Phan That, left, was exposed to Agent Orange during the war and has passed dioxin poisoning to his son, Pham Van Linh and daughter Pham Thi Linh. Adding to Mr. That’s troubles, the family house is built on low-lying land and is regularly flooded by storms. AP and AEPD raised $2,000 for this family.

The depth, persistence and virulence of dioxin-related sickness warn against any suggestion that the crisis is somehow lessening or “getting better” as veterans pass away.

In fact, statistics suggest the exact reverse. The Quang Binh government puts the number of current victims at around 6,000 – higher than it was in 2013. Dioxin poisoning is even being passed to great grandchildren of veterans, who are classified as F3 by the government. This is hardly surprising because dioxin has a half-life of up to twenty years in the human body, according to the World Health Organization. It is not clear at what point dioxin ceases to become a health threat, but Vietnam will no doubt continue to serve as a grotesque laboratory.

From an ethical perspective, it seems particularly wrong that children who were not even alive when the fighting ended have suffered more than their parents who fought in the war and were aware that there were risks. This raises interesting questions for international law. Do the children qualify as noncombatants under international law, even though the war itself has long since ended? Can legal protection be handed down to future generations?

Agent Orange presents other ethical dilemmas. When Senator Patrick Leahy and his aide Tim Reiser sought US government funding for Agent Orange from the US Congress, they took full advantage of Agent Orange’s fearsome reputation and the remorse felt by many Americans. The money was earmarked for use in eight provinces that had been heavily sprayed. The link to Agent Orange was explicit and useful.

But the officials at USAID who were implementing the policy were determined not to discriminate in favor of dioxin victims and against other forms of disability. As a result, the funds were used to provide support and care for all disabilities in the provinces, regardless of cause (known as “cause blind”).

USAID took a very different approach in 2004 when it launched a program on obstetric fistula, which is only one of several life-threatening lower-tract infections (including uterine prolapse) that plague women in Africa and Asia. Our own organization has had no problem advocating exclusively for Agent Orange (and uterine prolapse for that matter), because we believe that effective advocacy is almost always driven by personal experience and will thus gravitate towards single issues.

But USAID’s position made sense, as well as being principled, because it invested in health services and institutional support that would produce system-wide benefits – a rising tide that would lift all boats. This provides the sort of institutional support that Mai Thi Loi’s son Kien will need after his mother passes. The main problem, from AEPD’s perspective, was that USAID support was limited to sprayed provinces and did not extend to Quang Binh province.

Photos have also raised ethical questions, as is usually the case in humanitarian disasters,

The image of Mai Thi Loi’s son Kien chained to the wall, naked and barking, is certainly powerful but also potentially demeaning to Kien himself. We discussed this at length with Mai Thi Loi and our guide from the AEPD, Mr Hoc, who had himself been exposed to Agent Orange during the war. They concluded that photos of Kien should be published in the interests of exposing the horror of dioxin, but taken at a distance.

Even this proved too much for our Peace Fellow Angie, who visited Mrs Loi’s family last summer and was so upset that she had to put her camera aside.

One thing is certain – our photos of Kien and the other families do not allow the viewer to look away.

Read the story of Phan That’s family

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