The Northern Territory's remote and community-based haemodialysis program: Interesting times

The Northern Territory has the highest incidence and prevalence rates of kidney disease in Australia and the majority of people receiving renal replacement therapy are Aboriginal Australians and originate from a remote community. Providing community-based dialysis would seem a more practical option than relocation. However establishing remote community home haemodialysis is potentially an expensive and high support activity. Challenges include inadequate and overcrowded housing, unreliable power and water supply, limited community infrastructure, seasonal access to most communities and high transport and maintenance costs. Developing a system that addresses cultural issues, promotes flexibility and encourages community participation and cross agency support has been the aim of the NT Renal Services (NTRS) remote home and community based dialysis program. Integral to the program is the reintegration of clients into the community and the promotion of community-based dialysis as a treatment for well people. In order to successfully achieve reintegration NTRS promotes the view that clients should be seen as community members who require a specific health treatment, rather than health department clients living in the community. This program has been supported with significant funding and although operational for less than twelve months, is already seeing encouraging results.