To the editor-Although it is good that the Indian military are to beat swords into calipers for children with residual paralysis from polio (see" Indian military scientists beat swords into plowshares," Nature Med. 2, 138; 1996), your article contained some inaccuracies. The old government leg braces are indeed too heavy, but for the last ten years they have been replaced by lightweight aids made from plastic guttering and polypropylene sheets at Non Governmental Organisations (NGO) such as Handicap International. For the simplest leg support, the cost is about US $3, considerably less than the $10 for the new device discussed in the article. The new device should therefore be compared to these aids, not to the obsolete iron braces. Most estimates of polio incidence have suggested about 200,000 cases each year, in India, giving five million, not eight, over the last 25 years. Information from lameness surveys suggests that 65-75/b of those lame can walk without aids and that about 15% are severely crippled and cannot walk. However, these were descriptions of ability, not need. How many of those able to walk without aids would do better with aids and how many will later suffer complications which could be avoided? Although the group may not have been typical, my analysis of 208 children requiring appliances at the RFFI Workshop in Pondicherry showed that for every 100 of these children, the requirements were for 110 short or long calipers, 5 hip calipers, 10 sticks and 37 crutches. Five children required operations.

Unfortunately, the provision of walking aids is no substitute for the care of the children with paralysis. In a study of 76 convalescent cases and 80 with residual paralysis 86% had avoidable sequelae':" Limbs could have been preserved to a non-handicapping status if adequate and proper rehabilitation therapy was (provided) in the acute stage."