For Linda James, drinking a glass of water could have serious consequences.
If she uses the wrong water, that is.
Since 2020, her community of Kiwirrkurra, a remote community on the border of Western Australia and the Northern Territory, has been advised to only drink boxed water because the local tap water has unsafe levels of fluoride.
While drinking the water doesn't immediately make people sick, it can cause long-term health issues, especially for older people.
The Pintupi woman says she thinks about it all the time, not just because she's worried she'll make a mistake, but because she worries her community's elders might forget, and her young children might slip up.
Ms James is the chair of the Tjamu Tjamu Aboriginal Corporation.
Seven hundred boxes of water a week are handed out to the community of 200 people, creating 1,400 pieces of rubbish.
"We don't have the machinery for it. It's a big mess," she said.
It's a temporary solution that over time is taking a toll.
Despite the town's best efforts, foil water bags and cardboard boxes have been known to litter the landscape after escaping from the area's relatively small tip.
"Some relatives have left because of the water," Ms James said.
In some cases, that is because dialysis requires large volumes of extremely clean water, something the arid sandhill country around Kiwirrkurra has been unable to offer.
This means many of the community's cultural leaders are stuck in Alice Springs, 800 kilometres away, because they are receiving treatment.
Many of them are the grandmothers and grandfathers to Kiwirrkurra's children.
Senior Pintupi man Bobby West is one of those elders. He has missed funerals because he couldn't access treatment in his community.
He has also resorted to making day trips from neighbouring Kintore, driving 400 kilometres on rough outback roads in a day.
"We want to go back," he said. "Looking after country, being with family, funerals. It's very important to us," Mr West said.
Ms James agrees.
"It makes [the community's dialysis patients] sad, and makes them more sicker because they are away from their country and, you know, this is their home," she said.
Medical-grade water in the desert
Kiwirrkurra's water remains unsafe to drink, but as the new year approaches the community is quietly optimistic Mr West and other elders will be able to come home.
Remote dialysis provider Purple House biomedical engineer Michael Smith was trying to work out how the life-saving, water-hungry medical treatment could become more efficient when he stumbled on a happy accident.
Each dialysis treatment requires 400 litres of water, which can add up quickly in areas where water is scarce.
"Originally we tried to design a system that would save water, because it's precious in the desert communities where we offer dialysis," he said.
In the process of making a more water-efficient system, he discovered a way to purify contaminated water for dialysis using reverse osmosis.
The discovery landed Mr Smith and his team an Australian Water Association award.
It can't be used at a scale that would fix the community's water supply, but Mr West said it was a welcome development.
"We should be home for Christmas … but it's not right. This wouldn't happen anywhere else in Australia and we need help. We need water to drink," Mr West said.
Purple House will use the new technology in all of its new remote units and will retrofit it in clinics where water security is a serious concern.
Do not drink
Kiwirrkurra is one of Australia's most remote communities, separated from Alice Springs by 800 kilometres of mostly unsealed roads.
The United Nations says access to safe drinking water is a human right but Kiwirrkurra remains one of the 48 Indigenous communities in Australia where the local water supply is below Australian Drinking Water health guidelines.
And until recently, it was one of 500 Australian remote communities without any water quality monitoring.
Remote communities rely on bore water, which often requires treatment to remove impurities.
"If this was near Perth, it would be fixed by now but we are still waiting after two years," Ms James said.
Ms James has travelled to Perth, she's invited ministers to visit, she's written emails and made phone calls.
"We just want to be heard," she said.
A 2022 report shows Kiwirrkurra's water contamination was only picked up in 2020, when monitoring began and the WA government issued a "do not drink" notice for the community.
In 2021 the state government installed its own reverse osmosis water purifier, but it didn't work and it is still working to resolve the issue.
In the meantime, the community is left with boxed water that keeps Ms James awake at night and with more rubbish than it can handle.
The WA Department of Communities has been contacted for comment.
