'The chance I take': Dialysis patient conducts his own treatments in remote First Nation

Steven Chapman admits that conducting his own hemodialysis treatment hundreds of kilometres from the nearest hospital is “kind of a dangerous thing” for him to be doing.

But the 52-year-old prefers the risk to the available alternatives — move to the city or die.

Chapman is from Kitchenuhmaykoosib Inninuwug, a remote First Nation in northwestern Ontario.  He has kidney disease and requires dialysis treatment to stay alive. Until last February, the closest place to get treatment was 600 kilometres away in Thunder Bay, Ont.

Now, thanks to a pilot project between his First Nation, Thunder Bay Regional Health Sciences Centre and the Ontario Renal Network, a home hemodialysis unit has been set up in Kitchenuhmaykoosib.

The catch? Chapman has to conduct the four-hour procedure, three times a week, all by himself.

Steven Chapman

Steven Chapman connects the tubes that will attach him to a mechanical kidney as he conducts his own hemodialysis in Kitchenuhmaykoosib Inninuwug, 600 kilometres north of Thunder Bay, Ont. (Jody Porter/CBC)

“If there’s a blood leak and I’m sleeping, I won’t know, then all my blood runs out, I’ll lose consciousness and that will be it,” he said as he jabs himself with a needle to insert the intravenous tubes that will carry his blood through the machine, which cleans his blood the way a kidney would.

“That’s the chance I take.”

Like dozens of other people from remote First Nations in Ontario, Chapman used to receive treatment in Thunder Bay. He had to give up his job, leave his family and move to a strange place where few people could speak to him in his Oji-Cree language.

“It affects the mind when you’re in the city, if you’re from a village like this,” he said as he showed how the machine worked when CBC News visited in September. “You start being depressed and lonely and pretty soon you start doing what you’re not supposed to. It’s bad for a person, also it’s bad for their health.”

‘A different level of risk’

Kidney disease affects one in 10 Canadians, but it’s estimated that three in 10 people in remote First Nations have the disease, according to Mary Wrigley, manager of renal services in northwestern Ontario.

But home hemodialysis poses a challenge in those communities because it requires a constant supply of clean, running water and a reliable energy source, both of which are rare in isolated First Nations. A housing shortage on many reserves means families often don’t have space in their home to set aside for medical equipment and care.

“The risks for home therapy are the potential for infection, potential the machine may not work,” Wrigley says. ”In the remote community it adds a different level of risk because the only way in or out is to fly.”

Steven Chapman

A step-by-step instruction book rests on top of the machine that allows Chapman to conduct his own hemodialysis treatments in a special apartment set up in his remote First Nation. (Jody Porter/CBC)

She calls the pilot project with Chapman “a fantastic opportunity” made possible because his First Nation, with a population of about 1,000 people, was willing to provide the necessary infrastructure and designate an apartment in the local seniors’ complex as a dialysis clinic.

The year-long pilot project in Kitchenuhmaykoosib will wrap up in February.

Chapman prides himself on being a “guinea pig” and blazing a trail for other people in remote First Nations who require hemodialysis, but Wrigley says his success might not easily be replicated.

“We would not be able to transmit that exact success story in each other community,” she says. “In a year we’ll know it’s successful because we have a fantastic patient who is very motivated and interested in staying home and a community that has been very supportive.”

Chapman looks forward to providing instructions for hemodialysis in Oji-Cree, for those who are brave enough to follow his lead.

“It’s kind of like I’m on my own here, but I don’t worry about it,” he says. “My belief is if the Creator wants me to go, he will. If not, then I won’t. That’s all it is to me.”

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