Kidney Transplant Disparities in Australia

This assignment focuses on analyzing the significant disparity in access to kidney transplantation between Indigenous and non-Indigenous Australians. It requires a review and critical evaluation of research articles detailing these inequalities, examining factors contributing to the gap, and considering potential solutions for equitable healthcare access.

Indigenous Health 4 Media Articles

TABLE OF CONTENTS
Media portfolio................................................................................................................................1
INTRODUCTION..........................................................................................................................1
Media item 1: “Why simple school sores often lead to heart and kidney disease in
Indigenous children”........................................................................................................................1
Media item 2: “ Indigenous patients in need of new kidneys aren’t getting a fair go ”..................3
Media item 3: “Institutionalised racism, reason for fewer Indigenous kidney transplants”............5
Media item 4: “Remote kidney clinic heralds a homecoming for Aboriginal patients after years
spent away”......................................................................................................................................7
CONCLUSION ...............................................................................................................................9
REFLECTION ..............................................................................................................................10

Media portfolio
High risk of kidney diseases among Indigenous population of Australia and determinants
contributing lower rate of kidney transplantation among Aboriginal community (Paradies, 2016).
INTRODUCTION
Aboriginal children are more likely to develop kidney diseases as compare to non-
Indigenous community of Australia. Only a small percentage of Indigenous people who suffered
from kidney related issues undergo kidney transplantation. The health related factors of
Indigenous Australians are influenced by the factors like social structure, wealth, power and
living conditions (Australian Institute of Health and Welfare 2015). However, discrimination and
economic considerations plays vital role in determining lack of aces of Torres islander over
health care services.
The report will analyse four different media articles which will highlight the portfolio.
Through media resources the report will evaluate the causes which limits equal chances of
Indigenous Australians for kidney transplantation. It will also discuss that how Aboriginal
patients spent years away from their family just because of remote clinics which provides kidney
services.
Media item 1: “Why simple school sores often lead to heart and kidney disease in
Indigenous children”
Jackson, T. Erin, W. Gregory, P. & Nathan, M.C (2017). Why simple school sores often lead to
heart and kidney disease in Indigenous children. Retrieved from
https://theconversation.com/why-simple-school-sores-often-lead-to-heart-and-kidney-
disease-in-indigenous-children-86066
Key issues identified in media article
The article describes the impact of impetigo or school sores on kidney related health of
children. School sores is one of the most common bacterial skin infection. It results in abscess,
acute rheumatic fever or chronic kidney diseases. The underprivileged populations are more
vulnerable to this risk. Jackson. et.al., (2017) presents fact that around 40% of Indigenous
children are expected to suffer from the different types of infection. The infections are
contagious therefore it is essential for the individuals to maintain the good hygiene conditions.
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However, the Indigenous community members lack awareness as well as are incapable to seek
for the quick treatment (Gray & Tesfaghiorghis, 2018).
According to Jackson. et.al., (2017) when infection is untreated it results in autoimmune
kidney disease which is known as acute post streptococcal glomerulonephritis (APSG).
Australian Indigenous community are not at the same economic and social development level.
They live with minimum facilities and in most of them illness can be treated but is incurable
(Devitt & et.al., 2017). From the analysis of Northern territory report 1991-2008 it is observed
that 95% cases of impetigo were found among Indigenous Australians.
Out of this infected group, it has been determined that 98% of individuals were from
remote locations and had very limited health care services. In this proportion of Torres Islanders
around 88% were children below the age of 15 years. In the views of Jackson et.al., (2017) these
statistics were result of poor hygienic conditions and close livings in the regions of these
Aboriginal community. The lack of health care services is another crucial factor which is
promoting kidney diseases and is leading to impetigo infection (Barraclough & et.al., 2016). It is
also identified from the article that the living conditions of Indigenous community make them
vulnerable to these diseases.
Association with modules and current practices
The cultural beliefs and the perspective of people towards health care are key barrier in
promotion of healthcare strategies. Health professionals are required to introduce the cultural
safety principle in their clinical practices so that Indigenous communities can develop trust on
nursing approaches (Howson & et.al., 2018). According to module 3, Topic 1 (2018), the cultural
differences are also reflected in treatment strategies and determination of factors causing
diseases. For example, the social environment of Indigenous Australians affects their preference
over treatment and health care facilities.
It may be the reason that with the advent of APSG they do not pay much attention and
adopt their own care plan which differs from current practices of nursing professionals. The
Indigenous community have their different identity and groups such as Aboriginals and Torres
Strait Islanders. As discussed in module 3, Topic 2 (2018), each of these groups have their own
identity and stereotypes. Their communication skills, biological variations, social and
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environment control, personal spaces and planning methodology are different. Thus, on
occurrence of disease may act differently as compare to non-Indigenous individuals.
The Topic 3 (2018) of module 3 states that traditional healing approaches are prevalent in
remote areas. There are regions of western Australia which are occupied by Indigenous groups
where still traditional bush medicines are used instead of seeking for medical help from
professionals. These groups include culture, art and spirituality in their practices for healing the
diseases. These factors are important for consideration which leads to higher vulnerability of
diseases due to negligence of initial symptom or local practices of healing (Johnson & Toy,
2018).
Personal reflection
In my opinion the article has expressed the concern by highlighting the root cause of the
issue. The author has supported the information with relevant facts and evidences. However, as
per my view the article is not sufficient to provide details of cultural significance which makes
Indigenous people more vulnerable to disease. I believe that if article had highlighted cultural
beliefs and practices followed by people of Indigenous community then it would have been very
helpful in understanding the root cause of higher vulnerability of kidney diseases among this
group.
Media item 2: “Indigenous patients in need of new kidneys aren’t getting a fair go ”
Wendy, C. (2018). Indigenous patients in need of new kidneys aren’t getting a fair go.
Retrieved from https://nit.com.au/indigenous-patients-in-need-of-new-kidneys-arent-
getting-a-fair-go/
Summary and issues identified:
From medical journals and reports it is analysed that Indigenous patients are not given
priority in waiting lists of kidney transplants. According to Wendy (2018) various reports from
medical journals give evidences of biased and discriminatory systems towards Indigenous
people. The health professionals believe that Indigenous community does not believe in nursing
and medical practices. So it is not necessary to give complete information regarding transplant
option or details of available treatment methods (Dole & et.al., 2018). The kidney transplant also
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requires regular intake of medicines but medical professionals believe that Indigenous people
will never continue this medicine intake for long term (Lawton & et.al., 2017).
Wendy (2018) states health providers believes that Indigenous people have more chances
to develop infections after kidney transplant as compare to non-Indigenous individuals. This is
one of the another reason due to which they are considered as second priority for transplant. It is
also analysed that service providers assumes that old people and Indigenous people have lower
rate of life expectancy. Thus, according to them it is not beneficial to provide them with good
quality kidney which is in limited number (Maple-Brown & et.al., 2016). Instead, healthy and
non-Indigenous must be given chance for the transplant. However, from the researches it is
analysed that many of the Indigenous patients were interested for the transplant but they were not
given priority despite the fact that they were of young age.
Relation with approaches and current debates:
The Indigenous community is considered as backward marginalised group which does
who do not have equal access to live and for care services. For ensuring the development of all
citizens of the nation it is required that this belief must be eliminated. However, the non-
Indigenous people still assumes that the other community must not be given equal respect and
rights. The social and political factors are crucial in changing the scenario but still a great effort
is required to bring development in this minor population. According to module 1, Topic 1
(2018), the health of Indigenous community has deteriorated after colonisation. The major cause
for that is the changes in their pre colonisation life style. This was accompanied by lack of
knowledge and hence it resulted in increased death rates of Indigenous people as compare to
other section (Khanal & et.al., 2016).
The fact of high mortality and morbidity rates of Aboriginal Torres Islanders, encourages
the health professionals to predict that Indigenous people does not require high quality health
services because their situation will always remain same and under influence of poverty and
inefficiency. . Another significant cause for the issue is discussed in module 1, Topic 2 (2018). It
describes that Indigenous group have their own practices and beliefs which are in great contrast
from non-Indigenous people. Hence, this section of society has not experienced progress and is
far behind the authority and power. It keeps them separated from mainstream and thus they are
discarded from the privileges on the grounds of discrimination (Sypek & et.al., 2018).
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According to module 2, Topic 3 (2018), increasing instances of illness among Indigenous
Australians have gain the attention of authorities towards the issue. The government bodies have
made attempts to develop health policies and strategies which can focus on health concerns on
these communities as well. It is discussed in module 2, Topic 1 (2018), that the major causes for
the adverse condition of indigenous people is inadequate health, education services, social
dysfunctionality and losses of social cohesion. It is also observed that this community people are
involved in conflicts and have psychological issues due to violence and lack of basis amenities
(Carson & et.al., 2018).
It is also analysed from module 2, Topic 2 (2018) that aim of health policies for the
Indigenous Australians is to identify the barriers such as leadership, communication,
unavailability of resources and education. The health policies ensure that indigenous people are
not abused and are given equal opportunities in every aspect.
Reflective:
In my opinion the article has been very effective in representing the facts associated with
the discrimination faced by Indigenous community. It has also demanded the need of strict health
policy for providing better services to all sections Australian society. After getting through entire
facts and story of the article I believe that the support of non-Indigenous community is vital.
Moreover, it is important to develop a sense of equality and effort to bring Indigenous
community into mainstream.
Media item 3: “Institutionalised racism, reason for fewer Indigenous kidney transplants”
Helen, D. (2015). Institutionalised racism, reason for fewer Indigenous kidney transplants.
Retrieved from
https://www.theguardian.com/australia-news/2015/aug/27/institutionalised-racism-reason-for-
fewer-indigenous-kidney-transplants
Summary of article and highlighted key issues
The article highlighted various issues which serves as the reason for less number of
kidney transplants in indigenous people. Helen (2015), has addressed the term institutionalised
racism in the article. As per the author the Indigenous people has 50 times more risks of
developing kidney failure but irrespective of this fact their number is quite low as compare to
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non-Indigenous group for receiving treatment. The health professionals assumed that Indigenous
patients are not in compliance with the current treatment strategies because of their nutritional
intakes and other physiological aspects (Tang & et.al., 2015). This discrimination is known as
institutionalised racism.
According to Helen (2015) the higher vulnerability of Indigenous people towards kidney
failures is not because of alcohol addiction rather it is because of low birth rate, improper
nutritional intake and socio-economic disadvantages. Most of these Indigenous patients have
reached to the state that they are relocated to town centres for dialysis purpose. Their disease has
reached to the last stage where dialysis is the ultimate choice for them (Lawton & et.al., 2015).
The author also claims that government polices has widened the gap between two communities
but still there is a huge gap between both sections in terms of providing kidney transplant.
From the article it is also analysed that there are factors which prohibits these
communities from approaching towards the dialysis centres. For example, women have
responsibilities towards their family and this made it difficult for them to live separately from
them. This causes them to prefer their responsibilities prior to their health management issues.
Helen (2015) states that the cross cultural projects can be effective tool for educating both health
service providers and patients associated with the kidney transplant strategy. The effective and
complete communication with doctors will help these people to understand the impact and
details of kidney transplant (Khanal & et.al., 2018). The article also demands for the attention of
health professionals that they must not make prejudgements regarding the suitability of
Indigenous patients for kidney transplant. Rather, health parameters must be the criteria for
selection instead of social and economic background.
Current debates and approaches:
The prejudicial approach of health professionals towards Indigenous patients is supported
by different concepts by them but it is essential that suitable efforts must be made to eliminate
institutionalised racism. It will help medical authorities to improve the health status of
Aboriginals. The dialysis centres are located in remote areas and for survival patients with
critical conditions have to stay there. It is stated in module 1, Topic 2 (2018), racism has great
impact on Indigenous health. The non-indigenous health professionals show bias attitude towards
the other section of society.
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The treatment strategies and preferences of doctors for kidney replacement are
discriminative. This discrimination based on racism has great impact on public health of the
discussed community (Devitt & et.al., 2017). The drawbacks are also supported by language and
communication barriers between both the sections. Further, differences in their cultural beliefs is
another drawback between health care professions and Torres Islanders. According to module 1,
Topic 3 (2018), Indigenous people are strongly connected with their identity and spirituality. For
these groups their land and kins are of great importance. When they are asked to relocate for the
treatment away from their home and land then it is like to causing harm to their identity and
spirituality. Hence, their physical health is compromised by them for sustaining their cultural and
spiritual sense.
The Aboriginals and Indigenous community have varied beliefs from the mainstream
people. They have not observed development and understanding as per non- Indigenous groups
(Rix, Barclay & Wilson, 2014). This is the reason that health professionals assume that they are
not in compliance with the current nursing and medical practices.
Personal reflective:
From this article I have come to know the perspective of health professionals towards
Indigenous people and criteria used by them to give second priority to this section for kidney
transplant. It has also expressed the factors which represents that Torres Islanders are not much
concerned about the issue. In my opinion the article has critically compared and analysed the
various point of views which demonstrated the fact and factors which encourages
institutionalised racism. It gives deep understanding and clarification of compliance challenges
related to kidney transplantation in Indigenous group.
Media item 4: “Remote kidney clinic heralds a homecoming for Aboriginal patients after years spent
away”
Tom, J. (2018). Remote kidney clinic heralds a homecoming for Aboriginal patients after years
spent away. Retrieved from
http://www.abc.net.au/news/2018-09-19/remote-kidney-clinic-heralds-homecoming-for-
aboriginal-people/10255448
Summary and central issues
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Indigenous community of Australia lacks social as well economically development in
comparison to non-Indigenous people. They do not get proper health services and their
nutritional requirements are also not fulfilled. According to Tom (2018) these minority groups do
not have access to medical services in their nearby areas. Thus, for seeking healthcare they have
to rush away from their homes to remote located centres.
Most of the people neglect their sufferings just in order to avoid the long journey away
from their homes and due to lack of money. When social groups and government organisations
arrange services for them then also language barriers, distant places from their family and land
creates psychological effects such as loneliness and depression (McKercher & et.al., 2014). It
affects the quality of care. Tom (2018) also states that support of federal government policies
will help to provide treatment to more patients at lower fund. The effective services and
increased number of dialysis machines and staff will be helpful for these patients to go their
home at the earliest. In the view of Tom (2018) the availability of more services in the
Indigenous regions will definitely bring health improvements for this community.
Link with current practices and approaches
The degrading health condition and lower incidences of kidney transplant in Indigenous
community is the result of limited health services. Indigenous people has high risk of developing
severe kidney damages and thus must be given equal priority in the kidney transplantation. As
per discussion in module 2, Topic 2 (2018) health policies can be helpful for changing the
situation. These policies provide the treatment at low cost so that Indigenous sufferers can access
at initial stage to avoid the chance of severity. The regulations also ensure that health
professionals must not discriminate people on the basis of cultural differences.
Module 4, Topic 1 (2018) states that health professionals must manage cultural safety and
cross cultural practices. It will encourage Indigenous community to have more concern and
precautions about their health. They must be given guidance that health principles are for their
benefits and not for harming or damaging their cultural values. It is also analysed that when these
patients will be informed about need and benefits of kidney transplant then surely they will
support treatment and raise their voice against injustice (Friberg & et.al., 2018). According to
module 4, Topic 2 (2018) the partnership with patients in health services can greatly improve the
quality of services. Thus, it is required to empower Indigenous community so that they can
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understand the importance of health wellbeing and health culture. Empowerment will help them
to take better decisions for making their life qualitative (Garcia-Garcia & Jha, 2015).
Reflection
The article has proved to be one of the soul stirring documentation supporting pain of
Indigenous group. I can connect myself with the pain experienced by these people that how they
suffer from economic crisis. The dialysis procedure gives them great sorrow, not only physically
but emotionally as well. In my opinion article has been successful in drawing the attention
towards the need of development for this group.
CONCLUSION
From the report it can be concluded that the health status and quality of Indigenous and
non-Indigenous population group has great diversity. The Indigenous people are not preferred for
the treatment like kidney transplantation. The report analysed four media articles which
determined facts and consideration of health care systems. It also focused on institutionalised
racism and causes which makes these communities more vulnerable to kidney diseases. It has
been evaluated from the report that along with the government regulations the support of health
professionals and mainstream non-Indigenous community is required to improve the situation
and to eliminate the discrimination involved in healthcare services.
Thus, it can be concluded from the report that Aboriginals are also integral part of the
nation and society. So health professionals must make efforts to improve their health conditions
so that they can also be included with mainstream community.
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REFLECTION
Australian Institute of Health and Welfare. (2015). The health and welfare of Australia’s
Aboriginal and Torres Strait Islander peoples: 2015. Retrieved from
https://www.aihw.gov.au/reports/indigenous-health-welfare/indigenous-health-welfare-
2015/contents/table-of-contents
Barraclough, K. A., Grace, B. S., Lawton, P., & McDonald, S. P. (2016). Residential location
and kidney transplant outcomes in indigenous compared with nonindigenous
Australians. Transplantation.100(10). 2168-2176.
Carson, E., Sharmin, S., Maier, A. B., & Meij, J. J. (2018). Comparing indigenous mortality
across urban, rural and very remote areas: a systematic review and meta-
analysis.International health.
Devitt, J., Anderson, K., Cunningham, J., Preece, C., Snelling, P., & Cass, A. (2017). Difficult
conversations: Australian Indigenous patients’ views on kidney transplantation. BMC
nephrology. 18(1). 310.
Devitt, J., Anderson, K., Cunningham, J., Preece, C., Snelling, P., & Cass, A. (2017). Difficult
conversations: Australian Indigenous patients’ views on kidney transplantation. BMC
nephrology. 18(1). 310.
Dole, K., Casilli, A., Tinsley, N., Collett, J., & Majoni, S. W. (2018). Improving access to renal
transplantation among Indigenous patients with end-stage renal disease: A review from
the Top End of Northern Australia where graft and patient outcomes have generally been
poor. Transplant Journal of Australasia. 27(1). 14.
Friberg, I. O., Mårtensson, L., Haraldsson, B., Krantz, G., Määttä, S., & Järbrink, K. (2018).
Patients' Perceptions and Factors Affecting Dialysis Modality Decisions. Peritoneal
Dialysis International. 38(5). 334-342.
Garcia-Garcia, G., & Jha, V. (2015). CKD in disadvantaged populations.
Gray, A., & Tesfaghiorghis, H. (2018). Social indicators of the Aboriginal population of
Australia.
Howson, P., Irish, A., D'Orsogna, L., Swaminathan, R., Perry, G., Wong, G., & Lim, W. H.
(2018). Comparison of the Incidence, Risk Factors and Types of Acute Rejection
between Indigenous and Non-Indigenous Australians with Kidney
Transplants. Transplantation. 102. S324.
Johnson, C., & Toy, L. (2018). Unacceptable kidney transplant rate for Indigenous
Australians. Australian Medicine. 30(2). 6.
Khanal, N., Clayton, P., McDonald, S., & Jose, M. (2016). Overview of dialysis in indigenous
compared to nonindigenous Australians. Clinical nephrology. 86(7). 123.
Khanal, N., Lawton, P. D., Cass, A., & McDonald, S. P. (2018). Disparity of access to kidney
transplantation by Indigenous and non-Indigenous Australians. The Medical Journal of
Australia. 209(6). 261-266.
Lawton, P. D., Cunningham, J., Zhao, Y., & Jose, M. D. (2015). What are my chances, doc? The
competing risks of death and transplantation for indigenous Australian dialysis patients.
In ANZSN 51st Annual Scientific Meeting 2015.
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Lawton, P. D., McDonald, S. P., Snelling, P. L., Hughes, J., & Cass, A. (2017). Organ
Transplantation in Australia: Inequities in Access and Outcome for Indigenous
Australians.Transplantation. 101(11). e345-e346.
Maple-Brown, L. J., Hughes, J. T., Ritte, R., Barzi, F., Hoy, W. E., Lawton, P. D., ... & Cherian,
S. (2016). Progression of kidney disease in indigenous Australians: the eGFR follow-up
study. Clinical Journal of the American Society of Nephrology, CJN-09770915.
McKercher, C., Chan, H. W., Clayton, P. A., McDonald, S., & Jose, M. D. (2014). Dialysis
outcomes of elderly I ndigenous and non‐I ndigenous A ustralians. Nephrology.19(10).
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Paradies, Y. (2016). Colonisation, racism and indigenous health. Journal of population
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Rix, E. F., Barclay, L., & Wilson, S. (2014). Can a white nurse get it?‘Reflexive practice’and the
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Sypek, M. P., Clayton, P. A., Lim, W., Hughes, P., Kanellis, J., Wright, J., ... & McDonald, S. P.
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Tang, W., Grace, B., McDonald, S. P., Hawley, C. M., Badve, S. V., Boudville, N. C., ... &
Johnson, D. W. (2015). Socio-economic status and peritonitis in Australian non-
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