On the 8th December 2022 an email was sent to Australian Renal Nurses connected to the RSA. The email included the following…………
“Unprecedented demand for service due to a significant number of unexpected end stage renal failure clients requiring ongoing treatments”
That caught my attention and I read on……..
Do you want to make a difference?
Are you ready for adventure?
NT needs you!
This reminded me of the famous Lord Kitchener World War I recruitment poster with the direct finger point stating “Briton needs you!” Feeling like a dialysis soldier ready for combat, I placed my stethoscope around my neck and headed north. The following is a reflection of five months in Darwin and the richness it brought to my life.
Two significant events have shaped modern Darwin. The first was the bombing of Darwin in 1943 and the second, Cyclone Tracey which devastated the city on December 25, 1974. Both events have contributed to the modern tropical city and determined Territory mindset evident today. This was highlighted in the innovation and high level of care that I witnessed working with NT Health.
The Top End of Australia is definitely a front line in the fight for Kidney Health. First Nations peoples are five times more likely to develop kidney disease. This places a large burden on communities and with dialysis services mostly limited to large centres, patients often have to have to travel long distances to meet health needs. There has been a move by NT Renal Services to provide renal care within local communities. Purple House currently runs 19 remote dialysis clinics that are Indigenous owned and run and enable people to get back to their country and family.
NRU staff were very welcoming and supportive. The main focus of my work in renal nursing was a 32 chair outpatient clinic based in the Darwin suburb of Nightcliff called Nightcliff Renal Unit (NRU). Work started with a three day orientation and a day learning the Baxter machines that were currently in service.
Royal Darwin Hospital provides staff accomodation known as the staff village. I was housed in a one bedroom studio that was modest but functional. Darwin is known for its humidity and heat. In the dry every day is sunny and thirty degrees. When I was hot and needing exercise a hospital pool was available for lap swims. Nightcliff Park Runs on Saturdays were also a fun community event and good exercise.
The highlight of my adventure were the flights from Darwin to the Tiwi Islands for work. The capital of Tiwi Islands is Wurrumiyanga which has a small airport. I would awake early to get a taxi to Darwin Airport and board a small Cessna for a 20 minute flight over impossibly beautiful landscapes. Where else in Australia do you get to fly to work in dialysis?
Tiwi Dialysis Unit consists of seven Dialysis Chairs. Nursing staff or a Personal Care Assistant (PCA) would pick the patients up in a Toyota Hi-lux and start before sunrise lining the dialysis machines. Blister Packs would be provided for everyone and vitamins post dialysis were a regular part of the routine.
One morning a Tiwi man walked into the Dialysis Unit with a grossly infected fistula. In a major teaching hospital a doctor would be called for review or the patient would be assessed in an Emergency Department. Photos were taken, emails exchanged and after dialysis the patient was flown to Royal Darwin Hospital (RDH) for dressings and iv antibiotics. The patient returned a week later fully recovered.
The people of Bathurst and Melville Islands have a unique burial rite. In the final stage of these rites, it is customary to mark the grave with painted hardwood poles (Pukamani) made out of kartukuni or ironwood. Pukamani burial poles are traditionally decorated with marks which represent either the scars acquired during initiation ceremonies, or ceremonial body paint.
Tiwi Islanders have a strong passion for Aussie Rules Football. It was a treat to watch enthusiastic young men play AFL and kick up dust often barefoot with zealous enthusiasm on Wurrumyanga Oval.
It was a pleasure to meet Sister Anne Gardiner, a catholic nun who would wear her swans cap as she greeted the locals on her motor scooter. Much loved by the Tiwi people at 93 years old she plays a key role in the community as a mentor and has established a museum with local history and art. Tiwi Designs art studio is one of the longest running Aboriginal art centres and showcases screen printing, paintings and sculptures from local artists.
The Top End is a great place to bring family. There were some tourist highlights. These included spotting kingfishers in Kakadu with their fluorescent orange plumage, witnessing the birdlife and crocodiles at Fogg Dam (one of the richest biodiversity habitats in the world). Bush walks at Nouralangie Rock to see aboriginal art in a natural context, and visiting Kakadu and Cahill’s crossing to see fisherman edging ever closer to croc infested waters. One time there was an upturned Toyota Hilux that misjudged the current depth and force on Cahill’s crossing and we hoped the driver was a good swimmer. One final classic Darwin activity was eating Barra and Chips on Stokes Hill Wharf while watching the sunset with family.
On March the 25th I wrote in my diary……
“Darwin is a place of two worlds. Two cultures. Two peoples. Wealth and poverty. Homes and homeless. Both peoples united in love of family and sense of justice. Influenced by the memories past and intensified by the tropical heat of Darwin”
A year has passed since my trip. I reflect on the experience with fond memories and lessons learned. This Top End experience opened my eyes to the depth and complexity of Aboriginal health issues. It was a pleasure to meet and be welcomed into community and country as I provided Renal Nursing care. It was an opportunity to get a taste of culture and learn about their stories, hopes and dreams. Would you consider a trip to Darwin as a brave dialysis soldier?
