It has been a while since Jedda Marshall has come home to Papunya. She is one of many Aborigines with kidney damage who must move to distant towns that have dialysis clinics, but with accommodation and social support often in short supply, city life can be hard.
(Published: March 2015)
The rising prevalence of renal disease also creates a larger social problem in Australia, as it weakens the small communities and cultural tradition of the country's aboriginal people.
"Important members of the community are forced to live permanently in remote cities and don't have the opportunity to return home and participate in community life," says Sarah Brown, the manager and driving force behind "the Purple Truck," a new mobile dialysis service for Aborigines living in remote areas.
Now, thanks to the Purple Truck, Jedda Marshall is back in her birthplace after seven years living in Alice Springs, 240 kilometers (150 miles) away, and is the first patient to be treated in the truck, which carries a complete dialysis station and a generator to supply back-up power. Fresenius Medical Care, in a joint effort with other organizations, played a key role in this project: Not only did the company donate the dialysis equipment inside, but it provided technical expertise in designing and strengthening the vehicle to withstand the unpaved, corrugated tracks that serve as roads in the vast Australian outback.
For the communities and people it serves, the truck – its sides and rear are painted with motifs by the Papunya Tula artist group, but it's named for the brightly colored driver's cabin and the "Purple House" that provides dialysis for Aborigines in Alice Springs - is much more than a medical facility on wheels.
"The truck is of great social importance, as it allows the Aborigines to receive dialysis treatment in their home environment."
"Having to leave their home country puts a terrible strain on patients and their families," says nurse Deb Lillis, who accompanies Jedda Marshall. "The truck is of great social importance, as it allows the Aborigines to receive dialysis treatment in their home environment."
Margot Hurwitz, a Fresenius Medical Care manager, notes that "Aborigines are up to 15 to 30 times more likely to get kidney disease than other population groups," due to diabetes, hypertension and other factors linked to poverty and harsh living conditions. For years, she has been active in providing better access to better medical technology for Aborigines, and insisted on taking part in the Purple Truck's maiden voyage into the outback.
That the operation of complex equipment in the wilderness can be a challenge soon becomes evident on this first trip, as the scorching weather leaves the water from the truck’s two large tanks too warm for the dialyzer to function properly. The local people are at first unable to find any ice, but then someone remembers that the infirmary has a few small cooling packs, which are quickly wrapped around the filters. Jedda Marshall's dialysis soon continues.
The Purple Truck proves that the road to dialysis in Alice Springs is not just one way. Soon, many others like Jedda Marshall will also be able to return home and participate in community life again – an important experience for Australia's aboriginal people.