How Bukidnon’s quinine helped World War II Allies in the Pacific

CAGAYAN DE ORO CITY, Philippines – The Mount Kitanglad Range Natural Park in Bukidnon province is an ASEAN Heritage Park that holds a special place in the history of World War II.

Malaria was one of the most insidious challenges facing soldiers from both sides in the Pacific theater. Although not usually fatal, the soldiers would be unfit for combat for long, just as if they were wounded in battle.

The US Army Heritage and Education Center recounts how some 24,000 of the 75,000 American and Filipino soldiers defending the Philippines in 1942 suffered from malaria. 

If they had been healthy, the outcome might have been different. The experience taught the Army that effective malaria control was essential for success in the Pacific theater.

The main problem in the fight against malaria in the early days of World War II was securing a safe and reliable supply of antimalarial drugs. The preferred treatment was quinine due to its proven efficacy, relatively few, and mild side effects.

With at least two million malaria cases every year, the Philippines needed 32,400 kilograms of quinine per year, but often less than 2,000 kilograms were imported because it was so expensive.

Cinchona has been historically sought after for its medicinal value, as the bark of several species yielded quinine and other alkaloids that were the only effective treatments against malaria.

Before the war, The Netherlands had a virtual monopoly of the world supply with the island of Java, then a Dutch colony, as the world’s largest producer of cinchona.

But when Nazi Germany overran The Netherlands, and the Japanese conquered Java and the Dutch East Indies in 1941, the raw supply of cinchona was cut, and the Allies found themselves without access to any supply of quinine or cinchona bark. 

The Allies had several efficient quinine total syntheses already available, but each had unpleasant side effects, and none could compete in economic terms with the isolation of the alkaloid from cinchona trees.

Thus, Philippine Commonwealth President Manuel L. Quezon ordered the establishment of an Experimental Research Station with a Cinchona Nursery and Plantation in the Bukidnon village of Kaatoan in 1927.

Covering 1,725 hectares planted mostly with seven cinchona species and other indigenous medicinal trees, Bukidnon province was the only location in the Philippines where the tree was raised and thrived purposely for quinine production to treat malaria.

Cinchona is a medium-sized tropical tree that grows up to 79 feet with a 24-inch diameter.

“During the time the area was proclaimed, it was a mere barrio of Malaybalay,” said former forester Carlos Bagonoc who worked under the Department of Environment and Natural Resources (DENR) in Manolo Fortich, Bukidnon.

Successful development

Colonel Arthur F. Fischer of the US Army’s Military Intelligence Service who served as the director of the Bureau of Forestry of the Philippines from 1917 to 1936, was largely responsible for the successful development of the cinchona plantation in Mindanao.

The cinchona species originally came from South America’s Andes Mountain between Peru and Chile and was later introduced by Fischer in the Philippines with seeds he got in Java from American consul-general Chas L. Hoover.

After a series of failed trials in Baguio in 1912 and 1916, and Impalutao, Impasug-ong, Bukidnon in 1927, it was successfully raised in Kaatoan, Malaybalay, Bukidnon with nearly double the quinine content of the original.

By the time World War II in the Pacific broke out in 1941, there were already 1.2 million cinchona trees in Kaatoan, of which 750,000 survived the Japanese occupation.

Quinine for Bataan

By March 1942, close to 500 men with malaria were admitted daily to the hospital in Bataan, and the number nearly doubled by the end of the month. The infections were so acute and rendered them unfit for duty.

Driven by the desperate plight of the malaria-stricken defenders of Bataan, Fisher flew at great personal risk from Bataan to Mindanao where he organized a group of his former staff of foresters for collecting the cinchona bark.

Efforts to supplement the nearly exhausted supply of quinine were made as often as possible by planes of the little Bamboo Fleet based in Del Monte, Bukidnon.

Although they had flown in close to 800,000 tablets by March 30, it was a mere fraction of the estimated minimum of three million needed to quell the spread of the disease.

Fischer shuttled back and forth in an old Bellanca plane until Bataan fell. He supplied American and Filipino guerrillas until he was ordered to Australia.

Lieutenant Colonel William Kennard of the Medical Corps claimed that “through the initiative and sheer guts of the Air Corps pilots,” the drugs they delivered delayed Bataan’s surrender longer than the Japanese had planned.

Those extra months required the Japanese to invest additional manpower and resources in the Philippines intended for other areas of the Pacific theater, buying General Douglas MacArthur more time in preparing his forces to repel and eventually counterattack the Japanese forces.

Struggle in the Pacific

During the Japanese occupation of World War II from 1942-1945, Fischer secretly led the cinchona bark gathering under the very noses of the Japanese and brought it to an unspecified location near Macalajar Bay off Cagayan de Misamis (now Cagayan de Oro) where enough cinchona bark to manufacture a million five-grain quinine tablets was moved by submarine to the Allied Headquarters in Australia under MacArthur for its affected troops in Asia and the Pacific.

The fight against malaria was a struggle in the Pacific, and the disease affected both sides. By the war’s end, it was estimated that up to 90% of Japanese troops in some locations were combat-ineffective due to malaria and dysentery. 

Based on tabulations done after the war, US Army medical personnel treated 47,663 cases of malaria in 1942, with an infection rate of almost 251 cases per 1,000 troops. With a quarter of all troops infected, malaria was proving to be as large a menace to American operations as the Japanese. The US Army medical department estimated that casualties due to malaria for this period outnumbered combat casualties on an order of seven to 10 times. 

For his wartime services, Fischer was awarded the US Legion of Merit by the War Department for directing the harvesting of cinchona seeds under battle conditions in Mindanao from March 26 to April 13, 1942, transporting the seeds to the US, and collaborating in the work of organizing an American Cinchona Plantation for the production of quinine.

Bukidnon’s prestige

Today, the Cinchona Forest Reserve in Kaatoan, Lantapan, Bukidnon adds prestige to the Mount Kitanglad Range Natural Park’s stature as an ASEAN Heritage Park and the only area left in Asia and the Pacific where cinchona is grown.

Access to the area has recently been greatly improved with the completion of the 1,143-meter concrete access road in Lantapan, Bukidnon that leads to the cinchona forest reserve. The completion of this concrete road would hopefully promote greater awareness of the heritage and history of this area. – Rappler.com