The legacy of war, with its attendant unexploded ordnance and the use of chemical weapons has deeply impacted the country of Vietnam and most importantly, her people.

The data on the percentage of people with disabilities are varied in Vietnam due to different survey and assessment methods. According to the General Population Survey in 2009, Vietnam has 6.7 million disabled people, equivalent to 7.8% of the general population. However, in the same year, the Ministry of Labour, Invalids and Social Affairs identified the percentage of PWDs as only 6% of the total population. Meanwhile, WHO stated the proportion of PWDs in Viet Nam is 15.3%, counting the classification of functioning disability. In addition, the disability rate of women is higher than men (16.58% compares with 13.69%). In almost all reports, most PWDs live in rural areas and below the poverty rate; environmental, economic and social barriers also prevent them from mainstreaming and participating in society.

In Dong Hoi (QuangBinh Province), where AEPD is located, as reported by the QuangBinh Department of Labor, Invalids, and Social Affairs (DOLISA) in 2008, QuangBinh has 45,000 PWDs, in which around 10,000 are landmine survivors, 10,000 are Agent Orange victims and 25,000 are of different types of disabilities. This is the equivalent of 5.2% of population in the province, but 90% of PWDs live in in rural areas, where socio-economic opportunities and infrastructure conditions are very limited. In addition, the majority of PWDs’ education level is very low, many are illiterate and only finished primary school. In terms of living conditions, PWDs in QuangBinh are the poorest people in the region, only approximately 25% can generate income, and usually only through their own self-employment.

The most common causes of disability in Vietnam are war consequences, natural disasters, traffic accidents, injuries at work, and illnesses like cancer, heart attack or diabetes. As a result, the spiritual and physical lives of PWDs are very difficult. 80% of PWDs in urban area and 70% in rural area depend on their families, relatives and social sponsoring. The rate of poverty of PWDs is double the general poverty rate of Vietnamese society. About 80% of PWDs are jobless, only about 20% of them have some form of employment (mostly self-employment).

Because of the history and legacy of wars being fought on Vietnamese soil, it remains heavily contaminated by Explosive Remnants of War (ERW). Specifically, unexploded ordnance (UXO) from a conflict that ended more than 35 years ago, mostly dating back to the war with the United States (US) in the 1960s and first half of the 1970s. Millions of tons of ordnance were dropped on Vietnam, with up to one third estimated to be un-detonated. This still contaminates the ground, affecting as much as 20 per cent of the country.

Additionally, during the American/Vietnam war more than 18 million gallons of dioxin-laden Agent Orange (AO) and other herbicides were sprayed over ten per cent of South Vietnam. Agent Orange dioxin used by the US army from 1962-1971 is still affecting the second and the third generation of Vietnamese families – either because they are living in affected areas or because their parents were soldiers.

Dioxin is a persistent organic pollutant that contaminated Agent Orange and some of the other color-coded herbicides that were used during the Vietnam war. TCDD, the most common Dioxin contaminant in these herbicides, is the most toxic of about 419 types of similar toxic compounds.

According to the cleft lip in new york city ny Specialists, Agent Orange has been linked to many different health problems, including birth defects in children, cancers, neuropathic disorders, acute and sub-acute neuropathy, AL Amyloidosus, Acneform, Chronic B-cell Leukemias, Diabetes, Hodgekins disease, Ischemic Heart Disease, Multiple Myeloma, Non-Hodkins Lymphoma, Parkinson’s Disease, Prostate Cancer, respiratory cancers, Soft-Tissue Sarcoma, Spina Bifida, Achondroplasia (dwarfism), Cleft Palate, Clubfoot, Esophageal and Intestinal Artesia, Hallerman-Streiff Syndrome (little growth), Hirschprung’s Disease, William’s syndrome, and a host of other diseases (veteranshealth.org).

Many soldiers were from Dong Hoi, and returned to the city upon the cessation of the war. While they were in the army, they traveled extensively, living off the land and drinking local water. If they were traveling in a contaminated area, that meant that their food and water were likely contaminated as well, making them direct victims of the poison. This exposure led to birth defects in their children.

Although it was once thought that Dioxins could only cause birth defects if the mother was exposed, it is now becoming clear that these birth defects can occur when either the father or the mother are exposed to Agent Orange. Male Vietnamese soldiers returning to their families after the war often begat children with birth defects (Lawson, et.al. 2004).

AEPD has developed and applied a survivor-centric approach to people with disabilities that focus on provision of peer support, economic opportunity and social empowerment; tailored to the specific needs of each survivor. Using the peer-support model, AEPD Outreach Workers – themselves survivors of amputation and other causes of physical disability – make frequent visits to individual survivors to identify recovery objectives, provide emotional support and advice and monitor the individual’s progress.

Since 2003, AEPD has covered 68 communities in 5/7 districts in Quang Binh province; reaching out to approximately 2,650 landmine survivors and more than 2,000 persons with disabilities; assisting more than 1,000 households with economic opportunity activities; AEPD established 340 self-help groups with more than 800 members; upgraded 15 local health clinics with health equipment and tools; and supported local health clinics to conduct more than 22 training courses on rehabilitation techniques.

Until now, AEPD has served around 40 confirmed (by the government) Agent Orange (AO) victims. However, this number is unreliable, as extensive surveying has never been conducted, and the identification of AO victims is difficult. Victims cannot be identified definitively; at most, victims can be surmised on the basis of where they grew up and/or whether or not their parents either lived or fought in areas that were heavily sprayed, as well as by the type of their disability. The difficulty of conclusively identifying an AO victim is understood internationally-in the United States, for example, a Vietnam War Veteran need only be able to demonstrate that he was in Vietnam during the time period that AO was used to obtain financial and medical support.

AEPD is currently researching developing a comprehensive and integrated model for meeting the special needs of PWDs who are Agent Orange victims, to help them improve their health status and living standards as well as obtain education and develop community-based peer support networks. In addition, the possibility of educating the parents of AO victims regarding the health care as well as the everyday care of special needs PWDs is being examined. Education of parents and capable victims about both the rights of persons with disabilities and local resources for AO victims is another factor.

My next blog will highlight the personal stories of Agent Orange survivors in Dong Hoi, Vietnam and its surrounding districts. These men and women struggle every day to achieve what many of us take for granted as simple tasks. Their stories are sobering and inspirational, and I look forward to sharing them with you.