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One of the frequent acts of hubris by war makers is to ignore the consequences of war that will last a generation or more. Political leaders rarely point to any outcome of a war unfolding apart from the war’s aims — glorious victory, horrid enemy vanquished, few casualties, peace and prosperity for all.

But war has a mind of its own, as nearly every conflict of the past 70 years has taught us. The Second World War deluded Americans into believing that we could manage enormous conflicts and win them unequivocally. It was, however, a consequence of the bloody First World War and exacted a colossal scale of carnage — 50 million dead and an equal number displaced. And that was “the good war.”

Since then, we have had four major conflicts, and we see every day the lasting consequences of carnage. In Korea, there is the contemptible north. In Afghanistan, we are in effect waiting to turn the keys over to the Taliban, as a longtime observer of the country, Anna Badkhen, recently remarked to me. The toll of 100,000 or so Afghans and the millions displaced and immiserated hardly registers even on America’s short-term memory.

Consider, then, two other sizable wars: the U.S. wars in Vietnam and in Iraq. The Vietnam War ended 40 years ago on April 30 as the Viet Cong overran Saigon. Vietnam went through years of extreme hardship after the war, emerging to be a dynamic country. But the war took an enormous toll. Not only were there some three million killed and five million displaced, and the 10-20 years of deprivation following, but residual chemical warfare and unexploded bombs that bedevil the country four decades after the war’s abrupt end.

“From 1961-1971, the U.S. military sprayed 18 million liters of chemicals, including 366 kilograms of dioxin,” Pham Troung of the Center for International Studies and Cooperation explained to me recently in Hanoi. Dioxin, the lethal component of the defoliant Agent Orange used by American forces, is one of the world’s most toxic substances. “It got into water supply and land sediment. Humans, animals, and plants were contaminated. The local ecosystems were totally destroyed.”

Human contamination brings with it horrific disabilities. According to the U.S. Institute of Medicine, five cancers can result from exposure: “soft-tissue sarcoma, non-Hodgkin’s lymphoma, chronic lymphocytic leukemia, Hodgkin’s disease, and chloracne.” It can completely debilitate people who do not get cancer. It is passed to later generations genetically.

As many as four million Vietnamese were exposed to Agent Orange during the war in what was called Operation Ranch Hand. Twenty million gallons of the stuff were dumped onto an area in South Vietnam the size of Massachusetts. Estimates vary on the numbers of Vietnamese now affected by dioxin exposure, but it’s currently in the hundreds of thousands of those still living. Tens of thousands of children — at least 150,000, in fact — have been born with severe birth defects since the war ended. Washington has begun to take on some responsibility for this crime, thanks to Senator Patrick Leahy (D-VT), but the clean up costs are staggering given it’s widespread use in the war.

There’s a similar story about unexploded bombs and other ordnance. Chuck Searcy, a U.S. army veteran of the war who now lives in Vietnam to help deal with these issues, says estimates of 100,000 live, unexploded bombs, land mines, et cetera are littered throughout Vietnam. They can’t find and remove all the ordnance, but hope to raise awareness and have built a reporting network.

So we have, in just these two examples, the abiding consequences of war. Neighboring Cambodia and Laos were hard hit, too — hundreds of thousands dead in both countries as a result of U.S. actions — and have had a harder time since. It has taken decades to achieve even very modest recovery.

We don’t talk much about the scale of human suffering in Southeast Asia that came from U.S. intervention. American involvement in the Middle East could usefully be informed by the Asian experience, however: namely, that war has long-lasting consequences for the local populations, to say nothing of broader impacts.

In Iraq, we are seeing the short-term consequences in the abrupt and deadly emergence of ISIS, or the Islamic State, or ISIL, or Daesh. I needn’t list the atrocities and startling scope of its reach (now in Libya, for example, and threatening to invade Italy) to underscore the significance of ISIS as a demon seed of the Bush-Cheney-Rumsfeld war in Iraq, or, more properly, the 25-year war in Iraq that began with Saddam’s occupation of Kuwait in 1990. The sanctions imposed after Operation Desert Storm took hundreds of thousands of lives, many of them children, and then the war launched in 2003 took another 700,000 or so. To say that such a 25-year history is disruptive and distorting of society is a gross understatement.

One result has been ISIS. It played on Al Qaeda’s previous inroads made among Sunnis. Many of its adherents, including its leader, are veterans of the Bush war in Iraq and, notably, prisons like Abu Ghraib and Camp Buca. But ISIS may just be the short-term effect, the first to emerge. However chilling that is, there’s much to suggest that Iraq and the ill-begotten civil wars in Syria and Libya could produce decades of violence.

Among other effects of the war, there are orphans by the hundreds of thousands, and many boys without fathers. There is wicked sectarianism that is both a contributor to the emergence of ISIS and a response to that emergence. There is meddling by all the neighbors that often contributes to the violence. There is spillover from Syria. There has been widespread use of white phosphorous and depleted uranium in U.S. weapons that, while not nearly as devastating as dioxin, likely pose a significant health risk for Iraqis.

Vietnam and Iraq demonstrate vividly the human cost of war: not only the immediate war mortality, injury, and displacement, but the horrific effects that are realized only years later. In the case of Vietnam and the rest of Southeast Asia, a long period of wrenching poverty, and for the war zones, chemical consequences of epic proportions. It’s a small miracle the war didn’t stir violent instability beyond the psychotic rampage of Pol Pot in Cambodia.

Iraq and much of the Middle East and North Africa, as it looks now, may not be so lucky.