APY Lands: mobile dialysis bus

First posted on 12 August 2011 under APY Lands & Kidney Disease.
This article has been updated and archived.
Tags: dialysis

Summary

bus_opening2Since August 2010, the Northern Territory Government has run a mobile dialysis bus service out of Alice Springs. The service enables Aboriginal dialysis patients to return to their home communities for short visits.[i]  In June 2011, the Central Australia Renal Study highlighted the possibility of the mobile bus providing “regular respite services” on the APY Lands.[ii]

n October 2011, the bus spent a week in the APY community of Pukatja. On that occasion, six Anangu patients returned to the APY Lands and received dialysis treatment in the bus while it was there.[iii] A second APY trip followed shortly afterwards.[iv] The total cost of these visits was “approximately $23,500.”[v]

In 13 September 2012, the State Government announced plans to purchase its own mobile dialysis bus, stating that it expected its bus “to be operational in early 2013.”[vi]

The Paper Trail

Introduction

An alarming and growing number of Aboriginal people in Central Australia need regular dialysis treatment in order to stay alive.[vii] As of January 2012, this included 24 people from South Australia’s APY Lands.[viii]

In the Northern Territory, dialysis facilities operate in some remote communities including Kintore, Ntjaria and Yuendumu.[ix] As of December 2012, no comparable facilities had been established in South Australia.

Mobile dialysis bus

Since August 2010, the Northern Territory Government has operated a mobile dialysis bus service.[x] The service allows:

Aboriginal and Torres Strait Islander dialysis patients who must live in urban areas for treatment to safely visit their remote communities for special occasions such as festivals and cultural business.[xi]

The purpose-built bus is fitted out with:

  • two dialysis treatment chairs,
  • a “nurse-assisted renal dialysis clinic area” that can “treat up to four dialysis patients per day”, and
  • “onboard accommodation for staff“.[xii]

The Federal Government contributed more than $390,000 towards the cost of establishing the mobile dialysis bus service. Additional funding and equipment was provided by medical and therapeutic companies.[xiii]

On 7 August 2010, the Federal Minister for Indigenous Health (Hon Warren Snowdon MP) said the service would:

give dialysis patients more support and greater freedom. At a minimum, the bus will visit at least eight remote communities per year, and also attend festivals, ceremonies, sports days, and large funerals where possible.[xiv]

South Australian Government

As of 12 November 2010, 18 dialysis patients from the APY Lands were living permanently in Alice Springs.[xv]

On 22 November 2010, the Paper Tracker asked SA Health what steps it had taken to ensure these patients would have access to the Northern Territory’s mobile dialysis bus service “as a way of undertaking safe, short-term visits to their home communities”.

The Paper Tracker also asked SA Health:

  • whether it had “identified any obstacles that might prevent the bus from visiting one or more APY communities in 2011″, and
  • what actions it was “taking to overcome these obstacles”.[xvi]

In a reply dated 7 January 2011, SA Health advised the Paper Tracker that:

  • the South Australian and Northern Territory Governments were planning to establish a Memorandum of Understanding about the mobile dialysis bus service in 2011,
  • this memorandum would enable the bus service to support people from APY communities, and
  • SA Health would be in a position to provide “further information in approximately February 2011″ (once the Central Australia Renal Study had been completed).[xvii]

On 6 April 2011, the Paper Tracker asked SA Health for an update on this matter, including:

  • when the memorandum had or was expected to be signed,
  • the number of times SA Health expected the mobile dialysis bus would visit the APY Lands each year, and
  • “the estimated timeframe for the first of these visits.”[xviii]

In a reply dated 29 May 2011, SA Health advised that:

  • the final report of the review of Central Australia Renal Study had been delayed,
  • the development of the memorandum had “not been progressed” and was “awaiting the completion of the report”,
  • the report would “provide recommendations to governments on the issues” raised in the Paper Tracker’s letter, “including the use of a mobile bus on the APY Lands”,
  • SA Health would “be considering the implementation of these recommendations in conjunction with the Commonwealth Government and the relevant state governments for the central Australian region”, and
  • “a mobile dialysis bus may have an important role in providing a response service allowing people to be treated close to home.”

Click here to download a copy of the full advice (file size: 252KB)

Major report released

On 27 June 2011, the final report of the Central Australia Renal Study was released.[xix]

The study recommended that “renal services for people in the cross-border region” of Central Australia should be structured around a regional “hub and spoke” model with:

  • Alice Springs as the main hub, and
  • remote Aboriginal communities with local dialysis facilities being the spokes.[xx]

The study noted, however, that the proposed “spokes” would “not allow patients from all communities to obtain treatment closer to home”. Accordingly, the study recommended that “supplementary” mobile and respite dialysis services should be provided.[xxi]

The study also noted that that the establishment of the hub and spoke model “might see regular respite services … provided on the APY Lands” by the Northern Territory Government’s mobile dialysis bus “in collaboration with” SA Health. It continued:

[an APY] trial with the “mobile dialysis bus” in the early stages of implementation, might provide the best opportunity to gain experience of various service approaches for this particular setting, and work towards long term solutions.[xxii]

Possible long term solutions mentioned in the study’s report include:

  • the conversion of the under-used APY substance misuse centre in to a facility where dialysis chairs could be permanently located, and
  • the establishment of a “mini-satellite” dialysis centre in Amata by June 2013.[xxiii]

Federal Minister for Indigenous Health

On the day that the study’s report was released, the Federal Minister for Indigenous Health (Hon Warren Snowdon MP) drew attention to the capital funding that his government had provided to establish the Northern Territory’s mobile dialysis bus service. The Minister described this and other allocations as evidence of the government’s “pro-active approach to improving renal dialysis services in the Northern Territory.”

The following month, the Minister discussed the study’s key findings in an interview for the Paper Tracker radio show. In the course of the interview, the Minister was asked if it was “conceivable” that the mobile dialysis bus might visit the APY Lands within the next 12 months. In reply, the Minister cautioned against “holding out that sort of hope” and went on to explain that while the Federal Government had funded the establishment of the bus, decisions about its ongoing operations rested with the Northern Territory Government.

Anangu voices

On 8 July 2011, a group of 11 men and women from seven APY communities wrote a letter describing how difficult it is for them to live in Alice Springs on dialysis:

On the APY Lands, Aboriginal people have got no dialysis. We really want to go back to our own country, to the APY Lands …We know that some people who are living in the Northern Territory have already got their own dialysis machines in their own communities, but we’ve got nothing in our communities…

When we must live in hostels [in Alice Springs], our families can visit but they cannot stay. So we are separated and this makes us sorry and sad… At the Flynn Drive Renal Centre [in Alice Springs] there is a mobile dialysis bus. Pitjantjatjara and Yankunytjatjara people want a bus to come to their communities. The Nganampa Health Council has said they really want a bus for South Australia which could stay in the APY Lands…

We, the Aboriginal people really want the Government to start listening to us … Some of our people who have been waiting have already passed away.

Click here to download a copy of the full letter (file size: 663KB)

South Australian Minister for Health

On 28 July 2011, the South Australian Minister for Health (Hon John Hill MP) noted that the Central Australia Renal Study had “suggested” that a mobile dialysis service could:

provide temporary respite services to people who may have left [the APY Lands] to live in Alice Springs or elsewhere and who want to go back to their home communities for business for a week or two at a time.[xxiv]

The Minister continued:

You could have a mobile service, properly staffed, that could go to a community where there might be a week of ceremony, or a week of football celebrations, or anything of that like. You could have a van there, provide a few weeks-or even a bit longer-of service to a group of people who were gathered at that place, and then they would have to go back to where they are. It would be terrific to have dialysis available in all those communities.[xxv]

First bus visit

In early October 2011, the Northern Territory Government’s mobile dialysis bus travelled to the APY community of Pukatja. The visit made it possible for six Anangu patients to return to the APY Lands for one week from Alice Springs and Adelaide.[xxvi]

On 17 October 2011, Health SA reported that a second trial visit to the APY Lands would take place later that month and that, subsequently, a “detailed analysis” of the benefits of the two visits would be undertaken to determine if such visits should be continued.[xxvii]

On 8 February 2012, Health SA further reported that the “total costs to SA Health” for the two visits had “been estimated at approximately $23,500.”[xxviii]

Proposed bus visits (2012)

On 17 January 2012, Health SA advised the Paper Tracker that “based on [the] success” of the first two visits:

  • it was “planning five visits from the Northern Territory mobile dialysis bus to the APY Lands in 2012″; and
  • the first of these visits was “likely to occur in May or June.”[xxix]

On 13 June 2012, Health SA further advised that:

  • the bus would visit Amata from 25 June to 1 July 2012 to provide dialysis treatment for “approximately six patients”; and
  • in subsequent months the bus would visit:

-  Mimili (from 20 to 26 August)

-  Pukatja (from 10 to 26 September)

-  Marla (from 8 to 14 October)

-  a yet-to-be-determined location (from 22 to 28 October).[xxx]

South Australian bus

In September 2012, the South Australian Minister for Health (Hon John Hill MP) announced that his government had “secured $545,000 from the Commonwealth Government to purchase a mobile dialysis bus.”[xxxi]

The Minister also said he expected the bus “to be operational in early 2013″, after which it would “be able to visit a number of locations on the APY Lands and other remote areas in South Australia.”[xxxii]

This article was last updated in December 2012. It has been archived and will no longer be updated. It will, however, remain accessible online as a source of background information for anyone wishing to undertake further research on this issue. Information included in the article was current at the time it was archived. Keep in mind, however, that Ministerial changes and names of departments, among other things, may have since changed.


[i] Snowdon, W. & Vatskalis, K. 31 March 2011. “Mobile renal dialysis bus launched,” media release. Available at: Also: Snowdon, W. 7 August 2010. “Labor provides new renal bus to travel across the Territory” media release. Available at: http://www.alp.org.au/federal-government/news/labor-provides-new-renal-bus-to-travel-across-thet/. Accessed: 11 August 2011.

[ii] George Institute for Global Health. June 2011, Central Australia Renal Study, published by the Australian Department of Health and Ageing, p69.

[iii] Dialysis treatments in the bus commenced in Pukatja on Tuesday, 4 October 2011. The Paper Tracker’s Jonathan Nicholls visited the mobile bus on that and subsequent days. See also: Swan, D (Health SA). 17 October 2011. Transcript of evidence to the Budget and Finance Committee, Legislative Council, Parliament of South Australia.

[iv] Swan, D (SA Health). 17 October 2011. Transcript of evidence presented to the Budget and Finance Committee, Legislative Council, Parliament of Australia, p908.  Note: on this second trip, the bus was based at Marla, just outside the APY Lands and supported five Anangu dialysis patients (see: Swan, D (SA Health). 17 January 2012. Letter to Rev. P. McDonald).

[v] Swan, D (SA Health). 8 February 2012. Letter and attachments provided to the Budget and Finance Committee, Parliament of South Australia.

[vi] Hill, J. 13 September 2012. “New Mobile Dialysis Bus for South Australia,” media release.

[vii] George Institute for Global Health. June 2011, Central Australia Renal Study, published by the Australian Department of Health and Ageing, p3.

[viii] Swan, D (SA Health). 17 January 2012. Letter to Rev. P. McDonald.

[ix]In addition, in July 2011, the Federal Government provided $2.4 million to provide dialysis in two more Northern Territory communities (Kalkarindi and Lajamanu). See: Macklin, J. & Snowdon, W. 11 July 2011. “ABA funding supports 49 Northern Territory projects”, media release.

[x] Snowdon, W. 7 August 2010. “Labor provides new renal bus to travel across the Territory” media release. Available at: http://www.alp.org.au/federal-government/news/labor-provides-new-renal-bus-to-travel-across-thet/. Accessed: 11 August 2011.

[xi] Snowdon, W. & Vatskalis, K. 31 March 2011. “Mobile renal dialysis bus launched,” media release.

[xii] Snowdon, W. & Vatskalis, K. 31 March 2011. “Mobile renal dialysis bus launched,” media release. Available at: Also: Snowdon, W. 7 August 2010. “Labor provides new renal bus to travel across the Territory” media release. Available at: http://www.alp.org.au/federal-government/news/labor-provides-new-renal-bus-to-travel-across-thet/. Accessed: 11 August 2011.

[xiii] Snowdon, W. & Vatskalis, K. 31 March 2011. “Mobile renal dialysis bus launched,” media release.

[xiv] Snowdon, W. 7 August 2010. “Labor provides new renal bus to travel across the Territory” media release. Available at: http://www.alp.org.au/federal-government/news/labor-provides-new-renal-bus-to-travel-across-thet/. Accessed: 11 August 2011.

[xv] Sherbon, T (SA Health). 12 November 2010. Letter to J. Nicholls.

[xvi] Nicholls, J. 22 November 2010. Email to T. Sherbon (SA Health).

[xvii] Swan, D (SA Health). 7 January 2011. Letter to J. Nicholls.

[xviii] Nicholls, J. 6 April 2011. Letter to D. Swan (SA Health).

[xix] Snowdon, W. 27 June 2011. “Australian Government Responds to Renal Study with $13m Funding,” media release.

[xx] George Institute for Global Health. June 2011, Central Australia Renal Study, published by the Australian Department of Health and Ageing, p5.

[xxi] George Institute for Global Health. June 2011, Central Australia Renal Study, published by the Australian Department of Health and Ageing, p5. See also the report’s “Executive Summary”, p9.

[xxii] George Institute for Global Health. June 2011, Central Australia Renal Study, published by the Australian Department of Health and Ageing, p69.

[xxiii] George Institute for Global Health. June 2011, Central Australia Renal Study, published by the Australian Department of Health and Ageing, p53 and p77.

[xxiv] Hill, J. 28 July 2011, “Aboriginal dialysis services,” Hansard, House of Assembly, Parliament of South Australia, p4759.

[xxv] Hill, J. 28 July 2011, “Aboriginal dialysis services,” Hansard, House of Assembly, Parliament of South Australia, p4759.

[xxvi] Dialysis treatments in the bus commenced in Pukatja on Tuesday, 4 October 2011. The Paper Tracker’s Jonathan Nicholls visited the mobile bus on that and subsequent days. See also: Swan, D (Health SA). 17 October 2011. Transcript of evidence to the Budget and Finance Committee, Legislative Council, Parliament of South Australia.

[xxvii] Swan, D (Health SA). 17 October 2011. Transcript of evidence to the Budget and Finance Committee, Legislative Council, Parliament of South Australia.

[xxviii] Swan, D (SA Health). 8 February 2012. Letter and attachments provided to the Budget and Finance Committee, Parliament of South Australia.

[xxix] Swan, D (SA Health). 17 January 2012. Letter to Rev. P. McDonald.

[xxx] SA Health. 13 June 2012. “Media Statement” provided to J. Nicholls, Uniting Communities.

[xxxi] Hill, J. 13 September 2012. “New Mobile Dialysis Bus for South Australia,” media release.

[xxxii] Hill, J. 13 September 2012. “New Mobile Dialysis Bus for South Australia,” media release.

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