Living with Dialysis : a Qualitative Study of Social Well Being among Kidney Patients at Lady Reading Hospital in Peshwar, Pakisan

Abstract

This project looks at something that rarely comes up in Pakistani healthcare conversations, which is what daily life actually feels like for kidney patients who depend on long-term dialysis. The research was carried out at Lady Reading Hospital in Peshawar, one of the biggest public hospitals in Khyber Pakhtunkhwa. There is plenty of medical writing about dialysis, but the social and emotional reality of these patients is hardly ever recorded in any real depth. This study tries to do exactly that, focusing on the everyday struggles, relationships and coping methods of dialysis patients in their own words. The scale of the problem is hard to ignore. Recent figures suggest that hundreds of millions of people around the world are now living with some form of chronic kidney disease, and that a life is lost to it every few seconds. Pakistan sits inside this picture, with tens of thousands of patients depending on regular dialysis just to keep going. What gets lost in these numbers is the person behind them, and that is the gap this project set out to fill. Because the aim was understanding rather than measurement, the study followed a qualitative design. I interviewed thirteen male dialysis patients aged between 29 and 63, drawn from districts including Peshawar, Charsadda, Nowshera, Mardan, Swabi, Buner, Karak, Dir and Bajaur. One participant was an Afghan Hazara national living in Peshawar. Each interview ran for about half an hour to forty-five minutes and was conducted in Urdu and Pashto so participants could speak freely. The analysis used Braun and Clarke's six-phase thematic approach with NVivo Version 14, producing 1,247 references across 52 open codes, then 7 axial categories, and finally 5 main themes. These themes capture how dialysis dismantles Pashtun masculine identity, pushes families into severe financial stress, slowly disconnects patients from their communities, rebrands them as 'the sick one' in the eyes of others, and how faith and waiting-room friendships become their main forms of resilience. The findings connect to several United Nations Sustainable Development Goals, especially SDG 3, SDG 1, SDG 10 and SDG 8, and to the ESG frameworks now shaping global healthcare, as seen in recent 2024 reports from Deloitte, KPMG, EY and PwC. The project closes with practical recommendations around adding psychological support inside dialysis centres, expanding Sehat Sahulat Programme (commonly known as the Sehat Card) coverage, and running awareness campaigns to challenge the misconceptions surrounding kidney disease in Pakistani communities.