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Kidney Transplant Yarning in Queensland
Gary Torrens, clinical nurse consultant at Princess Alexandra Hospital, has been part of a $1 million national initiative to counteract barriers for Indigenous dialysis patients getting on the kidney transplant list. Here’s his story.
The title of the project is long: Outreach Kidney Transplant Yarning Session for First Nations People of Queensland. The principle is plain and simple, says Gary Torrens: appropriate communication.
Gary, a Bundjalung man, who has specialised in renal disease since he graduated in 1997 and worked in Australia and also in the UK for 12 years, is currently with the Queensland Kidney Transplant Service.
“I have been given a lot of support to focus on Aboriginal and Torres Strait Islander people,” says Gary, who is passionate about challenging barriers that are causing the gap in statistics that compare Indigenous and non-Indigenous dialysis patients.
“The amount of Aboriginal and Torres Strait Island people who receive a transplant is very disproportionate,” he says. “It’s a very poor ratio compared with non-Indigenous patients.
“Everyone has a right to ask for a transplant, and the project we undertook in Queensland was aimed at reaching and informing Aboriginal and Torres Strait Islander people about the transplant program. Our aim was to empower patients with information to help them understand the process so they can make choices.”
Yarning, a traditional way to receive and share information, was the lynchpin of the roadshow Gary took to various locations throughout the state, funded through the National Indigenous Kidney Transplantation Taskforce.
“It was the first Indigenous-led roadshow of this kind,” says Gary, who said the team included a surgeon, a dietician and a number of senior nursing staff. The locations visited were Mount Isa, Townsville, Cherbourg, Toowoomba, Woorabinda and Rockhampton. Unfortunately, the Rockhampton session had to be postponed due to a COVID-19 lockdown.
Gary recognised the importance of a more tactile, face-to-face approach after watching the video links on sessions explaining about transplants, delivered to people on dialysis living outside of Brisbane. Very few were Aboriginal or Torres Strait Islander people.
“There are many reasons for this,” says Gary. “They don’t like technology at times; they are fearful and shamed talking to people down the video link; and in general are scared to ask questions and look foolish.”
This led to yarning as the chosen approach.
“We sat down with the patients, breaking down that hierarchical system that so often happens in health systems, introducing ourselves by first name, sharing information about ourselves and sharing healthy food,” Gary says.
“We made sure we invited all the stakeholders to the sessions, including Elders, hospital health workers, non-government organisations, health units, as well as the patients and their families.”
The yarning was also aimed at cutting through assumptions and cultural biases, says Gary.
“Both patients and staff at centres perhaps making assumptions about a patient’s ability to have a transplant,” explains Gary. “They may focus on other health issues.
“Our aim was to empower patients to ask questions. ‘Can I go on the transplant list?’ ‘What can I do to get on the list?’ ‘Why am I being denied access to the list?’ It is a real cultural learning curve.”
As part of the roadshow, the team engaged champions in the communities who have had transplants to yarn with the dialysis patients about the whole process, and also presented a tactile model and a video to give more information on how dialysis and the transplant process work.
The team also had the opportunity to conduct a transplant assessment clinic, which usually involves patients having to fly to Brisbane.
Since the roadshow, Gary has recognised that people are talking to each other and sharing information.
The amount of referrals for transplant from patients in rural and remote communities has increased, as has the amount of patients who have received transplants, says Gary, who is looking to build on the roadshow to visit more locations in the future.
Read more stories from the latest edition of the CRANAplus Magazine.