The most immediate effect of the Vietnam War was the staggering death toll. The war killed an estimated 2 million Vietnamese civilians, 1.1 million North Vietnamese troops, 200,000 South Vietnamese troops, and 58,000 U.S. troops. Those wounded in combat numbered tens of thousands more. The massive U.S. bombing of both North and South Vietnam left the country in ruins, and the U.S. Army’s use of herbicides such as Agent Orange not only devastated Vietnam’s natural environment but also caused widespread health problems that have persisted for decades.