Chronic water shortages and struggles with water temperature are endangering life-saving kidney treatment for Aboriginal people in outback Australia

As Australia endures another heatwave, chronic water shortages are endangering life-saving kidney treatment for hundreds of Aboriginal people in remote desert communities.

The dialysis machines they depend on need cold water, and lots of it. But a run of hot summers mean “people are getting worried for their life”, according to Dadu Corey, among the elders sitting at the lunch table outside Purple House dialysis clinic in Alice Springs.

Purple House operates clinics in 18 remote communities, so Aboriginal people can be on country, receive treatment and still take part in the cultural life of their communities. People with end-stage renal failure usually need dialysis three times a week. A single treatment uses 600 litres of clean, cold water.

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“The last couple of summers we’ve really struggled with the temperature of the water,” says the chief executive, Sarah Brown. “The water has to be below a certain temperature or you can’t actually use it for dialysis. And over the last few years, two things have happened.

“One is that the temperature of the water coming into the system has risen and that’s because the water pipes in the community aren’t far underground. As the ground heats up, because the days are hotter, the water in the pipes is heating up too.”

Facebook Twitter Pinterest The chief executive of Purple House, Sarah Brown, at the clinic in Alice Springs. Photograph: Mike Bowers/The Guardian

At Kintore, 530km west of Alice Springs, Purple House raised funds to install a chiller tank inside the clinic to cool water overnight in an air-conditioned room. But this isn’t an option everywhere.

It would be incredibly sad if the next reason why people are forced off their country … will be because we can’t access enough water to dialyse people. Sarah Brown

“In most of our communities, where we don’t have chillers, we were having to limit dialysis to one shift a day, whereas before we could do two,” Brown says.

Last summer nurses were getting up at 4am to get a shift of dialysis done early in the day.

“It takes five hours,” Brown says. “If you get up at four, you’ve got the patients on by five o’clock in the morning, you can have the dialysis done by 10am before it’s too hot.”

Facebook Twitter Pinterest Treatment complete for today: Corina Abraham-Howard disconnects from the dialysis machine at the Purple House. Photograph: Mike Bowers/The Guardian

“The other thing is that you need quite a lot of water. And people worry about how long we’re going to have enough.”

The Norther Territory’s Power and Water Corporation, which is responsible for essential services in 72 remote communities and outstations, says most communities in the arid region are “faced with some level of water stress”.

At least nine remote communities and outstations are running out of water. A further 12 have reported poor quality drinking water as aquifers run low and the remaining supply is saline.

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NT Power and Water says emergency planning is under way and drilling programs are planned, but “finding new water sources is very challenging”.

“Without large or extended rainfall … the water security risks will progressively increase in some centres, with an increased likelihood that source supply capacity at some could fail.”

Since it began in 2000, Purple House has raised millions of dollars to set up remote clinics. It is a successful, independent Aboriginal community-controlled health organisation.

“And because it’s community run and the dialysis patients are our bosses, we have better outcomes than anywhere else in the country. So it’s one place where you can say we’ve actually closed the gap,” Brown says. “Purple House patients have a longer life expectancy than non-Aboriginal people on dialysis.

“It would be incredibly sad if the next reason why people are forced off their country … will be because we can’t access enough water to dialyse people.”

Brown says research and development is needed on a sustainable model of dialysis, better suited to new conditions.

“We need to start talking to these for-profit companies about really lifting their game to fight with us for technology which is more robust, cheaper and more sustainable and uses less water.”

Facebook Twitter Pinterest Murray Raggett from Papunya at the Purple House in Alice Springs. Photograph: The Guardian

Brown says she takes inspiration from the resilience shown by the desert communities she works for.

“We need to be valuing the knowledge of Indigenous peoples and helping them to remain on country. That knowledge is going to help us save it. But more than that, I think that Aboriginal people from remote communities are incredibly resilient and persistent and determined. And we all need some of that resilience now.”