Aborigines behind in kidney transplants

2011-09-16 17:02

Canberra - Internationally renowned musician Mandawuy Yunupingu's life of dialysis three times a week is far from unusual among Aborigines, with a report released on Friday indicating that indigenous kidney patients are far less likely than other Australians to receive an organ transplant.

The report by the government's Australian Institute of Health and Welfare found that only 12% of Aborigines suffering the most severe stage of chronic kidney disease have a functioning transplanted kidney, compared with 45% of other Australians. The statistic does not include patients whose transplant failed.

Aborigines are also four times more likely to die of chronic kidney disease than other Australians, according to the report, which claims to be the most detailed study ever of indigenous kidney disease.

Yunupingu, lead singer of the indigenous band Yothu Yindi, which reached international fame in the 1980s and 1990s with hits such as "Treaty" and "Sunset Dreaming," was forced to leave his traditional land in the northern Outback in 2009 for dialysis treatment in the city of Darwin and is on a transplant waiting list.

Yunupingu, one of Australia's most famous Aborigines, did not immediately respond a request for comment on Friday.

Battling alcoholism

In 2009, Yunupingu told Australian Broadcasting television in a rare interview that he had been battling alcoholism before his kidney problem was diagnosed. Alcohol did not directly cause his kidneys to fail, but exacerbated other contributing health problems.

"I had the whole world in front of me, and this small, little kidney problem got me right where it hurts," he said. "I have to be dependent on a machine. I never thought it would happen to me."

Alan Cass, professor of medicine at Sydney University's George Institute for Global Health, did research work with Yunupingu in the early stages of his kidney treatment. Cass said that even with a university education and his record of achievement in becoming the first Aboriginal school principal, Yunupingu, who turns 55 on Saturday, had difficulties in adhering to the strict treatment regime demanded of kidney patients.

"Mandawuy is obviously not typical in that he is such a unique, powerful and remarkable individual," Cass said. "But his story about kidney disease ... that speaks to the very real experience of indigenous people."

Cass, who is independent of the report, said the reasons why Aborigines have fewer organ transplants are complex, including that Aborigines have a higher rate of other health problems that could make transplant surgery dangerous.

Not overt racism

Aborigines often have problems complying with treatment regimes that are prerequisites for transplants. Barriers for Aborigines include difficulties with the English language, poverty, vast distances to hospitals and competing cultural responsibilities to families and clan groups.

"I've talked with kidney specialists across the country. I do not think there's overt racism," Cass said. "I think there is clear evidence that the health system doesn't yet adequately address the complex health, social and cultural needs of Aboriginal patients with complex chronic disease."

Cass said he does not believe there is a genetic explanation for the high rate of renal disease among Aborigines, since the indigenous people of the United States, Canada and New Zealand similarly have higher rates of kidney disorders and diabetes than their wider communities.

He suspects common threads of poverty and poor diets are more likely factors.

Aborigines make up less than 3% of the Australian population and are Australia's most impoverished minority group. They are more likely to be imprisoned and jobless and less likely to finish school than other Australians.