There are two main ways to reach the community of Natuashish in Labrador. Travellers can go by plane or, in the summer months, take a boat up the coast. No reliable roads connect the subarctic Innu community of about 1,000 residents with more populated towns to its south.
Frequent transportation delays and high prices for plane tickets also are strains on those trying to make the journey. These issues make it challenging for people with some medical conditions to get treatment, including life-sustaining dialysis that cleans waste and excess fluid from the blood when a person’s kidneys aren’t working properly.
Supporters celebrate at the project launch to provide portable dialysis equipment that allows patients or family caregivers to administer treatments. Courtesy of Geoff Goodyear
Without any dialysis clinics in remote Labrador, people with renal disease often need to move away to get critical care, says Mallory Peddle, a dialysis nurse specialist with Newfoundland and Labrador Health Services. Some have to live away from their families for extended time, and people with advanced kidney failure could face navigating the treatments towards the end of life far from their support system at home. “It’s a cultural shock to them because they had grown up, lived and breathed their culture, in very remote, rural communities and then were expected to uproot,” Peddle says. “It’s not fair to them because the resources weren’t available.”
But with help from Rotary clubs, that is beginning to change with the addition in recent years of portable dialysis equipment for the area.
A better life at home
The first Natuashish resident to use the machinery purchased with Rotary Foundation global grants was able to live at home while getting treatment nearby. He previously had moved away for his frequent dialysis sessions but had the chance to return while using the new equipment for several months near the end of his life. In a 2023 CBC/Radio-Canada article published after his homecoming, the man’s daughter said that it was the happiest she’d seen her father, who had been given the gift of coming home after being away for years.
He’d go fishing and was surrounded by family, says Peddle, who helped train the man’s daughter to use the equipment. “I kept in very close contact with the patient and caregiver, multiple times a day for any issues that came up, or just to check in,” she says. “Both of them said how much they truly loved being there.” Eventually, the man needed to leave Natuashish again, for health reasons, but the time spent at home was special for all involved.
Dialysis machines use a premixed solution, vital for areas with unreliable water. Courtesy of Geoff Goodyear
It also was a special accomplishment for the Rotarians and others who worked on the endeavour, says Mike Spurrell, past president of the Rotary Club of Happy Valley-Goose Bay Labrador, a grant applicant and one of many clubs that contributed funding. Patients “are not away from their families and are able to stay in their communities,” says Spurrell, now a member of the Rotary Club of Clarenville in another part of the province. That goes a long way in bringing comfort to a person receiving exhausting treatments several times a week.
Even more encouraging, the project brought hope of a solution for people in parts of the world who need dialysis but lack access to the equipment. The machines purchased through Rotary are not only portable but also solve another factor that commonly limits dialysis treatment in remote locations: an inadequate water supply. These machines do not need local water; instead they use premixed bags of the solution needed to clean the blood during dialysis, says Anne Rowsell, who was the project manager for the renal expansion program at Newfoundland and Labrador Health Services, Labrador Grenfell Zone. (Rowsell has since retired.)
“When you think about coastal Labrador, when you think of the cultural sensitivities that we were working with, when you think of the supply chain — if this could be established in Natuashish, what could stop us from doing it absolutely anywhere?” Rowsell asks.
A challenge recognized
The idea for Rotary clubs to get involved came about after a Labrador Grenfell Health executive and a former Happy Valley club member had a conversation about the dialysis challenges. Happy Valley-Goose Bay, a town about 300 kilometres south of Natuashish, is one of several in the south of the province where, according to the global grant applications, the majority of patients receiving dialysis are Indigenous people relocated from isolated communities in the north “at great personal and social expense” to them and their families.
Coordination between Rotary clubs, the health authority for the area, and chiefs and councils helped bring the project to fruition, Spurrell says.
Funding came together quickly. Rotary members began applying for the first global grant in 2019, says Geoff Goodyear, a former Happy Valley club member who continued to work on the initiative when he moved to the Rotary Club of Exploits. When the COVID-19 pandemic hit, “there was no dallying around” to get the project underway, he adds.
Clubs supplied four machines and staff and patient training using two Rotary global grants totalling $143,000, including club and district funds. Two machines are in Natuashish and available for treatments (one is a backup in case the other fails), and the other two are for training and replacement needs, Goodyear says. (The nonprofit International Grenfell Association separately purchased several machines in Sheshatshiu, another Labrador Innu community.)
The international partner for the grants was the Rotary Club of Port Angeles, Washington, an area that is also home to Indigenous groups, member Ann Murakami says. Members’ work to implement the grants stretched into early last year.
Eugene Hart (center), chief of the Sheshatshiu Innu First Nation, talks with initiative backers, including Rotarian Ann Murakami (right). Courtesy of Geoff Goodyear
To identify people who would be eligible for remote dialysis, a screening tool was developed, says Rowsell, the health facility’s former project manager. “The stability of the patient was really important. How stable was the patient? How compliant was the patient? How suitable was the support person in terms of reliability to be there?” Not every patient meets the requirements.
The Natuashish resident who used the equipment had a caregiver who was quick to train and eager to learn, says Peddle, the dialysis nurse. “She absolutely loved the idea of her father returning. That was really a driving force, because that’s where she resided with her kids, and that’s where all the family and friends were.”
When he returned to Natuashish, it was a celebration, Peddle says.
A model for remote areas
The project’s early success is promising for isolated locations. “It’s being watched on a whole bunch of levels for its potential benefits, but also its potential spread,” Goodyear says. “For me, it underlines the word ‘global’ in global grant when what we do here could have an effect on other parts of the world.”
Meeting this challenge proved to everyone involved that dialysis in remote places could be accomplished, with the potential to one day help people in other areas, Rowsell says. For that, she adds, the success of the project was the highlight of her career.
Other people will benefit over time from the machines, Rowsell explains, getting the dialysis treatment they need without having to leave the comfort of their community. “I have a positive outlook on that for any number of reasons,” she says. “It is just a matter of timing, the right intervention, and the right support.”
This story originally appeared in the April 2026 issue of Rotary Canada magazine.
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