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Health

Elcho Island elders celebrate new dialysis nurse and treatment, bringing them home to families

Malawa Dhamarrandji has reconnected with children and grandchildren on Elcho Island. (ABC News: Felicity James)

After the plane lands on Elcho Island's tiny airstrip, Malawa Dhamarrandji's mood visibly shifts to a sense of calm.

The Yolngu elder insists on walking down the plane's isle without assistance.

It has been years between visits home for Mr Dhamarrandji, who relies on nurse-assisted dialysis in Darwin to stay alive.

"Here in my home town, I reckon it's paradise," he said.

"There's all the family, it's all family – all my grandsons, granddaughters, everyone."

Malawa Dhamarrandji's recent visit to the island was short because of inadequate housing. (ABC News: Felicity James)

Mr Dhamarrandji and his late brother spent decades advocating for nurse-assisted renal chairs at their island home, the large Arnhem Land community of Galiwin'ku.

Now, a renal unit that has been sitting unused in the community for years has been staffed by a nurse from Indigenous-owned health service Purple House.

The organisation recently chartered a plane for its Darwin-based patients who wanted to host a ceremony celebrating the unit's opening.

"Prevent the sickness, prevent the kidney sickness."

Dianne Biritjalawuy Gondarra is among the group that has been pushing for nurse-assisted dialysis. (ABC News: Felicity James)

The Northern Territory has the highest rate of kidney disease in Australia, according to Australian Bureau of Statistics data.

The newly staffed renal unit at Galiwin'ku means respected elders who have been stuck in Darwin for treatment can now travel home – four patients at a time – for up to three or four months.

For Mr Dhamarrandji though, his recent trip home was bitter sweet.

He only stayed for the day and said he was undecided about moving home for longer because the community lacked housing for patients with mobility issues.

Minna Dhamarrandji wanted her father to meet all his young relatives. (ABC News: Felicity James)

"All renal patients from Elcho, we need housing back here," Mr Dhamarrandji said.

"The first priority for housing should be the renal patients, so we can come here for good, to country."

His daughter Minna said she was "overjoyed" to see her father but desperate for him to come home for good also.

"Every community that has family in renal, they miss them dearly, like how we miss Dad dearly," she said.

Minna Dhamarrandji would like her father to move home to Galiwin'ku permanently. (ABC News: Felicity James)

She said it was difficult for family members to visit their relatives while in Darwin and expensive for them to fly home.

"It's really hard to find accommodation there in Darwin. I come back and forth but I really want to stay here permanently," she said.

"For so many years he left this island and it's really good to see him back here and bring joy to his grandchildren, his sisters and his kids.

Dialysis nurse Katrina Baxter manages the new renal centre at Galiwin'ku. (ABC News: Felicity James)

The renal unit's new dialysis nurse Katrina Baxter said she had been overwhelmed by the response to her arrival.

"It's just an amazing thing that it's finally happened because these patients have been fighting for years and years to have dialysis on country," she said.

"It just helps the whole community because you're bringing elders, you're bringing family members, loved ones back home that haven't been able to be home for maybe 10 years."

Joyce Gondarra can now visit the island for longer than usual. (ABC News: Felicity James)

Ms Baxter said she recently took renal patient Joyce Gondarra to one of the community's outstations and witnessed her response to being back on country.

"She was feeling not so good and then as soon as she saw there was stingray on the fire she pretty much ran to the fire," she said.

"She was so excited because it's one of her favourite things."

Ms Baxter previously worked as a dialysis nurse in urban settings.

"So for me, to be able to get this mob back on country, the whole community's just embraced us all and welcomed me to the family, to be able to be a part of that," she said. 

The elders want younger people on Elcho Island to eat healthier, local food. (Supplied: Nadyezhda Dilipuma Pozzana)

Joyce Gondarra's nephew, Christopher Alchin, works with the dental team at the community's Miwatj Health service.

He said the dialysis program would give him a chance to get to know his relatives better and learn from them on country.

"For myself, not being brought up in Galiwin'ku, it's wonderful to have my Aunty Joyce with all her knowledge back in community, sharing the stories."

"I was born in Darwin, raised in Darwin, I was never brought up on country.

"Then I was able to come back to Galiwin'ku, reunite with all of my aunties."

The new renal unit has two dialysis chairs and is staffed by one nurse. (ABC News: Felicity James)
Alice Walnaypa's son died many years ago before on country dialysis was available. (ABC News: Felicity James)

Renal patient Maratja Dhamarrandji said he also wanted to warn young people about renal failure and encourage healthy eating.

"It's really important for the community to participate and be involved and to know the problems that we have with renal failure," he said.

"It's important to get back to traditional food, very important."

"Speaking Yolngu Matha, we can use examples of Yolngu education, Yolngu way."

Theresa Dhamarrandji attended the renal unit ceremony with her father Maratja. (ABC News: Felicity James)

His daughter Theresa said young people in the community were missing role models.

"I want him back home," she said.

"It makes me sad and worried because I was close with him, I grew up with him, that's why I feel sad in my heart.

"We need them back because our children and their children, they are missing them as well because they are role models for all of us."

The new renal centre has been named after the purple coloured rocks found on Elcho Island. (ABC News: Felicity James)

Gillian Gorham manages the renal health program at the Menzies School of Health Research in Darwin and also attended the ceremony at Galiwin'ku.

Dr Gorham witnessed the benefits of getting elders back home to communities while working as a renal nurse and said that experience led her to investigate the cost benefits. 

Her study found remote dialysis could end up costing less than urban relocation, when taking into account the increased hospital attendance and missed appointments linked with shifting patients to urban centres.

"I think you can't underestimate how strong that is, that people have such a close connection to their land and their community and how without that their whole social and emotional wellbeing is damaged."

Dr Gillian Gorham spent several years working as a renal nurse in the NT. (ABC News: Felicity James)

Dr Gorham also said her costing study did not factor in the extra social and financial costs of relocation, including the impact back in home communities of losing knowledgeable and skilled elders.

"If you start including those costs, then definitely relocation is not cost-effective," she said.

Dr Gorham said her findings had been shared with the NT Health Department.

Relocating remote patients away from their families and communities may not be cost effective. (ABC News: Felicity James)
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