 Good morning and welcome to the round table to release two new reports on Agent Orange in Vietnam, which is a part of USIP's War Legacies and Reconciliation Initiative for the last year. I've had the pleasure to work with three authors on two different reports, one about the overview of the effects and efforts to remediate Agent Orange and help victims in Vietnam, and the second looking specifically at US assistance and programs that provide non-medical support to victims and families. Two of the authors of these reports are with us today and will be sharing about the contents and their experiences in doing this research. First will be Phan Suen Thuong, who is a researcher at the Institute of Southeast Asian Studies in Singapore as a young Vietnamese researcher. He's written compelling articles about Agent Orange in Vietnam, its meaning in US-Vietnam relations. Welcome, Thuong, we're really delighted to have you here with us today at the US Institute of Peace. The second report was co-authored by Susan Hammond and Da Quang Thuong. Susan is the Executive Director of the War Legacies Project based in Vermont, which is a non-governmental organization supporting families affected by Agent Orange, both in Vietnam and in Laos. And Thuong, the co-author, works with Project Renew in Quang Chi Province, Vietnam. And Project Renew is an organization that was founded by the US veteran Chuck Cersey and Quang Chi provincial counterparts to address UXO and other war legacies, including Agent Orange. We will invite each of the authors here to give an overview of their reports and then we will have time for questions and answers with the audience in person and online. There are two mics down at the front of the stage and since we're starting later than planned, I think we will go over a bit into the coffee break and push the schedule back so there's enough time for discussion. And with that, I'd like to invite Susan to start. Thank you, Andrew. First, I would like to express my appreciation for the USIP and especially Andrew for entrusting me with the responsibility of preparing this very important report. It's a new and comprehensive analysis of Vietnamese Agent Orange victims and I hope that everyone will have the opportunity to read it later. And for the purpose of today's round table discussion, I will cover some key findings of my report. Okay, so my report, sorry. My report is based on a review of existing studies and also interview data that I collected in 2022. While writing this report, I visited the Vietnam Friendship Village in Hanoi which provides home for children with disabilities associated with Agent Orange exposure. And in this photo, you can see me and some of the children at the village. The village was founded by an American veteran, George Meizel, who had served in Vietnam and later passed away because of health complications related to dioxin exposure. The village stands as a symbol of people-to-people reconciliation in Vietnam-US relations alongside many other examples of humanitarian work by Americans and American NGOs such as Susan's War Legacy's project. However, in Vietnam, many believe that the US government has not done enough to reconcile with Vietnamese victims. So the purpose of my report is to make a case for greater efforts by the US government to address the needs and concerns of people affected by Agent Orange in Vietnam. Their ongoing suffering is a humanitarian tragedy that was caused by US wartime action and the US can't help to mitigate. And doing more on this issue will also enhance bilateral trust which serves as a solid foundation for the Vietnam-US comprehensive strategy partnership. So first, let's start with who are Vietnamese Agent Orange victims. The majority of people who identify as Agent Orange in Vietnam live in central and southern regions of Vietnam and that were sprayed with herbicides but they also include Northern soldiers who fought in the south and also their descendants. There are currently four generations of Agent Orange victims in Vietnam. The first generation includes those who were directly exposed to Agent Orange and they experience chronic illnesses such as cancer and diabetes. Later generations include the second, third and fourth generation, descendants of the first generation and were born with very severe and often multiple disabilities. Now, obtaining the exact number of Vietnamese Agent Orange victims is an impossible task because of scientific limitations and many other unknown variables. So we can only rely on estimates to understand the scope of the issue. One estimate puts the number of victims at three millions and there's another estimate suggests that there are about one million victims including 150,000 children with disabilities. But when we talk about people affected by Agent Orange, we also need to count family members, people who have to deal with the financial, physical and mental burdens while caring for affected individuals and taking that into account, it is evident that the number of people affected by Agent Orange in Vietnam likely reaches into the millions even if we cannot provide an exact number. So what have been their experiences? In my report, I highlight several key themes in this regard. The first theme is their social economic struggles. The health and disability effects of Agent Orange alone is already tragic, but many affected families also live in poverty and they lack access to healthcare services. Caregivers often have to forego stable employment to provide full-time care for the victims. As Mrs. Nguyen Thi Hong Tham told me, she had to quit her job as a tailor to take care for her daughter who has severe mental and mobility disabilities linked to Agent Orange. And her family earns meager income from a home-based motorbike washing business and so they have to rely on government assistance to make ends meet. The second theme that I highlight in my report is psychological distress. Parents of victims often feel ashamed and socially isolated, even hiding their status as Agent Orange victims to avoid communal judgment. In many communities, disabilities often are attributed to fat or karma for past sins, the sins committed by themselves or their ancestors. And so this idea could lead to stigmatization and discrimination against the families. Caregivers also worry about their children's access to education, employment, and medical care, as well as who will take care of their children when they, the caregivers, are no longer around. Children with disabilities often face bullying at school which can lead to a loss of self-confidence and also suicidal thoughts. As for the Kim Tuen, a second generation victim shared with me and I quote, when I was in school, other kids bullied me and I feel sad and quite alone. I feel ashamed when they made fun of me. I thought about death. Third theme that I mention in my report is the disproportionate impacts on women caregivers. Women not only bear the responsibility of caring for their families, but also can be unfairly blamed for the children's disabilities. Some cases even result in single motherhood as the husband leaves to help a new family. And this is what happened to Mrs. Pham Thi Zit, a single mother and caregiver of her 29-year-old daughter who has disabilities linked to Agent Orange. Mrs. Zit's husband, who was exposed to Agent Orange, left the family when the daughter was just three months old. For many victims and family members, Agent Orange is not just a personal pain but also a collective grievance that demands recognition and compensation from its human perpetrators. So there has been an ongoing struggle for justice led by Vietnamese victims and advocates. This includes a lawsuit against chemical companies by Vava, the Vietnam Association for Victims of Agent Orange in 2004, and another lawsuit by Mrs. Tran Tung Ngah, a French-Vietnamese victim in 2014. Now this struggle for justice is driven in part because of a perceived double standard of the US government and Agent Orange producers who recognize and compensate American veterans who are affected by Agent Orange but has not done the same for Vietnamese victims. And whatever the eventual outcome of these legal battles for recognition and compensation, Vietnamese people affected by Agent Orange will continue to rely on Vietnamese government support and also assistance from various international NGOs, often with funding from the US government. I will not go into the specifics of these assistance because I think Susan will cover in her presentation but I will provide a brief assessment of Vietnamese government assistance and US government assistance and provide some recommendations. Vietnamese government assistance can be categorized into two types. The first is preferential treatment for people with meritorious service for the revolution and the second is general disability assistance. The term people with meritorious service to the revolution refers to individuals according to the Vietnamese government have made significant contributions to revolutionary causes and Vietnam's development particularly during wartime. Vietnamese government assistance does alleviate some financial burdens for many families but however the monthly stipend provided is often considered insufficient to meet the needs of all families, especially those living in poverty. And for the policy for people with meritorious service to the revolution, it has not covered the third and fourth generation victims and there are also many problems with the beneficiary identification process that has caused some public satisfaction. Turning to US assistance, the US Congress has provided increasing funding to support health and disability programs in eight Vietnamese provinces and a few days ago during President Biden's visit to Vietnam it was announced that there will be two more provinces leading to the total of 10 provinces and the US AID implements these programs in the form of direct assistance, capacity building and policy development. I want to highlight notable development which is the updated language in the appropriations bill on this issue. Now until 2022, the language in appropriations bills was ambiguous about the connection between the allocated funding and agent orange. However, in the US Consolidated Appropriations Act of 2022 and 2023, it is explicitly stated that funds will be used to assist persons whose disabilities may be related to the use of agent orange and exposure to dioxin. So I believe this is a positive development toward greater acknowledgement of US responsibility. The programs themselves, the programs by US AID are viewed positively by beneficiaries in Vietnam. They are seen as beneficial to many later generations, later agent orange victims. However, they're still limited in scope, so it is necessary to increase funding and expand the current scope of existing services, particularly direct assistance because many affected individuals do not have access to rehabilitation centers and healthcare facilities. But beyond health and disability assistance, it is also important to have explicit acknowledgement of Vietnamese agent orange victims, especially in office of statements. This is necessary to reduce the criticism of US labor standard. Finally, engaging in direct dialogue with the victims and their families is a necessary step toward greater reconciliation with the civilian victims of agent orange. So what are the key takeaways from my report? There are three points. First is that the number of people affected by agent orange in Vietnam, maybe as many as several millions, and their needs are both diverse and pressing. Second, despite the scale of the challenge, the Vietnamese government, and increasingly the US government, have sought to provide assistance to agent orange victims and their families. Third, much more remains to be done to assist and reconcile with the multiple generations of Vietnamese affected. And to conclude, I would like to say that as the two countries, as the two governments enhance their ties, it is crucial not to leave war victims behind. Not just agent orange victims, also victims of UXO and many people who are still looking for their missing loved ones. And so I hope that my report and also Susan's and Thuan's report will contribute to the discussion on how to ensure that cooperation on war legacy issues is an integral part of Vietnam-US comprehensive strategic partnership. Thank you. Thank you very much, Zoltan, for that clear and quite comprehensive overview of your report. I recommend everyone to look at it. I think seeing the statements from President Biden and General Secretary Nguyen Phu Tham last weekend, emphasizing the importance of this issue, really this report, and Susan's do show some of what's been achieved up to now, but also steps for taking it forward into the future. Susan, over to you. Thank you. As Andrew mentioned, my report covers the summary of the US assistance in Vietnam for people who were believed to be affected by Agent Orange. But then we also, my colleague, Thuan, went to interview 14 organizations that are primary, they're focusing their work on providing non-medical assistance to families, so beyond the rehabilitation, which is the primary focus, really, of USAID funding. So I'm just gonna give a brief summary. We have heard a little bit about USAID, but I'm gonna give a little brief summary. But I first wanna give a shout out to Michael Martin, who we rely on his reports. And if you haven't read the CRS reports on US assistance on this issue, read them. They're still very valuable. It gives a nice history of where we've gone on this issue over the years. Since 2007, the US has begun funding specifically to address the Agent Orange issue in Vietnam. And it took more than, unlike the unexploded ordinance issue, which we heard this morning started in the 90s, earlier 90s, took almost a decade, more than a decade, actually, after the normalization of relations for the two countries to work together to how to address the problems of Agent Orange. And we could spend the whole day talking about that history, but we're really looking towards the future about where we are now on this issue. And in the beginning, as you mentioned, it really was not very specific. It was focused on addressing the related health issues around the communities that lived around the dioxin hotspots. And that was in the very early days where we were trying to basically define the full extent of the problems of Agent Orange. But luckily, we had Senator Leahy and Tim Reiser putting money into the system, and in a lot of ways forcing USAID to confront this issue. And over time, as was mentioned, the language has changed significantly to the point where it's much more direct to address people who are, persons whose disabilities may be related to the use of Agent Orange and exposure to dioxin. So in the Senate language, it's very clear that the target of this USAID funding is for people believed in Vietnam to be Agent Orange victims. And as we said, it's very difficult to define who they are. But because the USAID funding by its nature, really, needs to be looking at disabilities regardless of cause because you can't help one person with a disability and then ignore the person who has the Agent Orange-related disability and ignore the other person who's their neighbor who also has a disability. So morally, you really have to approach it as a regardless of cause. But the language and the appropriations bills targets it geographically, which I'm happy to see that another two provinces has been added. So the U.S. and over the years, the U.S. and Vietnam have really began to fine tune how they're gonna work together to address this, the disability section of impacts of Agent Orange. And as Daniel, Ambassador Curtinbrick mentioned back in 2019 when this partnership really began to be developed, he says our goal is simply put to improve the quality of life for persons with disabilities here in Vietnam. And in that expanded partnership on disabilities, the two governments agreed to cooperate to expand healthcare and rehabilitation services, expand the social inclusion and improve the quality of life of people with disabilities, improve policies and public attitudes, reduce barriers and increase social inclusion and strengthen the capacity in the implementation of support activities. And so currently the USAID funding, which is now at 30 million a year from the beginning of three million, is channeled through several organizations. Two are American, two are foreign organizations, the Humanity and Inclusion, which is really working on the capacity building of the rehabilitation sector. And then Vietnam Assistance to the handicapped who also works in that field, but it also has been done a lot over the past several decades to help the Vietnamese expand, develop and implement their disability, law and disabilities. And then there's currently five Vietnamese organizations that are the primary recipients of the funding, though there are many sub recipients like Project Renew who I worked with on this paper. As we said earlier, much of the funding has been focused on improving rehabilitation services in Vietnam and helping the Vietnamese develop and implement the law and disabilities. And although they are, as I skipped, the Vietnamese government has also made great efforts as was summarized earlier, partly for passing the law and disabilities, but also creating this support system through the Ministry of Labor and Social, I always get that mixed with the Ministry of Labor and Social Affairs. I get always mixed up with the Vietnamese, the Lao version of it. And so there's this monthly stipend program that if you are certified as a person with a disability who has a severe or very severe disability. And as Ong mentioned, it's not, the families welcome this assistance, but it's not sufficient to address all of their needs. Is it the 2016 National Survey on People with Disabilities in Vietnam found that households with disabilities are twice as likely to live in multi-dimensional poverty in Vietnam. The greatest impact is on the quality of their housing and sanitation and the likelihood of children not completing school. And these deprivations are greater in the rural areas of Vietnam. 80% of the people with disabilities in Vietnam live in rural communities. So they have a difficult access to the medical care that is existing, but the impact of disability tends to be more severe when you're living in a rural community. Also having a family, a person with a disability in your family is shown to increase a family's cost of living by 12% due to the increased cost of medical care, transportation, food, personal care, and many other expenses that come with caring for a family member with a disability. And often, if it's a child with a very severe or an adult in some cases, some of these children we're talking about are now in their 30s or 40s. They often require a full-time caregiver who therefore cannot work outside the home, cannot contribute to the income, can't even go into the fields to farm. So programs that are focused only on the medical side of disability, I mean, though they are very welcome and very needed in Vietnam, they do not address the impacts of disability that affect the whole family and make it difficult for families to move outside of this financial or multi-dimensional poverty. And so our report looked at 14 different organizations. Many of them were chapters of the Vietnam Association of Victims of Age and Orange who have programs in probably almost every province now, I would assume, in Vietnam that are providing some working directly with families who have victims, who have family members with disabilities, particularly those believed to be impacted by age and orange. Vietnam Red Cross is another organization that has a nationwide impact because they have both Vava and the Vietnam Red Cross have volunteers often down to the very local village level and even smaller level in that in some cases. So they have really developed direct relationships with the people with disabilities in their community. So they are well, both Vava and the Red Cross are very well placed to provide programs that are providing direct assistance to families who are caring for severely disabled children. And our interviews found that in the non-medical side of the equation, there are, these programs tend to fall into six main categories, livelihood support, which it could be helping families develop livestock, breeding, setting up a small business in their home so the caregiver does not have to leave the home, improving the living conditions. When you have, particularly in areas where many of these people live, where there's the rainy season and the monsoon season that comes through and the typhoons that come through, there are homes that are in vast need of safe housing, roofs that won't leak. So many of these organizations help in that aspect. Educational support, even though there are, if you're a child with a disability, you can get tuition reduction, you can get scholarships, but those don't cover the full cost of an education. You may need transportation to get to and from school and that can be difficult if you're someone with a physical disability. But also, some of these organizations provide support to the siblings of children with disabilities because after they will be the ones who will need to provide the caregiving for their disabled sibling when their parents pass on. And so to help with that, ensure that that child stays in school so that they can have a decent job upon graduation so that they can have, ideally, have some of the resources that are needed to care for their disabled sibling when their parents pass. Some other organizations provide just financial assistance for either an emergency situation that comes up or just cash assistance to help them deal with a medical trip or if they have some, they lose a job and are in a situation where they need cash on hand. So there's some organizations who will provide that type of support. Caregiver training and support, which USAID has also provided, but the Red Cross and VAVA and others have worked by training their network of local volunteers to provide, to assist caregivers in providing better care for their children with disabilities or providing some respite care even so the mother can go off to the market. And the other programs work on providing social integration and peer support and helping people with disabilities integrate into their local community. In addition, a few of the programs, and I want to shout out here to the children of Vietnam's Hope System of Care, work in collaboration with multiple government agencies and organizations to provide more comprehensive wraparound services to people with disabilities and their families. And since about 80% of the people with disabilities live and roll families, many of these programs come out in the form of the first, which is the livelihood support and often in the form of raising cattle, water buffalo. And these can be challenging because it's not, you can't just take this cow and hand it to a family and expect everything to go well. I mean, you really have to be engaged with the family from the very beginning. You have to bring the veterinary services there from the very beginning to make sure that that animal is healthy and that they can go, they can breed and go through the purpose of why they're there is really to have increased the family's livestock supply. And without that direct hands-on support, there can be a lot of failure. But if you have this program where you invest, the families are invested in the livestock by including their own investment, whether it's building the stable or helping to purchase the animal, there's more success that has been found. And then the number and scale of these programs that we looked at with the 14 organizations are pretty limited because their funding tends to come through individual donations, particularly when it comes to VAVA and the Red Cross, it's donations that they are able to generate in the local community or in some cases internationally. And so they can ebb and flow. There's no sustainability at this point. They're pretty, depending on what funding is available at the time. So there needs to be more sustainable funding sources targeted at this type of support. And as Ambassador Crittenberg noted in 2019, the U.S. and Vietnam were working together to create a comprehensive service system that supports caregivers as well as a person with disability. And so far USAID has done a pretty good job. I can critique some of their things, but overall they've been a very good job on the rehabilitation side and the disability rights side of these issues. But I think there can be more efforts over time to reach what Ambassador Crittenberg also mentioned, connecting people with disabilities and their families to economic and social support and particularly that economic support because having a child with a severe disability is an economic strain that impacts the whole family. And so when I was completing this paper, I was happy to read that the USAID is doing some pilot projects in this field. And maybe we can hear from Tony about some of the successes there and the lessons learned and how we can move this forward more. And on an individual level, these are just a few examples of some of the livelihood support and educational support, caregiving training. So on an individual level, these programs are not, it's not a huge amount of money. It depends on the type of program obviously, but for scholarships and small loans, up to that can be $100, $250 per family for building, helping renovating a home, which is a huge need as well. It's more around the range of 2,000 of family. The animal husbandry that I talked about is usually in the $20 million, 20 million dong range or about 340 to 860 per family, depending again on the type of livestock that you're helping them with. And then some of the more wraparound services that the children of Vietnam provide and others. The investment is around 1,000 per family, not including of course, the management costs that are involved in that. So I think, I believe that scaling up these projects can be possible if there's more cooperation between the implementing organizations and local government officials. And there is already a framework in place in Vietnam called the Action Plan on Disabilities from 2021 to 2030, which outlays how each ministry and each organization can work together to and set concrete goals in order to improve services and support people with disabilities. So there's a plan in place. The issue is trying to work, how do you filter in some of these individual organizations and efforts into the greater plan to provide more sustainable direct assistance to people with disability. And so the next round of appropriations remains at 30 million, which we hope it does. I mean, that investment in the future can, if that can be transferred, not just to the medical programs that are in the pipeline, but some of these additional support that families need beyond medical care, we could go a great, a long way in addressing some of the economic support that is needed for these families. And again, as we don't really know the full extent of how many people we're talking about, though there are surveys on disabilities in Vietnam and we do have a sense of how many have severe or very severe disabilities. And if you target it geographically to the areas where there are, where we're working now in the provinces that were sprayed, we're really talking an estimated population of about 73,000 or more, around 73,000, 74,000 people with disabilities. And if your average level of support is 500,000, I mean, $500, I'm sorry, with that 30 million that the US is already allocating hopefully per year for the next several years, if some of that can be put into these programs that are non-medical assistance, you could really make a difference in those 73,000 families. So in conclusion, oops, I didn't put this one on, sorry. One of my conclusions of my paper or paper is that one of the priorities is to vote more resources, time and attention to providing non-medical support for persons with significant disabilities. In addition to this, excluding what has been done in the rehabilitation side of things, but in addition to what has been done on the rehabilitation side. The second priority is to foster more and closer collaboration between Vietnamese government agencies and Vietnamese international NGOs in order to provide more wraparound services for people with disabilities. And third is to fully engage people with disabilities and their families in the programs that support them and that was your recommendation as well. You have to really bring the people into the discussion, you can't just bring the program to them. Thank you. I'll end here with, if you wanna read the quote from Ambassador, Samantha Power. Great, please join me in congratulating Zoom and Susan for their work and presentations this morning. And I'd also like to thank the USIP Publications Team that we've been working with to get these reports finished and printed. According to one of my colleagues, USIP produces a large number of reports on many different piece and security topics, but these reports have special meaning and the chance to be, I think really, go to sources for understanding Agent Orange issues in Vietnam for years to come. So they were also quite moved by what you've done and these issues that we're talking about. I'd like to ask the first question and then we'll open up for everyone else. At a workshop that USIP organized with the Diplomatic Academy of Vietnam several months ago, Charles Bailey, former Ford Foundation and Aspen Institute leader stated that he thought that key difference in the US Vietnam reconciliation process compared with any other post-war relationship is actually the Agent Orange issue. This is a unique feature between the US and Vietnam. And there are many reasons for that, right? One is that it affects both people and the environment around them. It's hidden and unclear in its effects and its causes. We're still finding out what some of the impacts might be and the fact that it affects US veterans as well as people throughout Vietnam. I'd be interested in your reflections on what role the Agent Orange issue has played in US Vietnam reconciliation and getting us to this new comprehensive strategic partnership. Who'd like to start? You wanna start? Yeah, I can start first. Yes, I've worked with Charles Bailey closely on this report so first I would like to extend my appreciation for him. I wish he could be here today. And as I learned about this issue, as I did research on this topic, it was the most difficult war legacy issue in Vietnam-US relations because of the reasons that you mentioned. For many years, even after normalization, the two sides could not agree on the science, on the basis facts. And so that state of deadlock persisted even as we have formal relationships. But I think what led to the progress was the initiatives by a lot of people from both sides, both from the state sector and the non-state sector working together because they realized that it is a humanitarian issue that we need to do something about. It affects not just Vietnam, but also the US and also veterans from other countries. So it's a shared humanitarian issue that connected us. And because of that, we had a lot of initiatives that led to scientific discovery of the hotspots. And then we talked about science. We began to talk about science. Before that, the issue was mired with politics and emotions, so it was very hard to reach a compromise. But then we discovered the science and we also recognized that the science might not be perfect, but it's something that we can work with. And we do see that there are a lot of people in need. So let's combine that together. We have some science and we also have the need, compassion to do something about it. And then we can compromise and work together. And it demonstrates that we can, it's the most difficult issue and we overcame that. And so I think it shows the strength of US-Vietnam relations, of US-Vietnam reconciliation. And it shows that people from both countries are willing to work together to deal, to confront with lingering war legacies. Yeah, I would agree with that. It's been I think very important because there was just so many throughout that earlier days that the two countries just could not figure out how to discuss this issue in a way that can address the humanitarian problems. Everyone was seeing the humanitarian issues. We couldn't agree on defining what was causing it necessarily, but there was certainly in a sense we got to help these people who are impacted by the war. But it really took, I mean, I think we really have to thank Tim and Senator Leahy for being so persistent in and evolving that language over time to the point where it was really forcing USAID, the administrative side, to reach out to this population that the Vietnamese, they weren't questioning the science. For them, they were a victim of Agent Orange and that victim, they were victims because of the war, caused by the US. But through Senator Leahy and Tim and Charles who also really finessed that language in a way to get the programs to more reflect what the Vietnamese, the people that the Vietnamese wanted helped which are those who were perceived to be or were believed to be or are victims of Agent Orange. I kind of hesitate because it's hard. You get stuck on the science, like you say. It's like, because you cannot prove that one individual person has this disability due to that Agent Orange. I mean, the science shows that in animal studies quite clearly, but that was that stumbling over the language, which I still do today was causing a lot of these problems. But we worked it out. The US and the Vietnamese worked it out. They found a way to address this really controversial, both scientifically controversial and just politically scientific controversial issue. And I think that it's a good example of what can be done in other countries to develop, to tackle some of those problems of where you just can't see to find a way to have a common language on it and then or agree in a way to stop debating over the language and just doing the work that needs to be done to provide assistance. Great, thanks to you both. So we welcome comments and questions in the discussion. He's come down to one of the two mics here in front. Would like to go first. We welcome questions in Vietnamese as well. Please. Hi, Scott Willis from Children of Vietnam. And I wanted to say thank you Dung and Susan for these reports and for continuing to draw attention to this really important issue. And thank you Susan for the shout out to Hope System of Care for the program that we run. It was in fact, Hope System of Care that drew me to Children of Vietnam back in 2014. So I'm very proud of the work that we do. My question is this. Well, first I wanna say that I think what's happening with respect to age and orange and the treatment of people with disabilities is making great progress. I mean, if we look at the 2022 and 2023 language in the budgets, right? You've got, first of all, I went from 20 to 30 million and you're actually saying the words age and orange, right? So these are milestones. I mean, I think we have to acknowledge that, right? So of course there's still work to be done. But, you know, and when we look at the infrastructure, albeit it's small and limited to certain provinces like we're in Quang Nam, you're in Quang Nam, but you're working with Red Cross. We have our local stakeholders and partners that we're working with. So, you know, the model is there. It just needs to be expanded. So in Vietnam, I think at least, of course it can be bigger and more, but it's on track, right? My question to you, Susan, I know you're very active in Laos and looking at the issue of dioxin contamination there. And I'm just wondering when you think Laos is going to be ready to kind of begin this journey, right? So we've got a 1.5 million there versus 30 million for Vietnam. It's obviously a smaller scale in Laos. That's, I got that. But, you know, we're not really doing anything there. I think in terms of remediation, in terms of helping people with disabilities, just wanted to get your thoughts on when you think Laos will be able to get on the train. Thank you. We're getting closer. So that's good. And first of all, the language is in the last two appropriation bill, 1.5 million. In Laos, the problem is somewhat different because the primarily the sprain that took place in Laos are in the spine along the border between Vietnam and Laos. Very rural communities, mostly ethnic minority communities that don't have access to healthcare to begin with. So even identifying how many people have disabilities that may be related to Agent Orange is challenging. I mean, my organization in Laos, we go village to village in the districts where we're working. And we do find the same types of disabilities, the same percentage population-wise that you see across the border in Vietnam. And the Laos know, particularly the border villages, they know that Vietnam is receiving this assistance from the US government. They're well aware of it. But things move very slowly in Laos. And we are now, as far as I know, the last I talked to USAID, which was several months ago, they are hoping to develop a program to reach those rural communities, the rural districts that were sprayed, hopefully having some type of program in place by the end of the year. They have a strong disability program there now, but they're not in these more remote areas. So we're hopeful that that will start to phase out and they'll be able to utilize the funding that's in the pipeline right now, which is a total of three million. On the dioxin hotspot side of the question in Laos, that's more challenging because of the secret nature of the war. There is no denying or Ben Hoa, no large military bases where millions of these barrels were stored in Laos. We're talking about much smaller bases that the CIA was operating out of that we have heard from CIA alumni, Air America former pilots that they did have barrels of herbicide, whether it was Agent Orange or something else, they're a little unclear, but for the dioxin hotspot, that's where science is very simple. You go in and you test and you analyze the soil. And if there's a dioxin problem, then we know ways to remediate that, but there's still a lot of sensitivity in Laos about these sites. I mean, these were former CIA bases like Long Chan, which are still sensitive areas today in Laos. So getting that moving forward on the remediation side is challenging, not only because the Laos are hesitant, but the US embassy, to them it's not a priority either because it's pretty small. So we're still moving, trying to push that a little bit further, but it's slow steps on the remediation side. If I can add to that, when I was in Laos a month ago with Sarah Kulabdura, we met with several of the Laos government's officials from the Ministry of Foreign Affairs who had recently gone to Vietnam on a study visit that Susan's organization sponsored. And they visited some of the hotspots and areas affected in Vietnam. It seems to me that that has increased their interest and perhaps they're ready to speak more about Agent Orange issues in Laos. And also from USAID, I met the mission director in Bing Chan. Yeah, so they have this existing OCARD project, which is supporting people with disabilities in several provinces. And their intention with this additional appropriated funds is to expand that to several provinces in central and southern Laos that were sprayed. So that's sort of a comparable strategy to the one that USAID has carried out in Vietnam, first geographic targeting. But then as you say, it's a question of, okay, it's in that geographic area, but what places exactly and how to reach and best support the people affected there. And particularly because unlike in Vietnam, which has a quite robust medical system in place quite many levels, these area of Vietnam, I mean in Laos, there's nothing really set up. I mean, if to get services, rehabilitation services, you would need to go all the way to Bing Chan, which can be an eight to overnight bus ride. And first you even have to get from your rural village to get to the bus. And so there's a lot more complexities in providing services to people with disability in Laos. Who would like to come up next? Hello, good morning. Thank you so much for the presentation. I was just curious, I mean, you all made such brilliant and insightful recommendations about what needed to be done to move this effort forward. And I was just curious to get your take on the kinds of strategies or approaches to get people's awareness or support to that place where that kind of action can become reality, particularly when it comes to just communication or I think you were at the session yesterday and discussing the arts or the role of the arts and these types of initiatives. So I'm just curious to get any ideas about just channels or approaches to build greater awareness or greater support. Lance, do you want to introduce yourself for a minute too? Sure, sure. Selfishly, I'm a filmmaker. My name's Lance Kramer. And so I spend my time thinking about storytelling and the arts and its role in working towards peace and reconciliation. So I'm not only interested in film, but I would love to just get your recommendations. And not just in the, I mean, I think I'm interested in government and NGOs, but also just amongst the general public in both cultures or both countries. Thanks. Well, I think your paper did that very well in a lot of ways in getting the voices out of the families who just understanding the day-to-day reality, the waking up, the preparing the meal, the feeding the child, which can take an hour or more. And then there's the bathing. And I mean, it's just, it's for some of these people that you spoke with very severe disabilities, I think for someone who does not have that experience of caring for a child with severe disabilities, I don't think you under, it's hard to understand the intensity of that and how it impacts the caregiver and the family. And so I think finding ways to get those stories out in your paper does, helps to do that. In Vietnam, I think if you mentioned Agent Orange to any Vietnamese person, they would know what you're talking about and they would get in their mind of vision of who that person is and the impact on that family because there has been a lot of, thanks to a great extent to the Vietnam assistance of victims of Agent Orange, Devava, who have that, who are working directly with these families and helping tell their stories, but then moving that into policy, that's very challenging to do. But I mean, there's the will there, I think, but it's just, it's a lot of it, it's the techniques. How do you actually do it? How do you go from that $30 million that's allocated by Congress to a program that's going to reach that family that was described in your paper, who's overwhelmed by the burden of caregiving and deeply in poverty? Yeah, so one of the themes that I mentioned in my report is psychological distress that comes from the reactions of people in the community because disabilities or disabilities linked to Agent Orange can be seen as curse. It's not perceived as, okay, this is human action and these people are suffering the consequences, but you also have cultural belief that this is God's decision, God decided that this family deserves that because they did something in the past, their ancestors did something in the past life. So people have this rumor, okay, so this family, they did something bad, they deserve that. So I think it's important to raise community awareness and I also think why it is so important to have acknowledgement that, okay, this is something that the US Air Force did, right? And these people are suffering the consequence. That's why we need clear language to say that, okay, this is not your fault, right? This is a mistake that happened. There needs to be people to take responsibility for those actions. And so I think we should replicate the language in the appropriations bill that we are supporting people with disabilities that might be related to Agent Orange, right? To show that, okay, so this is not fit, this is not karma for your actions. This is a worse tragedy, it is ongoing, and the US is doing something to address that. I think that's very important. Megan, do we have questions or comments online? Not yet, it's okay. Just to kind of expand on that too, I mean, like I said, in Vietnam, people understand the impacts of Agent Orange. It's been in the papers, there's been movies, there's a lot of fundraising done to support the victims. That's not the case in Laos at all. The people who were impacted are very remote, they know, they recall the planes, they talk about the spraying. They don't link, though, that that spraying that was done 50 years ago, maybe the cause of the disability in their family member. There is not that link in Laos at this point. Could I invite our colleagues from VAVA or USAID, if you'd like to share your thoughts? Thank you very much, Mr. Andrew, to invite her to have some comment. And first of all, I'd like to say thank you very much for UCIP, this time you organize a one round table about these subjects. And for these subjects, we agree with the study and survey from Susan and Mr. Zung here. We understand that it's already difficult to find out the number of the victims. As you said, and it is really difficult to find out how many of the people now, because as Zung said, it is they have some emotion about themselves and they don't want to show that they are the victims. So that's why during the wage that we find, we want to survey about that one, it's not easy even from outside. And the second thing is difficulties. We have no finance to do this for all our provinces in Vietnam. So that's why we need the help from the US first. And that's of course. And for the program that we know that with this program and with you can put it online, then it's very useful for us. Because from here, we can let everyone to know how about our victims and how about their life now is very difficult in Vietnam. And they always say that it is the poorest and difficult in our countries. And so I think so with your research, it's very useful for everyone if they can present here and they can understand more about that one. And we'd like to say thank you again for your try to do everything for ours during the days. And I think during the times and before and in the future. And we hope that in the future you have many actions for them and for the new relations between the two countries. And as Mr. Jeff Mucklake talked about this morning and we hope that they'll continue to this policy that we are doing for us. And we hope that in the future, it will be better for everyone above 50. Thank you. Thank you Chi-Khang. My kind is the head of international relations at Vava. And also with us today is General Minvan Ring who is the president of Vava. He'll be speaking on the closing plenary this afternoon. Yeah, and I think one sort of symbol of how this relationship has strongly developed is that USAID is working with Vava now as a sub-grantee, I believe, right? And that before it was Vava was sort of like they're here doing their advocacy kind of separate from what the US government was doing. And now they're really starting to work better and more closely together. And I think that's very promising because Vava has such a reach throughout the whole country for this population that we're really targeting which is the victims of Agent Orange. And I should add that in addition to this session being translated and live streamed in Vietnamese, we will be translating both Zobem and Susan's reports into Vietnamese. That's not ready yet, but it will be coming out and will be available online. I think we'll go for another 10 minutes so we do have time for several more comments. Yes, sir. So I am Michael Martin and thank you, Susan, for your comment earlier. This has been an issue that I've been dealing with when I was at CRS for about 15 years and it was actually representative Fali Omaviega of America Samoa who held the first congressional hearing on Agent Orange. And in that hearing he himself found out that he was potentially a beneficiary of the program the United States had for veterans. So that was sort of an interesting detail at the hearing that I found out. But that leads me into one aspect that's in the language and has been around for a while that often is looked past. You've been talking mostly about disabilities and indeed disabilities has been a word that's been used. But it also talks about healthcare. And it's very sensitive politically, both in the United States and in Vietnam. I know on the Vietnamese side, at least through my interlocutors, that they look at the presumed exposure programs that the United States has that provides to US veterans healthcare for multiple diseases including type two diabetes, which is what representative Fali Omaviega had. So far you have seen a great reluctance on the US side to actually activate that healthcare side. It has been USAID focusing almost exclusively on disabilities and trying to disentangle or disengage it from the Agent Orange exposure part of it. And there's been kind of a delicate political dance on how it gets brought in but not explicitly. So one of the things I've often pondered about when I was at CRS I couldn't, I could ponder things but I couldn't propose things. Now I can, now that I'm retired. But can either of you see a way that something parallel to the presumed exposure program in the United States could be brought into the provision of assistance by the United States in Vietnam, for example, to veterans of the conflict on the Vietnamese side who have some of these types of cancer or other medical conditions, not disabilities, but medical conditions that are in need of assistance. So I was wondering if you had any thoughts about how that might be brought into the program or is it just politically not feasible at this time? You wanna talk about that? Thank you, Mr. Martin for the question. I also consulted your report, inviting my report. So thank you so much for all your work. So one of the criticisms of US assistance in Vietnam is that so far it has disregarded first generation victims who were directly exposed to Agent Orange and like you said, have chronic diseases, not disabilities. So in Vietnam, there are support programs for veterans. There are social protection centers that provide healthcare and treatment for Vietnamese veterans and many of those are run by VAVA. So in Vietnam, there is that support system. And what I recommend in my report is for the US to support those existing infrastructure and system in Vietnam. And I also talked to some of the veterans who received treatment in these facilities and they reported improved health and they do want to see those kind of services being expanded to many other provinces. So I think there's an opportunity there for the US to support this program. And also, by doing so, they also recognize the first generation victims of Agent Orange in Vietnam. Yeah, but I do think it is, there are a lot of political sensitivities about that. And even on the disability side of things here that we also have not brought up the problem of children of veterans in the US who have disabilities that they believe are impacted by Agent Orange. And so that, I think that kind of adds to the complexity because if we're working with the children who have disabilities in Vietnam who may be Agent Orange related and now we're working with their parents or grandparents at this point and we're still ignoring the population back here in the US, it gets kind of challenging politically, I think. I've asked myself the same question that it's interesting that US assistance is going mainly to people in second and following generations that are less definitively linked to Agent Orange, whereas the first generation, which no one can dispute, they were exposed to dioxin, right? Has not benefited to the same extent. One reason may just be that USAID had existing disability programs and expertise in Vietnam that it could link this to. Tony says no. They did have that. I know I worked on some of those programs earlier, but you don't think that's the reason, no? Okay. Please come up to the mic, yeah. My name's Tony Kolb. I'm the Deputy Director of our Reconciliation and Inclusive Development Office in Hanoi and responsible for all the war legacy work that USAID has been tasked with taking on. I'm back in Vietnam for a second four year tour. I just started last November. I had previously worked on the super fun cleanup aspects of our work in Danang and Benoit, and now I'm working more closely with our Disabilities Team. I think the easiest way to connect the focus on disabilities within the the victims of age and orange support that we have currently is that there was from the beginning the Lehi War Victims Fund, which focused a lot on injuries from unexplored ordinance. A somewhat safer area or a clearer area of cause and effect. You step on a mind or deal with an explosion, you know what caused your injury. So there's no debate about the potential role of dax and say in a stroke victim's elderly experience or a child being born to somebody that perhaps was involved in the war. There's just, there's inherent uncertainty because if it was certain, there would be many more victims and it's simply it's not, that's not the way the human body reacts to environmental contaminants. Some bodies handle it very well and some are very sensitive to it. So and we'll never know really the, have the smoking biological gun per se. But I really frankly don't know exactly the Vietnamese perspective on age and orange impacts and the focus on birth defects. I just assume that it comes from a sense of catastrophic impact and somewhat clear impact from the get go. If you're born with a congenital issue which is gonna affect you your whole life, it's a huge burden on any family. And chronic illnesses come on slowly, they're associated with older age. I think it's just more accepted as that's life. I've had a rough life and I have to deal with it. But when it happens to a child who is sort of an innocent victim, it's just much more, it hits you right there. You need to do something about it. And so I assume that that's one of the reasons that in the communications on this issue that it's always been a big focus because I think it was the hope that it would spur action and response. And I think it has. It's been successful in that way. It's not that USAID has had no involvement. And in fact, just in the last year, we've been getting strong interest from counterparts in the Ministry of Foreign Affairs in particular in some of their realms to try to see what we could do to help on stroke care. Stroke later in life is associated with oxen exposure. It has, again, not a smoking gun. There's lots of other smoking in Vietnam causes potentially. But because it's affecting such a large number of veterans currently, I think there's a great interest in seeing what can be done to help. And we're currently starting some work with Blackwine Hospital, which is one of our oldest partners in dealing with the medical issues related to oxen exposure, to try to encourage their efforts to establish better quick response care to stroke to avoid disabilities. So we're sort of getting in a little bit in the back door and saying that we're trying to prevent disabilities from occurring by improved interventions in the early stages of stroke in victims there and trying to spread that experience through the medical system in Vietnam. I think I just comment on Laos a little bit. I mean, the big difference is that the Malaysian government does not recognize Agent Orange as a problem. And in fact, there's, I think, some active interest there in not talking about it because they don't want to create problems when they don't see them. So it's a little bit hard for us to cooperate with a bilateral partner if they don't see a problem. They typically come to us and want to work together on things that they self-define. So I think the exchange visit was very helpful between Laos and Vietnam to show some practical things that can be done to show improvements. And again, I think that's also the case in Vietnam. When you show solutions to a problem, you're gonna get a lot more cooperation. So that again, I think, explains some of the bias, potentially, in our assistance on disabilities towards the medicalized approach. When you deal with rehab, it's a time limited and results-orientated intervention. And if you don't rehabilitate to the best of your ability, there's no way that the caregivers are gonna have an easier life or that the family's going to potentially benefit economically from a disabled individual's efforts. So rehab is sort of an entry point and a critical one and tailored to the type of money that we have, which is year by year. So we can do something here, try to leave behind an improved rehabilitation medical system that exists in Vietnam and is just weak. When it comes to social support interventions, the types of things that Susan talked about, those are more akin to what we do for veterans, which is appropriations that are not gonna go away, they're gonna be there every year to support our VA system. So our veterans know that later in life, these benefits will be there. We can't provide that to Vietnam. We only have a small window of time to try to leave behind something significant. And I just think in general that we have not been so very satisfied with the short-term efforts to improve people's economic lives. It could be because we see those fail. And we see that's the way we work with poverty in America. We have benefits that are open to people over time because the challenges keep coming up. And especially when you have a disability, it doesn't really go away. You need some level of assistance all the time. And this is the type of things that VAVA, and hopefully everybody knows that acronym, it's the Vietnam Association for Victims of Age and Orange, a government program to support this sort of long-term assistance over time. Small amounts of money, but there are resources there all the time. And we are not currently granting money to VAVA. It's very difficult for us regulatory-wise to give money to Vietnamese government institutions because of some issues with financial transparency, which we're very sensitive to. But we are trying to build their capacity so that they can play this role into the future in a better, in a more, I guess, impactful way. So what we're doing is trying to share the U.S. experience in dealing with these sorts of chronic issues of poverty and social support and try to share those models and approaches, which rely on leveraging government resources and civil society support. Because that exactly is what VAVA is. Full of retired government people with strong connections, but have a network of individuals down to the local level who volunteer their time to support their beneficiaries. And we'd just like to see that be sustained and improve over time. So we're really proud of our partnership with them because I think it reflects what I think, for many of us, has been a frustration on the ground to be sort of hiding this focus on victims of Agent Orange under a basket of legal risk that the U.S. government has felt to have the space that our leadership, like Ambassador Crittenbrink, was able to do, to speak a little bit more directly to what we know those in Congress want us to do and have good partners in Vietnam to make that happen, is, you know, it's very satisfying now to be at that point. So, thank you. Thank you very much, Tony, for sharing. Zomer Susan, do you have any closing comments? I think we're about at the time. No, but I mean, I think there is more opportunity for USAID funding to get into this more non-medical side of things. I think it's challenging, but I think we're at a point now where we can start to find a way that, you're right, you can't do it without an ending, but I think there are ways that we can move into this field to at least just with some of the most immediate needs, but I know there's a lot of constraints within USAID, even house construction and helping a family renovate a house, there's a whole level of layers of bureaucracy even to do something like that. So, I think there's ways that we can find, the best thing about Vietnam, I think, is there's always a way. You can always find a way to solve the problem and the Vietnamese are very creative in doing that. I think there's openings here. Yeah, and to add to that, just as we overcame the initial deadlock, I do, I'm confident that the two countries can again find a compromise and think of a pragmatic way to advance their cooperation and I'm glad that there's great interest from both sides in enhancing the current programs and finding more ways to support people affected by Agent Orange. Great, thank you both. That concludes our round table. Congratulations again to both of you on publication of the reports and recommend them to everyone in the audience and online to look in more detail. Thanks for being with us today. Thank you.