In Katherine, a town with one of the highest rates of kidney disease in the world, dialysis patients are being forced onto a six-year waiting list for housing as they relocate for treatment.
There are just 16 usable dialysis chairs at the Katherine Dialysis Clinic, all in constant use.
In them sit people who have moved from their homes and communities, sometimes hundreds of kilometres away.
Dr William Majoni is the kidney specialist who covers the Katherine region.
He says people travel from all over the expansive region, an area of 336,674 square kilometres, to access the unit.
Finding accommodation when they get here is one of the biggest challenges patients face.
"The NT has one of the highest rates of kidney disease, not only in Australia, but also in the world," Dr Majoni said.
"There are several reasons for this, one of course is rates of kidney disease are much higher among Indigenous people.
"It is also associated with remoteness, poor socioeconomic backgrounds and high levels of diabetes."
It is highly prevalent in the Northern Territory in general and in Katherine in particular.
Kidney disease, last year, was the most common health problem people needed care for in Katherine, with 8251 same day presentations for dialysis.
Injuries with minor complications like a wound came in second with 173 presentations, and there were 165 presentations for chemotherapy.
"People who live in communities around Katherine, Mataranka is one of them, need to travel three times a week to come to the dialysis unit," Dr Majoni said.
"The majority of our dialysis patients have to move to Katherine and one of the challenges for the Katherine region is finding accommodation for these people while they are on dialysis."
He said some end up living in hostels like the Corroboree Hostel, while others apply to the housing waiting list, which leaves many in limbo for up to six years or more.
"As we know people can spend years on that list," he said, "even though people on dialysis get priority status".
Dr Majoni said he has even had cases of people becoming homeless because there are no other options.
"If you have health problems, living without a house is a challenge and as a result patients don't attend dialysis regularly.
"They can't take their medications, if they are not happy they don't follow up with check-ups and that can have a detrimental impact on their health."
Kidney disease is a debilitating, chronic disease, gripping communities across the Northern Territory.
Diabetes and high blood pressure are both leading factors.
Missing just one treatment can lead to a build up in toxins, causing severe complications and even death.
While Dr Majoni says there are currently enough dialysis chairs in Katherine for people to access treatment, patients are required to relocate to Darwin for two to three weeks for their first treatment, as it requires specialist attention.
The addition of just two dialysis chairs at the Katherine Hospital, where there is currently none at all, would drastically reduce the need for many patient transfers to Darwin.
"In Katherine a lot of patients who really need to be admitted are transported to Darwin straight away because kidney disease is also associated with complications like heart disease and risks of infections," Dr Majoni said.
The rise of kidney disease coupled with a lack of resources typical of remote living is forcing doctors to think outside the box.
Home dialysis is becoming more common as a cost cutting solution and a way to allow people to stay connected to their communities.
"Our patients want treatment closer to home," Dr Majoni said.
There are two different options: peritoneal dialysis and hemodialysis.
"Peritoneal dialysis uses a tube to drip fluid into the abdomen, acting as a filter, and removing waste," he said.
While there are risks involved, hemodialysis removes the need for a nurse. A chair is put into the patient's home and involves connecting needles, a skill some patients take up to a year to get the hang of.
"Both help patients cope and live closer to home, but they both need lots of training and obvious things like reliable electricity, which is not always common in remote communities," Dr Majoni said.
Dr Majoni said he is looking forward to a 'hybrid system' of peritoneal dialysis, hemodialysis and patients accessing the Katherine unit.
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