This post originally appeared on the Bill & Melinda Gates Foundation blog on March 16, 2011.
Nurse Dorah Nyanja’s brightly painted Senye Clinic stands in stark contrast to its surroundings – rusted tin shacks, piles of burning trash, and streams of raw sewage. I first met Dorah at Senye in 2007, when she was a franchisee with CFWShops (an Acumen Fund investment) in the Kibera slum of Nairobi, East Africa’s largest slum.
Credit: Shannon Jensen
In the last three years Dorah has expanded Senye, where she provides affordable, high-quality outpatient care to low-income patients, opened an additional maternity clinic, and has plans to continue grow her business. Dorah is one of the unsung heroes of global health, and TEDxChange @ Kibera was a thrilling first step to bring her voice to a global stage.
Dorah could work anywhere in the world, but chose to open a clinic in Kibera to provide care to its residents, who have few other options. “I wanted to be with a community where there was deep need,” she describes. It was not the easy option — it took almost one year to find a location, and business in Kibera is tough. Her customers are among the poorest in the world, and crime and disease are rampant in the area.
In the last three years Dorah has expanded Senye, where she provides affordable, high-quality outpatient care to low-income patients, opened an additional maternity clinic, and has plans to continue grow her business. Dorah is one of the unsung heroes of global health, and TEDxChange@Kibera was a thrilling first step to bring her voice to a global stage.Dorah travels 1.5 hours each way on public transport, leaving her own three children with family, to keep her clinic open from 7am-10pm, seven days a week. She treats problems ranging from malaria, to diarrheal diseases, respiratory infections, and secondary complications from HIV/AIDS. At times, she also serves as counselor, midwife, and mediator. “When you really work in the community, you end up doing everything,” she says with a laugh. When she realized that maternity care was lacking in the community, she responded by opening a new clinic to provide deliveries and pre- and post- natal care.
Though Dorah does not have a business degree or formal management training, she is one of the most entrepreneurial people I’ve met. “I go to the schools, I go to the women’s groups, I go to the chief’s barazas. The way you relate to the community also plays a big role,” she describes. The success of any product or service depends on knowing your customer, and too often top-down development solutions fail to listen to the consumer; in contrast, Dorah knows that her business depends on her ability to listen and respond to her customer’s needs.
The significance of Dorah’s work struck me most during the post-election violence in Nairobi in 2007. As violence erupted throughout Kibera, and many government and NGO facilities shut down, Dorah remained at her clinic (sleeping there for several nights) and continued to provide service. And when looters came to attack Senye, it was her customers who formed a human shield outside to protect her.
Dorah’s story demonstrates what is possible when we invest in local entrepreneurs building solutions in their own communities. Our challenge as a world is to find ways to support entrepreneurs like Dorah to scale their businesses, and to honor heroes like Dorah on a global stage. TEDxChange @ Kibera was an important and exciting first step.
Catherine Casey is an Innovation Manager at Acumen Fund.