The Solomon Islands tragedy--a tale of epidemic poliomyelitis.

BACKGROUND THE RAVAGES OF epidemic poliomyelitis have been well documented in the industrial world since the turn of the century, but it is not generally realized that a similar state of affairs has also existed in remoter parts of the world for many years. One such area is the Solomon Islands which has been particularly badly affected and a history of the disease in that territory is now presented for the first time. In order to furnish the reader with the requisite background knowledge (not otherwise readily obtainable), a brief outline of both the relevant geography and history of the region is provided." The Solomon Islands comprise a scattered archipelago in the Western Pacific. In a vast expanse of water the total land mass is only just over 30,000 sq. km. and is made up of six large forest-covered, mountainous islands surrounded by numerous smaller islands and atolls. The largest land mass is Guadalcanal with an area of some 5,000 sq. km. Having an average of only six people per sq. km., the Solomon Islands are sparsely populated, although several outlying atolls are overcrowded. The 161,000 population is made up of over ninety-three per cent Melanesians who inhabit the large islands, and four per cent Polynesians who live on outlying atolls. The remaining inhabitants, who are non-indigenes, consist of 1.5 per cent Micronesians, mostly Gilbertese immigrants, and just over one per cent non-oceanic races made up primarily of Chinese and Caucasians.2 The native inhabitants live in small coastal or inland villages which are well sited, traditionally for defensive purposes but now for ease of communication. The villagers are not dependent on a cash economy as they can live adequately by subsistence farming and fishing. Until recently the Protectorate's economy relied on the export of copra, but in recent years this revenue has been exceeded by that of timber and fishing. Communications have long been a majorstumbling-blockto economicdevelopment. Travel on the larger islands has, until recently, relied on a network of bush paths and on coastal canoeing. Even today there is still less than 400 km. of all-weather *A. B. Cross, O.B.E., M.D., F.R.C.S.I., D.T.M. & H., Late Govement Surgeon, British Solomon Islands Protectorate (1966-1974). Currently, Consultant in Accident and Emergency Services, Dudley Road Hospital, Birmingham.