The war that keeps being born: Agent Orange and its multigeneration effects

Some of us are lucky enough to catch a shooting star when we look up at the sky — a faraway light to make a wish upon. And some of us are unlucky enough to watch the decisions of old men in air-conditioned rooms send an airplane carrying a substance that would fall upon us and curse our entire bloodline to become a consequence of war.Vietnam, in the early 1960s, was a country acting like a rope in a tug of war.Caught between a communist North and an American-backed South, the land saw a harrowing ideological war strip its people of dignity.The jungle didn't take sides, but it picked one anyway — by existing.Dense, tangled and older than either ideology fighting over it, Vietnam's forests hid people, supply lines and an entire war from the eyes in the sky.The American solution to this problem was to make those eyes drop poison that would sting for years to come.They used Agent Orange.America has a habit of giving its worst weapons unsettling little names — Fat Man and Little Boy, the two nuclear bombs that ended one war and began a different kind of dying, nicknamed as though they were somebody's uncles.Agent Orange's own delivery system, though, had a name so comically mundane it barely sounds like the name of a military operation: Operation Ranch Hand.What is Agent Orange?To know that a chemical still affecting millions of people today got its name from nothing more than an orange stripe painted on a container is a harsh reminder of how ordinary the beginnings of catastrophe can look.Agent Orange was a herbicide designed to strip a landscape bare. Between 1961 and 1971, Operation Ranch Hand sprayed roughly 19 million gallons of Agent Orange and related herbicides across close to 10% of South Vietnam, as well as parts of Laos and Cambodia. The aim was to destroy the jungle cover used by the Viet Cong and eliminate crops that helped feed them.The herbicide itself was not the entire culprit. Some versions of its constituent chemicals are still used in agriculture. The danger came from what travelled with it: 2,3,7,8-tetrachlorodibenzo-p-dioxin, or TCDD, a highly toxic contaminant produced during the manufacturing process.TCDD's dangers were not unknown. It had been linked to chloracne in German industrial workers as early as the late 19th century, to an outbreak of illness in American cattle once called "X-disease", to contaminated animal feed that killed chicken flocks, and to severe injuries among workers following a 1949 factory explosion in West Virginia.By the time Ranch Hand began in Vietnam, dioxin's toxicity was not a mystery waiting to be discovered. Its dangers were already part of the scientific record.Dioxin activates the aryl hydrocarbon receptor, a molecular pathway found across many species, disrupting biological processes involved in development, reproduction and immune function.In Vietnam, it settled into soil, moved into the fat of animals and fish living in contaminated environments, and from there entered the people who ate them.Study on potential multi-generational effectsThe last Ranch Hand mission flew in 1971. For the people living on land it had already touched, however, the war did not end when the spraying stopped.And for some families, the children who never experienced the war themselves became victims of it.In 2012, a team of biologists at Washington State University led by Michael Skinner researched whether dioxin exposure could cause disease in the descendants of exposed animals.They exposed pregnant rats to a tiny dose of TCDD — just 0.1% of the dose that would kill half of them — during the period when their fetuses were developing their reproductive organs. They then bred those offspring, and their offspring, without exposing subsequent generations to the chemical.In the first generation, the pups were directly exposed in the womb. The researchers found defects and diseases including prostate disease, ovarian abnormalities and altered timing of puberty. That was not entirely unexpected, given that dioxin is a known endocrine disruptor.But in the third generation — the great-grandchildren, whose only connection to the chemical was through the germline of their ancestors — the researchers reported kidney disease, polycystic ovaries and altered puberty in females.In the sperm of third-generation male offspring, they identified dozens of regions of DNA with altered epigenetic marks.These were not mutations. They were epigenetic changes, molecular alterations that can influence how genes are expressed and, under some circumstances, may be passed through the germline.Skinner's work raised a disturbing possibility: that dioxin exposure could have biological consequences extending beyond the people directly exposed to it.But this is where the science needs an important caveat.The evidence for transgenerational effects of Agent Orange in humans remains contested and incomplete. Animal studies have raised concerns about possible epigenetic inheritance, but translating those findings into demonstrated effects in human grandchildren and great-grandchildren is far more difficult.The US Department of Veterans Affairs (VA) acknowledges some consequences of exposure. It provides benefits to children of Vietnam veterans with spina bifida and provides benefits for certain birth defects among children of female Vietnam veterans. But it does not recognise a demonstrated third-generation, transgenerational health effect from herbicide exposure.The National Academies of Sciences, Engineering, and Medicine has likewise concluded that evidence linking tactical herbicide exposure to birth defects in descendants remains inadequate or insufficient.Paul Cox, a Vietnam veteran who has spent years trying to understand the effects of Agent Orange, says the science remains unsettled.“The science is, at best, unsettled, but more likely limited by the current state of tech, failure to put adequate resources to the question, a muddled data set, and/or disinterest by the western corporate/scientific community,” he says.He also points to what he has observed personally.“I know a few Vietnamese who are thought to have been born with AO related disabilities or deformities who have had (so far) healthy children, and I know of many other former fighters, male and female, who have had seriously disabled children. Some have had many disabled or still born children and others who had one or two seriously disabled children, then a healthy child.”But the American story of Agent Orange is largely a story of consequences: what happened to veterans, what diseases they developed and what benefits they deserve.The Vietnamese story is also a story of actions, one that begins with the actions of the Americans and continues with decades of neglect.The Vietnamese accountGenerations of Vietnamese who were not even alive during the war have lived with its consequences.A father describes his experience this way:“My son has many disabilities including Tourette's syndrome, mental retardation, mild Cerebral Palsy, hydrocephalus and he is profoundly deaf. He will never be able to live on his own.”War can steal autonomy from children before they even enter the world.Another account comes from a man born in 1975, just after the war ended. His parents served in Quang Tri in 1972, where the US military sprayed some of the heaviest concentrations of Agent Orange. He was born with multiple deformities, and it was not until the 2000s that he was informed that his condition was believed to be linked to dioxin exposure.In Da Nang, one of the three major dioxin hotspots in Vietnam, remediation efforts have significantly reduced contamination. Yet for decades, families in affected areas have reported children born with conditions including hydrocephalus, spina bifida, missing limbs and cognitive disabilities.Parents have had to care for children who may never grow up, never work and never marry. Children who never get to live normal lives because of the consequences of a war they never experienced.There are innumerable Vietnamese accounts. Yet, until relatively recently, they were rarely granted the same attention or institutional recognition as American ones.Cox, as a veteran, also acknowledges this gap.“The US Veterans Administration presumes that US veterans with any of a list of 20 diseases may have been exposed to AO, and provides them with compensation and medical care. It provides no consideration for Vietnamese Americans who fought for ‘our’ side, nor Vietnamese civilians or fighters in Vietnam.”The proposed accountabilityToday, two bills sit in the early stages of the US legislative process: H.R. 3051 and H.R. 3052, both introduced by Congresswoman Rashida Tlaib to address some of the gaps in assistance and recognition.H.R. 3051, the Victims of Agent Orange Act of 2025, would provide assistance to Vietnamese people affected by Agent Orange. It cites estimates that between 2.1 million and 4.8 million Vietnamese, Lao and Cambodian people were exposed.The bill also points to continuing contamination at dioxin hotspots, where elevated concentrations have persisted decades after spraying ended. It recognises concerns about the potential health effects on the children and grandchildren of exposed individuals and calls for further research into possible epigenetic and intergenerational effects.The legislation would provide health care, medical equipment, caregiver training, housing assistance, poverty-reduction programmes and environmental remediation in affected areas. It would also extend formal recognition and assistance to affected Vietnamese and Vietnamese Americans, groups that have historically received little direct assistance from the US government for Agent Orange-related harms.H.R. 3052, the Agent Orange Relief Act of 2025, seeks to expand benefits for children of male veterans, addressing an imbalance in the way certain birth defects are recognised among the descendants of veterans. It also calls for research into the intergenerational effects of Agent Orange and health assessments for Vietnamese Americans.Both bills remain in committee. Neither has advanced beyond committee referral or become law.Americans have been able to make "Vietnam flashbacks" a punchline in poorly made jokes. But what about those for whom this isn't a flashback at all?For them, Vietnam is not something that ended in 1975.It is something they are still living with.The men in air-conditioned rooms who ordered Operation Ranch Hand are mostly dead now.But their decision continues to live on: in the land, in the water and in the people.Catch the latest World News and Live updates. Download the TOI app.