Mark Cash's father, a U.S. Air Force security policeman, was stationed at Andersen Air Force Base in late 1966.
His job on base mainly involved walking patrols – specifically, the area along the flight line, the fence perimeter, and the path of the above-ground fuel pipeline. "He told me about seeing people spraying,” Cashsaid. “He said he’d driven through it, walked through it, over and over again."
His father didn’t know, Cashsaid, what exactly was being sprayed. Just something to keep the jungle at bay.
His father, mother and two sisters had been living on base for right around nine months when Cashwas born prematurely.Atbirth, his liver did not function, and hewas diagnosed with hyperbilirubinemia.
Cash’s family didn’t make the connection at the time. “I was just a sick little boy who needed many blood transfusions to survive,” Cash said. He has since made the connection between his health problems and the use of Agent Orange on Guam.
Since the end of the Vietnam War and the realization that herbicideslike Agent Orangecaused serious health problems, much attention has been paid to Vietnam veterans who have filed for medical benefits with the U.S. Department of Veterans Affairs. Veterans stationed on Guam have historically struggled for recognition that Agent Orange was used here, despite denials from the U.S. Department of Defense.
On Feb. 3,Rep. Dennis Ross, R-Florida, introduced theFighting for Orange-Stricken Territories in Eastern Regions (FOSTER) Act, which would extend presumptive Agent Orange exposure status to Vietnam War-era veterans who served inGuam,the Commonwealth of the Northern Mariana Islands and American Samoa.
However, little has been said about the families of veterans who were stationed on Guam —three generations of spouses, children, and grandchildren still grappling with diseases and birth defects related to Agent Orange exposure.
In Dec. 2015, the HawaiiJournal of Medicine and Public Health published a study entitled “Disparities in Infant Mortality Due to Congenital Anomalies on Guam.” The study was authored by Jonathan Noel, Sara Namazi, and Robert Haddock,a territorial epidemiologist with the Guam Department of Health and Human Services Office of Epidemiology and Research.
The study conducted a village-level analysis in an attempt to explain large disparity between Guam villages in infant mortality due to congenital anomalies during the 1970s and 1980s. According to the study, during that period some villages reported no infant deaths due to congenital anomalies, while others reported death rates as high as 5.62 deaths per 1,000 live births – a figure “that was two times greater than the overall cause-specific death rate on Guam and in the US.”
The study examined behavioral, structural and environmental factors, including the assumed presence of Agent Orange. That assumption was based on VA rulings in 2005 and 2013 which “concluded that herbicides, particularly Agent Orange (AO), were used on Guam from 1968 to 1970.” The study also utilized sworn testimony, including that of Leroy Foster, to determine village-level spray estimates and to determine “AO and non-AO spray areas.”
After examining 11 “high risk” and eight “low risk” villages, the study ultimately concluded that “AO spray area was the only statistically significant predictor of infant mortality due to congenital anomalies under invariable and multivariable conditions.”
While he does not discount civilian exposure, Haddock believes “that the impact of AO was much greater on Air Force personnel and their families living on AAFB than on civilians because only a very few civilians were directly exposed to AO.”
These findings were considered consistent with previous studies showing increased rates of birth defects in the children of exposed Vietnam residents and veterans, in addition to an increased risk of infant death linked to paternal exposure.
Ultimately, the study concluded that more studies were needed given existing constraints – lack of official military records, small sample sizes due to village population, and lack of data confirming exposure.
A 2016 ProPublica analysis entitled “The Children of Agent Orange” went further, examining the VA’s ownregistry to determine the relationship between Agent Orange and birth defects.
The analysis, based on at least 34 years of records in which the VA asked questions about birth defects in the children of veterans, found that “the odds of having a child born with birth defects during or after the war were more than a third higher for veterans who say they handled, sprayed or were directly sprayed with Agent Orange than for veterans who say they weren’t exposed or weren’t sure.”
ProPublica found that since 2001, the VA had received claims for benefits from more than 8,100 people citing spina bifida and other birth defects, but that only 1,325 claimants had received benefits.
Spina bifida is the birth defect most commonly accepted by the VA to be a direct result of Agent Orange exposure. Yet, other birth defects are reported as common by children of Vietnam veterans, includingshortened or missing limbs, webbed toes, extra or missing vertebrae, degenerative spine disorders, spinal cord fusion or detachment, and a range of neurological, reproductive, immunological and developmental disorders.
Setbacks
But the biggest problem withlinking birth defects to Agent Orange is explained in the 2012 update to “Veterans and Agent Orange” from the Board on the Health of Select Populations at the National Institute of Medicine. The update noted that there is potential for TCDD (2,3,7,8-tetrachlorodibenzo-p-dioxin), a major carcinogenic component of Agent Orange,to alter the sperm cells of adults before fertilization. It also noted that direct exposure of a fetus throughout gestation is possible through the mobilization of dioxins stored in fatty tissue.
However, few studies exist to prove the connection because in order for any findings to be considered relevant, the veterans’ exposure had to occur before conception. Additionally,studies also assume that any pregnancy that occurred post-exposure would take place long after the fact, making it harder to prove a connection.
Thanks to lack of official recognition, researchers never considered that people like Mark Cash might exist -a child conceived and born on Guam while his father worked on base, his mother lived on base, and whose first years of life were during the prime years of his parents' allegedexposure to Agent Orange.
Cash’s medical problems did not end with infancy. The list, considered altogether, is substantial: poor immune function that led to frequent illnesses and rarely a single month of school without missed days; moderate to severe bin-aural hearing loss in the 45-50 decibel range; degenerative disc disease detected in high school; mild peripheral neuropathy in fingers and toes that was for years written off to natural clumsiness; and extremely low testosterone production.
In 2015, Cash’s mother died at age 73 from non-Hodgkin’s lymphoma. Cash’s younger sister, who was born at his father’s next duty station after leaving Guam, died in 2011 at age 39 after fighting persistent breast cancer for 10 years. Cash’s older sister has thyroid problems. Her daughter suffers from VACTERL association, a multi-system genetic disorder that causes a combination of vertebral defects, anal narrowing or blockage, cardiac defects, tracheo-esophageal fistula or detachment,genitourinary anomalies, kidney anomalies, and limb abnormalities, according to the U.S. National Library of Medicine. Cash’s father did experience high blood pressure in later life, Cash said, but “he had the constitution of an ox.”
“All of these can occur by themselves randomly, but all of them together are indicative of Agent Orange exposure,” Cash said. “I have one son. Thankfully, he is apparently very healthy.”
Cash has applied for assistance from the VA “because I was told the Agent Orange exposure would make me eligible for help, but the VA counselor told me I wasn’t even eligible to applybecause ‘there was no Agent Orange on Guam.’”
Of the veterans who have testified to the use of Agent Orange on Guam, including Leroy Foster, nearly all have reported birth defects in their children and grandchildren. However, stories like Cash's —children conceived and born on Guam during their parents' tour of duty — are not unique.
- Carol Tamara, a secretary to the Environmental Stress Division at the U.S. Naval Hospital, moved into Navy housing in Umatac with her husband when he was drafted as a physician. Tamara observed "regular landscaping" done around her home and the hospital compound, and did the majority of her shopping on Andersen AFB. In Jan. 1970, her only biological son, John, was born on Guam. Three years later, after returning to the United States, Johnwas diagnosed with autism. In 2003, a few years after her husband was diagnosed with diabetes mellitus, Tamara herself was diagnosed with Parkinson's disease.
- Air Force veteran Larry Doolittle lived in Hagåtña and Yigo while stationed at Andersen AFB from March 1961 to Feb. 1963. His firstborn son was born at Navy Hospital, and hisdaughter was conceived on Guam. Doolittle, his wife and his son are the only members of his family to have Type 2 diabetes. His daughter was found to have shrunken, nearly undetectable ovaries and cannot have children. At age 28, three years after leaving Guam, Doolittle underwent his first breast cancer surgery, and less than 10 years later, his second.Doolittle also reports adrenal tumors, kidney tumors, heart disease, hearing loss, bone deterioration, and skin and scalp lesions.
- Barbara Garcia stayed on base with her husband Michael, who was stationed at Andersen AFB from Dec. 1967 to Dec. 1968. Barbara was nearly 8 months pregnant when she arrived on Guam, and gave birth at Naval Hospital in Feb. 1968 to Denise, who has since been diagnosed with lupus and autoimmune disorders. Barbara's second daughter, Karen, was conceived on Guam. In Sept. 1968, while pregnant, Barbara checked into the hospital after spotting blood. While there, she said, nurses told her that they had seen an abnormal amount of miscarriages lately. The Garcias returned to Nebraska, where Karen was born in 1969. Karen suffers from asthma and a number of allergies. In 2001, Michael was diagnosed with stage 4 aggressive non-Hodgkin's lymphoma and Type 2 diabetes. Ten years and two courses of chemotherapy later, he was diagnosed with the final stages of non-alcoholic cirrhosis. Michael Garcia died on Veterans' Day 2011 from liver failure.