Keeping kidney health in the Indigenous community


Dr Della Yarnold

7 July 2011

Dr Della Yarnold is a Biripi woman who has worked extensively with Indigenous communities across Australia.

Prior to studying medicine Della worked in a range of government roles covering a diverse range of areas including heritage, health, employment and training.

She has remained active in policy development and implementation working as the Senior Policy Officer for the NSW Health Aboriginal Chronic Disease Program and as a Chief Investigator on a number of NHMRC grants. Della is also a Director of the Australian Indigenous Doctors Association.

Della is completing her PhD in Aboriginal renal disease in communities of NSW while working as the Indigenous Academic Leader for Flinders University’s new medical school in Darwin.

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Transcript of podcast

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Interviewer: Hi Della Yarnold thank you very much for joining us here for an NHMRC podcast.

Dr Yarnold: Oh that’s fine Carolyn I’ve been looking forward to this.

Interviewer: Della you’re trained as a doctor and are particularly interested in the area of Indigenous health, can you tell us about why you got into that area?

Dr Yarnold: Well I am a Biripi Dunghutti woman although I was raised on Ngarabal Aniwan land so you know Aboriginal health to me has a very personal face… it’s family, so I think it was inevitable that I go into Aboriginal health.

Interviewer: And your other great love is kidney health.

Dr Yarnold: I think it’s just the heart-breaking nature of someone on dialysis you know a young person someone in their twenties or thirties being strapped to a machine routinely and the quality of life that inevitably comes with that life saving measure. You know it’s not the place for someone to be at that age and people having to be removed from country and put into regional centres where there’s greater access to dialysis machines is just heart-breaking, it shouldn’t happen.

The front end of that of course is chronic kidney disease. We’re talking about end-stage kidney disease with renal replacement therapy including dialysis, but the front end of that is chronic kidney disease where there are five stages of kidney disease and we can do a lot within the community to recognise kidney disease as a potential problem and raise people’s awareness of it, screen effectively for it and put in place some rena-protective measures to prolong the kidney life if there is evidence of chronic kidney disease, so that’s what I’m so passionate about.

Interviewer: Now my understanding is that there’s a lot of work going on in kidney disease, why did you chose to contribute to that… what do you think that you’re adding that’s something special?

Dr Yarnold: What I actually started off with is when I was a year four medical student I was approached by a Hunter New England Area Health Service staff member who had an idea for chronic kidney disease risk factors or chronic kidney disease prevalence study and so I prepared the ethics submission and implemented that study and it was going to Aboriginal communities, talking to people about kidney disease, doing micro albuminuria urine screens and then blood pressures …having a chat about their medication and their medical history… and that information was collated into a report and given to NSW Health and was one of the factors that was instrumental in chronic kidney disease receiving dedicated, recurrent funding. So for me I was hooked, you know it was community-based work and it was easily translated into a very practical outcome. It doesn’t address chronic kidney disease entirely …it was a first step… but for me it was a very clear research pathway that went through to a translated outcome and I just thought well this is something that is very worthwhile doing.

Interviewer: And you’re now doing your PhD in this area.

Dr Yarnold: Yes, so that was quantitative research and now I’m doing qualitative research for my PhD which is around how different stakeholders in that chronic kidney disease health setting…so the patients obviously- people who have been told that they have chronic kidney disease - the GPs who treat them in the community… the specialists… the aboriginal health workers and a very key part of any health paradigm…how they actually view chronic kidney disease, so I’m interested in collating that 360 degree picture of chronic kidney disease in Aboriginal communities in NSW and hopefully that will inform how we address it.

Interviewer: And Della when you’ve finished the PhD what next for you?

Dr Yarnold: I’m very interested in the results of phase two of the ARDAC Study – The Antecedents of Renal Disease in Aboriginal Children Study, and that’s being run by Professor Jonathon Craig and a very eminent team from the Kidney Research Centre out of Westmead Children’s Hospital and that’s a longitudinal study looking at markers of chronic kidney disease in Aboriginal children in NSW. It’s unique in that it’s providing a very robust information about the natural history of chronic kidney disease which is sorely missing on the research front. This is phase two so it’ll be very interesting. I think we are getting to a stage where we are going to see some differences between Aboriginal children and non Aboriginal children in terms of kidney markers and perhaps we can target at what point in early life, or young adulthood, is it appropriate for us to target our interventions.

Interviewer: Dr Della Yarnold thank you very much for speaking to us today.

Dr Yarnold: Thanks very much Carolyn.

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