“When I was an intern, I delivered for the first time in my life, a severely deformed baby—it had no brain and limbs. It was horrible for me. I was nauseous, vomiting, and shaking. And how was the scared young mother? She was in shock when she saw her baby,” Dr Phuong said in her interview with the Ramon Magsaysay Awards Foundation, narrating her experience in 1968. “Since then, every day or two, I have witnessed such birth defects and mothers’ sufferings. But, for many years, I didn’t know what caused these tragic events.” 

What she didn’t know then was that, between 1962 and 1970, over 45 million litres of Agent Orange would be sprayed across central and southern Vietnam. This chemical, formulated in concentrations up to 20 times stronger than what was used for regular agriculture, not only killed every plant it touched within two days, but the dioxin it contained would leach into water sources, further contaminating fish and livestock. The Vietnam Red Cross estimated that 4.8 million people were exposed to dioxin, with at least three million of them affected—including around 150,000 children in the second, third, and even fourth generations.

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In the years following the Vietnam War, Vietnamese doctors began observing an unusually high number of birth defects, cancers, and other health issues in areas that had been heavily sprayed with Agent Orange. Although initially anecdotal, these observations laid the groundwork for formal research into the health effects of dioxin exposure. Dr Phuong and other Vietnamese doctors played key roles in documenting these cases.

“There are five types of birth defects that are very common in Vietnam but rare, or even absent, in other countries. These include deformities of the neural tube, abnormalities in the head and brain development, conjoined twins, or siamese twins, deformities of the sensory organs, cleft lip and cleft palate, and limb deformities such as missing arms or legs,” Dr Phuong says in an interview. “We see many of these birth defects in Vietnam, but they are rarely found in other countries, even in the Philippines or other Southeast Asian nations. This suggests that there is something different causing these defects in Vietnam.” 

Dr Phuong, whose work eventually led her to become the director of Tu Du Obstetric Hospital, conducted extensive research, including retrospective studies, surveys, and case-control studies. She measured dioxin levels in the fat tissue of individuals from areas heavily sprayed with Agent Orange, comparing them to those in regions that were not exposed. “Our findings show that the rate of birth defects in the exposed population was at least four times higher than in those who were not exposed,” she explains. “These studies have been published in countries such as the UK, the USA, Korea, and France.”

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Beyond her research, Dr Phuong has been a prominent advocate for Agent Orange victims. For her, the battle has not only been fought in laboratories, but also on the global stage. At home, she joined the Vietnam Association of Victims of Agent Orange/Dioxin (VAVA), a group that seeks accountability for the damage done by Agent Orange.

“Since the beginning of the VAVA, I have been a member and currently serve as the vice president of the association. I am also a member of the dialogue group with the United States, which consists of five members from both the United States and Vietnam. My role is to focus on the victims of Agent Orange,” she says.

Abroad, she took the fight to the American Public Health Association, and has supported legal action against chemical companies. “We work together with the American Dialogue group, and through our efforts, we have received some support from them. They have raised the issue of Agent Orange in the U.S., working through American courts and with American lawyers. However, despite our efforts, the U.S. legal system has not accepted our proposals or claims,” she reports.

While the American government initially allocated over USD 197 million in compensation to American veterans exposed to Agent Orange, getting restitution for Vietnamese citizens has proven to be much more challenging. As of this writing, the United States has yet to issue an official apology or accept responsibility for Agent Orange.

The journey is challenging, but Dr Phuong remains dedicated to reducing the stigma faced by victims of Agent Orange. “If you have the opportunity to visit Vietnam and see the Peace Village, you will meet many disabled children. Despite their challenges, they continue to enjoy their lives,” she says.

“We understand that there is still significant stigma and social barriers surrounding those with disabilities. This is why we need to educate both the local communities and the world about the effects of Agent Orange on birth. This education is crucial to reducing stigma and promoting the inclusion of these victims in society,” she emphasises.

Dr Phuong notes that treating and advocating for those affected by Agent Orange presents complex challenges. Health conditions linked to TDCC exposure are varied, severe and difficult to diagnose. These conditions often lack effective treatments and require long-term, specialised care.

She adds that access to healthcare, especially in rural areas, remains limited. “Many victims face significant barriers, such as the lack of nearby medical facilities, financial constraints, and limited access to specialists familiar with the specific health effects of Agent Orange. To address this, we’ve worked to equip villages with ultrasound machines so that birth defects can be detected early during pregnancy. This allows us to provide advice and support to mothers and families sooner,” she says.

Dr Phuong acknowledges that sustaining efforts—both medical and financial—is one of the most difficult challenges in her work. “Raising awareness about the lasting effects of Agent Orange and securing the necessary support—both medical and financial—for the victims remains a significant hurdle. It’s a complex issue that requires continuous effort to secure the rights and resources that these victims deserve,” she says.

“The care needed for these victims is long-term, and we require ongoing support, funding, and collaboration with various stakeholders, including NGOs and international partners,” she adds.

Despite these challenges, Dr Phuong is proud of the progress made by her team and the Vietnam Association for Victims of Agent Orange/Dioxin (VAVA). “We have improved medical treatment, and there is greater awareness and recognition of the issue within the country. However, there is still much work to be done, and we remain committed to continuing our efforts to address these challenges and advocate for those affected by Agent Orange,” she concludes.

While history has shown humanity at its darkest, Dr Phuong’s enduring commitment to healing and to justice is cause for hope.

This article is part of Business of Good, the series that explores how global leaders drive change and address the complex problems of our time through sustainable, innovative solutions. New stories are found Wednesdays on TatlerAsia.com.

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