10 Worst Ways To Die During The Vietnam War

The Vietnam War was such a complicated, sprawling, and gory conflict that it's difficult even to say when it began and ended. The 21 years from 1954, when Vietnamese forces destroyed the French colonial army, to 1975, when communist North Vietnam overran the American-aligned south, provide a common and convenient periodization. But Vietnam was not at peace before or after these dates: From 1940 to 1945, it was occupied by Japan during World War II as part of French Indochina, then fought against the French attempt to reestablish control until 1954. After 1975, Vietnam saw conflict with the vicious Khmer Rouge in neighboring Cambodia erupt into open war and fought off a Chinese attempt at counter-intervention; the Sino-Vietnamese border would not be fully at peace until 1991.

The casualties were so high that Vietnam did not release official estimates of the number of dead until 1995: a whopping 2 million civilians in total and a million or more North Vietnamese soldiers and Viet Cong. The United States estimates 200,000 or more South Vietnamese soldiers dead and over 58,000 dead or missing Americans. Additionally, deaths among South Vietnam's other allies numbered close to 5,000 across South Korea, Thailand, Australia, and New Zealand. During these bloody decades, all participants committed atrocities beyond even the depressingly standard cruelties and mistreatments of war. Rising military and chemical technologies were unleashed on Vietnam, its neighbors Cambodia and Laos, and the armies contesting its future.

"Setting the other guy and/or his stuff on fire" is an ancient and effective war strategy, reflected in Byzantium's lost Greek fire, the firebombing of German and Japanese cities in World War II, and one of the Vietnam War's most feared weapons: napalm. The term napalm  describes both a class of thickening agents added to gasoline (or a similarly combustible hydrocarbon) and the resulting mixture, which can be used in flamethrowers or incendiary bombs, or even dropped from the air. The resulting mixture burns especially hot and sticks as it burns, ensuring combustion of whatever it hits — even human beings.

Invented during World War II, napalm was used heavily during the bombing of Japan, the Greek Civil War, and the Korean War, but it was during the Vietnam conflict that the fiery gel became notorious. In 1972, then-9-year-old Kim Phuc Phan Thi, known more broadly as "Napalm Girl," was photographed running nude in a panicked attempt to escape the flames that stuck to her. The photographer, Nick Ut, saved Phan Thi by smothering the burning napalm with a blanket. The image won a Pulitzer for Ut, set Phan Thi on a trajectory as a symbol of war and children's rights advocate, and alerted the public to the horrors of napalm. Unfortunately for those who would spare future children Phan Thi's experience, the use of napalm remains legal under international law, and it was used as recently as 2003 by U.S. forces during the invasion of Iraq.

North Vietnamese and allied forces were able to both conceal themselves within and draw sustenance from the lush, heavily forested Vietnamese countryside. The United States addressed this operational challenge with the cynically named Operation Ranch Hand (renamed from Operation Hades), which aimed to strip much of Vietnam (and officially neutral Laos and Cambodia) of its leafy cover by spraying "defoliants" — poison — over the landscape. The "rainbow agents" were given color-coded names; of them, Agent Orange was the most effective and thus most widely used, accounting for about 60 percent of the 20 million gallons of herbicide dropped on Vietnam and its neighbors. 

One of the key ingredients in Agent Orange was dioxin, a catchall term for a class of related chlorine-containing toxins. They are both extremely poisonous and extremely persistent, meaning they do not readily break down in the environment or in animal metabolism. (They can, in fact, remain in an animal until it is eaten, going on to poison predators or consumers.) Exposure to dioxins can cause cancer; hypertension; diabetes; fetal abnormalities; impaired liver, immune, and endocrine function; and a particular form of acne, which seems a bit like adding insult to injury. The U.S. National Institutes of Health place dioxins among the most toxic chemicals exer discovered. 

Agent Orange is no longer used by the United States military, but the scale of the operation means it is difficult to impossible to assess how many service members were exposed, let alone how many local fighters or civilians (Vietnam estimates 3 million), as well as how many people ultimately died from the poison's effects. 

The Viet Cong were feared for their clever and frightening use of booby traps, defined as a hazard concealed by or disguised as something appearing harmless. Booby traps are broadly forbidden under international law, but this proviso was not added to the Geneva Conventions until after the Vietnam War ended. Though booby traps certainly could and did kill people who triggered them, they were designed to be more likely to cause serious but non-fatal (or at least not immediately fatal) injury, sapping the effectiveness of the hostile force through caution, horror, and the need for uninjured soldiers to help their injured comrades. 

Booby traps showcase the near-infinite capacity of human creativity when it comes to inflicting harm on one another. Punji sticks were among the most feared; these pointed sticks (of bamboo or metal) were placed in concealed pits, into which the unwary could fall and impale themselves. For added danger, the sticks could be adulterated with poison or feces (to encourage infection) and were sometimes placed in clusters to ensnare would-be rescuers. 

Other traps included the swinging mace, a spiked ball that would swing toward the victim when a tripwire was triggered; the self-explanatory but terrifying snake pit; activated bullets and grenades that went off when disturbed; and bamboo whips, spiked bamboo poles under tension that would snap back into place and gore whoever was unlucky enough to have dislodged it.

Chronic traumatic encephalopathy (CTE) has become a news story in recent years due to its apparent prevalence among football players, but it can affect anyone who's gotten their bell rung enough times. Through a mechanism scientists have yet to completely understand, repeated blows to the head, covered under the nonreassuring term "mild traumatic brain injury," lead to the death of brain cells. Symptoms overlap with those of a number of other disorders but include mood disturbances; personality changes; trouble with walking and balance; loss of other motor skills; and most saliently, memory loss and cognitive impairment.

Shock waves from explosions are the most frequent source of mild brain injuries like those that can cause CTE for service members (and anyone else unfortunate enough to be in a war zone). An NIH report on the disorder also cites vehicle accidents, falls, training incidents, and recreation as possible ways for these blows to occur. In addition to its own, potentially devastating effects, CTE seems to raise the risk of motor neuron diseases (like ALS, aka Lou Gehrig's disease) and Parkinson's, both of which can, like CTE, prove fatal. Unfortunately for research, CTE can only be definitively diagnosed during autopsy.

Sepsis occurs when a patient has an infection, usually but not necessarily bacterial, and the immune response is so intense that it begins to damage the organs. (It is distinct from septicemia, a bacterial infection in the bloodstream, but can result from this condition.) Sepsis is a medical emergency and believed by the World Health Organization to be among the leading causes of death worldwide, causing 11 million recorded deaths in 2020 from nearly 49 million cases. Notably, it's difficult to collect statistics from the entire global population, so this is almost certainly an undercount. Symptoms of sepsis include fever, pain, rapid breathing and heart rate, and confusion; these can progress to shock, organ failure, and ultimately death if not quickly addressed.

Measures to prevent sepsis center largely on hygiene, sanitation, and basic infection control, all of which are of course difficult to maintain in a war zone. Sepsis has therefore remained a high-mortality condition among U.S. service members, even as medical advances have improved treatment. An NIH study of deaths among hospitalized service members in 19 treatment centers during the Vietnam War placed sepsis behind only head injury and blood loss as a killer of surgical patients; behind only blood loss among those admitted who died in the first day; and the leading cause of death among those who died after their first 24 hours in the facility. 

Malaria, a serious and widespread disease, occurs when a mosquito bites a person or other animal and transmits a single-celled parasite. These parasites have a complex life cycle that leads to their infecting both liver and red blood cells, causing symptoms including fever, headache, joint and muscle pain, vomiting, rapid heart and breathing rate, and cough. Some people experience "cycles" of illness that will seem to resolve, only to recur after a period of time. While malaria can be treated, some populations of the parasite have developed drug resistance, and over 400,000 people die of malaria annually. 

Malaria has affected American service members in every war that has involved deployment to the warm, humid climates where the carrier mosquitoes thrive. During the Vietnam War, over 24,000 service members were diagnosed with malaria, leading to an estimated 392,000 sick days taken (that's over a thousand years!) and 46 confirmed deaths. While this is a relatively small toll compared to other causes of death, the convulsions, coma, kidney failure, and respiratory distress that can mark severe cases of malaria mean that many of its victims are not granted a gentle exit.

The Vietnam War formed part of a complex system of intertwined conflicts in Southeast Asia that extend past the common definition of the war in both time and space. Vietnam's neighbors Laos and Cambodia were pulled into the conflict and suffered their own civil wars, and the war in Cambodia would become one of the most horrifying conflicts of the post-World War II catalogue of conflicts. The causes of the Cambodian Civil War are a complicated web of shifting alliances and Chinese and Vietnamese interference, and the hard-to-follow origins of the war are overshadowed by the appalling genocide carried out by the victor, the Khmer Rouge.

Initially supported by Vietnam, the Khmer Rouge (the Khmer are an ethnic group in Cambodia; "rouge" is French for Communist red) took the capital Phnom Penh on April 17, 1975, and immediately began killing. The Khmer Rouge vision of a wholly controlled peasant society began with attempts to empty the cities, quash individuality, and break apart families, and proceeded to include forced labor in pursuit of wholly impossible goals for agricultural production. Ethnic minorities, religious people, so-called "intellectuals," and civil servants in the toppled government were marked for torture and murder. The carnage continued until Vietnam, now unified, toppled the Khmer Rouge and installed a puppet government in 1979.

Nearly 20,000 mass graves — not individual graves, mass graves — have been uncovered from this period. Estimates of the total dead vary, but a 2015 statistical analysis from a UCLA demographer places the likely total at anywhere between 1.2 and 2.8 million; the high end of this range would indicate nearly a third of the 1970 population killed.

Sadly, suicide is among the leading causes of death in the United States, and this unhappy trend is especially pronounced among veterans. Statistics from 2018 show that 32 per 100,000 veterans died by suicide that year, a little less than twice the rate of the non-veteran population (17.2 per 100,000, which is still not an encouraging figure). Many of these suicides occur among older veterans in the 55-to-74-year-old age bracket, but younger veterans between 18 and 34 show the highest increased risk for suicide above their non-veteran peers. Women are at a lower risk of suicide generally, but the additional suicide risk for veterans appears to affect women more severely, with female veterans facing a higher additional risk for suicide than their male counterparts. All told, these grim statistics paint a complex picture of veteran suicide that affects people across demographic lines.

Specific risk factors for Vietnam veterans include long combat duty, injury, survivor guilt, and guilt about their perceived commission of immoral acts. For suicides among service members during their tours in Vietnam, researchers additionally point to the high-even-for-combat-zones stress levels they faced, which included frequent anxiety about unannounced attacks and the physically uncomfortable conditions. The fear, guilt, and tension could combine to create intolerable mental states, which sometimes led to suicide either in the theater of war or well after the fact.

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Closely allied to the idea of "trying to set the other guy's stuff on fire" is the related concept of "just blowing it all up." Indochina during the Vietnam War was bombed more intensely than any other place in history, doubling even the staggering bombardments of World War II. The 7.5 million tons of bombs fired at targets across Vietnam, Laos, and Cambodia made the small, landlocked Kingdom of Laos, onto which 2 million tons of this ordnance fell, the most bombed country in history on a pounds-per-capita basis. (For comparison, unhappy Gaza absorbed "only" 85,000 tons of explosives in the first year of the post-October 7 war.) 

As the Vietnam War ground on, the United States and its allies shifted from tactical bombing, relatively small and targeted strikes against military targets, to strategic bombing, hammering the general infrastructure of the affected areas in an attempt to cripple production and shock civilians into arguing for peace. American bombers could release bombs from so high that the attacking planes could not be seen from the ground; the price of this stealth was a loss of accuracy. 

The deaths didn't stop with the war. Not all of the bombs detonated, and even at present, explosives are still sometimes found and accidentally detonated by civilians, despite the efforts of local nonprofits to clear the hazardous residue of a past war. 

The Geneva Conventions barring, among other bad behaviors, torture, ostensibly bound all major parties in the Vietnam War. The North Vietnamese argued that foreign troops they captured were not prisoners of war but criminals, and therefore the Geneva Conventions and related rules didn't apply. This interpretation theoretically freed them to treat their prisoners as they wished, and so many of the 766 American service members known to have been held as prisoners during the conflict suffered torture. Additionally, the length of the war meant that terms in captivity were often long, with the longest-held captive, Commander Everett Alvarez Jr., languishing for over eight years.

American prisoners were held in generally poor and unhygienic conditions and provided with insufficient rations, little ventilation, and meager warmth in winter. They were sometimes paraded in the streets of Hanoi, including on one infamous occasion in 1966 when authorities lost control of angry crowds, and the POWs were nearly all injured in the resulting chaos. Prisoners were beaten, sometimes fatally; had their joints intentionally dislocated; suffered electric shocks; were bound in intentionally painful positions; and were whipped with fan belts that whittled away the skin. Much of this torture took place with a soundtrack of hectoring, ideological transmissions from Radio Hanoi, and POWs were often kept isolated from one another to increase the psychological torment. All told, 114 of the American POWs died in captivity, with many of the rest bearing severe physical and mental scars for the remainder of their days.