Assessment 3_S00358321
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Dec 6, 2023
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Title: Assessment 3
Student number: S00358321
Unit of Study: HLSC120 – INDIGENOUS HEALTH AND CULTURE Word Count: 1500
The Purple House- Renal dialysis
a.
The social context of the establishment of The Purple House- Renal Dialysis
While continuing to “study, work and raise children”, Aboriginal and Torres Strait Islander
people frequently encounter the health effects of condition like renal failure at a young age.
The Purple House is a program that developed a new model of care based around families
that seek treatment for end- stage renal failure. In Australia, those who identify as Aboriginal
or Torres Strait Islander are “five time” more likely to begin dialysis than “non-Indigenous
Australians, with kidney failures rates in rural areas being “10 to 20 times higher” (Kelly, J.,
et al. [2022], 46:622-629). “Chronic kidney disease” or “end- stage kidney disease” patients
in particular experience poor health outcomes and a lower quality of live (Australian Institute
of Health and Welfare [AIHW], 2011). The health of Aboriginal and Torres Strait Islander
Australians is significantly worse than that of the general population, with chronic kidney
disease or end- stage kidney diseases being more common among individuals who live in
isolated places. The necessity of Aboriginal and Torres Strait Islander people to actively participate in the
development of innovative renal care models that address their clinical and cultural needs in
being more acknowledged by the health and kidney care sectors. “The Western Desert
Nganampa Walytja Palyantjaku Tjutaku” (WDNWPT) Aboriginal Corporation and Purple
House Service were established to protect members of Aboriginal communities including the
“Pintupi and Luritja” people (PurpleHouse- Purple Truck). In order to receive treatment for
end-stage renal failure, a lot of people had to leave their homes, loved ones, and even their
nations and go to Alice Spring. With the assistance of “Medicines Australia, Papunya Tula
Artist, and Fresenius”, “The Purple Truck” was established in 2012 to prevent Aboriginal
people from leaving. It offers patients with chronic kidney disease or end-stage renal failure
the chance to return home for their families, nations and cultural (Medicines Australia). The
Purple Truck is a “self-contained dialysis unit” on wheels that travels to isolated areas, allows
patients to visit their homes with the assurance that they will make it through the journey.
According to Medicines Australia, Central Australia has gone from having the poorest to
greatest survival rates for dialysis in Australia.
b.
Freedom has been incorporated into The Purple House- Renal dialysis program
to improve health.
Freedom is one of the tenets of self- determination. It places emphasis of “right they freely
determine” and autonomy that individuals or groups have over their own decisions, actions,
and resources (Australia Government Attorney- General’s Department). It acknowledge the
importance of individual autonomy and the capacity to control one’s own fate. According to
Purple House-Dialysis, prior to this, a large number of Aboriginal individuals in need of
dialysis due to “kidney failure” have to leave their communities and go to far-off urban
centres for treatment, which caused social and cultural alienation. Due to this circumstances,
the Purple House program established remote dialysis clinics because it recognised how
important it was to maintain ties to one’s family, country, and culture, the Purple House
programme worked with Aboriginal groups to established dialysis clinics in isolated areas.
Aboriginal people are able to obtain treatment while remaining in familiar settings and being
offered dialysis treatments within the communities enable people to keep their “cultural and
social” relationships with others developed a sense of freedom and self- determination. By
giving Aboriginal communities communities the power and choices to design their healthcare
services to match their unique requirements, the Purple House program reflects the notion of
freedom.
c.
How has the principle of Cultural Safety, reflect on your own practice has been
incorporated into the Purple House- Renal dialysis program to improve health.
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A safe environment must be created in order to secure the protection of Aboriginal and Torres
Strait Islander people. Additionally, equal access to healthcare and improved health are
crucial for Aboriginal and Torres Strait Islander people so that there is “no assault, challenge,
or denial of their identity or experience” ( Department of Health, 2023). One of the principle
of Cultural Safety is reflect on your own practice which mean to “reflect on their own
experience” to share and give advice to other people (
Hobson‐West, P., & Millar, K. [2021]).
For example having personally experienced the path of living with renal disease, Purple
House has a team of “Patient Preceptors” that can offer expert guidance and comfort to
Aboriginal renal patients. In the report of “Panuku Renal Patient Preceptor Workforce
Development Project” in 2019, “Warlpiri and Gurindi patients and families in Darwin needed
support and Purple House recognised this need. The requirement for a “community cultural
guide” to work with non-Indigenous professionals who had no ties to the core community
became soon apparent as Darwin’s support system took shape. Lachlan Ross was a member
of the first Lajamanu committee, which oversaw the establishment of the rental care in the
community and was the perfect candidate for the position, offered to serve as the “linked-
social support worker”. Preceptors are competent intercultural communicators who can help
both Aboriginal and non- Aboriginal people build and manage relationships that support the
provision of high quality relevant renal care. d.
Connection to Country and Respects for elders in the Purple House program
The health of Australia’s ecosystems, which have evolved as a result of human “caring for
country over thousands of years”, can be improved and maintained through indigenous land
management (Schultz, R., & Cairney, S. [2017]). Aboriginal have a strong bond with the
“land and water” in their own homeland. This link which they see as the core of their
“spiritual identity” and one that is tied to their “culture and identity” is important to them
(Victorian Aboriginal Heritage Council, 2021). They have kept this bond throughout
colonisation and forceful deportation. For example the Purple Truck provides the patient an
opportunity to return to their own hometown to united again with their own land. Having
access to this service, give hope to the communities to live longer and to keep going with
their treatment which would improve treatment compliance. “Aboriginal elders” are acknowledge as cultural guardians who are crucial to preserving
family and community harmony. Some elders are still recovering from the “trauma” of the
“Stolen Generation”, where Aboriginal children were removed from their families through
government policies between “1890s and the 1970s” (Cox, T., Hoang, H., Mond, J., & Cross,
M. [2021]). Due to these issue, the Purple House provide high quality of services in taking
care of elders with “dignity and respect”. The aged care services collaborate with clients’
families or carers to establish specific care objectives that are intended to promote elders
“health and wellbeing” (Purple House- aged care).
e.
How does social support and education been used in the Purple House?
In general, Aboriginal people do significantly worse than non- Aboriginal people in terms of
their “safety, wellbeing and mental health” (Department of Health, 2021). The Purple house
have a social support group that helps people as it can be difficult and frightening for people
from isolated villages to go to a “regional centre” for dialysis. At the same time, they are
separated from their “family and country”, experiencing sickness and confusion, and
managing to understand the healthcare system. Social Support group ‘Malpas’ which means
“friend or helper in Pintupi” whose are friendly to “dialysis patients”, offering support and
help in a variety of circumstances by visiting patients in hospitals or their homes and
organising social events like “lunches or picnics” to ensure they are not feeling lonely (Purple
House- social support).
In order to enhance the health outcomes of Aboriginal and Torres Strait Islander people,
education is a primary focus. The Aboriginal communities health and the prevalence of renal
disease are important goals for the Purple House. Their main focus is to “educate” about
health broadly and want to make a difference in all of their communities. The Purple House
volunteers and employees educate the people and make them aware of what they can do to
maintain “healthy kidneys”. The Purple House has created “The Phosphate Story” video in
different cultural language such as Pintupi, Warlpiri, Ngaanyatjarra and English for dialysis
patients to inform them about the effects that “phosphate” may have on their bodies, the
functions of “phosphate binders” and significants of taking them (Purple House-education).
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References
Australian Government: Attorney- General’s Department: Right to self-determination
https://www.ag.gov.au/rights-and-protections/human-rights-and-anti-discrimination/human-
rights-scrutiny/public-sector-guidance-sheets/right-self-determination
Australian Institute of Health and Welfare. (2011).
Chronic kidney disease in Aboriginal and Torres Strait Islander people
. Canberra: AIHW. https://www.aihw.gov.au/reports/chronic-kidney-disease/chronic-kidney-disease-
indigenous-australians/summary
Cox, T., Hoang, H., Mond, J., & Cross, M. (2021). “It all comes back to community!”: A qualitative study of Aboriginal Elders promoting cultural well‐being. The Australian Journal of Rural Health, 29(6), 909–917. https://doi.org/10.1111/ajr.12791 Department of Health (2021) Supporting the social and emotional wellbeing of Aboriginal
and Torres Strait Islander Victorians https://www.health.vic.gov.au/priorities-and-transformation/supporting-the-social-and-
emotional-wellbeing-of-aboriginal-and
Hobson‐West, P., & Millar, K. (2021). Telling their own stories: Encouraging veterinary students to ethically reflect. Veterinary Record, 188(10), no–no. https://doi.org/10.1002/vetr.17 Medicines Australia: Purple Truck https://www.medicinesaustralia.com.au/community/special-purpose-fund/purple-truck/
Purple House (2019) Panuku Renal Patient Preceptors Workplace Development Project
Report:
our
work
is
for
our
people.
Retrieved
from:
https://www.purplehouse.org.au/wp-content/uploads/2019/04/Purple-
House_Panuku_web-2.pdf
Schultz, R., & Cairney, S. (2017). Caring for country and the health of Aboriginal and Torres Strait Islander Australians. Medical Journal of Australia, 207(1), 8–10. https://doi.org/10.5694/mja16.00687