Accra, Ghana Behind every dialysis chair at the Ridge hospital Dialysis Center, tucked inside Ridge Hospital in Accra, sits a patient carrying more than a failing kidney. According to Mariam Darko, the Center’s in-house psychologist, the physical machinery of dialysis is only half the story. The other half often invisible, rarely discussed, and almost never treated is the psychological weight patients carry from the moment they are diagnosed to the moment they walk into the treatment room.

Darko’s account, given in an interview at the Center, paints a picture of a healthcare system where the mental and emotional dimensions of kidney disease are consistently outpaced by its clinical demands.

A Diagnosis That Attacks the Mind Before It Attacks the Body

For Darko, the psychological damage begins long before a patient ever reaches a dialysis machine. “Anybody who is suffering any kind of kidney disease is already stressed,” she said. “Your kidneys are a vital part of your entire human system. Nobody’s kidney is going to function as it’s supposed to function. And that alone is going to be a burden on your mental health.”

That baseline stress, she explained, is compounded almost immediately by financial anxiety. A significant share of the patients she sees, she said, simply do not have the financial capacity to sustain their own treatment a problem magnified for those who travel from Ghana’s northern regions to seek care in Accra.

The Long, Punishing Road South
Much of Darko’s account centers on what she describes as an underappreciated source of trauma: the journey itself. With airfare from Tamale and Kumasi to Accra having risen sharply in recent months, she said, many patients are left with no option but overland public transport a journey that is physically brutal for someone already battling kidney failure.

“The stress of sitting in a public transportation to come to Accra is going to deteriorate your mental health,” Darko said. She described patients who are unsure whether they have relatives to receive them in Accra, uncertain about accommodation, and anxious about how they will be received by hosts who may see them fairly or not as an added financial burden. “Are you coming to bring more financial burden? At some point, do they have to step in to help? There’s all that uncertainty,” she said. “So the anxiety is already building there.”

Layered on top of that emotional strain is a distinctly physical one. Kidney patients frequently need frequent bathroom access and struggle with prolonged immobility, which can trigger swelling if they are unable to move during long journeys. Darko noted that many patients underestimate how bad the roads are and how much longer the journey will take than expected turning an already difficult trip into a source of compounding distress before treatment has even begun.

A System Under Pressure
Once patients arrive, Darko said, a different kind of stress takes over: the strain of an overburdened healthcare system. Ridge hospita dialysis center draws patients from across Ghana’s regions, creating long queues for a limited pool of nephrologists. “The number of doctors Specialist to the patients it’s not balanced at all,” she said, pointing to what she described as a steadily rising number of new kidney disease and renal failure cases nationally.

That imbalance, in turn, feeds a cycle of fear and misinformation. Darko said many patients arrive having already heard stories often from other patients suggesting that starting dialysis is a precursor to death, leading some to refuse treatment altogether out of fear rather than medical necessity. “That’s another case of anxiety fear of the unknown,” she said.

The Silent Weight of Stigma
Stigma, Darko said, remains one of the most damaging and least discussed aspects of the dialysis experience. Many patients are reluctant to disclose their condition even to those close to them, which cuts them off from potential emotional and financial support at the exact moment they need it most. “If there’s someone who can actually offer you help, you’ve lost it because you’re unable to reveal your issues to the person,” she said.

She stressed that caregiver support is critical to a patient’s psychological resilience through treatment but that support only works if caregivers are trusted with the full picture of what a patient is going through. Patients without that support system, she said, often face the emotional burden of dialysis largely alone.

A Gap in Care That Nobody Has Time to Fill

Darko was candid about the structural reasons psychological care is so often absent from the dialysis experience: doctors are stretched thin and rarely have time to address the emotional dimensions of a patient’s condition, even though they are, in effect, expected to.

“They have very little time to spend on your… mental health,” she said, describing her own role at the Center as one of the few points in the system where that gap is directly addressed.

Without that support, she warned, the consequences extend beyond emotional discomfort into clinical outcomes. “Once your mental health is deteriorating, your treatment is useless,” Darko said. “We need to have a strong mental mind to be able to go through dialysis.”

A Call for Integrated Care
Darko’s account underscores a broader gap in Ghana’s renal care infrastructure one where psychological support remains the exception rather than the standard. As the country continues to report a rising number of kidney disease cases, her testimony suggests that closing that gap may be as critical to patient survival as the dialysis machines themselves.

Mustapha Bature Sallama
Medical/ Science Communicator,
Private Investigator, Criminal Investigation and Intelligence Analysis,

International Conflict Management and Peacebuilding. ( USIP)

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