Within two decades, central Australia has gone from having the worst survival rates on dialysis to the best.
In large part the turnaround is due to Purple House, an Aboriginal community-controlled health organisation based in Alice Springs.
As people walk into Purple House, they're being greeted with a message: "Vote yes for hope".
Chief executive Sarah Brown says Purple House is an example of how Aboriginal people and communities can come up with creative and innovative solutions to issues.
Ms Brown believes it shows how an Indigenous voice to parliament could work if voters support the referendum on October 14.
In the late 1990s, Pintupi people from the Western Desert of central Australia were forced to leave their country and families to seek treatment for end-stage renal failure in hospital in Alice Springs or Darwin.
Thousands of kilometres from home and family, they suffered great loneliness and hardship, and weren't around to pass on cultural knowledge in their communities.
"When your kidneys are buggered, you need dialysis three times a week to stay alive," Ms Brown said.
"People were moving to try and stay alive but they were doing very poorly, they were finding it really hard to navigate the whole system."
So they decided to do something about it.
In 2000, Papunya Tula artists from Walungurru and Kiwirrkurra collaborated on four stunning paintings.
They were auctioned along with other works at the Art Gallery of NSW thanks to assistance from curator Hetti Perkins, an Eastern Arrernte and Kalkadoon woman.
In that one night they raised over $1 million, which was used to start the Western Desert Nganampa Walytja Palyantjaku Tjutaku Aboriginal Corporation.
Now called Purple House, it practises a model of care based around family, country and compassion.
Indigenous people have higher rates of diabetes as well as a higher rate of hospitalisation and death from diabetes than non-Indigenous Australians.
Endocrine, nutritional and metabolic diseases were the fifth-leading cause of death for Indigenous Australians in 2015-2019.
In that period, 7.3 per cent of Indigenous Australian deaths were due to diabetes, with the rates in remote Australia more than three times higher than non-remote areas.
"It's a little bit complex but the simple answer is that it's about dispossession, powerlessness, and poverty," Ms Brown said.
"It's about access to healthy food and clean water.
"It's about access to education, with housing.
"It's about being able to access culturally appropriate services in the place that keeps you strong, with your family around you, so a lot of things that other Australians absolutely take for granted but that Aboriginal people in remote communities still don't have access to."
Diabetes isn't the only health condition where Indigenous people have worse outcomes than their peers.
Addressing the inequitable health outcomes between First Nations and other Australians is the reason the Closing the Gap framework was developed.
Indigenous people carry a higher disease burden than other Australians, and the statistics are usually worse the further they are from urban centres.
According to the National Aboriginal Community Controlled Health Organisation (NACCHO), mortality rates from cancer in Indigenous people have been trending upwards while declining for non-Indigenous people for at least two decades.
The situation is far worse in regional, remote and very remote areas.
NACCHO chief executive Pat Turner says the discrepancy in five-year survival rates between major cities and remote areas is particularly stark for certain cancers, including lung cancer (12 per cent compared with 6 per cent) and head and neck cancer (47 per cent compared with 31 per cent).
"The state of Indigenous health in this country is appalling," she said.
"And the main reason is governments have not listened to our advice and have not taken action on the statistics before them, and certainly have not provided the funds required.
"Having worked in government as a senior executive for decades I strongly believe having a voice written into the Australian Constitution together with the National Agreement on Closing the Gap is the best way to improve living conditions and health outcomes for our Aboriginal and Torres Strait Islander peoples."
More than 120 health and medical organisations have signed an open letter asking people to vote 'yes', including the Australian Nursing and Midwifery Federation and the Australian Medical Association.
On Tuesday, grassroots organisation Doctors for Yes added their backing.
Wotjobaluk man Glenn Harrison, an emergency physician at Melbourne Hospital, pointed to positive outcomes where Indigenous health policy has been informed by consulting First Nations people.
"The COVID response is one of the best in the country with lives saved just because we actually listened to Aboriginal and Torres Strait Islander people," he said.
Purple House has become a much-loved Alice Springs institution and now offers remote dialysis, social support, aged-care and NDIS services.
Since the opening of the first dialysis clinic in Kintore in 2004, Purple House has expanded to 19 remote clinics and two mobile dialysis units in the specially kitted out "purple truck", which enables patients to visit family for festivals, funerals and other cultural business.
"We've gone from having some of the worst survival rates in the country on dialysis to the best," Ms Brown said.
"Our patients are living longer than non-Aboriginal people on dialysis in Sydney or Melbourne, and we don't have flash machines.
"It's about having having a voice and having some agency over your life, and having some hope that life will really get better."
Ms Brown says Purple House is what you get when Australia says 'yes' to an invitation from Indigenous people to walk with them together, for a better future, as the Uluru Statement does.
"The Purple House model is a story about the very best in humanity, of people working together to make life better," she said.
"And I think that's what what a vote 'yes' for the voice can be too - it can show the very best of us."
Australian Associated Press
