areas, average breast milk levels were

nearly four times higher, and average adipose levels were over 24 times higher.70 A separate study

of blood dioxin levels of Da Nang residents reported TCDD concentrations “more than 100 times

(...continued)

D.D. Nhu, P.V. Thuc, D.J. Moats, and L. Borton, “The Agent Orange Dioxin Issue in Viet Nam: A Manageable

Problem,” Hatfield Consultants, Ltd., paper presented at the 26th International Symposium on Halogenated Persistent

Organic Pollutants—Dioxin 2006 held on August 21-25, 2006, in Oslo, Norway.

T.G. Boivin, K.S. Le, L.W. Dwernychuk, M.H. Tran, G.S. Bruce, N.H. Minh, N.T. Tran, K.S. Trinh, T.D. Phung, D.

Moats, J.A. Allen, L. Borton, and M. Davies, “Agent Orange Dioxin Contamination in the Environment and Human

Population in the Vicinity of Da Nang Airbase, Viet Nam,” Hatfield Consultants, Ltd.

Ibid.

Boivin, et al., op. cit.

E.J. Dionne, Jr. “Ultrahigh Level of Poison Cited at Love Canal,” New York Times, July 13, 1982.

Adipose tissue is specialized connective tissue that functions as the major storage site for fat in the human body.

Arnold Schecter, Le Cao Dai, Le Thi Bich Thuy, Hoang Trong Quynh, Dinh Quang Minh, Hoang Dinh Cau, Pham

Hoang Phiet, Nguyen Thi Ngoc Phuong, John D. Constable, Robert Baughman, Olaf Päpke, J.J. Ryan, Peter Fürst and

Seppo Räisänen, “Agent Orange and the Vietnamese: The Persistence of Elevated Dioxin Levels in Human Tissues,”

American Journal of Public Health, Vol. 84, No. 4 (April 1995), pp. 516-522.

Ibid.

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

globally acceptable levels.”71 Elevated TCDD concentrations were also found in blood samples of

Bien Hoa residents.72

Studies of U.S. Vietnam War veterans to

determine dioxin concentrations in their

bodies have obtained seemingly contradictory

results. A 2006 study of U.S. Army Chemical

Corps Vietnam War veterans revealed

statistically significant elevated TCDD levels

in blood samples for veterans who reported

spraying Agent Orange when compared to

veterans who reported they had not sprayed

Agent Orange.73 A 1988 study of blood and

adipose tissue sample from Vietnam veterans

found higher TCDD levels when compared to

a control group, leading the authors to

conclude, “it is likely that the elevated TCDD

levels arose from wartime exposure.”74

However, other studies failed to find elevated

TCDD levels among Vietnam veterans. A

second 1988 study, which compared U.S.

veterans who served in part of Vietnam

“heavily sprayed” with Agent Orange to

veterans who did not serve in Vietnam, found

the TCDD levels in the two groups were

“nearly identical.”75 A third 1988 study, which

compared TCDD levels in adipose tissue from

Vietnam veterans, non-Vietnam veterans, and

non-veterans, also revealed no significant

difference between the three study groups.76

Vietnam Red Cross List of Diseases

Caused by Agent Orange/Dioxin

(combined 1998 and 2000 lists)

•

Acute, chronic, and subacute peripheral neuropathy

•

Chloracne

•

Diabetes (Type 2)

•

Hepatoma

•

Hodgkin’s disease

•

Lipid metabolism

•

Malignant (non-Hodgkin’s) lymphoma

•

Multiple myeloma (Kahler’s disease)

•

Porphyria cutanea tarda

•

Prostate cancer

•

Reproductive abnormalities

•

Respiratory cancers (bronchial, tracheal, and

laryngeal)

•

Sarcoma

•

Spina bifida

Source: Vietnamese official

Some scientists maintain that the apparent contradictions in the study results may reflect

differences in the circumstances surrounding Vietnam veterans’ exposure to Agent Orange. There

Boivin, et al., op. cit.

Ibid.

Han K. Kang, Nancy A. Dalager, Larry L Needham, Donald G. Patterson, Jr., Peter S. J. Lees, Katherine Yates, and

Genevieve M. Matanoski, “Health Status of Army Chemical Corps Vietnam Veterans who Sprayed Defoliant in

Vietnam,” American Journal of Industrial Medicine, Vol. 49 (2006), pp. 875-884.

P. C. Kahn, M. Gochfeld, M. Nygren, M. Hansson, C. Rappe, H. Velez, T. Ghent-Guenther and W. P. Wilson,

Dioxins and Dibenzofurans in Blood and Adipose Tissue of Agent Orange-Exposed Vietnam Veterans and Matched

Controls,” Journal of the American Medical Association, Vol. 259, No. 11 (March 18, 1988), pp. 1661-1667.

The Centers for Disease Control Veterans Health Studies, “Serum 2,3,7,8-tetrachlorodibenzo-p-dioxin levels in US

Army Vietnam-era Veterans,” Journal of the American Medical Association, Vol. 260, No. 9 (September 2, 1988), pp.

1249-1254.

Han K. Kang, Kevin K. Watanabe, Joseph Breen, Janet Reemers, Margaret G. Conomos, John Stanley, and Michele

Flicker, “Dioxin and Dibenzofurans in Adipose Tissue of US Vietnam Veterans and Controls,” American Journal of

Public Health, Vol. 81, No. 3 (March 1991), pp. 341-349.

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

seems to be a general pattern that veterans

who handled or sprayed Agent Orange have

elevated levels of TCDD. Results are less

consistent for veterans who operated in areas

sprayed with

Agent Orange. Some studies find elevated

TCDD levels, others do not. Some scientists

speculate that studies comparing Vietnam

veterans to other control groups fail to find

differences in the TCDD levels because the

Vietnam veterans include people who were

exposed to Agent Orange as well as people

who were not exposed.

Studies have also examined food produced in

contaminated areas to determine if they

contain significantly elevated levels of TCDD

or other dioxins. One study of various food

crops and livestock from the A Luoi Valley

revealed negligible TCDD levels in rice,

manioc, and vegetable oil samples, but

exceptionally high TCDD levels in some duck

fat and fish fat samples.77 It is thought that the

higher levels in fish and ducks are an

indication that TCDD remains in the sediment

of Vietnam’s rivers, streams, lakes, and ponds.

Other studies have also found evidence of

elevated dioxin levels in Vietnamese

immigrants from non-sprayed areas and

children born after the war, as well as elevated

TCDD levels in food and soil samples from

the study area.78

Number of Vietnamese Exposed

U.S. Department of Veterans Affairs List

of Diseases and Conditions Presumed to

be Related to Service-Related Exposure

to Agent Orange/Dioxin

Chloracne

Non-Hodgkin’s lymphoma

Soft tissue sarcoma

Hodgkin’s disease

Porphyria cutanea tarda

Multiple myeloma

Respiratory cancers (including lung, larynx, trachea, and

bronchus)

Prostate cancer

Acute and subacute transient peripheral neuropathy

Type 2 diabetes

Chronic lymphocytic leukemia

Primary (AL) amyloidosis

For children of all exposed veterans:

•

Spina bifida (but not spina bifida occulta)

For children of exposed female veterans:

•

Achonodroplasia

•

Cleft lip and cleft palate

•

Congenital heart disease

•

Congenital talipes equinovarus (clubfoot)

•

Esophageal and intestinal atresia

•

Hallerman-Streiff syndrome

•

Hip dysplasia

•

Hirschprung’s disease (congenital megacolon)

•

Hydrocephalus due to aqueductal stenosis

•

Hypospadias

•

Imperforate anus

•

Neural tube defects

•

Poland syndrome

•

Pyloric stenosis

•

Sundactyly (fused digits)

•

Tracheoesophageal fistula

•

Undescended testicle

•

Williams syndrome

Source: National Organization on Disability

Determining how many Vietnamese nationals were exposed to Agent Orange during and after the

Vietnam War is both complicated and controversial. One study estimated the number of

Vietnamese nationals exposed to Agent Orange and/or dioxin ranged from 2.1 million to 4.8

million.79 Vietnam Association of Victims of Agent Orange/Dioxin (VAVA) estimates that 2.1

L. Wayne Dwernychuk, Hoang Din Cau, Christopher T. Hatfield, Thomas G. Boivin, Tran Manh Hung, Phung Tri

Dung, and Nguyen Dinh Thai, “Agent Orange/Dioxin Hot Spots—A Legacy of U.S. Military Bases in Southern Viet

Nam,” paper presented at Viet Nam—United States Scientific Conference on Human Health and Environmental Effects

of Agent Orange/Dioxin, Hanoi, March 2002.

Arnold Schecter, Hoang Trong Quynh, Marian Pavuk, Olaf Päpke, Rainer Malisch, and John D. Constable, “Food as

a Source of Dioxin Exposure in the Residents of Bien Hoa City, Vietnam,” Journal of Occupational and

Environmental Medicine, Vol. 45, No. 8, August 2003.

Stellman, et al., op. cit.

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

million to 4.8 million Vietnamese were exposed to Agent Orange during the war and at least 3

million suffer serious health problems due to that exposure.80 According to MOLISA, over

365,000 Vietnamese veterans and their children and grandchildren have medical conditions

attributed to exposure to dioxin.81

Vietnam’s Health Claims

The Vietnamese government maintains that TCDD is harming the health of its people in several

ways. It asserts that Vietnamese civilians and soldiers who were directly exposed to Agent Orange

during the war are experiencing certain diseases and health problems at a rate higher than the

nation’s unexposed population. Additionally, it maintains that people living in areas with residual

TCDD in the soil and water are also suffering from health complications related to the aftereffects

of Operation Ranch Hand. Finally, it argues that the children and grandchildren of people exposed

to dioxin have an unusually high level of birth defects and/or health problems.

In 1998 and again in 2000, the Vietnam Red Cross (VRC) compiled lists of diseases it associated

with Agent Orange/dioxin exposure (see textbox on previous page). In March 2008, Vietnam’s

Ministry of Health reportedly compiled a confidential list of 17 diseases and deformities that it

maintained were related to exposure to dioxin. The VRC list contained many of the same diseases

identified by the U.S. Department of Veterans Affairs (VA) as being related to exposure to Agent

Orange, including bronchial carcinoma, tracheal cancer, laryngeal neoplasm, prostate cancer, and

type 2 diabetes (see textbox on the previous page). Other diseases on the VRC’s list are not

recognized by the U.S. government as being related to dioxin exposure. The Ministry of Health

also considers a number of congenital deformities and mental disorders in the children of those

exposed to TCDD as being dioxin-related, but are not found on the VA list.

In the last few years, much of the Vietnamese government’s concern about the effects of Agent

Orange has focused on the affected children and their families. Because the deformities and

disorders are frequently quite severe, the children often require continual care. Given the current

status of Vietnam’s health care system, it is not possible to place many of the children in

managed-care facilities. As a result, most of the children are cared for by their families. This not

only creates a financial burden for the families, it typically means a significant loss of household

income as at least one person must remain at home with the affected child or children.

Cleanup Efforts

The prospects for cleaning up the dioxin in Vietnam distributed by the spraying of Agent Orange

and other herbicides are complicated by the area sprayed, the passage of time, and a general lack

of resources. There is a supposition that sunlight, Vietnam’s episodic heavy rains and the passage

of time have probably removed most of the dioxin from sprayed areas or lowered concentration

levels below the danger level, but there are no definitive studies to verify this notion.

In addition, political and other considerations have tended to shift the focus on Agent Orange

cleanup efforts towards the confinement and cleanup of dioxin from the identified “hot spots”

Conversation with representative of VAVA, Hanoi, December 10, 2008.

Conversation with representative of MOLISA, Hanoi, December 10, 2008.

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

with elevated levels of dioxin in the soil, such as the airbases used by Operation Ranch Hand.

Both the Vietnamese and U.S. governments have had reasons to avoid or delay consideration of

the topic of Agent Orange cleanup. It is thought that Vietnam avoided raising the issue prior to its

obtaining NTR in 2002 and “permanent normal trade relations” (PNTR) status with the United

States in 2006 and membership in the World Trade Organization (WTO) in 2007. The U.S.

government purportedly also has avoided the issue because of concerns about potential liability

issues and/or presumptions of responsibility.82

However, since Vietnam obtained PNTR status and joined the WTO, the issue of Agent Orange

and its cleanup has risen in prominence in bilateral relations.83 In February 2007, the United

States announced it would provide $400,000 to support mitigation planning for the dioxin cleanup

of the Da Nang airbase.84 In June 2007, the DOD presented the Vietnamese Ministry of Defense

with a detailed map of herbicide storage locations from 1962 to 1971 during a Hanoi workshop

on chemical herbicide use during the Vietnam War.85

The official entity responsible for the bilateral efforts to address the environmental and health

effects of dioxin in Vietnam is the Joint Advisory Committee (JAC). Although the two nations

agreed to form the JAC in 2002, it did not hold its first meeting until 2006 due to disagreements

between the United States and Vietnam over the role of the JAC.86 The seventh meeting of the

JAC was held in September 2012 in Hanoi. The U.S. delegation to the JAC consists of

representatives from the Department of Defense, the Department of State, the Environmental

Protection Agency, the U.S. Centers for Disease Control and Prevention (CDC), and USAID. The

Vietnamese delegation includes representatives from Office 33, the Ministry of Defense, the

Ministry of Foreign Affairs, the Ministry of Health, the Ministry of Natural Resources and the

Environment, and the Vietnam Association of Science and Technology. In addition, a group called

the U.S.-Vietnam Dialogue Group on Agent Orange/Dioxin (Dialogue Group), established by the

Ford Foundation, is regularly consulted on the cleanup process.87

The cost and scope of cleaning up Vietnam’s dioxin “hot spots” have gradually increased over

time. In 2006, the Vietnamese government estimated the cost for the detoxification of the Da

Nang and the Bien Hoa airbases could reach $10 million.88 In November 2008, the estimated cost

of cleaning up the Da Nang airbase was raised to $17 million.89 According to then-Acting Deputy

Assistant Secretary, Bureau of East Asian and Pacific Affairs Matthew Palmer in his July 2010

For more information on the mutual reluctance of the Vietnamese and U.S. government to raise the issue of Agent

Orange, see Robert Dreyfuss, “Apocalypse Still,” Mother Jones, January 2000.

The United States extended PNTR status to Vietnam in December 2006, and Vietnam became a member of the WTO

on January 1, 2007. For details, see CRS Report RL33316, U.S.-Vietnam Relations in 2008: Background and Issues for

Congress, by (name redacted).

“US Gives Vietnam $400,000 to Plan Clean-up of Agent Orange Hotspot,” Associated Press, February 9, 2007.

“US, Vietnam Continue Wartime Toxin Cleanup Efforts,” Thanh Nien News, June 21, 2007.

The Vietnamese government wanted the JAC to proceed with plans for environmental remediation; the U.S.

government preferred to focus on areas of scientific cooperation.

The Dialogue Group includes U.S. representatives from the American Association for the Advancement of Science,

the Aspen Institute, the Ford Foundation, and the National Organization on Disability; Vietnamese members include

representatives from Ngoc Tam Hospital Corporation, the Vietnamese Communist Party’s External Relations

Commission, the Vietnamese National Assembly, Vietnam National University, and the Vietnam Veterans Association.

“Vietnam to Clean Dioxin in Hot Spots,” Thanh Nien News, July 19, 2006.

Conversation with Charles R. Bailey, Director of the Special Initiative of Agent Orange/Dioxin of the Ford

Foundation, November 26, 2008.

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

testimony before the Subcommittee on Asia, the Pacific, and the Global Environment of the

House Committee on Foreign Affairs, USAID has estimated the remediation of Da Nang will cost

at least $34 million.90 In his testimony at the same hearing, USAID Director of Technical Support

John Wilson stated that the current plan was to use thermal desorption destruction technology to

remove the dioxin from the affected soil at the Da Nang airport.91 According to USAID, the cost

of remediating the Da Nang airport has been increased to $43 million.92

As the cost and size of the cleanup efforts have risen, the estimated time for their completion has

been delayed. The Voice of Vietnam, a Vietnamese government-run radio station, reported on

February 15, 2008, that the cleanup of the Da Nang airbase was expected to be completed by the

end of 2008.93 However, issues concerning the manner by which to decontaminate the soil, as

well as the recent identification of a new “hot spot” at the Da Nang airbase by the U.S.

Department of Defense, have delayed completion of the cleanup effort.94 In 2010, USAID

projected the cleanup at Da Nang would be completed by the end of FY2013, if sufficient funding

was made available. As of August 2012, the estimated date of completion of the thermal

remediation of Da Nang airport has been moved to late 2016.

While the total cost and timing of the cleanup of the Da Nang airport remains uncertain, the two

governments have agreed on the method to remove the dioxin from the contaminated soil. After

consideration of several different methods, thermal remediation using in-pile thermal desorption

(IPTD) technology was chosen as being the most cost-effective, reliable, and practical method for

the Da Nang airport project. TerraTherm, the company awarded the remediation contract, intends

to use a combination of conductive thermal heating elements and negative pressure (partial

vacuum) to circulate heat throughout the contaminated soil to break down the dioxin into nontoxic compounds. TerraTherm reportedly will excavate and treat 72,900 cubic meters of soil in

two stages in an above-ground, covered pile located at the airport.95 The estimated size of the

thermal pile is 100 meters long, 70 meters wide, and 8 meters tall. To break down the dioxin, the

contained soil will be heated to 335°C (635°F) until such time as the soil’s concentration of

dioxin is less than 150 parts per trillion (ppt). A groundbreaking ceremony for the remediation

project was held in August 2012.

Information on the status of cleanup projects on hot spots other than Da Nang airport is limited.

The Vietnamese military has begun cleanup operations at the Bien Hoa airbase, with an estimated

cost of $4 million-$5 million.96 There is limited evidence of detoxification efforts undertaken in

areas heavily sprayed with Agent Orange. One area where the Vietnamese government—with the

assistance of international agencies such as the Asian Development Bank and other

Available online at http://www.state.gov/p/eap/rls/rm/2010/07/144702.htm.

U.S. Congress, House Committee on Foreign Affairs, Subcommittee on Asia, the Pacific, and the Global

Environment, Agent Orange: Recent Developments in Remediation, 111th Cong., 2nd sess., July 15, 2010.

CRS correspondence with USAID.

“Da Nang to be Free of Dioxin in 2008,” Voice of Vietnam, February 15, 2008.

The third “hot spot” at the Da Nang airbase is at the location where a DOD-contracted Taiwanese company gathered

the remaining Agent Orange for shipment to Johnston Island as part of Operation Pacer Ivy which began in September

1971. The Agent Orange was shipped to Johnston Island in April 1972. For more information about Operation Pacer

Ivy, see A. Young, The History, Use, Disposition and Environmental Fate of Agent Orange, Springer, 2009, pp 121134.

“US Agency to Conduct High-Tech Dioxin Cleanup at Da Nang Airport,” Thanh Nien News, May 9, 2012.

Conversation with Charles R. Bailey, Director of the Special Initiative of Agent Orange/Dioxin of the Ford

Foundation, November 26, 2008.

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

contributors—has attempted to address the long-term damage caused by Agent Orange is the

rehabilitation of affected forestland.97

The Vietnamese government asserts it lacks the financial resources to undertake the cleanup

projects on their own. In addition, other war-related projects—such as the removal of unexploded

ordnance and care of Vietnam’s war veterans—require significant financial resources, making it

difficult to allocate more resources to Agent Orange and dioxin. The United Nations

Development Program (UNDP) announced in August 2007 it would provide $350,000 in

financial support for the cleanup of the airbases at Da Nang, Bien Hoa, and Phu Cat.98 The Czech

government has also offered assistance with the remediation of Phu Cat. According to UNDP

estimates, it will cost nearly $51 million to clean up all three hotspots.99

The Dialogue Group’s Plan of Action

In June 2010, the Dialogue Group—with the assistance of the Aspen Institute—released a

proposed 10-year “Declaration and Plan of Action” to address the legacy of Agent Orange in

Vietnam.100 The proposed plan would be carried out in three phases, with an estimated cost of

$300 million. The plan is divided into remediation efforts and services for people with disabilities

linked to dioxin. The remediation efforts are projected to cost $97.7 million; the services to

people with disabilities are estimated at $202.3 million.

The first phase of the remediation plan would last three years with an estimated cost of $29.7

million, and would focus on the cleanup of the Da Nang site. The second phase would last four

years and cost an estimated $50.0 million, and clean up the hot spots at Phu Cat and Bien Hoa, as

well as reforest affected areas in A Luoi, Ma Da, and Ngoc Hien. The third and final phase would

last three years with an estimated cost of $18.0 million, and would primarily address the

remediation and reforestation of secondary hot spots.

The Dialogue Group’s proposed plan for services for people with disabilities is also divided into

three phases. The first phase would be three years in duration, costing $68.3 million, involving a

national survey of disabilities in Vietnam and training of health care providers to improve

services to people with disabilities. The second phase would run for four years with an estimated

cost of $125 million to establish a bio-monitoring program for people living near hot spots and a

district-level early identification/early intervention program for children with disabilities. The

third phase would last three years and cost $9.0 million, and would center on evaluating the

various service programs being provided to people with disabilities.

The Dialogue Group did not stipulate how the Plan of Action was to be funded. It did, however,

state that “the U.S. government should play a key role in meeting these costs, along with public

and private donors, supplementing an appropriate continuing investment from the government

and people of Vietnam.”

For one account of the forest rehabilitation effort, see Christie Aschwanden, “Through the Forest, a Clearer View of

the Needs of a People,” New York Times, September 18, 2007.

“UNDP Helps Clean Dioxin Hotspots in Vietnam,” Saigon Times, August 28, 2007.

Ibid.

100

U.S.-Vietnam Dialogue Group on Agent Orange/Dioxin, Declaration and Plan of Action: Addressing the Legacy of

Agent Orange in Vietnam, The Aspen Institute, Hanoi and Washington, DC, June 2010.

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

In May 2012, the Dialogue Group released its Second Year Report on the Declaration and Plan of

Action.101 The report reviewed the developments of the year, including congressional

appropriations, funding provided by the Vietnamese government, and private contributions. It

also updated the projected costs of environmental remediation of dioxin “hot spots.” The

Dialogue Group projects the cost of dioxin cleanup at Da Nang at $43 million; at Bien Hoa at $85

million; at Phu Cat at $5 million; and at lesser sites at $17 million—raising the total remediation

cost to $150 million. Similarly, costs of health-related services to Agent Orange/dioxin victims

were increased from $200 million to $300 million. The Dialogue Group suggested that the U.S.

government provide $65 million each year for five years ($325 million), and other groups provide

an additional $17 million per year.

Vietnam’s Assistance to the Victims102

There is little publicly available information on Vietnam’s assistance program for people exposed

to Agent Orange, and what is available is often contradictory. In addition, there are differing

views within the Vietnamese government on the importance of the Agent Orange/dioxin issue. In

general, Vietnam’s Ministry of Defense, MOLISA, veterans, and victims support groups would

like to see more help from the United States, while MOFA and the Ministry of Agriculture and

Rural Development (MARD) do not want the AO issue to cause problems in bilateral relations

with the United States or with agricultural exports.103 The following summary represents the best

compilation of information possible given the current level of disclosure about Vietnam’s

assistance programs.

Office 33 works with Vietnam’s Ministry of Health (MOH) and Ministry of Health and the

Ministry of Labour, War Invalids, and Social Affairs (MOLISA) to provide special assistance to

Vietnamese presumed to be suffering from conditions related to exposure to Agent Orange.

People who have certain medical conditions are eligible to receive a disability stipend from

Vietnam’s AO Central Payments Programme (see details below) of up to 300,000 Vietnamese

dong ($20) per month.104 According to one source, the Vietnamese government categorizes people

eligible for income supplements into three groups: (1) those who have partially or totally lost the

ability to work; (2) children with deformities or who have lost the ability to work; and (3) orphans

with deformities or who are unable to work.105 One study estimated the total Vietnamese budget

for Agent Orange income supplements in 2000 at $41 million.106 Another source reports that the

Vietnamese government is paying about $76 million per year in income supplements to people

with disabilities caused by Agent Orange/dioxin.107 The annual cost of providing a $20 per month

101

U.S.-Vietnam Dialogue Group on Agent Orange/Dioxin, Second Year Report, Washington, DC, and Hanoi, May

2012.

102

Portions of this section and following sections of the report were originally written by Evan Coutts, a previous intern

for the Congressional Research Service.

103

For example, the Ministry of Agriculture and Rural Development is concerned that highlighting the continued

presence of dioxin in Vietnam may lead other nations to ban the import of agricultural and aquatic goods from Vietnam

for health reasons.

104

Tom Fawthrop, “Agent Orange Victims Sue Monsanto,” Corpwatch, November 4, 2004. For comparison, the U.S.

State Department estimates that Vietnam’s per capita GDP in 2007 was approximately $70 per month.

105

Michael G. Palmer, “The Legacy of Agent Orange: Empirical Evidence from Central Vietnam,” Social Science and

Medicine, Vol. 60 (2005), pp. 1061-1070.

106

Ibid.

107

Conversation with Charles R. Bailey, ex-Director of the Special Initiative of Agent Orange/Dioxin of the Ford

(continued...)

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

stipend to all of Vietnam’s estimated 2.1 million-4.8 million “victims” of Agent Orange would be

$500 million to $1.2 billion.

Vietnam’s central government also works closely with private and provincial government

agencies providing assistance to people with medical conditions associated with Agent

Orange/dioxin exposure. On July 24, 1998, the VRC established the Agent Orange Victims

Protection Fund. Various national organizations, such as Vietnam Association of Veterans,

Confederation of Vietnam Labour Unions, Vietnam Farmers Association, Vietnam Women’s

Union, Vietnam Lawyers Association, and the Ho Chi Minh Youth Union, contributed to the

central fund. In addition, there are 57 Agent Orange Victims Protection Funds at the provincial

level. Between 1998 and 2004, the VRC fund raised 23 billion dong ($1.4 million) and provincial

funds raised 50 billion dong ($3.1 million) for programs to provide aid to people who were

exposed to dioxin.

Government Support

On June 1, 2012, Prime Minister Nguyễn Tấn Dũng approved the “National Action Plan to

Overcome Fundamental Consequences of Toxic Chemicals Used by the U.S. in the War in

Vietnam to 2015 and Oriented to 2020.”108 The main objectives of the plan are to decontaminate

the most heavily contaminated areas, plant trees on 300,000 hectares of decontaminated land,

provide assistance to all dixoin victims who are relatives of people who “took part in the

resistance war,” offer allowances and health insurance for people with disabilities, and enhance

research of toxic chemicals. The decision also assigns specific tasks to Office 33, the government

ministries, and the local governments as part of the implementation of the national action plan.

Office 33 is responsible for the coordination of the national effort.

A recent focus of the Vietnamese government’s efforts on Agent Orange/dioxin is the

identification of people affected by Agent Orange/dioxin and ensuring that they receive their

monthly stipend from the AO Central Payments Programme. Identifying those with diseases or

disabilities directly related to dioxin is done at the local level according to standards put in place

by MOLISA.109 The Medical Test Boards of cities, provinces, and branches “determine the extent

to which the victims have been infected, their deformities and damages to their health.”110 The

district files the paperwork with MOLISA and, if approved, the funds for the stipends are

distributed. According to a 2006 MOLISA report, approximately half of the households with

disabled members were receiving either direct income support through the AO Central Payments

Programme, free medical treatment, and/or a Health Insurance Card.111

(...continued)

Foundation, November 26, 2008.

108

Text available online in English at http://vava.org.vn/modules.php?name=News&op=viewst&sid=1297.

109

“Health Check-up for Agent Orange Victims,” Press Release - Embassy of Vietnam, January 8, 2001.

110

Ibid.

111

Michael Palmer, “The Case of Agent Orange; Term Given to a Herbicide and Defoliant Used during the Vietnam

War by the U.S. Military,” Contemporary Southeast Asia, April 1, 2007.

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

AO Central Payments Programme

The Vietnamese government’s main effort in assisting those affected by Agent Orange is the AO

Central Payments Programme. Established in 2000, it offers monetary benefits to veterans,

civilians, and children exposed to Agent Orange. More than 200,000 individuals receive a

monthly allowance, totaling 60 billion dong ($4 million) a month.112 According to Vietnam’s

official news agency, the program costs the government approximately $50 million a year.113

According to a representative of Office 33, the amount of the monthly stipend depends on several

factors, including whether or not the person is a veteran and if the family has more than one

affected person.114 Veterans reportedly receive 1 million dong ($56) per month; non-veterans

receive 240,000 dong ($13.50) per month for the first victim and an additional 120,000 dong

($6.75) per month for each additional victim.115 The program also covers the survivors of

Vietnamese war veterans who died as a direct result of AO-associated diseases. Individuals who

served with the Army of the Republic of Vietnam (ARVN) are not considered veterans.

There are no AO Central Payment Programme formal provisions made for non-monetary benefits

except for humanitarian center assistance and medical treatment for orphans. Furthermore,

persons able to work or study and those already receiving state benefits (such as the Health

Insurance Card) are excluded from the program.

Health Insurance Card

The Vietnamese government has created a Health Insurance Card, which provides free or lowcost access to health care. People on government assistance, such as victims of Agent

Orange/dioxin, are provided a health insurance card and free medical care. There are also

voluntary health insurance cards that require city residents pay an annual premium of 280,000

dong ($17), and rural residents, 200,000 dong ($12.50).116 The goal of the Ministry of Health’s

Health Insurance Department is to provide 70%-80% of the population with health insurance by

2010 and all students, as well as all children under the age of six, with health insurance by

2008.117 In the first six months of 2007, 14.5 million people were granted Health Insurance Cards.

By the end of 2010, 53 million people, or about 62% of the population, had health insurance

cards.118 In addition, coverage may infringe on the recipient’s right to receive monetary

compensation from the AO Central Payments Programme.119

112

“Human and Environmental Consequences of Agent Orange/Dioxin in Viet Nam,” Ministry of Natural Resources

and Environment.

113

“Ten Percent of Agent Orange Victims receive Aid,” Vietnam News Agency, May 16, 2008.

114

Conversation with representative of Office 33, Hanoi, December 10, 2008.

115

Ibid.

116

“Vietnam State Health Insurance Costs Rise,” Thai Press Reports, May 4, 2007.

117

“More to Receive Health Insurance Coverage,” Vietnam News Agency, March 31, 2007.

118

“Health Insurance Fund Posts Surplus,” Vietnam News Service, December 25, 2010.

119

Michael G. Palmer, “Healing the Wounds of War? A Discussion of Agent Orange Compensation Programmes in the

United States and Vietnam,” International Journal of Comparative Sociology, June 2003, vol. 44: p. 273.

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

Agent Orange Day

The government has also set aside August 10 as “Agent Orange Day,” an official commemoration

in support of the “victims” of Agent Orange/dioxin. August 10, 1961, was the date of the first

usage of Agent Orange defoliant on Vietnamese forests. In 2008, the Vietnam Red Cross

organized a “month of action” to support Agent Orange/dioxin victims, running from August 10

to September 9.120

U.S. Civil Suit for Compensation

The Vietnamese government has also been supportive of a U.S. civil suit, Vietnam Association for

Victims of Agent Orange/Dioxin v. Dow Chemical Co., seeking compensation for the Vietnamese

exposed to Agent Orange from the manufacturers of the herbicide. According to sources close to

the case, the Vietnamese government was initially reluctant to support the suit because it might

have undesirable implications for diplomatic relations with the United States. However, the suit

had influential supporters with the Ministry of Defense (including Vietnam’s war hero, General

Vo Nguyen Giap) who were concerned about the possible expiration of statute of limitations.

On March 10, 2005, the U.S. District Court for the Eastern District of New York dismissed the

case, concluding that the government contractor defense—which protects government contractors

from state tort liability under certain circumstances when they provide defective products to the

government—applied to the manufacturers of Agent Orange and other herbicides used during the

Vietnam War. The court also ruled that the use of the herbicides was not a violation of

international law because they were not intended to be used as a poison against humans.

The District Court ruling was appealed to the United States Court of Appeals for The Second

Circuit in New York City. On February 22, 2008, the Second Circuit Court upheld the decision of

the District Court.121 The Vietnamese government and various Vietnamese organizations reacted

strongly to the U.S. Court of Appeals decision. The Vietnam Association for Victims of Agent

Orange/Dioxin (VAVA) called the decision “irrational, biased, and unfair.”122 The Vietnam

Association of War Veterans termed the decision “legally and morally erroneous.”123 Foreign

Ministry spokesman Le Dung said, “It is particularly regretful that the ruling came in a time that

the U.S. government has started cooperating with Vietnam to resolve the consequences caused by

Agent Orange/dioxin.”124

On October 6, 2008, the plaintiffs filed a petition with the U.S. Supreme Court requesting a

reconsideration of the Appeal Court’s decision. The Supreme Court decided on March 2, 2009,

not to review the case, effectively ending the claimants’ appeal process. Vietnam’s response to the

Supreme Court decision was again strong. Foreign Ministry spokesperson Le Dung said, “The

Vietnamese people are extremely indignant at the wrong and unjust decision.”125 VAVA responded

120

“Month of Action to Help Dioxin Victims Nationwide,” Vietnam Net, August 10, 2008.

90 United States Court of Appeals for The Second Circuit, Docket N. 05-1760-cv, In re “Agent Orange” Product

Liability Litigation, February 22, 2008.

122

Press statement of the Vietnam Association for Victims of Agent Orange/Dioxin, February 25, 2008.

123

“Veterans Protest US Court’s Agent Orange Verdict,” Thanhnien News, March 9, 2008.

124

“US Court’s Ruling Erroneous and Unjust: VN Foreign Ministry Spokesman,” Ministry of Foreign Affairs,

February 25, 2008.

125

Ministry of Foreign Affairs, “Vietnamese People are Extremely Indignant at the Wrong and Unjust Decision of the

(continued...)

121

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

to the decision by stating it “greatly regrets the decision.” VAVA also noted, “It is ironic that the

U.S. Supreme Court decided not to review this lawsuit at a time when the U.S. Congress and

government have recently demonstrated certain preliminary steps in resolving the consequences

of Agent Orange/dioxin in Vietnam.”126

The civil suit mirrors one submitted on behalf of U.S. Vietnam veterans in the same U.S. District

Court in 1979. Although the District Court also dismissed the claim in the 1979 case, there was an

out-of-court settlement in which the manufacturers of Agent Orange agreed to pay $180 million

to Vietnam veterans who claimed that exposure to Agent Orange caused them numerous health

problems. It was also thought that the court case and the out-of-court settlement contributed to the

passage of the various laws providing Vietnam veterans with medical coverage and disability

compensation for conditions attributed to Agent Orange and dioxin. The Vietnamese plaintiffs

may have hoped that their court case would have resulted in a similar out-of-court settlement

and/or passage of federal laws granting them assistance or compensation.

Vietnamese Americans and Agent Orange

There are an estimated 1.6 million Vietnamese Americans in the United States. Approximately

half of the Vietnamese Americans left Vietnam either immediately after the end of the war or as

part of the “boat people” migration of the late 1970s and early 1980s. Some of those Vietnamese

emigres were soldiers for the Army of the Republic of Vietnam (ARVN), and may have handled

Agent Orange and other herbicides during the Vietnam War.127 It is likely that some of them may

have been exposed to Agent Orange and may have health problems related to that exposure.

Information about possible dioxin-related medical problems among the Vietnamese American

population is not readily available. Because much of the Vietnamese American community is

unfriendly towards the current Vietnamese government, some Vietnamese Americans may be

reluctant to publicize their medical problems that may be potentially related to exposure to Agent

Orange. However, this attitude may be changing with the younger generation of Vietnamese

Americans.

Other Sources of Assistance

Prior to the early 1990s, there was little domestic or international non-governmental involvement

in assisting those with AO-related diseases. In recent years, support specifically for people

exposed to AO/dioxin has grown, mostly provided by non-governmental organizations (NGOs).

Inside Vietnam, several Agent Orange-related organizations have been formed to raise funds via

charity events and celebrity concerts. In addition, a number of Vietnamese programs for people

with disabilities or the handicapped have provided medical assistance to people with conditions

associated with exposure to Agent Orange/dioxin, as well as advocacy work for the rights of the

(...continued)

US Supreme Court,” press release, March 3, 2009.

126

Vietnam Association for Victims of Agent Orange/Dioxin, “Statement of the Vietnam Association for Victims of

Agent Orange/Dioxin (VAVA),” press release, March 3, 2009.

127

Under an agreement between the United States and South Vietnam, ARVN soldiers were responsible for the

transport and handling of the herbicides used in Operation Ranch Hand.

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

disabled.128 Outside of Vietnam, a variety of NGOs have offered technical assistance and financial

support for the provision of medical care for Agent Orange victims.

Vietnamese Non-Governmental Assistance

Vietnam Red Cross Fund to Support Agent Orange Victims

In 1998, the Prime Minister of Vietnam announced the establishment of a fund to support Agent

Orange victims under the Vietnam Red Cross (VRC).129 The VRC’s Fund to Support Agent

Orange Victims has chapters in 64 cities and provinces across the country. It receives financial

and material support from both domestic and foreign donors, as well as special fundraising

events. The VRC claims it raised over 1.5 trillion dong ($93.75 million) in 2010 for Agent

Orange/dioxin victim programs.130

The VRC provides treatment, rehabilitation, literacy and vocational training programs, and

monetary support for AO victims. Since its creation, it has assisted more than 667,000 people,

with almost 87,000 having received startup capital for new businesses reportedly employing more

than 150,000 people.131 The VRC plans on raising at least 10 billion dong ($602,000) annually

and will contribute at least 1 billion dong ($60,000) to provincial funds.132

One major contributor to the VRC’s Agent Orange programs is the Rare Antibody Antigen

Supply, Inc. (RAAS)—a blood plasma company founded in the United States, but now also

operating in China and Vietnam. RAAS has donated over 17 billion dong ($1 million) to the

VRC, and over 71 billion dong ($4.4 million) in various forms of assistance.

On December 9, 2010, the VRC and VAVA signed a joint activity agreement to foster greater

collaboration in advising the Vietnamese government on Agent Orange related policies and

implementing aid programs for victims of Agent Orange/dioxin.133

Vietnam Association for Victims of Agent Orange/Dioxin (VAVA)

According to their own literature, VAVA is “a social organization formed by Vietnamese

AO/dioxin victims themselves and individuals or groups who volunteer to contribute their part in

helping our victims in overcoming chemical consequences left behind by the U.S. military

forces.”134 At present, there are VAVA chapters in 53 provinces with over 60,000 members.135

128

Two examples of these Vietnamese organizations are the Children of Vietnam program in Da Nang City and the

Disability Resource and Development Program of the Ho Chi Minh City Open University.

129

“For Agent Orange Victims,” Press Release - Ministry of Foreign Affairs, Government of Vietnam, undated. There

is some uncertainty over the formal name of the fund as different versions appear in official Vietnamese documents and

in the Vietnamese press. This report will use the name of the fund presented in the referenced material. The VRC’s

webpage is located at http://chuthapdo.org.vn/redcross/en/home/index.jsp.

130

See http://chuthapdo.org.vn/redcross/en/home/InfoDetail.jsp?area=1&cat=299&ID=2725.

131

“Fund to Help Agent Orange Victims Expands,” Thanh Nien News, June 5, 2008.

132

Ibid.

133

“Agent Orange Victims Get More Help,” Viet Nam News, December 11, 2010.

134

The Vietnam Association for Victims of Agent Orange/Dioxin, “Join Hand in Appeasing AO/dioxin Connected

Pains,” pamphlet, undated.

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VAVA is a self-supporting non-government organization (NGO), reliant on private, mostly

domestic contributions; it has received over $4 million in contributions over the last five years.136

Hundreds of districts and communes in Vietnam have benefitted from contributions from

VAVA.137 VAVA was originally established to organize the filing the lawsuit in the United States,

which sought compensation for Vietnamese nationals exposed to Agent Orange. VAVA’s work

subsequently expanded to social services and assistance, including encouraging people exposed to

Agent Orange in overcoming the difficulties of daily life; providing monetary and social

assistance; raising public awareness; managing donations from individuals, organizations, and

businesses; and organizing volunteer activities.138

VAVA is arguably the leading Vietnamese organization for raising the profile of the Agent

Orange/dioxin issue in Vietnam and the United States over the last few years. Inside Vietnam,

VAVA has continued to exert pressure on various ministries and agencies to press for greater

efforts to clean up Vietnam’s environment and provide assistance to the purported Agent Orange

victims. In the United States, representatives from VAVA have been among the most active

proponents of greater U.S. assistance to Vietnam to address the Agent Orange/dioxin war legacy.

Charity Events

In the past decade, various organizations and groups have held multiple charity events to benefit

those affected by Agent Orange, ranging from walks to raise awareness, benefit concerts, sports

tournaments, and auctions, and have raised a considerable amount of money for aid. The amount

of funds brought in has been substantial, with the most for a single event reportedly being around

$1 million-$2 million. The charity events frequently feature well-known Vietnamese pop stars

and/or international celebrities. For example, fund-raising concerts have been given by

Vietnamese artists Trong Tan and Khanh Linh, as well as Peter Yarrow of the folk group Peter,

Paul, and Mary, and Irish folk musician Mick Moloney.

Peace Villages

With the support of government assistance, a network of special schools, or “Peace Villages,”

have been set up across the country for children suffering from disabilities, many said to be

caused by AO/dioxin. Many of the villages have been set up near dioxin “hot spots.” The Hoa

Binh Peace Village and Vietnam Friendship Village, two of the more well-known centers, are

residential facilities with health care services for orphaned children, elderly or disabled adults,

and children affected by dioxin poisoning and other mental and physical disabilities. Although

they are privately run and funded, the Vietnamese government has given them land grants,

including 27,000 square meters for the Vietnam Friendship Village. Thousands of victims,

particularly children with disabilities, have been cared for and treated in the aforementioned

(...continued)

135

The Vietnamese Association for Victims of Agent Orange/Dioxin, “Summary of Its Executive Central Committee’s

General Report at the 2nd Congress,” press release, December 3, 2008.

136

Ibid.

137

“Ten Percent of Agent Orange Victims Receive Aid,” Vietnam News Agency, May 16, 2008.

138

Ibid.

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

villages and other centers around the country. However, such support activities “only meet a small

part of [the] very large and long-term demand of Agent Orange/dioxin victims.”139

International Sources of Assistance

According to an Aspen Institute table summarizing non-U.S. government and non-Vietnamese

government sources of assistance for dioxin remediation and related health care services in

Vietnam, a total of nearly $40 million had been contributed by February 2012 (see Table 3).

While some of the funding has come from other governments, the United Nations—via the

United Nations Children Fund (UNICEF) and the United Nations Development Program

(UNDP)—and various private foundations have made the most significant contributions. A brief

summary of the assistance programs of some of the larger non-government sources follows.

The Ford Foundation

A philanthropic organization that funds humanitarian efforts around the world, the Ford

Foundation has been involved with both the environmental and health legacy of Agent

Orange/dioxin in Vietnam since 2000. In 2006, a Special Initiative on Agent Orange was

established, seeking to address the healthcare services offered to disabled Vietnamese, reduce

exposure to at-risk communities, aid in “hot spot” cleanup efforts, and encourage dialogue

between Vietnam and the United States about the legacy of the Vietnam War. The Ford

Foundation is working closely with both the Vietnamese and U.S. governments on its Special

Initiative on Agent Orange, as well as UNICEF and the UNDP.

Since 2000, the Ford Foundation has funded a wide variety of programs and initiatives aimed at

addressing the impact of Agent Orange and dioxin on post-war Vietnam. These include assisting

in the development of scientific facilities to assess the impact of dioxin on the people of Vietnam,

contributing to the cleanup efforts at the Da Nang airbase, supporting health care facilities for

people with medical conditions associated with dioxin, disability rights advocacy, and organizing

the U.S.-Vietnam Dialogue Group on Agent Orange. Through February 2012, the Ford

Foundation had made grants of over $17 million to Agent Orange/dioxin related projects in

Vietnam. The Ford Foundation has also been instrumental in mobilizing funding from various

other sources, including the Atlantic Philanthropies, and the Bill and Melinda Gates Foundation.

The Ford Foundation is the largest international contributor of assistance to Vietnam’s efforts to

clean up dioxin. From 2000 to 2007, the Ford Foundation gave grants totaling more than $4.8

million to government agencies, NGOs, and universities to promote the study of Agent

Orange/dioxin related diseases, the creation of adequate healthcare services for children and the

disabled, environmental cleanup projects, and scientific research.

139

Professor Nguyen Thi Ngoc Phuong, MD, testimony before the House Committee on Foreign Affairs,

Subcommittee on Asia, the Pacific and the Global Environment, May 15, 2008.

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

Table 3. Non-Vietnamese Sources of Agent Orange/Dioxin Assistance

(through February 2012, in U.S dollars)

Source

Amount

Multilateral Organizations

UNDP

$5,450,000

UNICEF

$2,090,119

Governments

Canada

$1,835,000

Czech Republic

$1,800,000

Greece

$125,500

Ireland

$455,600

Netherlands

$236,000

Foundations

Atlantic Philanthropies

$2,800,000

The California Endowment

$100,000

Chino Cienega Foundation

$20,000

Ford Foundation

$17,133,140

Gates Foundation

$2,750,000

Kaiser Family Foundation

$60,000

Nathan Cummings Foundation

$22,000

Rockefeller Foundation

$306,800

Wallace Alexander Gerbode Foundation

$50,000

Other U.S. Foundations

$406,336

Civic Groups, Businesses and Individuals

HSBC Bank

$62,800

Hyatt Hotels

$22,000

Other

$2,857,100

Source: Aspen Institute, September 2012.

In September 2007, the Ford Foundation pledged $7.5 million in support for the Dialogue

Group.140 Since November 2006, the Ford Foundation has supported the work of the Aspen

Institute in establishing the Dialogue Group’s effort to bring key individuals in both the United

States and Vietnam together to develop practical responses to the health and environmental

consequences of the use of herbicides during the Vietnam War.

140

Thu Thuy, “US, Vietnam Discuss Agent Orange Remediation,” Thanh Nien News, February 2, 2008.

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

The United Nation’s Children’s Fund (UNICEF)

In April 2008, UNICEF launched a project to provide healthcare and education to children with

disabilities in Vietnam. In close cooperation with the government of Vietnam, UNICEF started a

pilot program in Da Nang to train health workers, educators, parents, and other caregivers how to

properly monitor the health and nutrition of children with disabilities.141 In addition to the pilot

program, UNICEF has organized a fund-raising campaign that matches dollar for dollar a $1

million grant from the Ford Foundation, with the goal of implementing similar programs all over

Vietnam.142

The United Nations Development Program (UNDP)

In 2007, the United Nations Development Program (UNDP) provided $350,000 to a dioxin

cleanup program in cooperation with Vietnam’s Ministry of Natural Resources and Environment

and Ministry of National Defense.143 Preliminary plans called for the funds to be used to assess

dioxin contamination in Bien Hoa and Phu Cat.

The Bill and Melinda Gates Foundation and the Atlantic Philanthropies

The Gates Foundation and the Atlantic Philanthropies have combined efforts with MONRE to

finance a $6.75 million high-resolution dioxin testing laboratory in Vietnam. The two U.S.

foundations are providing $5.50 million; MONRE is contributing $1.25 million. The new

laboratory will be the first facility in Vietnam capable of accurately measuring very low

concentrations of dioxin or other chemicals in food and human tissue samples. The laboratory is

expected to lower the cost of conducting more extensive dioxin contamination and exposure

studies in Vietnam.

Implications for Bilateral Relations

Over the last 10 years or so, economic and security trade issues have gained priority over war

legacy issues in U.S.-Vietnam relations. Although war legacy issues in the United States

complicated and held up efforts to normalize relations between the two countries, the perceived

mutual benefits of bilateral trade currently exert more influence on overall U.S.-Vietnam

relations. However, there still remains the risk that the mismanagement of war legacy issues—

such as the status of Vietnam’s “victims” of Agent Orange—could derail or delay further progress

in bilateral relations.

For the Vietnamese government, it appears that economic and strategic considerations will

continue to take priority over U.S. assistance in cleaning up dioxin and providing assistance to

people with illnesses thought to be related to dioxin exposure. Vietnam is actively seeking

acceptance into the U.S. Generalized System of Preference (GSP) program,144 which would

141

“Improving Healthcare and Education for Children with Disabilities in Vietnam,” UNICEF USA, April 16, 2008.

“UNICEF Launches Initiative to Provide Assistance to Children with Disabilities in Vietnam,” UNICEF USA, April

9, 2008, available at http://www.unicefusa.org/news/releases/unicef-launches-initiative-to.html.

143

“UNDP Helps Clean Dioxin Hotspots in Vietnam,” Vietnam News Agency, August 28, 2007.

144

See CRS Report RL34702, Potential Trade Effects of Adding Vietnam to the Generalized System of Preferences

(continued...)

142

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remove tariffs on U.S. imports of selected goods from Vietnam, and is a party to the ongoing

Trans-Pacific Partnership (TPP) negotiations.145 Additionally, since the middle of the decade,

Vietnam has been seeking to expand its security relations with the United States, perhaps due to

China’s growing influence in Southeast Asia.

Within Vietnam, however, there is widespread concern about the living conditions of its estimated

2.1 million-4.8 million people who were exposed to Agent Orange and the already identified 3

million people with medical conditions the Vietnamese government attributes to that exposure.

Much of that concern is focused on the physical problems of Vietnam’s children who have

medical conditions associated with direct or indirect exposure to dioxin. Some observers think the

Vietnamese people’s generally positive attitude about the United States could change for the

worse if the U.S. government is perceived to be insensitive or intransigent about Agent Orange

and its associated problems.

For the U.S. government, the past policy was to deny legal responsibility for any health effects of

Agent Orange/dioxin while providing some assistance with the assessment, containment, and

cleaning up of any Agent Orange-related dioxin found in Vietnam. As a result, the United States

has been unwilling to provide medical or financial assistance to programs specifically targeted at

purported victims of Agent Orange.

For the present, the governments of both nations apparently welcome U.S. involvement in the

identification, containment, and cleanup of dioxin “hot spots.” At the current pace of funding, it

could take several more years before all of the major dioxin “hot spots” have been remediated.

It is likely public attention will shift to caring for people exposed to Agent Orange once the

cleanup is done, raising the risk of the emergence of bilateral tensions. The Vietnamese

government would like to see greater U.S. support for upgrading social services to people with

disabilities associated with exposure to Agent Orange/dioxin. The Vietnamese government and

people see some inconsistencies between the U.S. government’s reluctance to provide aid to

Vietnamese victims of Agent Orange and its generous support programs for U.S. veterans who

claim their medical problems are Agent Orange related.146

Whereas U.S. Vietnam veterans are presumed to have been exposed to Agent Orange, and thereby

automatically qualify for various benefits for a range of medical conditions, the U.S. government

continues to claim that there is insufficient evidence to demonstrate that the medical conditions of

Vietnamese who were exposed to Agent Orange are a consequence of their exposure to the

herbicide and its dioxin. In the same vein, the willingness of the United States to provide aid to

Vietnamese who lost limbs to land mines while refusing to provide help directly to people

exposed to Agent Orange can be difficult to explain to Vietnamese officials and civilians. These

apparent inconsistencies in U.S. policy could pose future problems for bilateral relations.

(...continued)

Program, by (name redacted) and (name redacted).

145

See CRS Report R42694, The Trans-Pacific Partnership Negotiations and Issues for Congress, coordinated by (nam

e redacted).

146

Based on interviews with Vietnamese officials and citizens. For more information about the U.S. assistance

programs for U.S. veterans with medical problems associated with exposure to Agent Orange, see CRS Report R41405,

Veterans Affairs: Presumptive Service Connection and Disability Compensation, coordinated by (name redacted)

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

Conversely, there is a concern in the United States that if the U.S. government were to seemingly

accept some legal or moral responsibility for the Vietnamese “victims” of Agent Orange, it could

have undesirable implications for future military conflicts. In this view, for the U.S. government,

it remains important that any and all assistance being provided to address the aftereffects of the

use of Agent Orange in Vietnam be seen as a humanitarian act, and not an admission of

culpability.

Issues and Options for Congress

For over three decades, the effects of Agent Orange and its accompanying dioxin, TCDD, on the

people and the environment of Vietnam have remained in the background of U.S.-Vietnamese

relations. Currently, through fora such as the Joint Advisory Committee (JAC) and the Dialogue

Group, U.S. and Vietnamese officials, as well as prominent citizens of both countries, are meeting

and discussing ways to jointly address the “war legacy” issues of Agent Orange, including

scientific research, environmental remediation, public awareness, and health care. Assuming that

recent patterns of economic and security issues taking precedence over war legacy issues

continue, as well as the comparatively positive dynamics in the JAC and the Dialogue Group, it

could be argued that there is no need for congressional involvement at this time.

Pending Legislation

At least two bills have been introduced in the 112th Congress that would directly or indirectly

result in the appropriation of additional funds to finance the cleanup of Agent Orange/dioxin in

Vietnam and/or provide assistance to Vietnamese victims of Agent Orange/dioxin. The Victims of

Agent Orange Relief Act of 2011 (H.R. 2634) would require the Secretary of State to develop a

plan to address the health care needs of Vietnamese nationals exposed to Agent Orange during the

designated exposure period, or their progeny.

The Department of State, Foreign Operations, and Related Programs Appropriations Act, 2013 (S.

3241) would appropriate not less than $20 million for “remediation of dioxin contaminated sites

in Vietnam,” and not less than $5 million for “health/disability activities in areas sprayed or

otherwise contaminated with dioxin.” In S.Rept. 112-172 associated with S. 3241, the Senate

Committee on Appropriations recommended the appropriation of

not less than $20,000,000 for site analysis and environmental remediation of dioxin

contamination at the Bien Hoa and Phu Cat hot spots, and not less than $5,000,000 under the

GHP [Global Health Programs] heading for disability surveys, monitoring, and related health

activities in areas that were heavily sprayed with Agent Orange or are otherwise

contaminated with dioxin.…

The House version of the appropriations bill, H.R. 5857, contains no provisions pertaining to

either environmental remediation or health and/or disability activities in areas of Vietnam sprayed

or contaminated with dioxin. Both H.R. 5857 and S. 3241 were approved by their respective

committees of jurisdiction in May 2012, but neither of them have been passed by their respective

chambers of Congress.

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Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

General Issues

If Congress addresses the issues related to Agent Orange, there are several aspects of U.S. policy

it could examine and consider. The most immediate issue may be to obtain more information on

how the appropriated and obligated funds have been and will be used. Although the State

Department and USAID have released information on the grants awarded out of those funds, they

have not provided detailed information on how these funds are being used and to what extent the

grantees have achieved their expected results. One option for Congress is to exercise oversight to

ascertain the status of USAID’s progress, including requesting that the Government

Accountability Office (GAO) conduct an audit of U.S. agent orange assistance in Vietnam.

In addition, Congress may choose to consider the appropriation of additional funds for exposure

assessment research, dioxin remediation, and/or humanitarian assistance to Vietnamese nationals

allegedly suffering from medical conditions related to exposure to Agent Orange. Although past

cooperative efforts in exposure assessment research encountered problems, more research can be

done and the estimated cost of such research would exceed Vietnam’s current budgetary capacity.

Similarly, the projected cost of containing and removing the residual dioxin in and around

Vietnam’s Agent Orange “hot spots” is beyond the Vietnamese government’s resources.

According to USAID, the estimated cost of decontaminating the Da Nang airport site exceeds the

amount already appropriated. The precedent for U.S. financial and technical assistance with

dioxin remediation is already established, making the appropriation of additional funding

potentially less problematic.

Appropriations for medical assistance specifically for purported Agent Orange “victims” in

Vietnam may be more problematic. Although there exists a precedent, critics remain concerned

about the possible implications for future conflicts. In addition, Cambodia and Laos may insist on

similar treatment for their purported Agent Orange “victims” (given that parts of their nations

were also sprayed during the Vietnam War), raising the potential overall cost and the

administrative difficulties of addressing this war legacy issue. However, past and existing

humanitarian aid programs in Vietnam, addressing victims of land mines and HIV/AIDS,

demonstrate the provision of aid need not imply legal or moral responsibility. One potentially less

contentious area for medical assistance may be technical support with the development of a

national birth defects registry and other efforts to develop a more comprehensive assessment of

the size and scope of Vietnam’s disabled population.

Another alternative for Congress would be the development of a multi-year policy on the general

issue of Agent Orange and dioxin in Vietnam. This policy could take the form of legislation that

addresses all aspects of the issue—research on the level of dioxin in Vietnam, general population

studies to determine the level of dioxin exposure in Vietnam, dioxin containment and

remediation, and medical care for people with medical conditions related to dioxin exposure. One

model multi-year plan has been proposed by the Dialogue Group. The development of such a

program would likely necessitate consultation with the Obama Administration, as well as the

Vietnamese government, in order to ensure its effective implementation.

One potential benefit of the development of a comprehensive policy on Agent Orange in Vietnam

could be the enhancement of U.S. “soft power” in Southeast Asia.147 To some analysts, U.S.

147

For more on the issue of U.S. “soft power,” see CRS Report RL34620, Comparing Global Influence: China’s and

U.S. Diplomacy, Foreign Aid, Trade, and Investment in the Developing World, coordinated by (name redacted).

Congressional Research Service

Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations

global influence is being challenged by China (and other nations) by the use of non-military

engagement—“soft power”—to encourage other countries to adopt policies or stances consistent

with the goals and objectives of the nation employing these policies. It has been postulated that

the U.S. military interventions in Afghanistan and Iraq have undermined its global image, and

that to restore its image, the United States should more actively engage in “soft power” exercises,

such as humanitarian assistance to Vietnam to address its “war legacy” problems. In addition,

relations between China and Vietnam since 1975 have ranged from hostile to cool, but more

recently China has sought to foster more friendly ties with its neighbors. Increased U.S.

assistance for Vietnam’s Agent Orange “victims” could strengthen U.S.-Vietnam relations, and

encourage Vietnam to be a stronger partner to the United States in other diplomatic and security

areas.

Author Contact Information

(name redacted)

Acting Section Research Manager/Specialist in

Asian Affairs

[redacted]@crs.loc.gov, 7-....

Congressional Research Service

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