DOCUMENT 3 A declassified report by Herbert E Segal M D printed on the letterhead of the United States Army Medical Component Armed Forces Research Institute of Medical Sciences subject heading “Trip Report Chemical agent use Hmong refugee populations ” dated January 2 1980 in CBW Box 5 Reports Articles Papers and Memoranda 1979-1981 National Security Archive Poem “When the Poison Fell Before 1979” on page 21 of book YELLOW RAIN Page 1 U ITCD STA TES UMY MEDIC U Alt l D fORCES R£ 5£ARCH l STITUT£ CO'lh'1 ' T or rtltOICAL 2 January 1980 SGRD-UWQ SUBJECT sc c cr 3 Trip Report Olcmical Agent Use Hrrong Refugee Populations The American Amb3ssador American Embassy Bangkok Purposes To determine the feasibility of identifyin1 and studying Hmong refugees who have been subjected to a chemical agent at tack rs within the recent past To collect· infonna t ion speciaens and Nterials from Hmong refugees found to have experienced such an attack s Date 26-28 December 1979 Places Udornthani Province C Onsulate Loei Province Loei City Chian Khan District Pak Otoa District Ban Vinai Hmong Refugee Camp Ca np Accompanying Persons Mr Donald E_ Stader Vice Consul AmConsulate Udorn and Mr Pon1kaset Suwannakoon Political Assistant AnConsulat-e Udorn Officials contacted Dr Pichit Lalsanasomphon s Ph D Mr JCase• Chaisit Pol Mr Dr Dr Maj Jteo Teecharoen Watana Sa nhn • I ai DeeAnn Rice Celeste Wood ard overnor Loei Province District Officer Chiang Xhar Police Chief Oaiang X an Caap Director Ca Physician Cainp Physician IYlfl 0 1NI UII • Ito ll'llt l IITUtl Of IUt1101 •-dNl I _ DC 7 Page 2 -SGRD-UWQ SUBJECT Trip Report Ch end cal Aeen t Use Hmong Refueee Populat ions 2 January 1980 and Narrati ve I met Mr Stader durine LTG Pixley's recent visitrefu e became aware of his periodi c surveys of newly arrived Hmone them are p-oups The objecti ves of his visits as I understa ndm ilitar y claihes to obtain informa tion on areas nature and scope of forces The involvi ne the Hinong Pathet Lao and North Vietnaniese the l vel Consula te's priorit ies are to detect signific ant changes in of th n of militar y and politic al insurge nt activity The questio th use of chemica l agents in Laos enjoys a high priority Ourin and trip reporte d here Mr Stader and Mr Pongkaset identif iedarrived intervie wed selecte d persons in two laree eroups of newly ution refugee s and I reviewe d the adminis trative and medical organi account which serves these refugee s The Distric t centers visitedthan 50 for the large inajorit y of Hinong refugee s probabl y fewer month crossin g to the east in Nongkhai Provinc e who had In Otiang JChan Distric t we found a group of 1 682 Hmong a 35 year old 1 Year Heur r DeceJnbe 15 on Laos from over crossed lead Distric t Chief Phu JChe Distric t was intervie wed He had the arei this group consist ing of approxi mately 2 000 H ng from of hardshi p of Phu JChe Lo mg Prabang Provinc e to Thai land becau e Vietnanies in the jungle lack of food and continu ous pressur e by er and and Pathat Lao troops The group left Phu Khe on 4 Novemb Only er reached Thailan d at Chiang l han Distric t on 15 Decemb Vietn - ies 1 682 of the origina l group made it as ambushes by the many and killed people 10 than more in d resulte enroute troops s of account related group the amone men Four lost and dispers ed as appear ws intervie Their area their in chemica l agent attacks Append ix A who had In Pak Chom Distric t we found another group of 293 Hmong for old year 29 a Vong Lee er Decemb 24 and 23 on crossed over the Loung LT vi th the Vang Pao furces and later deputy leader of d that he ad Prabane resista nce forces was intervie wed He reporte r with Octobe 31 on arP a Koi La Pha Pha the in post his ed abandon t 0 1 Distric Chom Pak at d Thailan in arrived group 293 peoJ • His many gas 23 and l4 Decemb er Lee Vong said that there had been but that attacks in his area between Octobe r 78 and January 79 ix A Append in ed describ one the as attacks such cent no n re·re had been reporte d to hi • res were At Ban Vinai Ca111p he ac biin istrativ e and medical procedu T e Camp the in HDDng 36 000 over are there t presen reviewe d At 2 8 Page 3 _SGRO-UWQ SUBJECT Trip Report 0- einical Agent Use Hncng Refugee Populations 2 January_1980 nuni er of new arrivals is variable there having been 616 in Aug st this year 1 598 in September 645 in October and 545 in Novemb£r Thus far over 2 000 have arrived at the District centers in December and are awaiting rovement to the Camp There i an active building program to provide cinder block metal roofed residences for the expanding Camp population Newly arrived refugees are allocated to one of eight living areas and are sent there without medical screening The camp health care delivery system directed by the World Vision Foundation operates outreach clinics within these eight areas and in the District Centers to identify ill patients and to carry out well baby and i11u111mization activities The hospital includes an outpatient facility which sees an average of approximately 400 patients a day and pediatric and adult medicine wards presently organized with approximately 100 beds with separate sections for tuberculosis and measles There is no surgical capability and at present no laboratory The staff numbers 26 and is au mented by locally trained H iong interpreters and aides The physicians questioned did not report seeing any patients with signs or symptoms suggestive_ of the use of chemical agents Comments There is some information that t¾e use of chemic al ag£nts against the Hmong in Laos is continuing Certainly resistance by the Hmong is still active and the like lihood of additional large groups ·o f these people seeki_ng refuge in Thailand is high The prospects of achieving the purposes stated above is low under the present organizational struc ure After escapes requiring six or 1110re weeks Hrong cross daily into Thailand and are brought when found to the District coi lection centers There they may remain wtscreened for periods of days to weeks Only in the event they are SYDptomatic and choose to be seen by a clinic team from the Camp would they be identified Once brought to the Ca p the same situation applies It is thus possible perhaps likely that Hmong with in portant information and or pathogno1TOnic signs symptoms or biochemical derangements enter the camp unidentified and remain ·so Durin1 the present trip no Hmong were found with siinS or symptcms or a recent enough reliable history of exp sure to warrant_the collection of specimens The attacks described are suggestive of the use of several different classes of agents Recoa•ndations l- 'SGovernment interest s _sufficiently hi h expenditures for the following level of act1v1ty seem appropriate l 9 Page 4 · SGUJ-UWQ SUBJECT 2 January_1980 Trip Report O emical Agent Use Hmong Refugee Populati ons l The stationi ne of an interview er close to the District collectio n centers to assure timely identifi cation of chemical aeent-ex posed Hu-ong The present level of staffing at the American Consula te Uciorn and the lack of an organize d active health surveilla nce £fort by the Camp medical services rules out both a organiza tions Tempora ry duty expendit ures and the hiring of Hu-o_ng-Thai translat or would be required 2 The establish ment of standard ized procedur es for inter• lviews and speci en collecti on should a Hmong with recent chemica agent exposure be found It is suggeste d that hese be· designed nt ·by referrin g to standard referenc es e g Army TM 8-28S Treatrre l of Otemical Agent Casualti es and Convent ional Military Chemica Injuries and in consulta tion with experts in the field 3 The establish ment of a local capabili ty to complete s handling prelimin ary laborato ry testing of biologic al specimen could collecte d AFRIMS cannot perform these tasks at present but with mipimal supply augment ation t - c M D LTC MC Director Cy furnishe d Dir Walter Reed Army Inst of Rsch 10 Page 5 Append ix A Interviews Tong Her a 26 year old native of Xeo JCacham Muang Xieng gen ung Prabang Province heard of a gas attack which took place in March 1 76 at Ban Hong khouy a village of about 6 000 H1110n1 Twenty-eight people died after an unidentified aircraft delivered bombs which produced red green and yellow s111 ke Tong Her also heard of another gas attack at Ban Na111 JCai in which 27 Hrong were killed The second attack took place on · Septeri er 1979 He had no information of the signs or symptoms experienced by those affected Xiong Wue a 24 year old is a fonier medic at the Ban Son USAID Hospital 1969 to 1975 He treated 49 patients who suffered from gas attacks a 11 died They had been brought from the villages around Phu hia The attacks took place in l 976-1977 the last patient came to him in March 1977 All of the patient5 died within 24-48 hours They had the following signs and symptolllS Red and swollen eyes Bitter taste in the mouth Convulsions Oiest pain Difficulty breathing Darkened faces Stiff necks Excessive flow of saliva By auscultation Xiong Hue said he detected two different types of breath sounds which I to k as describing coarse rhonchi and tubular breath sounds He used penicillin on saae of the patients but it did not help Jer Por a 3S year old native of Ban Pha Lu Loung Prabang Province witnessed a ps attack in September 1979 and saw two people exposed both of who• later died He was about 10 meters fro • where the bo• bs landed So• e of the boros did not go off these vere tvo types The first type was d3rk green artillery shell-like and the second type vas a dark green cylindrical canister of about one • eter in lencth and 30 ca in dia111eter There was letterin1 ancl nuabers on the• but since Jer Por is illiterate he could not identify the lan1ua e Jer Por liaself vas sick with chest pain cough and pain Nost rom neatly he said that it stung when he Jd1 and yellow saoke produced by the bod s like 'Ille tvo people he saw exposed died vi thin 2 days in lis eyes 11 Page 6 · They coughed up blood had runny noses and very severe bloody diarrhea Other than these two there were more than 20 people killed in the same attack out of 80 defend rs All of their animals chickens and pigs also died Tia Soua Her a S6 year old native of Phu Chia area Loung Praban becam emconscious for 7 days he was told within 30 minutes after a L-19 dropped two bombs on hls village in early 1978 The two bombs produced red and black smoke when they exploded on the ground Six of his relatives died in the attack Tia Soua Her felt very badly after he regained consciousness His finger-nails and toe-nails were black from herorrhage His tongue was stiff and he could not talk for 7 days He also claims to have lost his vision for 30 days 12