How I grew a Speech Therapy Practice in an Underserved Country; Kenya
Today, I am doing something that is not the most comfortable for me…sharing my story.I have heard many of your stories. Some have been uplifting, some have been heart-gripping, but I have been touched immensely by all. I feel the families I’m serving may wish to know more about the journey I have been on and continue to be on.

Opening my private practice

I reminded myself that this is what dreams were made of.All the changes I experienced in quick succession, were dizzying, but I put on a brave face. I mostly saw children who presented with quite severe speech and language delays. And each day, my heart broke. I was seeing children with Autism, who at 6 years of age, had unmanaged behaviour and were nonverbal or spoke very little. I thought back to Australia and reminisced how all the children I saw, even those low down on the Autism Spectrum, spoke and communicated. Why wasn’t this the case in Nairobi?
There had to be a better way. . .
Ever since I can remember, I have always been a problem-solver. I’ve always loved to serve. To offer ideas that alleviate burden and that are sustainable. I pondered hard on why the children I first saw in Nairobi were so severe in their presentations and only realised poor outcomes. These were the reasons:- These children had not received early intervention.
- Meaning, they either were diagnosed very late and/or hadn’t received appropriate speech therapy early (below the age of 3 year)
- Parents did not have the proper skills to stimulate their children’s language themselves, from home.
- And for the children I saw who had hearing impairment for example, they either had inadequate hearing devices or
suspiciousinaccurate diagnosis.
It got worse…way worse
Kenya is truly a country of contrasts. And more often than not, the people who end up suffering are the common wananchi (I know how politician-like I sound). You just have to watch news once to feel completely helpless and resign yourself to the status quo. It’s a country where we have all taken an oath to be silent to the status quo. And it’s comfortable not to act. It’s comfortable to run. People understand if you do. In fact, people applaud you if you do.State of special needs in Kenya
In my maiden practice in Kenya, I witnessed how completely taken advantage of, most parents with children with ‘special needs’ were. I decided it’s a culture that is acceptable here. Anyone who can take advantage of you, will. I, for one, completely understand the confusion that takes over within the days (and months) following the news of your child’s diagnosis of an issue or realisation of an issue. You first go through the initial period of shock, denial, agony and depression and slowly ease into acceptance and for some, determination, but for many, confusion. You’re confused about the best course of action. You also are unsure about your own capability. And depending on which specialist you experience, the confusion can be replaced with appropriate action or more confusion and disillusion.I would be lying if I said I have never seen parents with children who have communication difficulties taken advantage of by us, the specialists.Special needs in Kenya is big business. Parents are so desperate that they would do anything that promises to resolve the issue for their child. We sit on high horses barking directives and playing god. “Your child will never talk”, “your child has x”… It will not be fair to mention the vices I’ve heard of, reported to me by some of the parents I’ve encountered because those are not my stories to tell… Or it could have been ME dishing out an inappropriate remark (oh how I dread the thought) Because I’ve wanted nothing more than to empower those parents for whom our paths have crossed. I believe that parents must become advocates for their children, whose voices they’re trying to build. Parents must guard against being easy prey for anyone who has no qualm preying on their vulnerability. I say parents must question everything… For that to happen… They should be armed with knowledge. Parents should question a diagnosis of doom. More parents also need to seek second opinions unapologetically.
Setbacks I encountered as a speech therapist in Kenya
Back at the start of my speech therapy practice in Kenya, I also encountered my own personal set-backs. Everywhere I looked, no one wanted to collaborate with me. Sadly, in Kenya, we seem to regard each other with skepticism. Very few are willing to hold your hand or even join forces with you. When I started offering speech therapy in Nairobi, I remember dropping my CV to schools that already had had a speech therapist offering their services but for whatever reason there was a break of the service, and most pretty much said “NO”. A couple of schools told me that their parents preferred foreigners!! Some didn’t come out straight to say it, but the undertones were clear. I remember 1 school that told me they would wait for a speech therapist that the outgoing speech therapist had promised would be coming from the UK! I was shocked! I had lived overseas for 13 years and I had never experienced racism, never overtly at least, only for my first encounter to be in my very own country! I quietly prepared myself for some rough seas. I flew solo. The few referral sources I had initially established, seemed to be drying up. It appeared that once parents brought their children to me, they never honoured their return review with their children’s specialists… Or was it that they finally felt they were home (toot your own horn, anyone
Devising a sustainable model
I had devised a system of training speech therapist assistants so that I could re-imagine speech therapy in Kenya and circumvent the severe shortage this country had (and still does) for speech therapists. But, I suffered disappointment every which way. When I approached my colleagues, they didn’t think it was a good idea. Some came out and implied that it would dilute our profession. Anyway, I created a short curriculum. I was by this time also expecting my second child and my practice had now moved to our largest premises yet in Lavington. The sky was the limit, or so I deluded myself. Boy! Was I in for a rude awakening! At the time, I had employed about 8 speech therapist assistants, but somehow our growth wasn’t sustaining our overheads. The majority of the first cohort of speech therapists I trained did unimaginable things. Were my colleagues right? Should speech therapy remain an elitist field, fit only for a privileged few?Hitting Rock Bottom
I welcomed my second baby in 2013. I was back at work within weeks of giving birth. It became more difficult to train my staff on weekends because they all had excuses for why they couldn’t make it. I relied on training them so that they could in turn deliver sessions in the way I wanted them to. But, they no longer seemed interested. I was raging mad. If I could make the sacrifice to come on a weekend in spite of my condition, why couldn’t they? How would we improve the quality of service we gave the children we saw? It wasn’t until I was faced with a bill of Kshs 150,000/- (US$1500) from the company I was hiring a photocopier machine from that things slowly clicked into place. Suddenly, I wisened up ten- fold while also reflexively losing a little faith in humanity. The decision to hire a photocopier machine made sense when for whatever reason the 2 the clinic had kept breaking down and the cost of repair just didn’t make sense anymore. The plan I was on should have seen me pay about ksh20,000/- (US$200) per month if all we did were black and white copies. The company charged ksh10/- (US$ 10 cents) per copy for coloured copying. A photocopier is an important resource in a speech therapy clinic. It allows us to make therapy materials, which are an important part of effective speech therapy practices. My investigations uncovered that my staff were doing a massive amount of photocopying of my clinic materials for their own personal use. They would collude with my clients and start seeing them in their homes and they would tell me that the client suddenly stopped coming for sessions. I still paid each a monthly salary in spite of their decreasing caseload. It now made sense why most of them were not available for our Saturday training sessions… I was devastated.
Terror Attack
Then, Westgate struck. I summoned all the strength I could… On that Saturday, I had a scheduled teacher training session at a Kindergarten in Lavington, my 6 week baby in tow
The decision to give up and unexpected unfoldings
I revisited my position with my practice and my husband and I agreed it would be best if we relocated to Australia. It was then that I made the decision to give a 1-year notice to the hospital where I was offering consultancy services. I told them I was willing to train some assistants for them, but it would be up to them to manage the quality of their work. Quietly, I started mapping my way back to Australia. I felt like a huge weight had been lifted off my shoulders with this small decision. That night, I slept well (except for the thoughts of how we were going to pay our debts)… But, those were far better thoughts to have than a different eventuality. The beauty of perspective!With my bags metaphorically packed, I felt lighter.
Lorna Muthamia-Ochido
I did not seem to be swimming upstream. It was strange how things worked out, I have to admit. I seemed to be having fewer panic attacks. I calmly mapped out my debt repayments and went about adjusting our lives to completely basic living. It’s funny because I actually thought we had been living pretty basically before, but it went down a notch further. I did not indulge in anything that was remotely luxurious like owning more than 1 pair of shoes, going for pedicures, etc.When you hit rock bottom, the only place left to go is up
Weirdly, things started to magically fall into place; almost without any efforting on my part. I was gaining a lot of clarity on many things and I allowed myself to flow into what was unfolding. I had at this point fired many of the dishonest staff and was left with about 3 loyal staff; 1 of them was a support staff. I had mentioned my plans to them and they extended compassion. They had witnessed the obliteration of my dreams by careless opportunists. They could see how beaten I looked and I felt, they understood my stand. One day, one of my 3 remaining staff said jokingly to me, “you know you could train me”. I wasn’t sure I understood her remark. “Train you?” “For…?” “To become your assistant”, she responded with a smile. “Oh!” You see, this lady was actually our receptionist and so it had not occurred to me that she meant she could become a speech therapist assistant, which, she absolutely could!

Becoming the change I would like to see…
I have always wanted to live a purpose-driven life filled with intentions I had set. I did a pros and cons analysis of moving versus staying. Sure, there were compelling reasons that supported our moving back to Australia. But, I wrestled with what that would make me… A quitter? A good mother? I couldn’t have had any chance being a good mother if I was uber stressed all the time. I tried to justify. I decided to stop overthinking it and I allowed myself to flow with wherever my intuition was guiding me. I wanted to settle on decisions I had made on my own terms. And just like that, we decided to stay; against all odds. There was a reason I kept wanting to return to Kenya in the first place. Going back to Australia didn’t feel like a decision I was making with a sober head, but one that was being forced on me. Remember how I said most of us become mere spectators of the status quo because Kenya has beaten us to subservience? Watching how life is in Kenya and giant steps in the wrong direction most politically-motivated agendas take, sometimes watching from afar is the wisest thing to do. But, is it? Kenya as well as the rest of Africa suffers tremendous brain-drain because people like me (and you) give in when life brings us to our knees.I needed a paradigm shift.
Could I attempt to be the change I wanted to see in this country? Albeit, even in the minutest of ways? Are regrets more painful than failures? I was resolute. I will make this my street. People go to the streets to fight for what they’re being denied. I made up my mind that I would make the work I am doing my street. Whatever I felt wasn’t right with the status quo with regards to the speech therapy field, I would protest by shining light on it. I vowed to keep fighting this good fight.Taking it to the streets…
With each passing day, I gained clearer and deeper insights into how to re-imagine things for speech therapy in Kenya and Africa. Heck…the whole world wide even.They say if your dreams don’t scare you, they’re not big enough.I also drew a lot of courage from this quote;
Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness that most frightens us. We ask ourselves, Who am I to be brilliant, gorgeous, talented, fabulous? Actually, who are you not to be? You are a child of God. Your playing small does not serve the world. There is nothing enlightened about shrinking so that other people won’t feel insecure around you. We are all meant to shine, as children do. We were born to make manifest the glory of God that is within us. It’s not just in some of us; it’s in everyone. And as we let our own light shine, we unconsciously give other people permission to do the same. As we are liberated from our own fear, our presence automatically liberates others.” Marianne Williamson

When things are not going well, it is easy to fixate on everything that is not working out and forget that at any given moment (and for all of us), there is usually more right than wrong with us; with our situations, etc.I learnt a lot during my clinic’s season of ‘growing pains’ and at the same time, I learnt a lot about myself. I would beat myself so much each time I encountered a set-back and I remember watching my husband somehow managing to remain calm or pretending to because I looked so defeated. My husband would always say, “being stressed about it won’t make things better.” I had to find a new way of reacting as being stressed didn’t seem to work, but in the middle of a storm, it is never clear what else you could do when you’re feeling helpless. What I learnt from each set-back was one thing. That we were able to get out the other end.
If you can still have belief in your heart after all the hardships you’ve had in your life, it is so much easier to believe in yourself…
A new way of being


Charging through with confidence
Around this time too, I welcomed baby no. 3. I thought I would enjoy this baby for at least 5 months something I had not done with my 2 older ones. It wasn’t to be again as I experienced any new mama’s unwanted misfortune of losing my trusted nanny within days of bringing home the new baby; 9 days to be exact. There I was stitches and all orientating a new nanny, quickly becoming a series of nannies, who only lasted to the point where I was beginning to warm up to them only for things not to work out. This period was a good test of my new way of thinking; the so-called liberating discovery. My neutrality of emotions amidst rattling situations would again be put to the test when I was forced to return to work because the person I had hoped would stand in for me suddenly couldn’t keep to their end of the bargain because of an unexpected situation. I was calm, but a little disappointed. Going forward in my practice (and in my life generally), I continued to maintain single-minded focus on the task at hand.I guarded myself from negative energy with acute vigour.I steered clear of anything that did not serve me. I tried not to dwell on where all the assistant speech therapists I was training were going to. But, I eventually would be told. You see most of them went out to start their own freelance practices. It’s amazing how with even little knowledge most of them found some success. I tried not to feel jilted. I continued to immerse myself in my work. I recall a learning support teacher at a renowned international school in Nairobi one day calling me to his office. He told me if I kept training my staff, I would be the one worse off in the end because they will just keep leaving. I came to learn being trained by Lorna earned anyone direct entry into most highly coveted international schools. I had become the training ground for runaway speech therapist assistants. How could the solution be to stop training them? I tried not to be egotistical about the whole situation and not make rash decisions. It wasn’t fair that all my efforts were all coming to a crashing halt. All the late nights working only to keep returning to the drawing board. I now understood why almost all vendors at Maasai market sold the exact same things.

A new dawn…
As I buried my head deeper into re-growing the practice…yet again, I re-hired and re-trained. I started retaining some loyal staff; which made things easier.

Homegrown Innovative Solutions…
I started by saying, I am a problem-solver and proudly so. I am a strong proponent for homegrown solutions to our own problems. It’s unfortunate that as Kenyans and Africans in general, we do not invent as much as we consume. I still craved to be part of the solution than the problem. I needed to invent more. Kenyans are capable of creating and being world leaders in their chosen industries.My dad has often joked that Kenyans exported money…![]()
My dad.
For the second time, I gave myself permission to be an inventor. I decided to take my parent- empowerment crusade to the next level. I started to create videos. If you’ve ever wondered how I am able to do all this, well… I have a superb team


This course along with the other resources I am now putting out, are geared at empowering parents to make intentional and effective choices that impact positively on their children’s communication outcomes.
I’ve also decided it’s about time that I started to market our services for these reasons; First, a very famous marketer and teacher wrote this,Marketing is the act of making change happen. Making is insufficient. You haven’t made an impact until you’ve changed someone.Whether or not there was good or bad speech therapy in the country was either way a service or deservice to humanity. Just wearing blinders and creating in my little corner without letting whoever is interested in my creations know about them, is still a deservice to those interested… And should a different quality of creation appear in the market that gains traction, and say people suffer or are dissatisfied as a result or simply crave another to act as a comparison, then I can wholly wear the blame of inaction. I am embracing marketing as a crucial piece of the puzzle. No longer hiding. I am owning this problem of the shortage of speech therapists in the continent and I am ceasing to just be comfortable that I am serving a small stream (worthy nevertheless) while leaving an entire ocean. And we’re more connected than we’re not. For me to thrive and be at peace, we all must equally thrive because we’re each a tiny piece that makes up the whole and if there is dis-ease in 1 piece, there cannot be harmony in the whole. I believe this with all my heart and soul and it has been easier to serve from this place. My hope and prayer is that you can take advantage of the resources I put out to increase your knowledge of what we do as speech therapists and how you too can do it. The knowledge can hopefully also place you at an advantage when interacting with your child’s speech therapist, other specialists or teachers. Whether you choose to take advantage of any of our free resources or our paid programs, you can make that determination. If you keep subscribed, I will keep sharing. We all have stories, this has been snippets of mine. I don’t know how the next chapter will read for me, but I remain optimistic and excited. God has been kind to me and my family. I remain eternally appreciative and humbled by His mercies.Seth Godin, This Is Marketing: You Can’t Be Seen Until You Learn to See
