Big Girls Don’t Cry: A new kidney

The images of a sick baby on dialysis are very difficult to watch, but the unwavering faith of the parents and medical support staff saw Mariah survive infancy.

Big Girls Don't Cry synopsis

A moving documentary about Indigenous women living with kidney disease.

Big Girls Don't Cry curator's notes

The prevalence of kidney disease is overwhelming in Indigenous communities, with Darwin having an incidence ten times higher than anywhere else in the country, with 80 per cent of that number being Aboriginal. It is difficult to watch the impact of renal disease on Mariah, who has lived with it since she was a baby, as well as elder and activist Essie Coffey OAM, who in her final years lived with renal disease. The title Big Girls Don’t Cry comes from an affirmation Essie Coffey’s family uses in the film. Essie Coffey eventually succumbed to a common cold, her immune system so weak she could not fight it off.

This is a very moving film, and the strength of women – Essie Coffey of the Muruwari clan, Mariah Swan of the Kamilaroi clan, Glenda Kerinaiau of the Tiwi clan – who lived with, and continue to live with, renal disease touches your heart.

Notes by Romaine Moreton

Education Notes

This clip uses a series of interviews intercut with family photographs that tell the story of Mariah and the effect of kidney disease on her and her family. Her parents, Angie and David, recollect their experience of Mariah’s illness, dialysis and the news of a possible transplant. Photographs of Mariah and her parents at the time of the illness complete the picture they describe. A doctor provides information about the illness and the clip concludes with shots of Angie and David describing their joy at receiving the news that a suitable kidney is available.

Educational value points

• The effect of chronic kidney disease on Mariah and her family, who are from the Kamilaroi clan, is graphically illustrated through her puffed-up face, a symptom of the disease. When kidney function falls below a certain level due to chronic kidney disease, the kidneys fail. At this point drastic medical intervention is necessary to sustain life. Her parents’ recollection of this time causes them considerable anguish.

• The doctor in the clip explains that the kidneys’ essential function in the body is removing waste products and extra water from the blood. They also regulate blood pressure, balance essential chemicals such as sodium and potassium, produce hormones to help bones grow and keep the blood healthy by making new red blood cells. Damage to the kidneys impairs their capacity to perform these functions and wastes build up in the blood.

• The sensitive issue of a child’s illness and the suffering of Mariah and her parents is well handled in this clip. The camera pans slowly across a photograph to show toys, then a child’s hand and arm, before we see Mariah with tubes taped to her face. Her parents recount the development of the disease over photographs of Mariah at the time. The camera only briefly focuses on the parents’ faces so as not to intrude on their personal distress.

• The disruption to the lives of parents whose child has a chronic illness is alluded to in the clip. Photographs show Angie and David living in Sydney, an unfamiliar city that was to become their home for 12 months. Describing themselves as 'shy and from the bush’, they were only teenagers when the Royal Flying Doctor Service transported them and their sick baby daughter from their home in Moree, New South Wales, to Sydney’s Children’s Hospital.

• It is recommended practice for parents to be with their children during the period of treatment and hospitalisation to provide the comfort and love that will assist with the child’s recovery. As was the case for Angie and David, this period can last for many months. For parents from rural or remote Australia the period away from home can be very difficult because of enforced absences from work and from other family members and the pressure on family finances.

• Kidney disease is rare among children, with adults 20 times more likely to experience the disease. Kidney failure resulting from injury or poisoning is usually temporary. The two leading causes of irreversible kidney failure among children aged 4 and under, such as Mariah, are birth defects, for example being born without kidneys or with abnormally formed kidneys, and hereditary diseases.

• The subject of kidney donors is raised in the clip. Most kidneys for transplant come from people who have recently died, as was the case for Mariah who received a kidney transplant from another child who had died in a car accident. As most people have two kidneys, but need only one functioning kidney, it is possible for living people to also donate a kidney provided there is a good blood, tissue and size match.

• The clip is from the documentary Big Girls Don’t Cry produced by the Central Australian Aboriginal Media Association (CAAMA) about Indigenous women living with kidney disease. Established in 1980 and owned by the Indigenous people of central Australia, the Association’s primary purpose is to represent Indigenous Australians in film and television. This film is in the form of an informational report, but its purpose is also to persuade Aboriginal people to seek medical advice.

Education notes provided by The Learning Federation and Education Services Australia