Kimberley Aboriginal Medical Services

The incidence of Kidney Disease in the Kimberley is one of the highest in Australia. Chronic Kidney disease (CKD) and End-Stage Kidney Disease (ESKD) incidence within the Aboriginal population of the Kimberley greatly exceeds the national burden of disease.
Dialysis prevalence for this region has more than tripled in the last decade and is increasing at a much faster rate than in the rest of Western Australia (WA).

KRS Mobile Dialysis Unit (MDU)

The KRS Mobile Dialysis Unit (MDU) has been operational since June 2014. The vast majority of dialysis patients in the Kimberley are Aboriginal and the importance of their links to culture; country and language are well documented as are the negative effects of disconnection from them. Given the size of the region and the dispersion of the population many patients must move from their home communities to large towns many hundreds of kilometres away for treatment (or to Perth in some cases) and once started on dialysis, find it extremely difficult to make return visits to family and friends in their own communities and are unable to maintain these vital connections.

In a strategy to allow Kimberley haemodialysis patients to have extended visits home to be with family and maintain ties with their communities, KAMS/KRS has been funded to acquire a purpose built Mobile Dialysis Unit (MDU) truck to visit communities regularly in order to provide a Mobile Respite Dialysis.

Kimberley Renal Support Services (KRSS)

The Kimberley Renal Support Services (KRSS) was set up to deliver a support service to patients who are in the early stages of kidney disease prior needing a renal replacement therapy such as dialysis.
A Team of health care professionals focusses on the prevention of renal disease and the implementation of strategies to slow down the progression of renal disease.

The KRSS team consists of the following health care professionals:

• Aboriginal Care Coordinators
• Chronic Kidney Disease Educators
• Pre Dialysis Coordinators
• Renal GP’s

History

The service came to be following years of lobbying for a dialysis service in the Kimberley as up until 2002 patients requiring dialysis treatment were required to relocate south to Perth to receive their renal replacement therapy within Royal Perth Hospital, which is approximately 2,349 kilometres from Broome. This led to patients being away from family, friends and country for many years, this caused feelings of dislocation and isolation.

An advocate for the provision of renal health services to be provided within the Kimberley was Dr Arnold “Puggy Hunter”. Puggy starting from meetings in 1995 with Dr Mark Thomas from the Royal Perth Hospital pressed for a satellite dialysis unit for the Kimberley. This would be the ‘hub’ that would provide dialysis services to people locally, as well as support those able to manage home dialysis in their own communities (the ‘spokes’). When the state government indicated that it was planning to commit resources for regional dialysis, it was Puggy, who by negotiating matched Commonwealth government funding, and managed to ensure that the Kimberley unit would be a fully functioning community based unit – not only with nurses and machines, but with transport, Aboriginal Health Worker support and accommodation.

The provision of a comprehensive renal health service was seen as vital to support those whose need for dialysis services would require them to move away from their remote communities into the town of Broome, the main town within the Kimberley where their treatment would be provided. It was ensured that patients were provided with access to secure accommodation within the Aboriginal Hostel and were able to access transport services to get them to and from dialysis.