COMMUNITY BASED
REHABILITATION APPROACH IN PHU
Vu Le Thao Chi
* I spent the final year of the Master program
to do library research and to process raw data in order to finish up the final
thesis. Here is the summary of my thesis.
1. Title: Quiet Victims of a Silent War:
2. Introduction:
Agent Orange-
Dioxin has been known as one of the worst legacies of the Vietnam War and has
been the focus of many medical researches inside and outside of
3. Scientific and its role in decision making by ordinary people:
While the
scientific evidences and warnings about the toxicity of Dioxin and Dioxin-like
chemicals are believed to be taken seriously by the ordinary people, the thesis
argues that scientific evidences alone are not the decisive factors to guide
the actions of these people including the already known Agent Orange- Dioxin
victims in their daily life. Table 1 graphically illustrates different groups of people have
different degrees of beliefs about the toxicity of Dioxin. Table 2. shows how
the beliefs may or may not be reflected in their actions such as avoidance of
risk-taking action. For example, the majority of the scientists and medical
specialists do believe that Dioxin is toxic. But the majority of ordinary may
not even know about Dioxin, even though they may have heard about it. So the
toxicity of Dioxin does not interfere with their life and the belief does not
occupy their minds. On the other hand, I would assume that the victims and their
families have the firmest belief about the toxicity. Also, even though the
graphs show that the dots do not move, some may move from the less firm belief
to the firmer or firmest positions depending on the conditions of their
encounter with Dioxin.
Table 1. Belief in the Toxicity of
Dioxin
Table 2. Action connected to Belief
But these different groups may not
act simply according to their beliefs of different degrees. As I have mentioned
repeatedly, the majority of the victims and their families in Kim Bang, Thanh
Khe and Phu Cat behave as if Dioxin contamination did not matter. For example, these families still choose to have more children even after the
first or even the second child was suspected of being affected by or identified
as having the ailment because of the Agent Orange-Dioxin contamination. (See
Tables 3 and 4 below.)
Table 3. Effect of Birth Defects
(The number of children after the first
handicapped child)
|
|
0 |
1 child |
2 or more |
NA |
Total |
|
Phu Cat |
11 |
14 |
19 |
4 |
48 |
|
Thanh Khe |
3 |
7 |
5 |
0 |
15 |
|
Kim
Bang |
4 |
4 |
19 |
1 |
28 |
|
Total |
18
families |
25 |
43 |
5 |
91 |
Table 4. Effect of
Birth Defects
(The number of children after the second
handicapped child)
|
|
0 |
1 child |
2 or
more |
NA |
Total |
|
Phu Cat |
5 |
4 |
1 |
0 |
10 |
|
Thanh Khe |
3 |
1 |
1 |
0 |
5 |
|
Kim
Bang |
2 |
7 |
8 |
0 |
17 |
|
Total |
10
families |
12 |
10 |
0 |
32 |
Source:
Calculated from my research data
Besides, they try to increase cash income by all means including using toxic chemicals in farming and trying to be fully integrated into the community by observing its customs and traditions. In other words, these victims are trying to lead a ‘quiet’ life in a way that they still choose to act like many other normal people or normal families. “Fate” is their means not only to explain their own situations but also to keep the seed of hopes in future.
4.
Fate
as the means to Face danger:
When the victims’ families use “fate,” it
means that they do not see things in a cause-effect framework. Rather, they
think life is given that way and things happen for some reasons already
predetermined beyond their control. Risk theorists argue that the term risk is
usually used antithetical to that of fate. They argue that “risk” assumes that
there are no aspects of human action that follow a preordained course (Deborah
Lupton, 1999, p.76). However, from the answer to the first question above, it
is obvious that they do understand the reasons for their situation which are
the exposure to Agent Orange during the war or at the contaminated areas. What
they cannot explain is that why it happens to them, but not to others. This is
where they rely on “fate,” adding that their ancestors must have done something
wrong in the past and now they are chosen as the ones who must pay for it.
Consequently, “fate” is the only means of explanation for their sufferings
especially when it is hard for them to accept it. But, with this explanation,
at least, they can contain the suffering to themselves.[1] It is the
means for them to keep their lives undisturbed and quiet.
But their reliance on “fate” does not mean that they give up. They believe in “fate” and believing in “fate” can become the motivation for them to have hopes in the future that what happened before may not happen to them again.
Table 5: Cost and Benefit Calculations by the
Victims’ Families
|
Actions |
Costs |
|
Benefits |
|
More children |
More handicapped children è Leave it to Fate |
＜ |
Normal child (hopefully a son) à more labor, more hope about future,
easier integration into the
community |
|
Use chemicals |
＜ |
Increased productivity à increased food supply, increased income |
|
|
Reliance on the contaminated areas for water, food and other resources |
＜ |
Sustainable life àEnough food for daily consumption, water for irrigation and others. |
Given all the pressures and
problems they have everyday, the victims and their families have to make a
calculation between costs and benefits for each action they take.
While the
risk of further contamination is still hiding from their eyes, they let Fate determine
what may happen to them. This does not mean they do not ignore the possibility
of having another handicapped child. But that possibility, to them, is a 50-50
chance. They do not want to take preventive actions when they are not sure
about the outcome. On the other hand, they want still to take another chance
when there is still possibility that that a bad scenario would not happen. In
addition, they have to think of other immediate problems that they think they
can solve with a more certainty or hope. For example, they have to look for
ways to increase cash income to purchase food and clothes given the penetration
of market economy even into their rural community. They have to invest hope
into another baby to change the face of their family and to bring more hope for
themselves. The benefits of these actions are much more visible. So meeting the
immediate needs, to them, consequently outweighs the costs which are still
vague and invisible in their thinking. They leave the costs for Fate to decide
5.
Conclusion:
Medical doctors may emphasize the fact that
the victims’ families have high chances of producing more handicapped children,
or suggest that there maybe future possibilities for improving the conditions
of handicapped children. But the medical doctors may be missing an important point
about life of the victims and their families. It is not just the Dioxin-related
problems that the victims and their families have to face. The Dioxin-related
problems are merely among many others in the midst of economic pressures and
cultural biases. Also, the victims and their families are not unique but among
many who face these and other problems: the danger of Dioxin and other toxic
chemicals contamination; the pressures of sustaining household economies; and
the pressures of making their life harmonious with the tradition, culture and
customs.
What make the victims and their
families unique are the additional burdens: taking care of the victims
everyday; suffering from all kinds of mental stresses and anxieties; and facing
the self-imposed demand for making sure that they live according to the customs
and tradition of the community.
There is one more important point I would like to emphasize. The Dioxin issue is no longer the problems around the Dioxin contamination caused by the wartime spraying of Agent Orange. The Dioxin contaminant has stayed on in the land or has silently moved from soil and water to human bodies, and from human bodies to human bodies often across generations. More victims of the War have emerged after the War. The increasing abuse of the chemicals in agriculture has only broadened and worsened the Dioxin issues. Maybe, the victims and their families cannot simply lead a quiet life, because their life can be a precious lesson to be shared by a much larger population.
REFERENCES:
- Allen, Robert, The Dioxin War- Truth and Lies about a
Perfect Poison, London- Ann Arbor, Mi: Pluto Press, 2004
- Boivin, Thomas, et al., “Agent Orange Dioxin Contamination in the
Environment and Human Population in the Vicinity of
- Buckingham, William A. Jr., Operation Ranch Hand- Herbicides
in Southeast Asia 1961-1971,
Office of Air Force History, United States Air Force. (I used the
following version, Air and Space Power Journal , July-August 1983.
- http://www.airpower.maxwell.af.mil/airchronicles/aureview/1983/jul-ug/buckingham.html
- Le Cao Dai, Agent Orange in the
- Lupton, Deborah, Risk,
- Schecter, Arnold, Le Cao Dai, Olaf Päpke, Joelle Prange, John D. Constable, Muneaki Matsuda, Vu Duc Thao, and Amanda L. Piskac, “Recent Dioxin Contamination from Agent Orange in Residents of a Southern Vietnam City,” Journal of Occupational and Environmental Medicine, vol. 43, no. 4, 2001, pp. 435-43
- Umegaki, Michio, Vu Le Thao Chi, Tran Duc Phan and Truong Quang Dat, “Agent Orange-Dioxin Problems in Vietnam: Human and Social Dimensions,” currently under review for publication.
- Zumwalt, Admiral Elmo II and Elmo Zumwalt III, “Agent Orange and the Anguish of an
American Family,” The
New York Times Magazine, August 24 1986.
- http://www.wellesley.edu/Polisci/wj/Vietnam/Readings/zumwalt.htm
- Zumwalt, Admiral Elmo.R. II, Report to Secretary of the
Department of Veterans Affairs on the Association between Adverse Health
Effects and Exposure to Agent Orange, (May 5 1990).
- http://www.gulfwarvets.com/ao.html