The history of the Mekong Delta is one of water and rice growing. Twelve provinces comprise the most southern portion of Vietnam. Massive river systems emanating from the Mekong River have brought silt into the region for millions of years. The abundance of water, fertile soil, and a warm climate are good combinations for productive rice cultivation.

During my tour, I was never out of the Delta. I had never seen such gigantic rivers as the My Tho and Hau, Ham Luong and Co Chien, the major branches of the Mekong flowing into the South China Sea. Tentacles of water are spread throughout the region, important for agriculture and transportation. Roads provide far less access in the area than the intricate system of waterways. Canals, having been built for centuries, provide more water for irrigation and travel by sampans. They increased the reach of trade and farming in a saturated terrain that made road-building difficult to construct and maintain.

The history of these man-made channels is fascinating, somewhat reminiscent of the labor required to build the pyramids in Egypt. The very earliest evidence of these projects dates back two thousand years. As late as 1818, a conscripted labor force of 50,000 worked five years building forty miles of strategically placed waterway to help solidify Vietnamese control of the Mekong Delta. Bars of sediment form differently each year where tidal currents meet the force of the major rivers. Root systems from the incredible flora of the region also clog the canals. Keeping them navigational requires immense effort.  

Farming villages dot the intricate waterways where families own small plots of land requiring intensive labor to grow, tend, and harvest rice in a climate where two and three crops are produced annually. Even today small landholders comprise most of the Delta’s population of eighteen million people. The average family plot is one and a quarter acre. What that acre grows is indicative of the importance of rice to the region and the nation.

Each of those one and a quarter acres averages over seven thousand pounds of rice per crop. Double that amount if two crops a year are produced and triple the total if it’s three. Forgive my enthusiasm for the details of these figures, but I have spent my working life in agriculture coaxing and nurturing yields from the land. With just twenty percent of Vietnam’s population, the Mekong Delta produces over half of the country’s total rice. With eighteen and a half million acres seeded to this essential grain, the Delta produces thirty-eight million tonnes per year (2,204 pounds comprise a tonne).

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Due to the intensity of the agriculture practiced throughout the region, the Mekong Delta is both rural and densely populated. This led to a great tragedy of the Vietnam War—the number of civilian war casualties. The mix of American firepower in the highly populated Delta caused the wounds and deaths of many Vietnamese civilians, children and aged among them. Nothing impacted my own tour more than the numbers of civilian war casualties I saw and treated. Nothing has stayed with me like the scenes of our firepower landing on innocents caught in situations beyond their control. None of the excuses and euphemisms used to explain the numbers of civilian casualties ring true to me. Three-year-old children did not harbor grenades waiting to blow us up. Five-year-old girls were not waiting with rifles to ambush us.

We created a lot of fear and hatred with our searches in the villages. Some of them were VC friendly, or even controlled by the enemy. It’s true we tripped booby traps that villagers never did. Young American grunts were placed in dangerous and impossible situations. I don’t blame them for wanting to avoid death and return home. There was plenty of cruelty on both sides. Killing begets killing and more cruelty. The response of our firepower took a tragic toll on innocents.

I will devote a future blog to more about civilian war casualties, CWC’s on our field medical tags and the charts in the evac hospitals. I do not look forward to it. In Poisoned Jungle, Andy Parks grapples with all of the emotional cross currents of trying to save lives while everyone around him is focused on killing. As the medic, he is the member of the platoon brought forward to see what can be done for six children wounded in a napalm strike. Much later in life, the repressed memory of treating a five-year-old surfaces while tucking his own son into bed, safe and secure as all young children should be. More than anything, I think the civilian war casualties touched something deep within me that psychologists are now calling “moral injury.” I will also get to that in a future blog.

With this column I wanted to give a sense of the Mekong Delta and how intricately entwined the population is with the rice cultivation of the area and why a largely rural-based society can still be densely populated. According to the research of Nick Turse in Kill Anything that Moves, the Delta was an area with a high degree of civilian war casualties. My experiences as a medic bear that out.