There appears to be considerable variation in the extent to which Yolŋu
share the biomedical understanding of renal function. A long-term patient,
who would be expected to be very familiar with the medical story about
kidneys, explains that:
(the kidney) washes the bad blood; it gets the rubbish
and makes it clean by making urine (interview with Galikali)
When talking about healthy kidneys she said:
It means you can walk to far away places, go hunting, you can go everywhere
and still be fine..
When the physician asked other Yolŋu who had little experience with renal services, they said they did not know anything about how the kidneys worked. It may have been that they did not know what the term 'kidney' was referring to. Yolŋu sometimes use the English term 'kidney' even when talking in Yolŋu Matha and it is possible that some Yolŋu do not connect the term 'kidney' with the Yolŋu term 'dingting'. Most Yolŋu are familiar with the 'dingting' of animals but they do not necessarily realise that 'kidney' refers to the same thing, or that humans have kidneys, as most Yoŋlu are unlikely to have any direct knowledge of human internal body parts.
As well, an awareness of what a kidney looks like does not guarantee any understanding of kidney function, which cannot be understood from dissecting (and eating), for example, wallaby kidneys.
According to renal staff, there are no adequate educational resources
which are appropriate for Yolŋu and which tell the whole story:
what kidney function is, what happens when that function
starts losing - what happens to the body , what treatment you need and
then what happens when they stop working completely; there are some materials
down south...but they are not probably appropriate for all the aboriginal
communities (interview
with nurse educator)
Some initial attempts to address this serious lack of resources are currently
being made by renal staff and by an Aboriginal student working with this
project:
so that is what I'm trying to develop - that story
from the beginning to that treatment option video ; and from there, once
they're on dialysis there's that information they need to know, that continual
(information) about their medication, about pathology (interview with nurse educator)
The absence of shared understandings about all these concepts - from kidney function to failure to treatment - was illustrated repeatedly in the videotaped interactions and the interviews with participants.