He says he feels weak. Plastic tubes protrude from his arms and connect to a rectangular machine next to his bed. They are coloured crimson with his blood.
Richard Kusi Yeboah is only 15 years old, but he spends 12 hours every week at the renal unit in Accra’s Korle-Bu Teaching Hospital. In early 2011 his kidneys failed. He has been on dialysis ever since.
“I don’t play the games they play [in the school yard],” says Yeboah as he lies in a hospital room that smells like the sterile disinfectant you would find in a dentist office. “I play with my friends normally. I don’t run but sometimes I go for a walk.”
He lives with his mother, Janet Donkor, who has struggled to raise funds for the dialysis that keeps her son alive. Each session—and Yeboah must go three times a week—costs 140 cedis, or about $81. Korle-Bu asks that patients leave a 5,000 cedi deposit before they begin the treatment. That’s about $2,300. Donkor had to borrow money from her mother for the deposit.
“The majority [of Ghanaians] cannot afford renal replacement therapy,” says Dr. Vincent Boima, a kidney specialist at Korle-Bu.
Renal replacement therapy comprises of dialysis and an eventual kidney transplant, which is the only way for someone with kidney failure to live a normal life.
Boima says some families have lost everything they own paying for dialysis. Once they lose all their possessions they also lose their loved one because they can no longer afford a kidney transplant, which can fetch a price as high as 40,000 cedis, or roughly $23,000.
Donkor is a single mother. She wants to donate one of her kidneys to her son but cannot afford the operation. She has pleaded local media to help her raise the money she’ll need to donate her kidney to Yeboah.
“He can’t go on like this for the rest of his life,” says Donkor. “I don’t have anybody. I only pray to God for help.”
Ghana’s National Health Insurance Scheme does not cover renal replacement therapy for patients who have chronic kidney disease. The government says the treatment is too expensive and would put too great a toll on the system.
But kidney disease is a growing problem in Ghana. Boima says 10 per cent of all hospital admissions in the country are now kidney-related.
In 2010 Korle-Bu handled 2,121 kidney-related cases. In 2011 that number shot up to 2,687 cases—a 31 per cent increase.
But Dr. Charlotte Osafo, the head of Korle-Bu’s renal unit, says the increase is due at least in part to more awareness of kidney disease. More patients are coming forward for treatment.
Boima says kidney patients often arrive at Korle-Bu “crash landing.” The kidney disease has progressed to the point where they must be put on dialysis right away to survive.
The three main causes of kidney disease in Ghana, and around the world, are diabetes, hypertension and inflammation of the kidneys. The first two can be controlled through diet, exercise and the right medication if they are detected early enough.
Korle-Bu has 135 patients who are regularly on dialysis due to kidney disease. The youngest is eight years old and the oldest is in his 70s. The hospital has 18 dialysis machines. “These machines are under real pressure,” says Boima. “In the near future they will break down.”
A basic dialysis machine costs about $20,000.
In addition to Korle-Bu, Ghana has one other kidney centre at Komfo Anokye Teaching Hospital in Kumasi. A local charity called the Christian Council of Ghana is raising funds to build a third kidney centre at 37 Military Hospital in Accra.
Rev. Fred Deegbe, the Christian Council’s general secretary, says appeals from the families of people suffering from kidney disease encouraged the group to build the new centre. He says it should be ready by the end of 2012.
Boima says kidney disease is a “silent killer” that kills people when they are often in their most productive years. Most people with kidney disease in Ghana are in between the ages of 20 and 50. He says Ghana should follow South Africa’s lead and at least cover treatment for patients under the age of 40.
Donkor is desperate for a solution in the near future. She cannot afford to keep her son on dialysis indefinitely.
“For the past year I’ve struggled to take care of him,” she says. “I won’t let him die.”