AN UNEXPECTED JOURNEY - BIG RED KIDNEY BUS

By: Fabian Cotter, Photography by: courtesy Sean Owens + KHA


KIDNEY DISEASE affects more Australians than many think it does – and that’s even if people know they have it. A Big Red Kidney Bus helps those patients, now fully aware of their ‘silent killer’, to get back some quality of life through travel. A new Royans-Coachworks-refurbished ‘BRKB’ adds to the charity’s vital patient support program.

AN UNEXPECTED JOURNEY - BIG RED KIDNEY BUS
“I am very proud of the way our team have been able to put the project together considering the unique challenges of building a medical-grade bus," said Coachworks general manager Scott Isaacs.

Was country singer and white-bearded icon Willie Nelson in some sort of restricted movement situation, or enforced home confinement, when he penned his famous 1979 lyrics: "On the road again. Just can’t wait to get on the road again..."? More specifically, the second verse’s: "Goin’ places that I’ve never been. Seein’ things that I may never see again..."?

While these invitingly lullaby-like song words seem equally, if not more so, relevant to thousands across Australia and citizens across the world today, where government lockdowns persist in an attempt to tackle the coronavirus pandemic, to some people such an escapist idea will largely remain just a beautiful ideal. And that’s because, for many, their more pressing health concerns – like cancer treatment, crucial surgeries, CT scans, blood tests for diabetes and treatment for the frequently ensuing kidney problems – means their ability to travel and achieve some quality of life and therapeutic freedom is severely limited or - unfortunately - non-existent at all.

Imagine, if you will then, the ability to receive vital medical treatment while on a holiday trip or lifelong coveted journey whereas prior you’d have no chance of getting out on the road again...

Gratuitous segues aside, peak charity for kidney disease, Kidney Health Australia (KHA), is doing its bit to expand the horizons of thousands of Australians with kidney disease who are unable to travel due to their dialysis treatment. And that’s where its custom-modified buses come in to help things.

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THE SILENT KILLER

While many of the abovementioned medical conditions are often talked about in the mainstream media and the like – yet granted not as much as all those charities connected to them crucially need – arguably kidney disease is even less talked about or known about, and often it’s after it’s all too late.

According to the Australian Institute of Health and Welfare (AIHW) (last updated 15 July, 2020), an estimated 1.2 million Australians (4.9 per cent of the total population at the time) had diabetes in 2017–18, based on self-reported data. Additionally, diabetes contributed to 11 per cent of Australian deaths in 2018 (16,700 deaths), which were underlying or associated deaths. Diabetes is also a key contributor to kidney disease, which has a greater impact than many realise, with about 63 people dying every day with kidney-related disease. According to Kidney Health Australia, kidney disease affects 1.7 million Australians each year.

When a person’s kidneys stop working, treatment such as haemodialysis or a transplant is needed to sustain life. Currently 13,000 people are receiving dialysis treatment for kidney failure in Australia, including 1,000 children, KHA explains.

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BUSES TO THE RESCUE

One of the key support programs offered via KHA is the ‘Big Red Kidney Bus’. In its simplest terms, the Big Red Kidney Bus, "...makes holidays possible for people on dialysis", the charity explains. Kidney Health Australia’s award-winning Big Red Kidney Bus program operates with clinical partners in Victoria and New South Wales to provide mobile haemodialysis services in these states, allowing people on dialysis a chance to have a holiday or visit family and friends and still receive their lifesaving treatment, it says. 

On average, haemodialysis patients need to have treatment for at least five hours at a time, three days a week – which can be very restricting as they need to stay close to their dialysis unit, KHA general manager, Marketing and Community, Maria O’Sullivan, explained.

"The Big Red Kidney Buses are open to all Australians on hospital, satellite or home haemodialysis. The buses travel across Victoria and News South Wales, where they are located at popular holiday locations for up to six weeks at a time," O’Sullivan stated. 

"The bus features three comfortable chairs – each fully equipped with dialysis machines. It offers up to six sessions per day and patients can book in as many sessions as they require while they are on holiday in that location, without worrying about missing critical appointments.

"The buses are staffed by experienced dialysis nurses and renal technicians from Monash Health in Victoria and Royal North Shore Hospital in New South Wales."

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NEW NSW BUS

As one can imagine, custom buses set up to deliver such specialised treatment don’t roll off the showroom floor, so discerning modification needs to take place. For a recent NSW-bound bus, as shown on ABC magazine Issue 409’s cover – featuring a 2001 Volvo B12R chassis with an NCBC body – KHA sought the services of bus industry restoration expert Coachworks, now part of the Royans heavy-vehicle collision-repair group.

Royans Coachworks, based in Brisbane, recently completed the refurbishment of the bus, which is to replace an ageing vehicle that KHA currently has in operation. 

The new bus is thanks to the generous support of Toronto Lions Club in NSW and AstraZeneca and it will, "...provide the ultimate in safety and comfort of patients and staff, and we expect the new Queensland bus [the next project] to offer the same level of comfort," O’Sullivan explained.

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AN EXCITING PROJECT

Coachworks general manager Scott Isaacs told ABC magazine the ‘Big Red Kidney Bus’ (BRKB) project gave Coachworks an opportunity to do, and be involved in, something new and exciting, "...from the amazing concept itself to the relationships with key stakeholders at KHA and RNSH through to the challenges experienced by the production team in bringing the project to fruition.

"The obvious challenge to the project was the Covid disruption, which made it difficult and sometimes impossible for the project management team – represented by KHA, Royal North Shore Hospital (RNSH) and Coachworks – to physically meet due to lockdown restrictions and border closures. Thanks to technology, this could be overcome.

"The flip side to this was the availability of experienced labour within the business required to complete the project, available in part by the slowdown in our industry during these difficult times.

"The project required input from all areas of the business due to the scope of work required, a core group of people – including coach builders, auto electricians, fitters and painters, along with purchasing staff and sub-contractors - have enjoyed the challenge and look forward to the potential opportunity for future BRKB projects with the experience learnt.

"I am very proud of the way our team have been able to put the project together considering the unique challenges of building a medical-grade bus.

"Equally, it was impressive to see individuals add real value to the project, sharing ideas and information from their personal life experiences that allowed us to better understand the facility from the perspective of the nurses and patients," Isaacs explained.

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SUITABLE OUTCOME

In terms of how easy – or not – it is to convert a bus over to be CKD-treatment ready, Isaacs stated: "The biggest challenge with the project was ensuring that all aspects of the vehicle from the front entry through to the clinical area and storage/stowage spaces were fit for purpose.

"The initial stages of the build required many engineering solutions to be found, so the vehicle structure could be modified to allow for a user-friendly entry, comfortable head room throughout the main cabin, and storage spaces capable of securely stowing consumables and clinical equipment as required. 

"The project team enjoyed this challenge and have worked methodically through the build to what I feel is a very suitable outcome."

So how long was the project?

"It was completed over a 20-week period including two weeks planning and preparing for the build initially and the quality checks and commissioning of the vehicle prior to completion. This is the first BRKB for Coachworks," Isaacs confirmed, happy to participate in future Big Red Kidney Bus builds, if needed.

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HUGE IMPACT

So, just how does having such a vehicle like this help impact kidney disease for those involved day to day?

As O’Sullivan explained: "In 2019, almost 1,200 dialysis sessions were conducted on the buses. There is [also] a high demand from our kidney community to have a Big Red Kidney Bus in Queensland to enable people on dialysis to visit the state and take a holiday in some of the beautiful coastal locations."

"The bus would be available to all 13,000 Australians currently on dialysis and users would be able to book sessions online. 

"In year one of operation, we would aim for over 300 sessions of dialysis to take place. Due to the popularity of holidaying in Queensland, we expect awareness and interest levels to grow in subsequent years.

"Thanks to the generous support of Robina Lions Club on the Gold Coast we are close to achieving our target to purchase another bus and refurbish it. However, we are calling on continued generous supporters to help us close the gap," O’Sullivan stated.

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MORE ABOUT KIDNEY DISEASE

Chronic Kidney Disease (CKD) affects every organ system in the body and damage accumulates over time. The kidneys are a vital organ and when functioning normally, remove waste and harmful substances from the blood. The kidneys also play a vital role in maintaining blood pressure and electrolyte balance. When there is a problem with kidney function, this balance is disturbed.

Shockingly, a person can lose 90 per cent of their kidney function without experiencing any signs or symptoms of the disease. Kidney disease stages 1 to 3 are usually symptom-free, though with high-risk implications.

Undiagnosed, kidney disease can rapidly progress to stages 4 and 5 when kidney function will fail, requiring dialysis or a kidney transplant (if suitable) to stay alive. Those with high blood pressure and diabetes are most at risk! 

Data from the Australian Health Survey shows that 10 per cent of all Australian adults have biomedical signs of CKD, which is almost double the rate of diabetes and cardiovascular disease. Since 2009, admissions for dialysis have increased by 3.9 per cent on average each year. More than 26,000 Australians live with kidney failure (dialysis or kidney transplant), which shortens their life and has a major impact on the quality of life for themselves, their families and community. 

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Kidney Health Australia’s Evidence Report revealed that dialysis currently accounts for 13 per cent of all hospitalisations Australia-wide, and 34 per cent of all hospitalisations of Aboriginal and Torres Strait Islander Australians.

CKD is also a major public health problem in Australia, costing the health system an estimated $5.1 billion each year. Many people living with kidney disease face large out-of-pocket costs, too. Patients receiving care for CKD Stages 3–5 face costs in excess of $900 per quarter on average.

More than half of households reported economic hardship as a result of out-of-pocket costs of CKD.

For more information visit: kidney.org.au/bigredkidneybus

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ABOUT KHA

Kidney Health Australia is the peak national charity dedicated to helping all Australians to achieve better kidney health and provide vital resources and services to those affected by kidney disease, it states.

The organisation is focused on decreasing the incidence of kidney failure through promoting earlier detection of kidney disease, and funding and supporting research, it explains. The organisation has been operating for more than 50 years and works closely with an extensive network of clinical, corporate and community groups and individuals to improve the care and support for all Australians at risk of, or affected by, kidney disease and other kidney conditions, it adds. 

Kidney Health Australia relies on the generosity of individual donors, corporate sponsors and grants to provide these vital resources and programs, it says.

For more information visit: https://kidney.org.au/

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