Diane Fox begins her book, Living with Agent Orange, with the story of Mrs. Hà and her husband, Mr. Binh, who was on reconnaissance in Tây Ninh, in 1972, where he lived in tunnels and used mud to camouflage his body. Mr. Binh recounted that “we thought whoever died, died at once, and whoever lived, lived whole,” unaware that he had been exposed to a chemical agent that lingered in his body, triggered his multiple illnesses, and caused severe birth defects in his children. This is a book that focuses on the narratives of the families, survivors of the American War in Viet Nam whose exposure to the dioxin (2,3,7,8-tetracholorodibenzo-p-dioxin or TCDD dioxin) contaminated herbicide, Agent Orange, created illness and hardship that endured decades after the war’s end. Using interviews collected sometime between 1999 and perhaps 2001 (the dates are not clear), Fox breaks them into three sections of north, central and southern Viet Nam, marking geographic zones and to some extent tensions within her project. All of the families had at least one family member exposed to Agent Orange, often times directly as the mist fell from the sky and other times drinking water downstream or living in an environment contaminated by the chemical.
Though her visits with each family were singular and brief, the stories that survivors told share common themes of exposure through years of living in forests or combat zones such as Khe Sanh and the Rừng Sắt Forest. In the north, Fox visited twelve families in Thai Binh and Hà Nam provinces. She was accompanied by Vietnamese Red Cross officials from the Agent Orange Victims Fund in Hà Nội, who located the families and facilitated the interviews. Although each family recounted their experiences with the war and where they were exposed to Agent Orange, their primary concerns were with their children who have illnesses that do not respond to western or Vietnamese medical therapies and whose physical and intellectual development rendered them permanently disabled. With a few notable exceptions, most families are anonymized. Family visits usually began with the father recounting where he served during the war and the duration of his time. Sometimes the mother also conveyed that she served in some capacity. Men and women disclosed that they suffered through multiple miscarriages and stillbirths, and when children did survive some had “enlarged heads, dull eyes, and ‘slow’ minds” and other children had “limbs twisted from birth, unusable.” In most instances, only one parent was either alive or able to work; as one mother declared, “I just run every which way digging for crabs and catching snails and transplanting the commune’s fields in order to feed my children.” The one child who was able to speak hoped for a cure for his illness so he “could walk and help my family.” The parents expressed longing that “the American side has to take responsibility to compensate these children” and one woman was “enraged with those people who sowed our futures with this misfortune…those who gave us such a perilous future—we are very angry.”
Parts two and three, in Thừa Thiê Huể and Đổng Nai Provinces (central and southern Viet Nam) form the second half of the book. These sections of the book are shorter and provide fewer details in the interviews and the entourage swelled to include more officials. The first family interviewed near Huể has a child that officials believe was among a third generation affected by Agent Orange. The second family was so poor that a female staffer from Hà Nội found the clean but simple materials in the house too distressing to spend time in, she “could barely contain her distress about the house… [she asked] ‘Why were some houses of people who weren’t so poor rebuilt [after the floods] but hers wasn’t?’” The eight household visits in the central province were carried out in four days and the presence of Red Cross and government staff personnel complicated the interviews as the female staffer interfered frequently in the interviews, asking one man who cared for his disabled sister why he wasn’t married, suggesting that a family struggling to pay for medicine needed to buy health insurance, and undermining one woman’s request for better housing by asserting she needed pigs instead. These intrusions escalate as Fox journeys further south, demonstrating the limits to officials’ patience and their ability to listen to what impoverished people with severe disabilities in small hamlets and communities needed. The families of Agent Orange victims knew there was nothing that could be done to cure their kin, so their requests were more focused on ways to improve the families’ circumstances and to anticipate the problems of continued care for an adult child once the elderly parents have died.
Đổng Nai Province forms part three, where the interviews are the most truncated, perhaps because the stories are so similar to what was told earlier or because the tensions within the group reached a nadir. Families who lived in Đổng Nai had “no place to go,” unlike areas further north, where “strategic hamlets” were created to prevent exposure or only soldiers were exposed. Fox admits to some missed opportunities here, whether because she did not understand the cues or because officials interfered, these interviews offer less in personal narratives about the families. What does stand out in this section are the veterinary consequences of Agent Orange, which caused livestock to miscarry or have deformed young and chickens to lay eggs that developed into chicks with tumors. Cancer was common in people, including cancers of the “liver, the digestive tract, and the lungs.” In the book’s conclusion, Fox provides the most detailed story, which was the story of Mrs. Hồng, who wanted her story to be “put into the pages of history…of our country, our generation, of the world, to understand that the country of. Viet Nam has people…all of them living a life like this…Let them see everything.” Fully embodied as a woman with demands, Mrs. Hồng is also featured in one of the book’s photographs, the documentary Last Ghost of War, and she was among the delegation by the Viet Nam Association for Victims of Agent Orange/Dioxin (VAVA) who appeared at the “New York Court of Appeals hearing on a class action suit against thirty-two U.S. chemical companies.”
Diane Fox presents important household-level knowledge to build an understanding of the high costs of Agent Orange upon the Vietnamese people. The fact that it took over twenty-years for these interviews to find an audience makes this type of work frustrating. By now, many of the subjects have died and the question of what happened to their children plagues the reader. What has been done to help the families, outside of small gifts and remonstrations to have nội lực “internal strength,” everything seems inadequate. The afterward by Susan Hammond gives useful information about efforts to clean up the Agent Orange/dioxin contaminated areas of Viet Nam, which were finally started in 2009. As of March 2025, the cuts to USAID mean that the clean-up efforts have been halted. Although the efforts to clean up the dioxin in Viet Nam are laudable and over-due after fifty years, the funding-cuts endanger the people and land. Unlike poisons (such as inorganic arsenic or cyanide), dioxin is an endocrine disruptor, which means there is no “safe” or “minimal” dose for those exposed to it.
Chau Johnsen Kelly is an historian who works at the intersections of science, medicine, environmental and postcolonial studies. She was born in Viet Nam and grew up in California. She has published on a variety of topics, including Muslim Awqaf (charitable endowments), urban planning and public health, water regulation and commodification, and on colonial nutrition programs. She is an associate professor of history at the University of North Florida in Jacksonville, Florida.
