Dr Esther Nyambura Njoroge has been actively involved in the treatment of children born with cleft lip and palate in Africa for the last 10 years. As vice president and regional director of Smile Train Africa, the Top 40 under 40-award winner narrated to ESTHER AKELLO how a volunteer position to help children with cleft lip and palate led to a fulfilling career.

Growing up, the last thing I wanted to become was a doctor. I wanted to be a pilot! I thought it was cliché to study medicine just because I was from the village and had performed well, as was the norm for top achievers. However, when I attended my first medicine class, I fell in love with the course. I also have a Masters degree in public health and have taken two short courses in executive healthcare management and leadership at Strathmore University. I also have an accounting background.

I grew up in Muchakai village in Gatundu North, Kiambu County. I am the third born in a family of 10 – two boys and eight girls. I was the second best performing student in my district in the Kenya Certificate of Primary Education. However, after reviewing the schools I had picked for my secondary school education, the district education board felt I needed a better challenge and sourced for me Loreto Limuru Girls.

On arriving at the school, one of the first things I realised was how strong my Kikuyu accent was. Often times, I’d be so conscious of it that I’d stay quiet. The second was that my K.C.P.E marks, which I thought were glorious, were actually rather average compared to those of students in the school.

So I promised myself that by the time I was leaving the school, I’d be the best student and worked at it. By the time I left, I was index one and position two overall in the school when the Kenya Certificate of Secondary Education results came out. When I realised becoming a pilot was never going to be – my father said it was too expensive although there are times I feel if I’d just pushed a bit harder, he’d have gone the extra mile- I opted for an electrical engineering course.

My father, however, subtly recommended medicine and I accepted. I loved it because it was a tough course hence challenging and secondly, coming from the village, it showed me that my background did not limit my capabilities. After my studies, I was hired by the Ministry of Health as a doctor at Kihara Sub-District Hospital in Kiambu.

True calling

In 2008, I met someone who was just starting out at Smile Train Africa. They were looking for volunteers to help with the expansion of a programme the NGO was interested in rolling out at the time. Before volunteering with the NGO, I had come across only one case of cleft lip and palate – a friend’s child – the fact that I was a medical student/practitioner notwithstanding. My decision to volunteer was inspired by the fact that while I enjoyed working with patients one on one, I knew that I didn’t want to do that forever and was looking for something different.

As a volunteer, I was tasked with administrative tasks such as finding prime organisations and hospitals to partner with Smile Train Africa, then my boss would follow up to sign them on board. I also helped the partner organisations start and roll out the treatment projects.

After about three years, I was appointed Smile Train Africa’s official coordinator and shortly thereafter, I applied to become the programmes manager for East Africa. I worked in that position for four years before becoming the vice president and regional director, sub-Saharan Africa in 2015, after my boss moved to another organisation.
Smile Train is a US-based charity organisation that provides treatment to children with cleft lip and palate (a gap in the upper lip and/or palate) in over 85 countries. We build capacity through training and funding in either cash and/or kind, for instance, equipment to partner hospitals to enable children and adults with cleft lip and palate receive treatment. Currently, we are in 33 sub-Saharan African countries but hope to increase that number to 42 by 2019.

Ours is a unique model because we are keen on sustainability. We don’t fly in experts for surgery nor will patients suffer when doctors fly out because we work with local doctors by training and empowering them. Surgery for the patients is absolutely free provided it is within our partner hospitals and we have them spread out across the country. Since it’s a partnership, the hospital or partners also have to offer their services for free or at subsidised rates.

Dr

My day-to-day agenda involves crafting Smile Train Africa’s strategy for Africa, that is, who we are, what we are doing and what our plans for the future entail. I also craft, advise and implement the NGO’s budget. While fundraising is done at the US headquarters, we do have individuals and institutions in Kenya who support us and my challenge to Kenyans is: if other people around the world can help Kenyans whom they don’t know or haven’t met, how much more should we do for our own?

Children and adults with cleft lip and palate face a lot of stigma and tend to be hidden from society which is why even though we have been working in Kenya for more than 10 years, we have a long way to go in demystifying it as well as getting communities to understand that it’s a treatable condition and children can go on to have normal lives. Most cleft lip and palate infants end up malnourished with some even dying, as breast-feeding becomes a challenge. Many take in air as opposed to breast milk simply because they can’t latch on properly.

I dream of a time where it will be so normal for medical practitioners to know how to handle a child with a cleft palate from birth and that child undergoes all the proper channels to make full recovery. We have treated over 1.3 million children worldwide, 100,000 of those in Africa. In 2016, which marks our best year yet, we treated 11,882 children and adults in Africa. We hope to increase that number to 13,000 in 2017.

Lessons learnt along the way

Hard work pays. It sounds like a cliché but I did not get to where I am by sitting back and waiting for things to be handed down to me. I’m also aggressive. I know what I want and go for it. I also demand utmost discipline and best results from partners and myself. If donors give out money, equipment and so on, we need to see what it has done or that it facilitated what it was meant to and the return is higher than what we started with. As Africa’s director, I travel a lot around the countries I manage.

It is not easy attaining work-life balance especially as the responsibilities grow. My advice for those in similar situations is to simply know what’s important to them. For me, my family comes first. That doesn’t mean I neglect my career. It simply means if I’m not present at either one of those ends for whatever reason, there is someone filling that gap. There’s no perfect balance by the way. One side at any given point will suffer but to what extent? You decide. That means there are times some of my ambitions have taken a back seat.

My 10-year career plan is not such that I have such huge aspirations that they demand I’m away from my family for prolonged periods, but not so small that I don’t progress. The truth is, while technically there shouldn’t be any penalty for any woman who has put her career on hold in order to raise her family, by the time one comes back, things have really moved ahead and it may be hard to catch up.

My husband, Michael Nteere is my biggest cheerleader and support system. When I’m frustrated, he’s the one I run to and when I have I have good news he’s the one I rejoice with. He’s an IT specialist and has stepped up to the plate when it comes to balancing work or when our daughter and two sons need us. It’s challenging but we always make sure we know each other’s plans and always ensure there is someone covering the important stuff as he also travels for work as well.

I also have a wonderful nanny who’s been with us for six years. She manages my home and that has helped me manage my life in some ways. I owe her a lot!

My advise to other women is to ‘never arrive’. Women downplay their education and achievements and it’s partly due to our socialisation. We need constant training and shaping on how to sell ourselves! It’s not bragging. It’s who we are. Always be learning and updating yourself on prevailing and trending issues.

I also believe in social networks such as chamas. I think they’re good because you will always do more when many, as opposed to when you are by yourself. It also provides you with a social circle away from your kids, work and husband, which is healthy!”