Kiwirrkurra is 700km of bad roads west of Alice Springs. I have been visiting the community during the last 12 months, as part of my work with a leading social services organisation. Its senior community members talk about the need to show the young men how to behave with their partners and families, and how to put their community first; how older men need to take these younger men out to country, sit down with them and share this hard fought wisdom.
Old people on remote communities are the glue that keeps them strong. They negotiate cultural and contemporary life in these places. When they pass away, the community suffers a tangible loss. The community becomes more chaotic. The emotional wellbeing of the whole community is destabilised.
Kiwirrkurra has lost a lot of its old people to renal failure either by death or distance. Renal failure, too, forces many women and men from their important roles. Many choose not to make the journey to Alice Springs for dialysis, seeing life away from country and family to be a fate worse than death.
Often people with renal failure don't come to town alone; many family members accompany them. This sense of family has both positives and negatives. The tight-knit family will add homelessness to its woes in overcrowded accommodation in Alice Springs. However they feel it is better to suffer together than in isolation.
Life on dialysis is tough. You are tied to the machine three days a week for five hours at a time. You feel tired and sick. The machine is an assault on your body, trying to do in a few hours what healthy kidneys do all the time.
These conversations have become more urgent recently because more and more older people are being told they have to go to Alice Springs to be put on the machine.
This is one of the ways the system fails these people. The Mandarins in governments of all colours calculate the cost of dialysis in term of cost to their individual departments, not across government. In Central Australia the cost of one dialysis patient coming to town is multiplied by the added burden to housing infrastructure in regional centres, increased health costs for family members accompanying the patients, increased law and order issues resulting from overcrowding and moving people from their traditional land.
Really they are issues that are faced by any population forced to become refugees. These people