When Indigenous woman Gundimulk Wanambi’s was diagnosed with kidney disease, it was like being given a life sentence.
The chronic health problem forced her to live away from her community of Yirrkala, which sits about 700 kilometres east of Darwin on the coast in Arnhem Land and had no dialysis service.
“Dialysis is a sickness that [means I will] never return home,” she said.
The self-described saltwater woman needs regular dialysis treatment.
In the Northern Territory, as in other states, the service is mostly accessible in regional centres like Darwin or Alice Springs.
But a new partnership between two Aboriginal controlled health organisations means change is afoot.
Alice Springs-based Western Desert Dialysis has joined forces with the Miwatj Health Aboriginal Corporation in East Arnhem Land, thousands of kilometres away.
The pair have signed a new memorandum of understanding with the shared overarching aim of providing more dialysis services in remote communities.
Two health organisations collaborate on dialysis treatment
Miwatj Health Aboriginal Corporation’s director of regional health reform, Paula Myott, said the organisation wanted to focus on health promotion, prevention, management and treatment of renal issues to stop people ending up on dialysis.
She said providing dialysis was labor intensive, required specialist nurses and is expensive.
“Renal nurses are not always easy to secure for remote locations,” she said.
Ms Myott met Sarah Brown from Western Desert Aboriginal Corporation at a conference where it was suggested that Western Desert manage the Yirrkala clinic.
“Everyone saw it as a positive collaboration,” Ms Myott said.
“There are relationships between the two boards down there (Western Desert) and up here (Miwatj).”
The nurses from Western Desert recently started running and managing the clinic on behalf of Miwatj.
The Miwatj Health Aboriginal Corporation has been looking to pursue some additional funding for nurses to be based for short stints, of about six weeks, in remote communities like Galiwinku in Arnhem Land, to provide dialysis.
Western Desert Dialysis, formally known as Western Desert Nganampa Walytja Palyantjaku Tjutaku Aboriginal Corporation, was born from a community fundraising effort.
The organisation has been providing remote dialysis services in the Central Australia region for more than 10 years.
“It’s a great story about two Aboriginal community controlled health services working together,” Ms Brown said.
Lack of dialysis services a decades old problem
Ms Myott said dialysis has been a priority for leaders in East Arnhem for 20 years.
“It effects nearly every family,” she said.
“Over 30 per cent of adults over the age of 30 have some level of renal impairment in this region.”
There has been a dialysis service in Yirrkala since the end of 2012, which was started for former Yothu Yindi frontman Dr Yunupingu.
Ms Myott said the organisation had an agreement with the NT Government, who provided the dialysis chairs.
Miwatj also secured some money from the Federal Health Department to employ staff.
Then in 2013, a large community forum was held between numerous stakeholders, including Government bodies and health providers.
“The outcomes of the workshop was there was a huge demand for dialysis services,” Ms Myott said.
Miwatj then looked at developing a regional renal strategy.
“So as part of that … we’ve had the Yirrkala chairs for three years now, and had a number of clients there permanently and for respite,” Ms Myott said.
There are also dialysis chairs where patients can give themselves the treatment if they are trained in other communities, including Galiwinku and Milingimbi, but these are not staffed by nurses.
“There have been ongoing requests from the community to increase service provision,” Ms Myott said.
Miwatj chief executive Eddie Mulholland estimated about 30 people from East Arnhem Land are in Darwin to access dialysis treatment.
Mr Mulholland said there were also plans to create a central service hub.
“We’ve been talking to the Territory government about possibly making Nhulunbuy a renal hub,” he said.
Political blame game affecting services
The partnership comes as the political tussle over funding for remote dialysis services between the Federal and Territory governments has again been thrust into the spotlight.
The Federal Government has maintained that the responsibility for paying for the day-to-day running of dialysis clinics in remote communities is the responsibility of the Northern Territory Government.
The Federal Government has offered about $10 million for dialysis infrastructure but that money has remained unspent for years.
Chief Minister Adam Giles said last week he had spoken to the Federal Indigenous Affairs Minister Nigel Scullion about the money.
“I had a chat with Minister Scullion about this … about that $10 million in particular,” he said.
“He said he’s offered up the $10 million in that area and how can we support that. I’ve committed to Nigel that we will go have a look and see how we can advance that further.”
Darwin dialysis services treating Arnhem Land residents
NT Health Department acting chief operating officer Michael Kalimnios said there are currently 10 locations across the Top End for Top End Health Service patients to receive dialysis.
“These are at Royal Darwin Hospital, Nightcliff Renal Unit, Nightcliff Home Training Unit, Palmerston Dialysis, Tiwi Dialysis, Katherine Dialysis Unit (which is contracted privately), Katherine Hospital, Gove District Hospital, Lajamanu and Yirrkala,” he said.
At the Nightcliff Unit in Darwin’s northern suburbs, 85 per cent of the patients who receive dialysis are Indigenous.
“Approximately 45 per cent of patients at Nightcliff Renal Unit are from Arnhem Land,” Mr Kalimnios said.
“The Nightcliff Renal Unit treats 105 patients. The unit also has two ‘holiday dialysis chairs’ available, which are offered to people who need to receive dialysis while visiting Darwin. These are continually in use by visiting patients.”