Renal services boost sees Indigenous patients stay closer to family, but more dialysis needed
Posted
When local health services in north-west Queensland took over the management of renal services from their regional hospital this year, more patients were able to receive treatment closer to home.
Key points:
- Aboriginal and Torres Strait Islander people are almost four times more likely than non-Indigenous people to die from chronic kidney disease
- Until recently, renal patients had to relocate and undergo dialysis in Townsville awaiting a spot 'until someone died' in Mount Isa
- The Mount Isa Hospital will be able to accommodate 48 patients for dialysis, three times a week, in coming months
In January, the North West Hospital and Health Service (NWHHS) — covering Mount Isa, Cloncurry, Julia Creek and the Gulf country — took over the management of renal services from the Townsville Hospital and Health Service.
Renal health worker Belinda Johnson said before that there was limited capacity at the Mount Isa Hospital, and patients were sent to the Townsville for dialysis until someone died.
"They just had to wait in Townsville until someone passes on here in Mount Isa, on the dialysis chair. They'll send them back — one by one," Ms Johnson said.
"Some of these patients don't get to see their family, and the saddest thing is that [they] have to go home in a coffin."
Aboriginal and Torres Strait Islander people are almost four times more likely than non-Indigenous people to die from chronic kidney disease, according to Kidney Health Australia (KHA).
"It's a really big killer, and a lot of people die — not with chronic kidney disease, but with other conditions that have been made worse by their chronic kidney disease," said its clinical director Shilpa Jesudason.
High mortality rate
Chronic kidney disease is one of the biggest health problems in north-west Queensland, where Indigenous people are up to 30 per cent more likely than non-Indigenous people to develop renal disease, according to the NWHHS.
Dr Jesudason said Indigenous people often needed to relocate to receive treatment for end-stage kidney failure.
"That process of relocation is incredibly disruptive to their personal life and to their life within a community and family structure," she said.
"It leaves people in a very vulnerable state."
The Mount Isa Hospital will be able to accommodate 48 patients for dialysis, three times a week, in coming months.
Ms Johnson said that enables Indigenous people to be closer to home, allowing them to be better connected with their family and land.
"Family from Doomadgee, Mornington [Island], Normanton, they come up here, do their shopping all the time, and it's closer for them to see their family," she said.
"If they want to spend a weekend, or if a couple of dialysis patients want to go home for a weekend, they go home at their own expense."
A conversation with a man receiving treatment at the Townsville Hospital was a pivotal moment for the renal health worker.
"I saw a brother outside of the hospital and he asked me 'where do you work?'" Ms Johnson said
"I said 'Mount Isa, I work for the renal [unit] CKD', and he said to me 'sister, I'm on dialysis, can you just get me home as far as Mount Isa? I want to be close to family, I don't want to stay down here'."
She said she heard the same plea from many Indigenous people who were sent to the coast, motivating her to reach out to Queensland state MP Rob Katter.
Mount Isa Hospital's assistant director of nursing Tracey Wylie said Ms Johnson was instrumental in the successful transition of renal services to Mount Isa, helping to bridge the cultural and communications gap between the health service and its Indigenous patients.
"You need the respect of the Indigenous folk, she teaches us the grass roots knowledge and beliefs," Ms Wylie said.
"Without her it just wouldn't be as successful."
Aboriginal man Erwin Pardon, who receives dialysis treatment in Mount Isa, is only about 120 kilometres away from his home and family in Cloncurry.
He said it was a lot better for him and other patients to receive treatment locally rather than in Townsville.
"Townsville is too far away for their families to come and see them, so the closer they get to their family the better it is for them," Mr Pardon said.
He said as an Indigenous woman, Ms Johnson helps the Mount Isa renal service navigate cultural and language barriers.
"Aboriginal people are very timid people, some are very hard to talk to. So Belinda breaks that barrier down," Mr Pardon said.
More renal services still needed
Despite the improvement to renal services, Ms Johnson said more dialysis chairs were needed in remote communities.
"People here in Mount Isa — this is not their home, they're living in motels, they'd rather live in their own house in their own community — and that's what I'm going to aim for," Ms Johnson said.
"A lot of these people are missing out on family funerals, passing of their families back home in the communities. They can't make it because they're in Mount Isa."
Ms Johnson said remote Gulf communities would further benefit from a kidney bus fitted with two dialysis chairs.
"[The bus] would save them going home to Doomadgee and staying there for two days and then rushing back to have their dialysis in [Mount Isa]," she said.
She said a renal bus would also ensure patients do not die alone in Mount Isa.
"That really hurts me that they're here [in Mount Isa] all the time until they pass away," she said.
"When they're back in their own community, dialysing, whatever happens to them you know they're passing away in their country."
NWHHS is working with Ms Johnson to recruit health workers to provide dialysis in remote Gulf communities such as Doomadgee and Mornington Island where there is a high level of need.
Chief executive Lisa Davies Jones said the service would consider a renal bus in the future.
It also wants to increase home or supported dialysis in the Gulf communities and the uptake of peritoneal dialysis, which involves flushing fluid in and out of the body through a tube in the abdomen.
Ms Wylie said peritoneal dialysis was relatively easy to do almost anywhere.
"The fluids need to be warmed and I know of patients who go on a holiday and they'll warm up their fluid on the bonnet of their cars," Ms Wylie said.
"It's very transportable, you could do it on the banks of a river overlooking a beautiful scene if you wanted to."
Topics: health, indigenous-aboriginal-and-torres-strait-islander, liver-and-kidneys, regional, mount-isa-4825, doomadgee-4830, cloncurry-4824, townsville-4810
