Prevention of Renal Disease in Australian Remote Areas - Case Study Example

Prevention of Renal Disease in Australian Remote Areas: A Project Plan Student’s Name Institution Tutor’s Name Course Date Prevention of Renal Disease in Australian Remote Areas Introduction Chronic renal disease, commonly referred to as chronic kidney disease, is a public health issue in every country, Australia being one of them. The problem of renal disease is common in Australia, especially in the remote regions of the country (Gracey & King 2009). Renal disease is a progress malfunctioning of the renal system over a long period. It is difficult to diagnose the disease since its symptoms are non-specific. The most effective way of diagnosing this disease is by screening individuals who suffer from illnesses such as diabetes and high blood pressure, since these people are known to be at a very high risk of contracting it (Gray, Dent, & McDonald 2011). This project plan is designed to address a number of issues that revolve around renal disease in the remote communities of Australia. Firstly, the paper addresses the reasons why renal disease is more prevalent in the Australian rural communities. Secondly, the paper addresses the most effective measures that can be used to prevent the disease. Lastly, the paper outlines the benefits accrued from preventing the disease as opposed to treating it. The scope of this project plan mainly involves outlining the ways that can be used to prevent renal disease among the aboriginal Australians living in Woorabinda. Consequently, the project specifically addresses the issue of renal artery among the indigenous Australians in rural communities and not in any other region in the country. Literature Review The function of the kidney in the human body is to regulate the composition of mineral particles, acidity and amount of water in the body. The kidneys also participate actively in ensuring that metabolic waste products are removed from the body. Renal disease is among the health complications that affect the normal functions of kidneys in the human body. Renal disease damages the functional units of the kidney resulting in impaired filtration ability of this vital organ. As stated earlier, it is expensive to treat renal disease. This explains why most of the poor patients succumb to the disease (Gracey & King 2009). Most of the studies that have been conducted in Australia, which concern renal disease, indicate that it is a major public issue among the Australian aborigines. However, it is the recent studies that have established the extent of the disease in the aboriginal communities. The evidence from all of these studies reveals that there is a higher prevalence of renal disease among the aboriginal Australians as compared to the other non-indigenous people in the country (Gracey & King 2009). The records from most of the health institutions, such as the Australian and New Zealand Dialysis and Transplant Registry (ANZDATA), support the argument. The records from the ANZDATA in particular reveal that between 2001 and 2004, there were about 705 Aboriginal Australians suffering from renal disease. The records for the three years also show number of aborigines who suffered from the disease was 9 times more than that of the non-indigenous Australians (Gracey & King 2009). The number of patients, who suffered from renal disease in the last 8 years, has more than tripled in Australian communities. It is reported that the numbers of indigenous Australians are increasing at a faster rate than the number of the non-indigenous ones. The rate of the increment in the number of aborigines is currently estimated to be more than ten times the rate by which the non-Indigenous people catch the disease. For instance, in the years 2003 and 2004, there were about 84,000 Indigenous patients hospitalised in various hospitals in the country because of renal disease. This number comprised 57% females and 43%, approximately 16 and 9 times the number of non-indigenous people who were hospitalised in the two years because of the disease (Gray, Dent, & McDonald 2011). It is estimated that the number of Australian aborigines who die of renal disease is more than 10 times the number of non-Indigenous Australians who succumb to the illness. Diabetic nephropathy, which is a complication of renal disease, accounts for deaths of about 29% and 23% female and male patients respectively, while chronic renal failure accounts for 40% and 43% of female and male deaths respectively. Most cases of patients who succumb to death as a result of renal disease are adults aged 25 years and above (Hoy, Hughson, Singh, Douglas-Denton, & Bertram 2006). The state of indigenous patients with renal disease, in most cases, is worsened by co-morbid conditions such as hypertension, diabetes and poor nutrition. The co-morbid conditions, together with high-risk behaviours such as inadequate compliance to medication, heavy smoking and drinking, worsen the renal condition further. These conditions and the risk behaviours among the indigenous patients make treatment for the disease complicated and reduce the aborigines’ chances of survival (Hoy et al. 2006). There are a number of factors that contribute to the high levels of renal disease among the aboriginal Australians. Some of these factors include the humid climatic conditions in some in some of the remote areas, poor social and economic structure and other health complications in most of the areas. Other factors include inadequate personal hygiene, overcrowded settlements, inadequate access to proper medical care, and poor general sanitation. These conditions encourage the spread of health conditions, which in turn put most of the aboriginal Australians at high risk of contracting renal disease (Hoy et al. 2006). Although the extent of renal disease in the Australian remote communities is yet to be fully established, it is evident that the disease is a significant public health issue, especially in the indigenous communities such as those of northern Australia. This has been proven by most of the findings from surveillance studies and outbreak investigations. It has been difficult to establish fully the extent of renal disease in the rural communities due to a number of reasons. Firstly, the lack of standardised means of identifying cases makes it difficult to rank health issues in these communities. Secondly, some surveillance methods are at time less effective and may miss some of the critical cases and consequently give inaccurate figures (Hoy et al. 2006). There are a number of medical procedures that can be performed on patients with renal disease to improve their conditions. These procedures are quite expensive and most of the aboriginal Australians living in the remote regions cannot afford them. There are only two procedures currently: kidney dialysis and kidney transplantation. Kidney transplantation refers to a total replacement of the affected organ with a new one (Hoe 2009). The second intervention, kidney dialysis, involves the reinforcement of the affected kidney using a number of medical procedures. Dialysis is a mechanical way of filtering blood in the human body. Dialysis also performs all the other functions that are supposed to be carried out by the kidney. This mechanical procedure works like an artificial kidney and it has to be performed on a regular basis (Hoe 2009). Although it is evident that the rate of renal disease among the Aboriginal communities increases daily, they are less than one-third as likely as non-Indigenous Australians to receive proper treatment and kidney transplantation. For instance, in 2005, less than 17% of all the aboriginal patients with renal disease received kidney transplantation. This is a small number compared to the 49% of non-Indigenous Australians who received kidney transplantation. In the same year, about 83% of the Australian aborigines were placed on dialysis, which is just a temporary intervention, compared to only about 51% of non-indigenous Australians who underwent the procedure during that year (Al-Motlaq, Mills, Birks, & Francis 2010). To address the disparity between the aborigines and non-indigenous Australians in the issue of renal disease, the government through the health sector has initiated a few interventions in the remote areas. The government has brought self-care dialysis in the rural communities to compliment the inadequate treatment received in the regions. This intervention implies that the aboriginal patients with renal disease are treated in their communities by their family members through various health support groups. This strategy was initiated to assist the aboriginal patients who cannot afford to pay for the expenses involved in re-housing and relocated dialysis procedures (Al-Motlaq, Mills, Birks, & Francis 2010). However, as a result of all the problems that the indigenous patients with renal disease experience, it is evident that the disease has major social and medical implications for the aboriginal people, especially the ones living in the remote areas. The high costs incurred in dialysis and kidney transplantation call for a comprehensive strategy that can assist to address the socio-economic and medical implications associated with the public health problem (Al-Motlaq, Mills, Birks, & Francis 2010). The most effective intervention for this health problem is to enlighten the indigenous people on the importance of preventing the disease as opposed to waiting to treat it. This intervention involves involving the local workers in making the public aware. The second step should be initiating a community based strategy as opposed to a clinical based approach. Thirdly, the intervention should ensure that the participants are fully involved in medical tests to make them part of the prevention procedure. Lastly, the health personnel should assist the participants to personalise their health goals and to motivate them to work hard to achieve them (Al-Motlaq, Mills, Birks, & Francis 2010). Although the measures that have been implemented in the remote areas greatly assist in reducing the prevalence of renal disease in the regions, there are a few regions that the disease is still a major problem. It is reported that in Woorabinda, there are more than 30% of patients with renal disease who cannot access proper health facilities. Unlike other regions where preventive measures have been implemented, Woorabinda is yet to implement these measures. If these measures were brought to this region, the cases of renal disease would reduce by a significant margin (Gracey & King 2009). Studies show that active participation of the aboriginal Australians in primary health care measures, which involve proper nutrition check, treatment of infections and blood pressure control, promotion of factors that boost birth weight and healthy weight maintenance, are the most effective interventions for preventing renal disease (Gracey & King 2009). Problem Statement Implementing primary health care interventions in the remote areas is the surest way of preventing renal disease in the regions. Renal disease attacks people at any age and in any social status, but it is more prevalent among people living in remote areas and in poor conditions. The poor conditions in which these people live in propel them to engage in risky behaviour and poor nutrition that make them more vulnerable to contracting the disease. Although the disease is a natural factor that can catch any individual, the chances are increased in aboriginal Australians living in Woorabinda. The most effective way to prevent the locals of Woorabinda from contracting renal disease is by initiating the primary health care strategies in the region. Aims and Objectives of the Project The main aim and objectives of this project are to create a renal-disease free environment in Woorabinda. It is evident that with the current rate at which the aboriginal people in the region contract the disease, there may be no single person living without the disease in the region by 2050. The disease can be prevented in the region by implementing primary health care services, which assist the locals to evaluate and sustain high quality living standards. The primary health care can be established by training the locals to maintain their blood pressure at recommended levels, controlling other infectious diseases, engaging in proper nutrition, and maintaining healthy birth and body weights. Goal: To create a renal disease free environment in the community of Woorabinda. Target Population: The aboriginal Australians living in Woorabinda and the health officials working in the region Objectives There are several objectives that the project is intended to achieve. Firstly, the aboriginal Australians of Woorabinda should be able to control their own blood pressure by following the procedures outlined by the health experts. Secondly, these locals should be able to set living standards that can assist them to stay away from contracting infectious diseases, which are risk factors for renal disease. Thirdly, the locals should be aware of proper nutrition that assists in prevention of renal disease. Fourthly, the locals should adopt living standards and practices that help them to check on and maintain healthy birth and body weights. These preventive interventions can reduce the frequency by which the locals of Woorabinda contract the disease by 60%, by the year 2016. Project Design and Implementation Project Design This project involves enlightening the aboriginal Australians of Woorabinda on the importance of preventive measures as opposed to treatment in the case of renal disease. The stakeholders of the project include the locals of Woorabinda, the Australian government, health officials, and the entire country. A stakeholder is a group or a person who has interests in the outcomes of this project. That is why it is important to involve all the stakeholders in the planning and implementation phases of this project. In the project, the locals of Woorabinda stand to gain the most. The project, if well implemented, will assist the locals to improve their living standards and to prevent renal disease in the area. The government, on the other hand, will save the money it uses to take treatment programmes to this region. The country will also benefit as the money that would have been used to treat Woorabinda patients who suffer from renal disease will be used in other important programmes in the country. Planning and Timelines Activity Time Surveillance of the Woorabinda region 3-4 weeks Recruitment of health personnel to help in the implementation 1 week Building of health facilities that will provide the primary healthcare facilities to the locals 2 months Educating the locals on the importance of preventing renal disease 2 months Educating the locals on how to stay away from renal disease 4 weeks Implementation Strategy As indicated in the timeline, the project is intended to take about six months to be fully implemented. The project involves building other health facilities in which prevention related services will be offered. The facilities will be distributed evenly in the area to ensure that every member of the community has an equal chance of accessing the facilities. The government will be needed to employ more health experts to work in the newly built facilities. The experts will ensure that the locals are well trained on the ways of preventing renal disease and other infections to help them improve and sustain better living standards in the area. Expected Outcomes and Evaluation The progress and success of this project will be evaluated and recorded on a regular basis. Firstly, the locals of Woorabinda should be able to check and maintain their blood pressure at the recommended levels by March 2013. This will show that the locals have mastered the most effective step towards eliminating renal disease from their community. Secondly, the locals should be able to maintain healthy lifestyles through proper nutrition and regular physical exercises by April 2013. The other outcome that will be measured involves weight. It requires that the locals be able to maintain healthy birth weights and birth weights by May 2013 by relying on practices designed by the health experts. The last and most important outcome, which should be achieved by June 2013, is reducing the number of cases of renal disease by at least 70% in Woorabinda. It is this outcome that will be used to evaluate the first three outcomes. Achievement of the last outcome will show that the locals have adopted healthy living standards and the regular health checkups that are related to renal disease. Dissemination The strategy used in the project is going to ensure that all the people, groups and authorities that have a stake in the project receive the findings of the project at the right time. The findings will be availed to the federal government through the local leader s of Woorabinda. Since the government is the main funding authority of this project, it will be the first party to receive the findings. The government can use the findings to continue funding the project in the region and to initiate a similar scheme in other remote areas where there are many cases of renal disease. The findings will also be availed to the department of health to help it spread the project to other areas where the disease is still rampant. The findings of this project are intended to be used to persuade the department to initiate similar programmes in as many remote areas as possible. The common goal of this project is to reduce the cases of renal disease in the whole of Australia. This is the most effective way of persuading the authorities and departments involved to join hands in the fight against renal disease in the country. Lastly, the findings will be availed to all the locals of Woorabinda including those who might not have taken part in the study. Availing the findings to them is expected to be used as a strategy for motivating the locals to practice healthy living as the most effective way of fighting renal disease out of the region. The findings are also going to be used to show the locals that they have the power to eliminate renal disease from Woorabinda. Implications This project has strong implications on the target groups and the stakeholders involved in it. If the project becomes successful, its findings will assist the locals of Woorabinda to improve their living standards. The success of the project implies that lives of Aboriginal Australians living in Woorabinda will be significantly improved. The success of the project will also see the locals actively involved in the fight against renal disease in the region; the money that could have been used in the treatment of the disease will be used for other projects whose target is to improve the remote regions. The success of the project will mean that the government will be no longer spending a lot of money to deal with the cases of renal disease in Woorabinda. This means that the government is initiating other programmes to help the locals of this region improve their living standards. The success of the project also indicates that the government will have established better health facilities, educational amenities and infrastructures in the area. Most importantly, the success of this project indicates that very few Aboriginal Australians living in Woorabinda will be suffering from renal disease. The locals will be practicing healthy living standards such as regular blood pressure checkups, effective controls for infectious diseases, and healthy body weight maintenance. The success also implies that Woorabinda will be almost fully renal disease free. Conclusion The project is an outline of issues that revolve around renal disease in the remote and poor communities of Australia. The paper addresses the reasons why renal disease is more prevalent in the Australian rural communities. These are factors, such as poor living conditions and lack of proper health facilities, which make the disease more prevalent in the regions. The project addresses the most effective measures that can be used to prevent the disease in these regions. The paper also outlines the benefits that will be accrued from preventing the disease as opposed to treating it. The project uses Woorabinda to outline how renal disease can be prevented and the benefits of prevention as opposed to treatment of the illness. The projected is intended to achieve a number of objectives. Firstly, it is intended to assist the aboriginal Australians of Woorabinda to control their own blood pressure by following the procedures outlined by the health officials. Secondly, the aborigines of this region should adopt living standards and practices that can help them to check and maintain healthy birth and body weights. Lastly, the project is intended to reduce the frequency by which the locals of Woorabinda contract the disease by more than 50% in 3 years. The project is expected to be beneficial to all the stakeholders involved in it if it becomes a success. Firstly, the success of this project will result in very few Aboriginal Australians living in Woorabinda suffering from renal disease. Secondly, the government will not have to spend a lot of money in dealing with the issues that are related to renal disease in the region. Lastly, the Australians will use the findings of the project to ward off renal disease. References Al-Motlaq, M, Mills, J, Birks, M, & Francis, K 2010, ‘How nurses address the burden of disease in remote or isolated areas in Queensland,’ International Journal of Nursing Practice, vol.16, no. 5, pp. 472-477. Gracey, M, & King, M 2009, ‘Indigenous health part 1: determinants and disease patters,’ The Lancet, vol. 374, no. 10, pp. 65-75. Gray, NA, Dent, H, & McDonald, P 2011, ‘Renal replacement therapy in rural and urban Australia,’ Nephrology Dialysis Transplantation, vol. 27, no. 5, pp. 2069-2076. Hoe, WE 2009, ‘Closing the gap by 2030: aspiration versus reality in indigenous health,’ Med J Aust, vol. 190, no. 10, pp. 542-544. Hoy, WE, Hughson, MD, Singh, GR, Douglas-Denton, R, & Bertram, J 2006, ‘Reduced nephron number and glomerulomegaly in Australian aborigines: a group at high risk for renal disease and hypertension,’ Kidney International, vol. 70, no. 10, pp. 104-110. Read More