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Twenty-six of the 28 patients known to have been paralysed by poliomyelitis on St Helena over 40 years ago were traced. All had led fulfilled lives. Nine had since died but no deaths were attributable to the disease. The satisfactory outcome of these people's lives was due to a combination of factors. Initially early diagnosis and immediate appropriate treatment minimized contracture formation. Early intensive rehabilitation and return of the patient in an upright and ambulant position to a caring community established the pattern of their future lives. The later lack of surveillance resulted in six of the patients reverting to crawling and only two still using their calipers. In remote and poor areas appliances where possible should be made and maintained locally.