Vietnamese Victims of Agent Orange and
U.S.-Vietnam Relations
Michael F. Martin
Specialist in Asian Affairs
August 29, 2012
Congressional Research Service
7-5700
www.crs.gov
RL34761
CRS Report for Congress
Pr
epared 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.
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.
The Vietnamese government has long sought U.S. assistance. Although the United States
provided scientific and technical support in the past, it repeatedly denied any legal liability to
provide assistance. It also questioned Vietnam’s assertions about the extent of the environmental
and health problems attributed to Agent Orange and dioxin. As a result, there was a growing
possibility of friction between the two governments over the issue of Agent Orange.
In the last few years, the United States has shown a greater willingness to fund remediation
activities in Vietnam. Since 2007, Congress has appropriated $59.5 million for dioxin removal
and related health care activities in Vietnam. However, 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.”
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. 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.
Congressional Research Service
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............................................................................................................................ 16
Vietnam’s Health Claims ......................................................................................................... 22
Clean-Up Efforts............................................................................................................................ 23
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....................................................................................................... 29
Agent Orange Day............................................................................................................. 29
U.S. Civil Suit for Compensation............................................................................................ 29
Vietnamese Americans and Agent Orange .............................................................................. 30
Other Sources of Assistance .......................................................................................................... 31
Vietnamese Non-Governmental Assistance............................................................................. 31
Vietnam Red Cross Fund to Support Agent Orange Victims ............................................ 31
Vietnam Association for Victims of Agent Orange/Dioxin (VAVA) ................................. 32
Charity Events................................................................................................................... 33
Peace Villages ................................................................................................................... 33
International Sources of Assistance......................................................................................... 33
The Ford Foundation......................................................................................................... 34
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 ......................... 36
Implications for Bilateral Relations............................................................................................... 36
Issues and Options for Congress.................................................................................................... 37
General Issues.......................................................................................................................... 38
Pending Legislation................................................................................................................. 39
Figures
Figure 1. U.S. Trade with Vietnam, 2001-2011 ............................................................................... 6
Figure 2. Map of Areas of Vietnam Sprayed with Herbicides ....................................................... 18
Congressional Research Service
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
Congressional Research Service
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
S 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.
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.
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.
Not all of Vietnam’s ministries and agencies are supportive of the renewed effort to obtain 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.2
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.
1 For purposes of this report, the term “dioxin” and “TCDD” will be used interchangeably, unless otherwise noted.
2 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 Vivian C. Jones and Michael F.
Martin. For information on the TPP negotiations, see CRS Report R42694, The Trans-Pacific Partnership Negotiations
and Issues for Congress, coordinated by Ian F. Fergusson.
Congressional Research Service
1
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
military sprayed across much of South Vietnam as part of Operation Ranch Hand.3 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.4
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. The Bush Administration showed some willingness to provide greater support in
cleaning up the dioxin 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.”5 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.”6
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 FY20097 and
an additional $15 million in FY20108 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
in 112th Congress that would appropriate funds for Agent Orange/dioxin remediation and related
health activities in Vietnam (see “Issues and Options for Congress”).
3 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.
4 Observation based on various interviews conducted by author with Vietnamese officials and citizens.
5 “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.
6 Ibid.
7 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).
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).
Congressional Research Service
2
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
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.”9
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) program10 and the
possible negotiation of a bilateral investment treaty (BIT)—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.11
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.12 There are many reasons for this, including Vietnam’s
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.”
9 Bao Van, “Agent Orange Victims Need More Support: McCain,” Thanh Nien News, April 8, 2008.
10 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 Vivian C. Jones and Michael F. Martin.
11 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 Thomas
Lum.
12 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 Mark E. Manyin.
Congressional Research Service
3
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
In 1975, following North Vietnam’s victory over South Vietnam, President Gerald Ford severed
diplomatic relations and imposed a trade embargo on Vietnam.13 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,14 which the United States was
unwilling to do.15 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 China16 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, 1978.17
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.18 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
greater cooperation and assistance in locating the remains of U.S. personnel. On February 6,
1991, President Bush said,
13 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.
14 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.
15 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.
16 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.
17 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.
18 For more information on the POW/MIA issue, see CRS Report RL33452, POWs and MIAs: Status and
Accounting Issues, by Charles A. Henning.
Congressional Research Service
4
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
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.19
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. 103-
236) 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.20
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).21 Vietnam’s conditional NTR status was renewed every
year until December 2006, when Congress passed P.L. 109-432, a comprehensive trade and tax
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.
19 “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.
20 “US Wants Private, World Role in Agent Orange Plan,” Reuters, August 4, 2000.
21 Previously known as temporary most favored nation (MFN) status.
Congressional Research Service
5
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
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.22
Figure 1. U.S. Trade with Vietnam, 2001-2011
(U.S. $ Billions)
20
18
16
14
12
10
8
6
4
2
0
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Exports
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 held again in July 2011, off the coast of Da Nang.
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
22 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 Michael F. Martin.
Congressional Research Service
6
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
scientific methods because the results may not support their claims of widespread environmental
damage and severe health effects.23 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.24
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.25 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.26
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.”27 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
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 …
23 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.
24 “US Abandons Health Study on Agent Orange,” Nature, Vol. 434, April 7, 2005, p. 687.
25 “US Won't Compensate Vietnam’s Agent Orange Victims: Official,” Agence France Presse, June 5, 2006.
26 “US Refuses to Compensate Agent Orange Victims,” Australian Broadcasting Company, June 5, 2006.
27 “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.
Congressional Research Service
7
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
that have occurred in Vietnam…. We just don’t have the scientific evidence to make that
statement with certainty.”28
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).29 Similarly, the United
States—via the Agency for International Development and the Leahy War Victims Fund—has
28 Embassy of the United States in Vietnam, “Remarks by Ambassador Michael W. Marine,” press release, February 5,
2007.
29 For more information about the U.S. PEPFAR activities in Vietnam, see CRS Report RL34569, PEPFAR
Reauthorization: Key Policy Debates and Changes to U.S. International HIV/AIDS, Tuberculosis, and Malaria
Programs and Funding, by Kellie Moss.
Congressional Research Service
8
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
provided Vietnam with financial support for assistance programs for people disabled by
landmines and unexploded ordnance.30
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.31 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.32 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.33 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.34 For various reasons, it took over a year
for the State Department to determine how to use these funds.
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.
30 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.
31 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.
32 Personal communications with representative of State Department, April 25, 2008.
33 There have been two subsequent JAC meetings since September 2008.
34 For details, see CRS Report RL33900, FY2007 Supplemental Appropriations for Defense, Foreign Affairs, and Other
Purposes, coordinated by Stephen Daggett.
Congressional Research Service
9
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
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 33,35 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) co-
sponsored a roundtable meeting on remediation standards and technology.36 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 indentified “hot spots.”
Table 1. Congressional Appropriations for Agent Orange/Dioxin Remediation and
Health-Related Activities in Vietnam
(in Millions of U.S. Dollars)
Health-
Environmental
Related
Congress
Public Law
Date Enacted
Total Amount
Remediation
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
112th
P.L. 112-10
April 2011
18.5
15.5
3.0
P.L. 112-74
December 2011
20.0
15.0
5.0
Source: CRS research
Notes: Does not include $3.9 mil ion 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.37
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
35 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.
36 Information in this paragraph from correspondence with U.S. Embassy in Vietnam, March 25, 2009.
37 U.S. Congress, House Committee on Foreign Affairs, Subcommittee on Asia, the Pacific, and the Global
Environment, Testimony of Acting Deputy Assistant Secretary Matthew Palmer, Agent Orange in Vietnam: Recent
Developments in Remediation, 111th Cong., 2nd sess., July 15, 2010.
Congressional Research Service
10
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
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.”38 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.39
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.
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.
38 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).
39 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).
Congressional Research Service
11
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
Table 2. USAID Obligations and Planned Obligations of Agent Orange/Dioxin
Appropriations
(type and recipient, as of June 2012)
Planned
Recipient Obligated
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.40 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.41 The total cost of thermal treatment is estimated at
$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.42
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
40 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.
41 Thermal treatment will use in-situ/in-pile thermal desorption destruction. The contaminated soil will be relocated to
contained landfills to undergo treatment.
42 U.S. Embassy in Hanoi, Vietnam, “Remarks by U.S. Ambassador Michael W. Michalak,” press release, December
30, 2010.
Congressional Research Service
12
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
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 fiscal year 2012, 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-be-
determined date.
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.43
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
reliable and gainful employment, start a business, increase their awareness of the demand-
supply 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.44
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
43 Text from information provided to CRS by USAID.
44 Ibid.
Congressional Research Service
13
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
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 self-
help groups to access to health and social services, and economic support.45
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
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
45 Ibid.
Congressional Research Service
14
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
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.46 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.47
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.48 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.
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
46 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.
47 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.
48 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.”
Congressional Research Service
15
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
(p.p.m.).49 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.50
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.51 According to William
Buckingham’s calculations, Operation Ranch Hand sprayed about 19 million gallons of herbicide,
of which 11 million gallons were Agent Orange.52 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.53 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.54 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.55
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.56 Second, in addition to the areas intentionally exposed to Agent Orange, an
49 General Accounting Office, Use of Agent Orange in Vietnam (CED-78-158), August 16, 1978.
50 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.
51 GAO, op. cit.
52 Buckingham, op. cit.
53 Robinson, op. cit.
54 Stellman, et al., op cit.
55 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.
56 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.
Congressional Research Service
16
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
unknown amount of herbicide was leaked or spilled on military bases.57 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.
57 According to several cited sources, DOD records for Operation Ranch Hand record multiple cases of herbicide
leakages or spills at airbases.
Congressional Research Service
17
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
Figure 2. Map of Areas of Vietnam Sprayed with Herbicides
Congressional Research Service
18
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
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.58 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.59 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.60 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.”61 However, several researchers maintain that
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.62
58 Stellman, et al., op. cit.
59 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.
60 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.
61 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,
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.
62 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.
Congressional Research Service
19
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
Seventeen out of the 23 soil samples taken at Da Nang airbase exceeded the international
maximum standard.63 A study of soil samples from the Bien Hoa airbase found one sample with a
TEQ concentration at over 1,000 p.p.b.64 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.65
Tissue Samples
Another method of determining exposure levels to Agent Orange and TCDD is to take tissue
samples—usually blood, breast milk, or adipose tissue66—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.67 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.68 A separate study
of blood dioxin levels of Da Nang residents reported TCDD concentrations “more than 100 times
globally acceptable levels.”69 Elevated TCDD concentrations were also found in blood samples of
Bien Hoa residents.70
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.71 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.”72
63 Ibid.
64 Boivin, et al., op. cit.
65 E.J. Dionne, Jr. “Ultrahigh Level of Poison Cited at Love Canal,” New York Times, July 13, 1982.
66 Adipose tissue is specialized connective tissue that functions as the major storage site for fat in the human body.
67 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.
68 Ibid.
69 Boivin, et al., op. cit.
70 Ibid.
71 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.
72 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.
Congressional Research Service
20
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
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.”73 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.74
Some scientists maintain that the apparent
contradictions in the study results may reflect
Vietnam Red Cross List of Diseases
differences in the circumstances surrounding
Caused by Agent Orange/Dioxin
Vietnam veterans’ exposure to Agent Orange.
(combined 1998 and 2000 lists)
There seems to be a general pattern that
•
Acute, chronic, and subacute peripheral neuropathy
veterans who handled or sprayed Agent
•
Chloracne
Orange have elevated levels of TCDD. Results
are less consistent for veterans who operated
•
Diabetes (Type 2)
in areas sprayed with Agent Orange. Some
•
Hepatoma
studies find elevated TCDD levels, others do
not. Some scientists speculate that studies
•
Hodgkin’s disease
comparing Vietnam veterans to other control
•
Lipid metabolism
groups fail to find differences in the TCDD
•
Malignant (non-Hodgkin’s) lymphoma
levels because the Vietnam veterans include
people who were exposed to Agent Orange as
•
Multiple myeloma (Kahler’s disease)
well as people who were not exposed.
•
Porphyria cutanea tarda
•
Prostate cancer
Studies have also examined food produced in
contaminated areas to determine if they
•
Reproductive abnormalities
contain significantly elevated levels of TCDD
•
Respiratory cancers (bronchial, tracheal, and
or other dioxins. One study of various food
laryngeal)
crops and livestock from the A Luoi Valley
•
Sarcoma
revealed negligible TCDD levels in rice,
manioc, and vegetable oil samples, but
•
Spina bifida
exceptionally high TCDD levels in some duck
Source: Vietnamese official
fat and fish fat samples.75 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.76
73 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.
74 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.
75 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.
76 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
(continued...)
Congressional Research Service
21
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
Number of Vietnamese Exposed
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.77 Vietnam Association of Victims of Agent Orange/Dioxin (VAVA) estimates that 2.1
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.78 According to MOLISA, over
U.S. Department of Veterans Affairs List
365,000 Vietnamese veterans and their
of Diseases and Conditions Presumed to
children and grandchildren have medical
be Related to Service-Related Exposure
conditions attributed to exposure to dioxin.79
to Agent Orange/Dioxin
Chloracne
Non-Hodgkin’s lymphoma
Soft tissue sarcoma
Vietnam’s Health Claims
Hodgkin’s disease
Porphyria cutanea tarda
The Vietnamese government maintains that
Multiple myeloma
TCDD is harming the health of its people in
Respiratory cancers (including lung, larynx, trachea, and
several ways. It asserts that Vietnamese
bronchus)
Prostate cancer
civilians and soldiers who were directly
Acute and subacute transient peripheral neuropathy
exposed to Agent Orange during the war are
Type 2 diabetes
experiencing certain diseases and health
Chronic lymphocytic leukemia
problems at a rate higher than the nation’s
Primary (AL) amyloidosis
unexposed population. Additionally, it
For children of all exposed veterans:
•
Spina bifida (but not spina bifida occulta)
maintains that people living in areas with
For children of exposed female veterans:
residual TCDD in the soil and water are also
•
Achonodroplasia
suffering from health complications related to
•
Cleft lip and cleft palate
the aftereffects of Operation Ranch Hand.
•
Congenital heart disease
Finally, it argues that the children and
•
Congenital talipes equinovarus (clubfoot)
grandchildren of people exposed to dioxin
•
Esophageal and intestinal atresia
have an unusually high level of birth defects
•
Hallerman-Streiff syndrome
•
Hip dysplasia
and/or health problems.
•
Hirschprung’s disease (congenital megacolon)
•
Hydrocephalus due to aqueductal stenosis
In 1998 and again in 2000, the Vietnam Red
•
Hypospadias
Cross (VRC) compiled lists of diseases it
•
Imperforate anus
associated with Agent Orange/dioxin exposure
•
Neural tube defects
(see textbox on previous page). In March
•
Poland syndrome
2008, Vietnam’s Ministry of Health reportedly
•
Pyloric stenosis
compiled a confidential list of 17 diseases and
•
Sundactyly (fused digits)
•
Tracheoesophageal fistula
deformities that it maintained were related to
•
Undescended testicle
exposure to dioxin. The VRC list contained
•
Williams syndrome
many of the same diseases identified by the
Source: National Organization on Disability
U.S. Department of Veterans Affairs (VA) as
(...continued)
Environmental Medicine, Vol. 45, No. 8, August 2003.
77 Stellman, et al., op. cit.
78 Conversation with representative of VAVA, Hanoi, December 10, 2008.
79 Conversation with representative of MOLISA, Hanoi, December 10, 2008.
Congressional Research Service
22
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
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”
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.80
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.81 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.82 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.83
80 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.
81 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 Mark E. Manyin.
82 “US Gives Vietnam $400,000 to Plan Clean-up of Agent Orange Hotspot,” Associated Press, February 9, 2007.
83 “US, Vietnam Continue Wartime Toxin Cleanup Efforts,” Thanh Nien News, June 21, 2007.
Congressional Research Service
23
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
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.84 The fifth meeting of the JAC
was held in July 2010 in Hanoi. The U.S. delegation to the JAC consists of representatives from
the Department of Defense, Department of Health and Human Services, the Department of State,
the Environmental Protection Agency, 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.85
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.86 In November 2008, the estimated cost
of cleaning up the Da Nang airbase was raised to $17 million.87 According to then-Acting Deputy
Assistant Secretary, Bureau of East Asian and Pacific Affairs Matthew Palmer in his July 2010
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.88 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.89 According to USAID, the cost
of remediating the Da Nang airport has been increased to $43 million.90
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 2008.91 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.92 In 2010, USAID
84 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.
85 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.
86 “Vietnam to Clean Dioxin in Hot Spots,” Thanh Nien News, July 19, 2006.
87 Conversation with Charles R. Bailey, Director of the Special Initiative of Agent Orange/Dioxin of the Ford
Foundation, November 26, 2008.
88 Available online at http://www.state.gov/p/eap/rls/rm/2010/07/144702.htm.
89 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.
90 CRS correspondence with USAID.
91 “Da Nang to be Free of Dioxin in 2008,” Voice of Vietnam, February 15, 2008.
92 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 121-
134.
Congressional Research Service
24
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
projected the cleanup at Da Nang would be completed by the end of fiscal year 2013, 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 non-
toxic 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.93 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).
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.94 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
contributors—has attempted to address the long-term damage caused by Agent Orange is the
rehabilitation of affected forestland.95
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.96 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.97
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.98 The proposed plan would be carried out in three phases, with an estimated cost of
93 “US Agency to Conduct High-Tech Dioxin Cleanup at Da Nang Airport,” Thanh Nien News, May 9, 2012.
94 Conversation with Charles R. Bailey, Director of the Special Initiative of Agent Orange/Dioxin of the Ford
Foundation, November 26, 2008.
95 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.
96 “UNDP Helps Clean Dioxin Hotspots in Vietnam,” Saigon Times, August 28, 2007.
97 Ibid.
98 U.S.-Vietnam Dialogue Group on Agent Orange/Dioxin, Declaration and Plan of Action: Addressing the Legacy of
(continued...)
Congressional Research Service
25
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
$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.”
In May 2012, the Dialogue Group released its Second Year Report on the Declaration and Plan of
Action.99 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 Victims100
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
(...continued)
Agent Orange in Vietnam, The Aspen Institute, Hanoi and Washington, DC, June 2010.
99 U.S.-Vietnam Dialogue Group on Agent Orange/Dioxin, Second Year Report, Washington, DC, and Hanoi, May
2012.
100 Portions of this section and following sections of the report were originally written by Evan Coutts, a previous intern
for the Congressional Research Service.
Congressional Research Service
26
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
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.101 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.102 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.103 One study estimated the total Vietnamese budget
for Agent Orange income supplements in 2000 at $41 million.104 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.105 The annual cost of providing a $20 per month
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
101 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.
102 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.
103 Michael G. Palmer, “The Legacy of Agent Orange: Empirical Evidence from Central Vietnam,” Social Science and
Medicine, Vol. 60 (2005), pp. 1061-1070.
104 Ibid.
105 Conversation with Charles R. Bailey, ex-Director of the Special Initiative of Agent Orange/Dioxin of the Ford
Foundation, November 26, 2008.
Congressional Research Service
27
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
Vietnam to 2015 and Oriented to 2020.”106 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.107 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.”108 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.109
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.110 According to Vietnam’s
official news agency, the program costs the government approximately $50 million a year.111
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.112 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.113 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,
106 Text available online in English at: http://vava.org.vn/modules.php?name=News&op=viewst&sid=1297.
107 “Health Check-up for Agent Orange Victims,” Press Release - Embassy of Vietnam, January 8, 2001.
108 Ibid.
109 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.
110 “Human and Environmental Consequences of Agent Orange/Dioxin in Viet Nam,” Ministry of Natural Resources
and Environment.
111 “Ten Percent of Agent Orange Victims receive Aid,” Vietnam News Agency, May 16, 2008.
112 Conversation with representative of Office 33, Hanoi, December 10, 2008.
113 Ibid.
Congressional Research Service
28
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
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 low-
cost 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).114 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
2008.115 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.116 In addition, coverage may infringe on the recipient’s right to receive monetary
compensation from the AO Central Payments Programme.117
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 9.118
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
114 “Vietnam State Health Insurance Costs Rise,” Thai Press Reports, May 4, 2007.
115 “More to Receive Health Insurance Coverage,” Vietnam News Agency, March 31, 2007.
116 “Health Insurance Fund Posts Surplus,” Vietnam News Service, December 25, 2010.
117 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.
118 “Month of Action to Help Dioxin Victims Nationwide,” Vietnam Net, August 10, 2008.
Congressional Research Service
29
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
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.119 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.”120 The Vietnam
Association of War Veterans termed the decision “legally and morally erroneous.”121 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.”122
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.”123 VAVA responded
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.”124
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
119 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.
120 Press statement of the Vietnam Association for Victims of Agent Orange/Dioxin, February 25, 2008.
121 “Veterans Protest US Court’s Agent Orange Verdict,” Thanhnien News, March 9, 2008.
122 “US Court’s Ruling Erroneous and Unjust: VN Foreign Ministry Spokesman,” Ministry of Foreign Affairs,
February 25, 2008.
123 Ministry of Foreign Affairs, “Vietnamese People are Extremely Indignant at the Wrong and Unjust Decision of the
US Supreme Court,” press release, March 3, 2009.
124 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.
Congressional Research Service
30
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
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.125 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
disabled.126 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).127 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.128
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
125 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.
126 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.
127 “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.
128 See http://chuthapdo.org.vn/redcross/en/home/InfoDetail.jsp?area=1&cat=299&ID=2725.
Congressional Research Service
31
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
than 150,000 people.129 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.130
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.131
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.”132 At present, there are VAVA chapters in 53 provinces with over 60,000 members.133
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.134
Hundreds of districts and communes in Vietnam have benefitted from contributions from
VAVA.135 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.136
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.
129 “Fund to Help Agent Orange Victims Expands,” Thanh Nien News, June 5, 2008.
130 Ibid.
131 “Agent Orange Victims Get More Help,” Viet Nam News, December 11, 2010.
132 The Vietnam Association for Victims of Agent Orange/Dioxin, “Join Hand in Appeasing AO/dioxin Connected
Pains,” pamphlet, undated.
133 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.
134 Ibid.
135 “Ten Percent of Agent Orange Victims Receive Aid,” Vietnam News Agency, May 16, 2008.
136 Ibid.
Congressional Research Service
32
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
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
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.”137
International Sources of Assistance
The Dialogue Group released in July 2011 a report updating progress on its “Plan of Action” on
addressing Vietnam’s Agent Orange/dioxin problems.138 Included in the update was a table
summarizing non-Vietnamese sources of assistance for dioxin remediation and related health care
services in Vietnam, indicating a total of nearly $73 million had been contributed by May 2011
(see Table 3). While most of the funding has come from governments, the United Nations—via
the United Nations Children Fund (UNICEF) and the United Nations Development Program
(UNDP)—and various private foundations have made significant contributions. A brief summary
of the assistance programs of some of the larger non-government sources follows.
137 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.
138 U.S.-Vietnam Dialogue Group on Agent Orange/Dioxin, Declaration and Plan of Action: First Year Report, Aspen
Institute, Hanoi and Washington, DC, July 2011.
Congressional Research Service
33
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
Table 3. Non-Vietnamese Sources of Agent Orange/Dioxin Assistance
(in U.S dol ars)
Prior to May 2010
June 2010 to May 2011
Source
Cleanup Services Sub-Total
Cleanup Services Sub-Total Total
UNDP
5,450,000
5,450,000
5,450,000
UNICEF
2,090,119
2,090,119
2,090,119
Governments
United
States 18,208,811 3,423,155 21,631,966 15,500,000 3,000,000 18,500,000 40,131,966
Canada
1,835,000
1,835,000
1,835,000
Czech
1,400,000
1,400,000
32,000
32,000
1,432,000
Republic
Greece
125,500
125,500
125,500
Ireland
787,660 787,660
528,445 528,445
1,316,105
Netherlands
236,000
236,000
236,000
Foundations
Atlantic
1,375,000 1,375,000 2,750,000
2,750,000
Philanthropies
Ford
2,680,300 7,278,539 9,958,839
106,800
106,800
10,065,639
Foundation
Gates
1,375,000 1,375,000 2,750,000
2,750,000
Foundation
Other
45,000 45,000
45,000
Foundations
Civic Groups,
3,075,251 3,075,251
1,477,263 1,477,263 4,552,514
Businesses &
Individuals
Total 32,324,111
19,811,224
52,135,335
15,500,000
5,144,508
2,064,4508
72,779,843
Source: U.S.-Vietnam Dialogue Group, Declaration and Plan of Action: First Year Report, Aspen Institute, July 2011.
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 2000.139 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.140 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.
139 “Special Initiative on Agent Orange/Dioxin - Overview,” The Ford Foundation, available at
http://www.fordfound.org/programs/signature/agentorange/overview.
140 Ibid.
Congressional Research Service
34
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
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 August 2008, the Ford Foundation
had made grants of nearly $8 million to Agent Orange/dioxin related projects in Vietnam, and has
committed to an additional $2.6 million in 2009. The Ford Foundation has also been instrumental
in mobilizing nearly $8 million in funding from various other sources, including the Atlantic
Philanthropies, and the Bill and Melinda Gates Foundation.141
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.142
In September 2007, the Ford Foundation pledged $7.5 million in support for the Dialogue
Group.143 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.
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.144 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.145
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
141 Conversation with Charles R. Bailey, Director of the Special Initiative of Agent Orange/Dioxin of the Ford
Foundation, November 26, 2008.
142 “Addressing the Effects of Agent Orange/Dioxin in Vietnam,” The Ford Foundation, available at
http://www.fordfound.org/.
143 Thu Thuy, “US, Vietnam Discuss Agent Orange Remediation,” Thanh Nien News, February 2, 2008.
144 “Improving Healthcare and Education for Children with Disabilities in Vietnam,” UNICEF USA, April 16, 2008.
145 “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.
Congressional Research Service
35
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
and Ministry of National Defense.146 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,147 which would
remove tariffs on U.S. imports of selected goods from Vietnam, and has indicated a long-term
interest in negotiating a free trade agreement (FTA) with the United States. 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
146 “UNDP Helps Clean Dioxin Hotspots in Vietnam,” Vietnam News Agency, August 28, 2007.
147 See CRS Report RL34702, Potential Trade Effects of Adding Vietnam to the Generalized System of Preferences
Program, by Vivian C. Jones and Michael F. Martin.
Congressional Research Service
36
Vietnamese Victims of Agent Orange and U.S.-Vietnam Relations
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.148
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.
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.
148 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
RL34370, Veterans Affairs: Health Care and Benefits for Veterans Exposed to Agent Orange, by Sidath Viranga
Panangala and Douglas Reid Weimer.
Congressional Research Service
37
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.149 To some analysts, U.S.
149 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 Thomas Lum.
Congressional Research Service
38
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.
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.…
Author Contact Information
Michael F. Martin
Specialist in Asian Affairs
mfmartin@crs.loc.gov, 7-2199
Congressional Research Service
39