Short Takes: Pioneering a Holistic Approach to Speech Therapy in Kenya

How an unexpected entrepreneur used her passion and persistence to gain recognition for speech therapy in Kenya.

February 20, 2024

Meet Grace Macharia, a speech and language therapist and founder of SLT Support in Nairobi, Kenya. She created a social enterprise with a mission to support not only her patients but also the profession of speech therapy in Kenya as a whole.

“In 2011 there were about five speech therapists in Kenya, and all of them were trained out of the country. Can you imagine only five speech therapists for a population of 21 million?!” she recounts. When Macharia eventually found her true career calling in speech therapy, she realized that she couldn’t deliver the kind of impact she wanted without the help of others. So, she created a business, got the training she needed to formalize her business structure and organization, and began lobbying policymakers to give the profession the recognition and support it deserved.

Not everyone is born an entrepreneur. Grace Macharia certainly didn’t think of herself that way. But she had the persistence of an entrepreneur and a deep concern for her patients, many of whom needed more than just speech therapy services. Today her company treats patients, trains new therapists, and offers a multidisciplinary, holistic approach to care that is yielding better outcomes. And she’s created an association of speech and language therapists in Kenya to support each other and lobby for reform.

Of course, Macharia is still pushing for more. Speech therapy, she says, “is a profession that still needs a lot of attention. A lot of the people who need our services actually don’t get it. When we have access to all this in every county, not just in Nairobi, not in just the cities in Kenya, but in every county, and not just in Kenya, East Africa, that would be a success and a dream come true.”

Hear how Macharia got the entrepreneurial training she needed to run a business and promote her profession so that other therapists and patients succeed.

Grit & Growth is a podcast produced by Stanford Seed, an institute at Stanford Graduate School of Business which partners with entrepreneurs in emerging markets to build thriving enterprises that transform lives.

Hear these entrepreneurs’ stories of trial and triumph, and gain insights and guidance from Stanford University faculty and global business experts on how to transform today’s challenges into tomorrow’s opportunities.

Full Transcript

Grace Macharia: What inspires me is helping other people, being of service, being of service to somebody else.

Darius Teter: Social entrepreneurship can be transformative, not just for the entrepreneur, but for their wider community.

Grace Macharia: It’s not only helping the other person change their life, but you as a person also benefit in the sense that, not only on monetary gain, but as a person you find fulfillment in life.

Darius Teter: Welcome to Grit & Growth from the Stanford Graduate School of Business, the show where Africa and South Asia’s intrepid entrepreneurs share their trials and triumphs. I’m your host, Darius Teter. Today we’ve got another installment of our series of short takes where we bring you bite-size stories of amazing entrepreneurs. For this episode, we’re traveling to Nairobi, Kenya, where one entrepreneur is showing how a single business can build an entire profession.

Grace Macharia: My name is Grace Macharia. I’m a speech and language therapist, and I’m the founder of SLT Support, an allied health company that is working in hospitals.

Darius Teter: Grace doesn’t have the typical background of an entrepreneur.

Grace Macharia: It’s interesting, because my first career was a teacher. I used to be a fine art teacher, and I get bored easily, so teaching the system the way it was, once you qualify as a teacher, we just don’t progress much. So I got tired of teaching regular students, so I got into special education, so I went to teach deaf children because my thought was, if I could teach the deaf fine arts, then we can get them off the street, because a lot of deaf children, people will find them selling sweets in the streets because they had no other career choice. And so my first teaching was in a school for the deaf, but I also didn’t stay there long because shortly after that I went to UK to study to do a master’s in speech and language therapies. That’s how I became a speech therapist.

Being a speech therapist is very different from being a teacher. When you’re a teacher, once you have gone through a year, you know what you’re going to teach. In the next year you can actually even teach with your eyes closed. But as a speech therapist, anybody who walks into that door is different. It does not matter whether they have the same condition. If it’s somebody with a stroke, they’ll present differently, and so you get challenged on a day-to-day basis. But the most exciting beat is the impact you get to see in a very short period of time.

Darius Teter: Creating impact is what drives Grace.

Grace Macharia: When I was growing up, I thought life is made up of just having and acquiring a lot of money, but there comes a time when money actually is not a solution to anything. But when you provide a service to somebody and you see them getting a solution from what you’ve provided and making a difference in their life, you feel motivated. I remember the thing that really, really motivated me to be a speech therapist and to know that I actually was on the right path is getting a lady who was 24 years old and she had a stammer, and so she came for therapy and the first assessment, we couldn’t even read a paragraph for five minutes. We tried. She couldn’t even read. Her sister used to be her spokesperson. Her stammer was that bad. Then we started doing therapy. By the fourth session, she gave us a presentation for five minutes, and I knew this is what I wanted to do.

Darius Teter: But even with all her passion and training, Grace was limited in what she could accomplish by herself.

Grace Macharia: After coming back to the country, one of the things I found very difficult is to get support as a speech therapist working alone in an environment where you don’t have other people who can support you. You’d not get supported by the hospitals you work with, neither would you get money from the banks. And I realized if we want to change the way things are, we need to increase in numbers, and the only way we can increase in numbers is having access to something that you can be able to use on your own. Because when I approached hospitals explaining to them how I would love to develop the department, nobody took me seriously. The only way I can be able to help is if I become an entrepreneur. Then I would have a service that I’m in charge of. I can make decisions, and as a result I can be able to clone myself so that I don’t just work as a lone ranger.

Darius Teter: Business didn’t always come naturally to Grace.

Grace Macharia: So when I started this company, I still had a mindset of being employed, because all my life was in employment. So I actually was not an entrepreneur, so I only had one admin person. We didn’t have any kind of a business model. I didn’t have an entrepreneurial mindset. So being able to track our finances and how we are spending and budget, because before I was just getting money, put money in the bank,and sometimes I would not even account for it

Darius Teter: Even though she lacked business knowledge. Grace had one of the most important traits of an entrepreneur: persistence.

Grace Macharia: No matter how disappointing sometimes things can be, not giving up for me to have trained to become a speech therapist, I needed money to travel to UK and I needed a lot of funding, and as a teacher, my pay was not enough. So I got a scholarship from the Ministry of Health, and the way it happened is that I involved one of the directors of the institution I was working in, and I remember her telling me one day that she would hate to live with me because I’m very persistent and I told her, things don’t just happen. They need to happen.

Darius Teter: As Grace sought out business and leadership programs, her confidence grew.

Grace Macharia: I actually got to understand who an entrepreneur is and how we can use tools to be able to organize business. In fact, one of the things that I enjoyed most is operation because I had no operation, neither did I have a system, but attending that program helped me to see the need of getting some kind of formal structures and formal organization. So I was able to get a finance person to help us in outsourcing for funds and also budgeting, and also to get an HR person.

Darius Teter: It wasn’t just Grace’s business that was transforming.

Grace Macharia: It has changed me because before, I used to do things my own way and I only had myself to consult, but now I know that every person who I’m working with is part of a team. It is through the way I lead with them and the way I encourage them to lead with each other that will make a difference in our working situation. Before, I didn’t think that was that important, but everything has changed. I am now, actually, I would call myself a leader. I never used to think I was a leader.

Darius Teter: Grace demonstrated her leadership by thinking beyond the success of just her business, by lobbying policy makers to recognize speech therapy as a profession in Kenya.

Grace Macharia: I wanted to see how I could get people to understand that speech therapy actually is an important profession. So there was no employment because nobody recognized it as a profession. And so by getting myself a company, it was to see whether we could start a practice that we could also use to seek out guidance from the Ministry of Health so that we can be registered, recognized, and most probably also have a voice, input, in policy making. In Kenya, when I came back from training, that was 2011, there were about five speech therapists, and out of the five, all of them were trained out of the country, and so you can imagine five speech therapists for a population of 21 million. That was it. But today we have an Association of Speech and Language Therapists Kenya. I think practicing speech therapists right now, almost 20.

Darius Teter: As Grace built her business, she came to understand that speech therapy was sometimes only one piece of the support that her clients needed.

Grace Macharia: When I started working as a speech therapist, one of the most frustrating things is that we don’t work in a multidisciplinary approach. In most cases, most of the clients we see or patients we see need to be attended to by a physiotherapist, an occupational therapist, and a speech therapist, and sometimes even a counseling psychologist and a nutritionist. I’m happy to say that we have onboarded occupational therapy, so now we have an occupational therapist we’re working with. And recently we got spotted by a company from India that specializes with children development centers, and that is one of the things we are having a talk with them, how we can work together and they can assist us in training to start on early intervention when children are still very, very young in NICU, neonatal ICU, and we can start giving them therapy and stimulating their reflexes. And by the time they’re getting older, then most of the disability they end up developing then can be stopped because a lot of them end up going to hospital every two weeks, being admitted because of aspirational pneumonia. So if we can start early, then we can prevent a lot of disability that is ongoing right now.

Darius Teter: Grace and her company, SLT Support, have changed the landscape of speech therapy in Kenya, and she knows that there’s still more to do.

Grace Macharia: It’s a profession that still needs a lot of attention. A lot of the people who need our services actually don’t get it. When we have access to all these in every county, not just in Nairobi, not in just the cities, in Nairobi, in Kenya, but in every county, we have access to rehabilitation for everybody, child, adult, everybody, and not just in Kenya, East Africa — that would be ultimate success for me. And I wouldn’t say I’ve gone to where I want to be because I want to see my dream come true. I want to see the results — my dream.

Darius Teter: I love Grace’s story because it highlights some essential things about social entrepreneurs. First, success follows passion and persistence. Entrepreneurship wasn’t Grace’s first career, or even her second. The business didn’t take off right away, but she kept pushing, fueled by her desire to help others. Second, business knowledge is something you can learn. Nobody is born knowing how to run a company. The reason we know Grace is because she participated in the Aspire Business Growth Program, the collaboration between Stanford Seed and the African Management Institute. Finally, Grace’s story shows the transformative effects of social enterprise. Directly, SLT Support treats patients and trains new therapists, but it doesn’t stop there. Her vision is reshaping the therapeutic model in Kenya, creating an approach that is holistic, multidisciplinary, and better for patients. These compounding effects generate a far greater reach than what Grace had on her own.

Thank you to Grace Macharia for sharing her voice and helping others do the same. If you’d like to learn more about the Aspire Business Growth Program, which helps businesses with revenues between $30,000 and $400,000 per annum, we’ll have a link in our show notes. If you like this episode, follow us and leave a review on your favorite podcast app. Erika Amoako-Agyei and VeAnne Virgin researched and developed content for this episode. Kendra Gladych is our production coordinator, and our executive producer is Tiffany Steeves, with writing and production from Andrew Ganem and sound design and mixing by Alex Bennett at Lower Street Media. Thanks for joining us. We’ll be back soon with another episode.

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