The health model that offers ‘home away from home’ dialysis care

It is rare to find a space that offers dialysis services, primary and allied health, cooking and bush medicine workshops, a social hub and a place to wash your clothes, all under the same roof.
 
One location that offers all of these services is Purple House in Alice Springs/Mparntwe – a set up so unique that it led to the introduction of a new Medicare item number.
 
Sarah Brown is a community nurse and CEO of Purple House and works closely with the Board of Aboriginal and Torres Strait Islander directors to run the organisation.
 
She told newsGP that since its inception, the centre has become ‘a howling success’.
 
‘When people come to visit, they’re hearing the story of Aboriginal people from the most remote part of Australia having a problem, coming up with their own solutions,’ she said.
 
Medicare item number 13105 was created based on the specific model of care that Purple House offers, which is dialysis provided by a nurse or Aboriginal health worker under the supervision of a GP in a very remote (Modified Monash Model 7) area.
 
The story of how it came about is almost as unique as the service itself.
 
In the early 2000s, a series of Aboriginal and Torres Strait Islander artwork was auctioned with the intention of developing support for remote patients required to leave their families and communities for dialysis treatments.
 
Raising over $1 million, the auction funded the establishment of a new Aboriginal Community-Controlled Health Organisation, which offered a different model of care based around family and connection to Country.
 
Shortly after, in 2004, the centre attained a dialysis machine, further transforming the provision of healthcare in the area.
 
In the years since, it has provided culturally safe dialysis and support across rural and remote Australian communities, as well as a mobile dialysis unit, with the intention of offering a ‘home away from home’ for patients forced to relocate from remote communities for dialysis treatment, enabling them to return to Country with the option of self-care dialysis.
 
Currently, Purple House is actively caring for around 300 dialysis patients around the NT, with dialysis services across 19 remote communities. Ms Brown estimates that approximately 9000 dialysis treatments were delivered ‘out bush’ over the past year, including 202 people on dialysis able to get home to their community.
 
Supporting this work is a general practice clinic that operates out of Alice Springs/Mparntwe twice a week for patients and their families who have had to relocate to the town to access dialysis services. The GPs provide routine care and refer patients to specialists and allied health services when appropriate to ensure they are getting the right care.
 
In addition to the dialysis services, Ms Brown said Purple House serves as community centre in a residential area where people can come to connect.
 
‘It depends on the time of the day, but we will often have 30 people here for lunch on their non-dialysis days hanging out with us,’ she said.
 
‘It’s where the patients come to get primary healthcare services, bush medicine, do some cooking, their washing.
 
‘It’s a primary health model of care with dialysis chucked in. For GPs or other health professionals, it is an insight into how a different model of care can grow up based on cultural priorities and the needs of both.’
 
Purple House is included on day three of the Jon Baines Tours, ‘From the Red Centre to the Top End: A medical study tour via The Ghan’, where visitors can expect a full tour of the centre, learn about its models of care, meet the Board and some patients, as well as sample the bush medicine range.
 
‘When the tours come, depending on the time of the day, the patients will often be cooking kangaroo tails or making damper, and we’ve got a bush medicine business as a side hustle … the Bush Balm kitchen which operates from a separate social enterprise hub,’ Ms Brown said.
 
‘John Baines chose to do the tours for the original Purple House rather than take people over to the social enterprise hub, so here they see the dialysis room and our water recycling and bush medicine plants and meet some patients.’
 
Ms Brown is proud to tell the story of Purple House’s success – how it reinvented models of care for remote communities and honoured connection to Country.
 
‘There was an existing way of doing dialysis, which was basically that people from really remote and communities had to move to town,’ she said.
 
‘They had to leave their families and front up to the hospital three times a week, and were doing really poorly and were not engaged in the health system because it really didn’t suit that their needs.
 
‘Whereas at Purple House, the patients and their families are part of running the services and adapting them, meaning that people in town are being looked after in a culturally safe way … then have the opportunity to get home to live on Country with their families, and have dialysis in really remote places.’
 
The Jon Baines Tour, ‘From the Red Centre to the Top End: A medical study tour via The Ghan’ runs from 6–12 June 2023, and RACGP members can currently receive a 5% discount for the CPD-approved medical study tour.
 
Log in below to join the conversation.

Aboriginal and Torres Strait Islander dialysis medical tours Northern Territory remote care