Initial validation of novel water treatment for renal dialysis units in remote Aboriginal communities  

Researchers  

Funding  

This project was part of the Australian Human Rights Institute’s 2023 joint seed funding round with UNSW Engineering, receiving $23,880. 

Summary  

Access to dialysis for Aboriginal communities in remote Australia remains a fundamental aspect of the right to health, especially because of the high rates of kidney disease in these communities. Indeed, Indigenous Australians are around five times more likely to have end-stage kidney disease than non-indigenous Australians (Kidney Health Australia), making this challenge an important human right issue to address (Australian Institute of Health and Welfare). Furthermore, many Aboriginal people in remote areas have limited access to healthcare services, which can make it difficult for them to receive the treatment they need.  

Dialysis treatment involves filtering a patient’s blood through a semi-permeable membrane that removes waste products and excess fluid, while retaining red blood cells and proteins. The dialysate solution, made up of purified water and specific concentrations of electrolytes, is used to create a balance of ions in the patient’s blood and allows the filtration. Because the main component of dialysate is purified water, it is essential that the water used in dialysis treatment is of high quality and free from contaminants. Unfortunately, the quality, safety and sustainability of reverse osmosis (RO) production depends on the quality of the incoming town-water supply.  

In Kiwirrkurra (often named the most remote community in Australia), the groundwater contains several contaminants making it unsuitable for portable application. At present, fluoride levels (steadily around 2.5 mg/L) are above the Australian Drinking Water Guidelines’ (ADWG) health limit of 1.5 mg/L. The high concentration of silica in the groundwater is suspected to be responsible for the significant decrease in the performance of the current RO system. Finally, the levels of dissolved solids, nitrate and uranium have also been historically high, but have settled below the ADWG limit at the last rounds of sampling. A new water treatment unit, based on conventional reverse osmosis configuration was installed in 2021 and immediately failed. As of March 2023, the dispute between the contractor and their client (WA government) is not resolved, and the “Do Not Drink” sign is still in place.  

As the climate changes, the pressure on the various aquifers is increasing, and it becomes increasingly challenging to justify new dialysis units to be built, despite increasing demand for treatment. This project will build from the recent efforts of Purple House which aim to address the poor water quality and to reduce total water consumption for dialysis treatment through the design and implementation of the state-of-the-art water treatment systems. The project aims to assess the appropriateness of novel treatment processes used in these challenging environments. This short-term study will especially focus on two novel reverse osmosis treatment systems for the remote community of Kiwirrkurra in WA, where the available town-water has been deemed not suitable for human consumption or renal dialysis.