28. Agent Orange and the Vietnam War Legacy w/ Susan Hammond

The Vietnam War has created lasting effects that people are still experiencing to this day. Join me as we journey into the heart of Southeast Asia with Susan Hammond, founder of the War Legacies Project, whose experience and knowledge of the Vietnam War's aftermath is nothing short of awe-inspiring. Her decades-long dedication to understanding the enduring impacts of this conflict paints a vivid, and often distressing, picture of the lasting effects of Agent Orange and explosive remnants of war. From the chilling realities of dioxin contamination to the ongoing health hazards, Susan walks us through her significant work on the ground in Vietnam, Laos, and Cambodia.

This episode takes a hard look at the alarming effects of dioxin, a toxic compound present in Agent Orange, on the environment and human health. We traverse into the depths of containment strategies, shedding light on the collaborative efforts of Susan's organization and the US government in mitigating the contamination. The conversation takes a turn towards the human dimension, as we discuss the profound impacts of Agent Orange on health and the advocacy for those affected by the war. Understand how the US government plays a role in providing services and shaping policy for the affected populations.

Finally, we steer the conversation to the often overlooked issue of cluster munitions, particularly their use in Ukraine by the US government. Susan shares her research findings from Laos, where unexploded bombs continue to pose a deadly threat. As we approach the end of this enlightening episode, we discuss the importance of raising awareness about the enduring impacts of war and the critical role we all play in preventing future generations from experiencing similar suffering. Don't let this remarkable conversation pass you by.

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Thank you so much. We...

Transcript

Hetal Baman: 1:34

How many of us really paid attention in our eighth grade US history class? I know I didn't. Social studies was definitely not my strong suit, but I also think that at that age it was hard for me to truly appreciate the consequences of a topic like war. And specifically for today's episode, we'll be discussing the consequences and aftermath of the Vietnam War, consequences that many are still suffering with, even decades later. Between 1961 and 1971, the US sprayed 12 million gallons of dioxin-contaminated Agent Orange and 8 million gallons of other herbicides on Vietnam, laos and Cambodia. That's an average of 5,200 gallons a day. For 3,735 days, all three countries suffered an additional tragedy from 7 million tons of bombs and other explosives. Together, agent Orange and explosive remnants of war left a legacy of destruction, death and sickness. Today I get to share a conversation I had with the daughter of a Vietnam War veteran, susan Hammond. She first became interested in post-war Southeast Asia after traveling to Vietnam and Cambodia in 1991. In 1996, after earning her MA in international education from NYU, susan returned to Vietnam to study Vietnamese. She then became involved in fostering mutual understanding between the people of the US and Vietnam, laos and Cambodia and addressing the long-term impacts of war, while working as the deputy director of the Fund for Reconciliation and Development from 1996 to 2007. During this time, she lived in New York, vietnam, cambodia and Laos coordinating programs for FRD. In 2007, susan returned to her home state of Vermont and founded the War Legacies project, and in 2019, she received the Vietnam Order of Friendship Medal for her more than two decades of work in Vietnam. In this conversation, I asked her questions like what exactly is Agent Orange and dioxin? What were they used for during the war and why? What were the health hazards that we discovered after the war and how is it still affecting people to this day? What is her organization, the War Legacies Project, doing to serve those who were affected in Vietnam, laos and Cambodia? This is a conversation where I hope helps us appreciate our history and reflect on how we can be better in the future. My name is Hetal Laman and this is the Global Health Pursuit. Susan, I'm really grateful to talk to you today. I think it's a topic that is so important for all Americans to know about and just people around the world. It's something that I myself almost feel like guilty for not knowing about this, and so, before we dive in, I really would love for you to kind of take us back to when you were younger. Tell us a little bit about yourself. What's your story?

Susan Hammond: 5:24

Okay, well, I grew up in Vermont for the most part, but I'm an Army brat. So for the first eight years of my life I traveled. I lived in upstate, new York, okinawa, japan, massachusetts, connecticut, and then here in Vermont. I'm the sixth of eight children. Oh, wow, yeah, Big family. I grew up in a very big family and I just envisioned my mother as she took six of us and me in her arms as an infant on the airplane alone from California to Okinawa, japan, to meet up with my father who was stationed there. My father served two tours in Vietnam, so my real memory of my father was not until probably when I was about five, when he came back after his second tour because his first tour I was only three at the time and then he came back when I was almost six for his second tour. So that's my first sort of memory of my father. He then retired from the military and we settled back into Vermont where I lived until high school. After I graduated high school I went to Smith College down in Massachusetts. I thought it was going so far away and was only a mile away. I mean an hour away but originally I really thought I was going to be a pediatrician. I was really interested in medicine, really interested in children, and so that's what I started my college career as a biology major. But then organic chemistry just kicked my butt and I thought you know, oh my God, tell me about it.

Hetal Baman: 6:59

Tell me about it. I actually I was thinking about going to medical school in college and I this is just like a side A couple of my college mates they took OCam we called it OCam at RPI for some reason and they'd come back and be like I got a 15% and I made the curve Like what I know. Anyways.

Susan Hammond: 7:28

I started out gangbusters and then by mid semester it got harder and harder and I'm like, is this what I really want to do? And I got to think, well, is actually the kids that really were interesting me? So maybe I'll go into education. So then I switched majors and went into education until I discovered after college my first was going to start teaching. That actually happened, you know, when I was doing my student teaching, that I came so focused on the kids in the classroom were having learning disabilities that I lost the whole class. I mean, it was chaos. And I realized, you know, I don't think I'm going to be a very good classroom teacher. So then I, my first job I was going to take was working with kids with autism, until a friend of mine called me up and said, hey, I'm going to Germany for the for a year. You want to come with me? And I said, sure, yes, let's go. I went and that sort of led me on an international career. In a lot of ways I just decided you know I really like this international work. So I came back from that work for a while and convinced my sister to do a bicycle trip around the world with me. So for 18 months we traveled through Eastern mainly Eastern Europe, parts of Europe. Then we popped on a plane and went to India and Nepal and Indonesia and Malaysia and I ended up in Bangkok and, as luck would have it, when you're on these traveling you know, worldly traveling you always meet the same people. We kind of overlap. And, yeah, I was really wanting to go to Vietnam on this trip because I really wanted to understand what was about this country of Vietnam, you know, smaller than the state of California, that took my father away from me for five years, basically of my life, when I was a child, and it just opened up to foreign tourists. This was in 1991. And a guy that we kept meeting on the trip happened to be walking down the street in Bangkok and I thought he had left for the States long ago and he had just had his ticket in his hand to go to Vietnam and I said I'm going. My sister didn't really want to go because we're at the end of our trip. I said, tough, I'm going, if you don't want to come, don't. And she did in the end and we had a great two months in Cambodia and Vietnam and that was my first sort of experience of what a post war country looked like, what it felt like. Even now, at this point it was 16 years after the end of the war in Vietnam I mean you still saw the devastation of the war in that country. You saw the deep poverty that not only the war caused, but because the US was still had a trade and economic embargo against Vietnam at the time. So we would see kids like jumping off the edge of a bridge into the river to pick up scraps of fruits and vegetables that the vendors had been throwing over the bridge because they were too poor, they were too bad quality to sell, but kids were scavenging this stuff. And this is in Saigon, a major city, and you could still see bombed out areas of the country, buildings with bullet holes, beggars on the streets, missing limbs. I mean it was really sort of eye opening to see. I mean I saw the poverty of India, of course, when I was on the trip. But the poverty of a post war nation was for some reason much more harder to take because we were responsible for a lot. We, meaning the US government, were responsible for a lot of that impact that was still being felt in 1991. And so I knew at the time I had to find some way to get back to Vietnam to work. And eventually, after going to NYU for grad school, I volunteered for an organization called the Fund for Reconciliation Development that was based in New York but that was working to normalize relations between Cambodia, laos and Vietnam after the war, to encourage the US to end the embargoes and to address some of the war legacies that were affecting the country, and I volunteered with them. Then I went to Vietnam to study Vietnamese, thinking I would do a PhD, and ended up getting offered a job full time with the Fund for Reconciliation Development. And there went my PhD plans and I started working for them. And I did that for 10 years doing programs to foster relations between the two countries, and I became really engaged while I was working for FRD on war legacy issues. And then, long story short, in 2007, when my boss decided to focus mainly on Cuba because we had normalized relations at that point with Cambodia, laos and Vietnam and I was deeply engaged in the war legacy issues. I took that whole portfolio, moved back home to Vermont and founded the war legacies project.

Hetal Baman: 12:17

The term war legacies. How would you describe that term? How would you define what war legacies means?

Susan Hammond: 12:27

Yeah, it can be a large concept in a lot of ways. For me and for my work it's the remains of the impacts on human health, society and the land after a war. And what the remains are war, what happens after the bombing stops, but the war impacts are still impacting the country. So for Southeast Asia specifically, it means the impacts of unexploded ordinance cluster bombs, remaining bombs, you know even some large 500 pounds, 700 pound bombs that did not explode, that are still littering the countryside today, and the impacts of Agent Orange.

Hetal Baman: 13:12

Right. So I'm just going to read a paragraph off of your website, warlegaciesorg. If you haven't seen this website, I'm going to put it in the show notes, but here it goes. Between 1961 and 1971, the US sprayed 12 million gallons of dioxin contaminated Agent Orange and 8 million gallons of other herbicides on Vietnam, Laos and Cambodia an average of 5,200 gallons a day for 3,735 days. My God, all three countries suffered an additional tragedy from 7 million tons of bombs and other explosives. Together, Agent Orange and explosive remnants of war, of war, left a legacy of destruction, death and sickness. I mean, that's you know in a nutshell, like what, what you can even say, happened during those 10 years. Yeah, that is something that was like so shocking, I think, as, as the daughter of a US Vietnam war veteran, like when did you start to really learn about all of these, all of the impacts of this war?

Susan Hammond: 14:28

It was actually quite late because you know my father, when he came out for the war, just like many veterans, never spoke at all about the war and what he did there. I mean, he was in the Army Corps of Engineers, he wasn't in combat, so we always assumed, oh, he's fine, he's, he's not impacted because he's not, he's not a veteran On the ground right. I mean, but he was actually. I found out much later, years later, that he was. He was in charge of all the Army installations and roads and bridges in the northern part of the South Vietnam, so he was constantly out in the environment and in some dangerous situations. It's just, you know, he never told his, his family, you know, and wanted to have, you know, widdle my mother with, at that point, seven kids. So I never really thought much about the war. I saw bits and pieces of it on the television. Of course it was very US focused. You know what was happening to our veterans, not so much what was happening to people in Vietnam. So it really wasn't until that trip in 1991 where I was really confronted with the impacts of the war directly and I saw for myself that even though the war had ended 15 years earlier, you were still seeing people who were injured by unexploded ordinance that was still littering the littering the ground and you were still. I didn't see as much impacts of Agent Orange on that first trip, but you clearly saw people missing limbs, missing limbs, children who were severely injured, just begging on the streets. And that's when you kind of it really hit me that wow, the war is still impacting people today. In fact, since the war, over 100,000 Vietnamese have died from these unexploded ordinance, over 65,000 Cambodians and over 50,000 Lao since the end of the war, since 1975. In fact, four children were injured well, two who died just last two weeks ago in Laos when they came across an unexploded ordinance.

Hetal Baman: 16:34

What is that? Can you like paint a picture of that, where it is? Are these explosives like in the ground and you just kind of walk over it and just explodes, or like?

Susan Hammond: 16:45

it depends on what it is. I mean, for instance, in in Laos, a lot of the problem. There are what's called cluster bombs In fact that's what we just sent to Ukraine to use right In that war and cluster bombs are small bombs about the size of a tennis ball that are in a much larger bomb casing and in theory, when the plane drops this cluster bomb it opens, the canister opens up and it spreads these smaller bomblets outside the cluster. You know the mother bomb, they call it and they are supposed to spread out in a large area like couple football fields area and explode. Well, they had about a 30 to 40% failure rate, depending where they landed. So that left millions and millions of these unexploded cluster bomblets literally, literally littering the whole countryside Over time. You know they would get turned in this. They could work their way down in the soil. Some are right on the surface that you could walk and see them, and others got buried underneath the ground over time with the rains and the muds and whatnot, and so people who are farming would hit, could hit them with their hoe, and then it would explode on impact. Sometimes you could pick one up and it would explode right away and kids early on, before they're educated not to touch these small bomblets, they would play with them, thinking they were toys. I mean it was horrible and then, after a certain amount of time, their luck ran out and it would explode. And that's why two thirds of the casualties of these cluster bombs and other unexploded ordnance are children, because they come across these remnants of war not knowing what they are sometimes and sadly becoming casualties.

Hetal Baman: 18:37

So that's one side of the equation. The other side is agent orange. So can you explain what was agent orange used for? And I believe the chemical composition was dioxin or that's the name of the chemical.

Susan Hammond: 18:55

Actually the chemical is agent orange was one of many herbicides that the US military used during the war. They called them tactical herbicides because they were in much higher concentrations than the type of herbicides you may spray on your farm here back in the US or used to kill your poison ivy. So there are several different types. They're nicknamed the rainbow herbicides, of which agent orange was one. And agent orange is a mixture of 50-50 mixture of two herbicides One is 2-4-5-T and the other is 2-4-D, and 2-4-D is still used today widely across the world and particularly across the US, and it's also if you go, for instance, to your hardware store to get round up to kill that poison ivy.

Hetal Baman: 19:44

It has 2-4-D in it 2-4-5-T.

Susan Hammond: 19:50

the other half of agent, orange, was contaminated during the manufacturing process with dioxin. So what happened was the chemical companies, when they were making these herbicides for the US government, would create the chemical reaction at too high of a speed, too high of a temperature, and the end result was dioxin would be created, the molecule dioxin, specifically something called TCDD dioxin. I won't get into the longer name of that. So long probably won't mean much, but you can Google it and that is one of the persistent organic pollutants that do not leave. They have a very, very long half-life once they're in the environment and it's highly highly toxic and people tend to say that it's one of the most highly toxic chemicals created by man, because it's created in the burning process or in the manufacture of chemicals, so it's not naturally. Well, it's in the environment because of burning or chemical manufacturing, but it's highly highly toxic. So that was one of the problems with agent orange, and agent orange was and all the other chemicals were, sprayed throughout all of South Vietnam, parts of Cambodia and a large part of Southern Laos, and also sprayed around military bases in Thailand that the US was using and the purpose was to defoliate the trees that were making the locations of the enemy camps and enemy soldiers hard for the US to see, hard for them to bomb, because they couldn't see where these camps were, they couldn't see where the roads were, so they would defoliate the trees. But another purpose of the herbicides was crop destruction. They purposely went after crops that were being raised, thinking that their reasoning was that it would prevent the enemy forces from getting access to the crops, but they really were killing the crops of Vietnamese and Laos and Cambodian people in that effort.

Hetal Baman: 22:00

And not even just like targeting soldiers or people like that. It was just across the board.

Susan Hammond: 22:07

Yeah, because they considered basically all of Laos along the Ho Chi Minh Trail and majority of Vietnam as enemy territory, because it was that type of war. There wasn't set sort of like boundary points of you know, here's the end of the war zone, it was the whole part. So they destroyed and defoliated about what would be the size of land equivalent to, say, vermont, the size of that. That's completely defoliated and crops destroyed. A lot of that land was. I mean, it didn't naturally regenerate, and we're talking about, you know, asian tropical forests, triple canopies with bamboos and lots of underlayers, and then these gigantic teat trees and you know beautiful forest land that was defoliated and then, as a result of that, the heavy monsoons would erode the soil away. The hot sun would bake it dry like concrete, really depleted the nutrients of the soil. Today the Vietnamese have made efforts to replant trees in this area, but they can never bring back the natural forest that was there. It would be way too expensive. So what they have is plantations of acacia and eucalyptus trees just to protect the land basically from eroding away even more. But it wasn't known at the time, or at least it wasn't widely known to the military, that these chemicals, the 2, 4, 5, t part of Agent Orange was contaminated with dioxin. The chemical companies knew. They knew back in the 50s when they first started making the herbicides that dioxin if you don't make them properly by keeping the temperature low and making the chemical reaction happen more slowly, dioxin is a contaminant, a byproduct. They didn't tell the US government that and they were selling 20 million gallons of herbicides, of which 12 million specifically was Agent Orange. So they knew. They knew. The chemical companies knew when they were selling these chemicals to the US it was contaminated with dioxin. So this is in the late 60s, early 60s, part of the early 70s. What they did not know was that the full extent of the health impacts of dioxin. They knew it caused a severe skin reaction called Chora acne to their workers because they were dealing with that in their factories. But they did not know at the time the long term health impacts that we now know that dioxin causes on humans. We now know that it's considered dioxin as a cancer causing agent. This is many different types of cancers. It's been linked to Parkinson's disease, diabetes, high blood pressure, heart disease. Right now the VA compensates US veterans for 19 different classes of illnesses and cancers that they have found to be associated to their exposure to Agent Orange during their time in Vietnam, Also in animal studies. And dioxin is really complicated on how it impacts human health. I mean it's a hormone mimicking chemical, so it interrupts how your body reacts, how hormones act in your body if you're exposed to dioxin, and so there's been lots and lots of animal studies. Of course you can't poison a human being with dioxin and see what their end results are, and first of all you'd have to poison millions of people to follow their health and their children's health and their grandchildren's health over time A little unethical, a little unethical and also not feasible. So all the studies on dioxin have been done on animals, of course on mice, and that's when they first really learned the long term impacts. In fact, the impacts on reproduction were first noticed when because Agent Orange was also used domestically in the forest out west to control the undergrowth, and foresters started coming across frogs that were severely deformed after they started using the two chemicals 245T and 24D. That's when they connected to like, oh, there's something else going on here. It's not just for acne, there are longer other impacts, including reproductive impacts, from dioxin.

Hetal Baman: 27:33

So you had said that after spraying, it kind of it goes into the soil, how you said that it's very, very long half-life and since the time that it started they sprayed like what is? Is there like a prediction of like when it actually will be gone from the soil or because it's been you?

Susan Hammond: 27:56

know there actually is because studies have been done by a group in Canada called the Hatfield Consultants. They're an environmental group that's experts on the dioxins through. You know the creation of dioxins from making paper. It's another way that dioxins are created in Canada. So they went to Vietnam in the mid 1990s and they decided they wanted to test the theory of you know how? Where is the dioxin today? What are the impacts today? And so they tested the areas of the country that were sprayed by airplane and they thankfully did not find high levels of dioxin in the soil in the areas that were sprayed by airplane. Makes sense because you know at that point it was 20 years after the end of the war Right, they were talking about 20 years of monsoonal rains would move the soil, move the dioxin. It's it likely and thankfully dioxin is water soluble. It's stored in four clings to the soil and so you would not find it like a contaminated well that was sprayed. So they theorized that you know, over the year the dioxin migrated through the heavy monsoons. Possibly the dioxin can be broken down by sunlight, so if it was right on the soil surface it would be broken down by the sun into harmless particles. So thankfully they found in the areas sprayed by airplane there were not high rates of dioxin. It's basically the same level you would find in anywhere. I mean you find dioxin basically everywhere because we're an industrialized society, right, you know when you're burning things you create dioxin. But so they did not find it above the normal back, what they call normal background level. But what they found was on the former military bases, the bases where the barrels were stored, where the herbicides were moved from the barrels into the airplanes or where they were repeatedly sprayed around the perimeter of the base. They did find high levels of dioxin there. In fact, some of the highest levels found anywhere in the world are in Vietnam, because when you have 20 million gallons and they're stored in 55 gallon drums, that's a lot of spillage that happens and it's settled down in the soil. And so they went down to three meters and they could still spine dioxin at three meters down. And so they found that really in Vietnam there are three major sites of dioxin contamination to date well, at the time and that was the Da Nang Air Base, the Ben Hoa Air Base and the Phu Ca Air Base, where planes were loaded and millions of barrels of these herbicides were stored and that's what are still contained. Well, da Nang is now cleaned up, but there's still contamination today in the process of being cleaned up from 50, well, 60 plus years ago.

Hetal Baman: 31:07

How does one clean that up?

Susan Hammond: 31:10

It's a very expensive, time consuming process, and if it was heavily contaminated by that I mean you might have under a thousand parts per trillion of dioxin. And that's a hard concept to understand. What a part per trillion is? Basically, one part per trillion is a drop of water in an Olympic sized swimming pool. Oh, my gosh, yeah, I know, isn't that hard to sort of wrap your head around. And so and we're talking a thousand, so that's a thousand drops in a swimming pool causes significant impacts that you cannot live on that you have to move the population off. So we're talking small, small, small particles that have a huge, huge, huge impact because of these cancers and potential burqs that they cause if you're exposed to them. And how you get exposed is by eating contaminated food, mainly animals that is grown on that land. Okay, yes, and that bio bio it doesn't, thankfully doesn't go in plants. Oh, it doesn't. Okay, no, it the only thing is, of all things, the zucchini family and water locus are the two things that, yes, but because it's fat soluble. The way that it accumulates is animals eat, you know, eat the soil, get contaminated in the soil that they're on, they eat particles of soil, then it just bio, accumulates up the food chain until you know you may eat a piece of fish, well, actually the fat of a fish, because fat is a popular source of nutrition. You know, particularly in Southeast Asia, you eat the fatty parts of the fish, then that they can be highly contaminated and then you ingest the fish or the ducks and then it goes into your body. And they were finding, you know, populations who were living around the air bases with thousands of parts per trillion of of dioxin in their blood because they had been living off the land, off the animals that were eating off of those contaminated soils. And thankfully it was contained. In Vietnam it's been found to be contained to these former air bases. So that is one thing where you can control exposure to dioxin is by not eating the food that's raised, meaning the, the ducks, the fish, the cows on this contaminated soil and so they could cordon off these areas. And then you have to go through this process of cleaning up by removing the contaminated soil and how the the US government is actually funding this right now. It's one of the things they're doing in their post war support for war legacies is helping Vietnam to clean up Da Nang, which is completed, and the Ben Hoa base, and they the process that they're using is to dig up the soils and they put them in a the plan at least, I mean what they did in denying was put it in basically a gigantic oven it's like two football fields long, you know, 50 meters high Oven that they just heated up the soil To the temperature where that chemical reaction that created dioxin then breaks it down and it dissipates, and then they they can get rid of the soil and bury it too, or in a smaller site where you don't have as high rates of dioxin, you can just cap it, put it in a concrete Shell, basically, and cover it with concrete to make sure that it doesn't get into, can't move through the ground water and settle into sediment. You just contain it. So that's some ways that they're also managing it.

Hetal Baman: 35:02

Wow, I just can't, like you said, I can't wrap my head around the one drop. You know the one drop.

Susan Hammond: 35:11

Oh my goodness when I heard that I said that can't be possible. And then I, you know, it's like course, you Google it and Google it to get confirmation. And yeah, that's basically the one way to visualize it. It's just Incredible and what that one drop can do is amazing, because it does. It causes, it mimics the processes in our body and so it interferes with those. It mimics hormones, so it interferes with the processes in our body that are supposed to be, you know, for you know our, you know reproduction or creating healthy cells or any of those processes All different. In fact. There's the best person if you want to, anyone wants to go into the real details of what dioxin can do is to Google a woman named Linda Burnbaum. She used to be the head of the National Institute of Environmental Health Sciences and she's since retired and is now At Duke University and she is the expert on dioxin and she has a video. In fact it's on our website, we sites. One is agent orange record, calm, and then another one is the war legacies org site, and on the agent orange record site is a video that Linda Just goes through the whole steps of. This is dioxin. This is what it does, this is how it can cause, how it's and it's yes, and how it, you know, impacts the Reproductive system, the, the circulatory system, the, every system in your body. And they found this by studying animals. Because that's how you, how you Understand that and and as she explains, you know, if you find you know one, one chemical that only impacts one animal and only picks one system of that animal, then you can't easily say, okay, this would, you'll see the same results in humans, yeah, but because every animal studied, every system in that animal studied, is impacted by dioxin. Then you can make that sort of leap to assumption of what it can do to humans. And there are. The only way you can sort of look at these studies, you know, look at what they do, you know, look at what dioxin does in the human population, is looking at epidemiological studies. And that has been done by looking at veterans, by looking at Populations that were exposed, like chemical workers, areas where there were chemical accidents, like in Cervaiso, italy, where you can see, you know over time, what the health impacts have been. And this is how, really, the VA has developed this list of the 19 cancers and diseases that they now will compensate veterans if they're, if they come down with One of those conditions because of their exposure to Agent Orange.

Hetal Baman: 37:53

And just to be clear, though, like to have effects, to actually see the effects of Agent Orange. You actually didn't have to be there during that time, right? You can be a grandchild of one of these, yeah.

Susan Hammond: 38:11

Yeah, it, particularly when it comes to the reproductive impacts. And that's where there's still a lot of scientific debate is like how does dioxin cause multi-generational impacts? And what is now being looked at is in the study of epigenetics, which is it's not like changes in your DNA, but it's changes in the epigenetic layer of the DNA that kind of tells the genes what to do, when to turn on, when to turn off, when to create this process, and so it's that level that they they believe dioxin is has having impacts when, when you're supposed to, this part of development is supposed to happen. You know, in the fetus, the dioxin that changed the epigenetics of the grandmother, so it's not spelt in. You know the impact was on the grandmother exposed and it created some epigenetic change and actually probably the grandfather changes that. And then, or for instance, the mother, who was, you know, a young child, you know a fetus in the womb at the time. You know there's it's it's it's complicated in that it's there's obviously different pathways between a female and a male exposure to dioxin and how it would would cause impacts on the child or the grandchild. But anyway, what happens is the changes at that epigenetic layer and that's transmitted down to the next generation and you may not see the impact on that first generation, you may not see it till the second generation. And that's what they're starting. Starting through these epigenetic studies to see is that the impacts can go down through many, many generations. So you can get. If you're exposed directly yourself to dioxin, then you're likely you could get the cancers, you could get the Parkinson's, you could get these other diseases or you could have a child born with spina bifida, for instance, or some of the other birth effects, but you may not see those impacts until they're your grandchild or your great grandchild even. And that's what they're now seeing in the population in in Vietnam, where they compare areas of the country that were sprayed versus not sprayed so population sprayed versus population not sprayed, and they see higher rates of birth effects and disabilities in the populations where the herbicides were sprayed, then in populations that were not sprayed and particularly birth defects that have neural tube defects.

Hetal Baman: 40:44

I know I saw some photos, like on the article that you sent me, where, like some of the children's legs are just like permanently contracted and like can't extend, and I was reading that some babies were born without eyes. Like wow.

Susan Hammond: 41:04

Yeah, yeah, and you see that type of birth effect in the animal studies and now we're seeing them generations later in human populations. But it's hard, like with anything, it's hard to say that any one individual has a birth effect because of their grandmother's exposure to Agent Orange. But overall, when you look at larger populations and again when you look at animal studies, you clearly see that there is higher rates of these birth defects among populations that were sprayed Right.

Hetal Baman: 41:38

So, in terms of the US's involvement in Vietnam to kind of help reconciliate and clean up dioxin, is there anything else, like what are the other things that the US is doing to kind of facilitate the relationship between the US and Vietnam?

Susan Hammond: 41:58

Yeah, the war legacies issue is the sort of the main drivers of strengthening the relations between Vietnam and the US and, to some extent, vietnam and Laos, in that, first of all, with regard to the unexploded ordinance side of the equation, they are funding the removal of unexploded ordinance through organizations that do that work. They're funding mind risk education to help children understand not to touch such these various items that they find in the soil, and they are funding some support to people who have suffered from accidents due to unexploded ordinance. On the Agent Orange side of things, since 2007, the US has funded the cleanup of dioxin at the Denang Air Base and now the Benoit Air Base, and that's been over $300 million allocated by the US government since 2007 for the cleanup process, and also part of that is to educate the population who live around these air bases not to eat, you know, animals that could be contaminated with dioxin. On the human health side, the impact on people with disabilities that are assumed to be associated to exposure to Agent Orange. In fact, the US doesn't agree necessarily that all the disabilities in Vietnam are caused by Agent Orange, and again, their portfolio is to just provide services to people with disabilities regardless of the cause. But through advocacy that I have done and others I work with, we have been able to get the funding focused on those areas that were heavily sprayed by Agent Orange, and so the target is eight provinces that were sprayed with Agent Orange and the other herbicides during the war, and targeting people with disabilities that are quite severe that could be associated with Agent Orange, and so primarily what that looks like is rehabilitation services. So they have been training speech pathologists, physical therapists, occupational therapists in Vietnam. They go in and help train parents on how to better care for their child, particularly those with a severe disability that are unfortunately unable to go to school, who are pretty much full-time bedbound. So there's programs that the US is supporting, mainly through HI, which used to be Handicap International but it's now called Humanity and Inclusion, so they go in and they provide training for the Vietnamese. There are also some programs helping just the Vietnamese develop their policy on disabilities and their law on disabilities so that buses are accessible, buildings are accessible, children with disabilities go to, actually do go to school. And when I first started this work in the 90s, if you were at a child with a disability you were not going to school, even if it was relatively minor. In fact, one girl that we've been supporting for God since she was pre-K, we had to fight to let the pre-K school accept her and she was born without arms, arms that ended at her elbow, and her two legs or one is severely deformed so she couldn't walk. She scoots around on a little scooter, but we had to force the school to accept her and then, when she went to preschool, we had to force the elementary school to accept her, even though it was the law. So that was back in the early 2000s. Now the Vietnamese are really making efforts to make sure that children with disabilities do access school. In fact, this young girl is now in the ninth grade and still wants to be a doctor. She's quite a firecracker, she's really amazing and very smart. And when somebody asked her, well, how can you be a doctor if you have no arms? And she'd say well, I have a nurse for that, she can help me. Yeah, like okay.

Hetal Baman: 46:10

My gosh. She sounds like a fun one.

Susan Hammond: 46:14

She is a fun one, she's something else. But so the US is funding projects like that right now, and it's about since 2007,. They've provided over $400 million for these programs. But what we advocate for is, yes, the medical side of things is very important to help people physically, to help them get medical care, but not, sadly, not all people with disabilities at this point, rehabilitation it's too little, too late for so many of them. So we advocate that they help these families with their nutrition and income generation, so that they can care for their children in a house that the roof doesn't leak, that the children who are not disabled in their family are able to go to school. So we provide scholarships for them as well, so that the whole family can provide the best care possible for their loved one who has quite severe disability. That is sadly not. They need 24 hour care to meet their needs, and so we're encouraging the US to try to do a little bit more of that type of support as well. Not, I mean, it's great that they're helping children with disabilities go to school and get a job, but don't lose out. Don't forget those with the much more severe cases that, sadly, very little can be done, but they're still heavily impacting their families.

Hetal Baman: 47:43

And what about the US veterans that have been affected as well?

Susan Hammond: 47:48

Yeah, I mean for them. Over time, through their basically fighting the VA system, they've been able to get more and more of these conditions that they're suffering from recognized by the VA. And there's now, as I said, these 19, what are called presumptive conditions. That again has been shown by scientific studies to be linked to either Agent Orange or Dioxin or one of the other chemicals used. But they still have, if they're not on one of those that don't have the condition, one of those 19 conditions but they feel that their cancer that's not on the list is related to their time in Vietnam. They still have to fight for recognition from the VA for that, and children of Vietnam veterans receive absolutely no support from the US government. The only condition that the VA recognizes as being associated to the father's exposure to Agent Orange during the war is spinal bifida. If you were the child of a female veteran, of which there's only like 8,000 females who served in Vietnam, there's a much longer list of birth defects that the VA will provide compensation for. But they say it's for service in Vietnam for exposure to Agent Orange. But so if you're a child of a male veteran with another like a missing limb, like this young girl that I work with in Vietnam. You get absolutely no support from the US government for that because they don't. The VA doesn't recognize that Dioxin can have multi-generational impacts through the male's exposure.

Hetal Baman: 49:31

But they say that well, they would give support through the woman's exposure. Gotcha, I see Okay.

Susan Hammond: 49:41

But for their time in Vietnam, not specifically for Agent Orange. So that makes you think so okay, what was it in the environment for the females that it's not for the males? You know it's. I mean of course there's. You know different processes of which exposure can harm a fetus depending, but still you think you know what may actually just makes absolutely no sense. It's very for me, you know it makes no sense that, yes, you can, but only you know. Only only through the male is it spinal biphydom.

Hetal Baman: 50:14

So oh, interesting. So we're going to wrap it up, but I do have some closing questions. So the US manufacturers, within the US, are still creating this chemical.

Susan Hammond: 50:34

They're creating 2,4D. 2,4d which is, yeah, which was the half of Agent Orange, the 2,4,5T was. The US military stopped using it in 1971, I think it was 70 or 71. When they discovered that dioxin was a contaminant, chemical companies finally sort of fessed up to oh yeah, there's dioxin in this. And then they found out that it was causing who caused these serious health impacts. They stopped using Agent Orange before the war ended, but it wasn't until 19, I want to say 1979 or even later that they stopped allowing the 2,4,5T to be used in the United States. So it was still used after the war in the United States for about a decade. Then it was banned completely by the US so you could no longer produce 2,4,5T or use it in agriculture or forest or wherever you would use it. But 2,4D is still produced and still used today in agriculture and still used in people's backyards, you know, like dandelions. That's like the thing that you said right roundup, so it's still that's, and then that 2,4D is also shown in scientific studies to have some health impacts. But I mean it is also shown to cause health problems, but not it's not as much of a contaminant as, or toxic as, dioxin itself. Dioxin was not produced at high rates when they created 2,4D herbicide, only when they created the 2,4,5T herbicide, because chemicals involved in the combination of the herbicide and the dioxin Are there some things that we need to stay clear of, like don't buy roundup. Don't buy roundup. I mean I have. I live in Vermont, I have about three acres and a lots of it has poison ivy everywhere and I refuse, refuse to use roundup. In fact I pull it and I give myself poison ivy every spring because I'm like a fool pulling it by hand.

Hetal Baman: 52:46

You need to like dress up at like you know, put a bunny suit on and then pull everything out.

Susan Hammond: 52:51

It still sneaks in. It still sneaks in. So, yeah, do not use. Do not use pesticides in general. Stay away from the persistent organic pollutants. I mean we're fine. I mean, my high school right now is being closed, part of it because of PFAS, you know another contaminant that was, you know, widely used. It was in all types of construction materials in the 70s. Here we are 50 years later. My school was built 56 years ago and they have to close a majority of the school down because of the chemicals that were used at the time. So be really careful. I mean, that's my advice. Chemicals are everywhere. It's hard to stay away from them all, but do your research and find out what is what's ingredient list. Look at the ingredient list and you know, I know it's hard to eat organic, but as much as you can Do, you know that I just watched a Netflix documentary.

Hetal Baman: 53:55

It was called Poisoned and it talks about all these, like you know, the farms that the romaine lettuce is grown in and the different meats and all of that and where salmonella comes from. It makes me want to go vegetarian, but then at the same time, like lettuce, also produce.

Susan Hammond: 54:15

It's like what do I?

Hetal Baman: 54:16

do. Oh, my god, I'm like what do I eat?

Susan Hammond: 54:21

Yeah, it's hard, it's really hard. But of course the good thing is, a lot of these chemicals are, you know, research them because a lot of them they're not water soluble. So if you clearly wash your vegetables right, my daily will be getting rid of a lot of those contaminants. But I mean it's you can get sort of really deep into like worrying about everything which we are so surrounded by chemicals, that is it's hard to avoid.

Hetal Baman: 54:49

Avoid anything that's obvious, avoid anything that's obvious.

Susan Hammond: 54:52

Avoid anything that's obvious. Yes, exactly, that's really good yeah.

Hetal Baman: 54:55

Susan, this was so good and so informative. I do want to ask you one last question how can we support your work with War Legacy?

Susan Hammond: 55:05

Yeah, well, I mean what we do. We provide direct support to people with disabilities and their families in Vietnam and Laos, and so what that looks like really depends on their needs and some particularly in Laos it's helping people get access to medical care Because, unlike in Vietnam, where there's a well-developed medical care system, a child born with a disability a birth defect, I should say usually gets help pretty much right away. If left lip or foot or some type of condition that can be medically corrected through surgery, they get that surgery. In Laos that does not happen. They do not have access to that type of simple medical care. So we provide a lot of support to families like that. So on our website, if you want to provide some medical support to a child in Laos or Vietnam, you can donate and that money will get 100% to that family who has that need. In Vietnam we provide, we focus mainly with those children who have severe, severe disabilities, whose families are very poor, and we do income generation programs with them or provide that scholarship for their sibling who can go to school, who will be the child who will be caring for their disabled family member when their parents die sadly. So we provide some economic support to them? It could be helping them purchase a cow that they can breed, or fixing their roof or starting up a small business. Is that that type of support? If you're in the medical professional world and have specific knowledge about some of these conditions that we come across right now, particularly things like heart defects or severe birth defects that impact multiple parts of the human, something not as simple like the Vietnamese, for instance, can handle cleft lips and cleft palates that's not the problem but more complex conditions, if you're willing to go on a medical mission and encourage your institution to get involved in some of these medical missions, that would be great. So there's many things that, and just raising awareness about the long-term impacts of war, and particularly when I think of for Agent Orange. Hopefully that will never be repeated, but we're repeating right now. Cluster munitions in Ukraine. The US is funding providing these same weapons, very similar weapons, right now. So if you don't think that that is something that should be done, speak up to prevent another generation of people to stumble across these weapons and sadly be killed like those two kids who were just killed two weeks ago in Laos, 50 years after that weapon was dropped.

Hetal Baman: 58:10

Thank you so much for your time, susan. All of the information and resources will be provided on the show notes, so make sure you go check out the website and reach out to Susan too, if you have any other questions. Thank, you.

Susan Hammond: 58:25

This is wonderful.

Hetal Baman: 59:00

I'll see you in the next one.