The Miraculous Fever Tree by Fiammetta Rocco

Gail Vines enjoys an engaging history of the bark that beats the mosquito bite
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The Independent Culture

Fiammetta Rocco reckons she owes her life to quinine. Without regular doses of that repulsively bitter stuff, extracted from the bark of the South American cinchona tree, her father would surely have died as a boy in Kenya. Growing up in east Africa, Fiammetta too contracted malaria at 18, in a moment of pill-free carelessness on the mosquito-ridden coast.

For the first time, she felt not just sick but invaded. "With any other illness, I have always felt that I was still myself. I might be in pain or feel nauseous, but I was me - only sicker. Sick with malaria, however, my body felt it was no longer my own." Her body had become the target of a military coup. As her fever shot up, and the parasites in her bloodstream began to destroy her red blood cells, all she remembers is passing out. "The blood has been hijacked. That is how the delirium begins."

Her father's Italian doctor in Nairobi ensured that she did not become another victim. Every year three million people die of malaria: one life every 15 seconds. Worldwide, some 500 million people are infected: "eight times the population of France or Great Britain, or twice as many people as live in the United States".

Only a handful of drugs against the disease exist, and all are sold at prices far beyond the means of the world's most vulnerable people. The failure of the pharmaceutical industry to devote serious money to the fight against malaria is an enduring source of shame. Rocco steers clear of this scandal, and tops and tails her engaging history with a success story from the Congo. There, in the war-ravaged eastern borderland, stands the world's last cinchona plantation, beside a miraculously surviving processing plant. Affordable quinine retrieved from the bark of its trees still saves lives throughout Africa.

The Miraculous Fever Tree is a fascinating account of quinine's key role in the making of the modern world. Many have tried to tell this tale, and it is a testament to Rocco's flair and sheer hard work that she has found new things to say. Days spent in libraries in London, the Vatican and Seville are followed by weeks of searching through unlabelled boxes in a mouldering, uncatalogued archive in Peru.

There, the librarian gives her the key, and says she can work for as long as she likes each day. Box after box she searches, not knowing whether she will ever discover anything relevant to her quest. Occasionally, she has to spend the night there, when a curfew prevents return to her hotel. But such trials are lightly dropped into the narrative. The historical stories are the focus, and give depth and lasting value to her book.

Rocco's fine writing is at its best in her early autobiographical snapshots, although she is careful never to allow the personal to predominate. Sent from Kenya to a bleak convent school in Sussex at 14, the snow-filled clouds are like "a laundry bag waiting to burst". Lying awake in the dormitory at night she struggles to conjure up the smells of home. "It was as hard as sewing raindrops."

She found herself missing even the weekly dose of the vile-tasting quinine-syrup, which she swallowed every Sunday, though the foul taste lingered long on the teeth and gums. The bribe was always the same: the children were allowed to choose what the family would have for Sunday lunch, to be prepared by her Italian grandfather, who was "a tremendous cook".

Appealing as her memories are, you understand why she sticks to the story of quinine. Long before globalisation became something to talk about, this bark had been everywhere. Its story begins in 1623, when malaria killed ten cardinals who had come to Rome to elect the new Pope. Nine years later, a young Jesuit apothecarist set sail for Peru, and laid the foundation for an international trade in a fever cure made of exotic bark.

This "Jesuit powder" - with its troublesome associations for the Puritans of Cromwell's Britain - soon won over religious bigots, and did much to overthrow the stifling ancient doctrine of Galenic medicine. But throughout the 17th and 18th century, malaria remained common throughout western Europe, creating a terrible need for an effective treatment in peace and war.

Without quinine, explorers, missionaries and traders would never have survived in Africa, let alone lay the groundwork for European empires. By the 19th century, the question of how to ensure a cheap and regular supply was vexing colonial administrators everywhere, but nowhere more than in Britain. A scheme hatched at Kew, which eventually succeeded, was to smuggle the tree seeds out of South America and grow them in colonies in India. Alas, rival plantations started by the Dutch in Java would prove even more successful.

The scientific race to discover how the mosquito spread the malaria parasite, the stuff of Rocco's penultimate chapter, is well told, and the final chapter brings unexpected twists. During the Second World War, after the world's quinine plantations were captured by the enemy, the American pharmaceutical industry began to mass produce the synthetic chloroquine. Over the past 40 years, however, growing resistance to the drug has made it useless throughout central and eastern Africa. New drugs, such as Larium and Malarone, have replaced chloroquine for Western travellers, but are so costly as to be unthinkable for Africans.

The surprising news is that natural quinine remains an effective and affordable ally against the malaria parasite. Quite why this should be so is not clear, but no matter. Even after all these years, it's good to know that the bitter red bark of the cinchona tree is still performing miracles.