This was obviously a day of remembrance and an important anniversary for a day that none of us living at the time will ever forget. I can remember exactly where I was when I heard the news that President Kennedy had been assassinated despite the fact that I was only 7 ½ years old at the time. I recall listening live to Apollo 11 landing on the moon and remember where I was standing when I learned of the Challenger disaster. On September 11, 2001, though, our world had changed and would never again return to what it once had been. The horrible scenes of that day were forever burned into our memories and will never be forgotten for as long as we grace this earth with our presence. We can only hope that those memories will somehow serve to prevent a similar disaster from ever happening again.
Saturdays are quite typically slower than the other days of the week here at FAME and though we used to be open seven days a week, over the last several years, Sundays have been reserved for urgent or emergent visits only by enforcing a surcharge to be seen on these days. Anticipating the lower volume of patients for the day, we thought it might a good time to arrange a visit to the African Galleria later in the afternoon. The African Galleria is a wonderful shop that has everything one could ever imagine buying here in Tanzania as a gift for someone back home. Nish and his brother, Punit, own and run the African Galleria, and I have been bringing groups there for a number of years now to shop. In addition to the standard Tanzania crafts that are quite spectacular, Nish also does an incredible business in gemstones – specifically Tanzanite and Tsavorite, or green garnet, both of which can only be found here in Tanzania or East Africa. They are both spectacular, with the Tanzanite having a very wide range of the deepest blues and almost purple at times with tons of sparkle. The Tsavorite, or green garnet, is the most sparkly green you could ever imagine and has the hardness of a diamond. The garnet is significantly rarer then the Tanzanite and priced accordingly.
Nish’s gallery had opened shortly after I began coming to Tanzania on a regular basis and it has continued to grow over the years to include more and more artwork and even antiques. There has always been a small snack bar there, but about two years ago, he and his brother decided to begin constructing a somewhat more formal restaurant as well as place for safari guests to sit and eat their lunch boxes while traveling between Tarangire National Park and Lake Manyara National Park on their way to Ngorongoro Crater and the Serengeti that lays beyond. Unfortunately, this massive design and construction project was completed almost to the day that the pandemic first arrived here in Tanzania which essentially shut down the entire tourist industry overnight. Tour operators, safari guides, hotels, and virtually anyone related to the incoming tourist traffic in Northern Tanzania, which meant everyone, found themselves with nothing to do and a tremendous amount of very valuable equipment just sitting.
On my previous visits over the last year and a half of the pandemic, the African Galleria has mostly been closed, though did open on a more regular basis beginning in March which was great to see. Finding out that they had expanded their food services even more and now even had nyamachoma (barbecue) available on their menu was incredibly exciting as it now meant that we could couple our shopping trip with a good meal since we don’t receive dinner at the house on either Saturday or Sunday. With this in mind along with the typically lower volume, I had made arrangements for all of us including Sean and Kerry to go to the Galleria for a late lunch/early dinner. As is typical here, though, best laid plans will often go awry and, as our mission here is to see patients and teach rather than eat and shop, clinic will take priority over our extra-curricular activities.
The morning seemed to be going along quite smoothly and we had three stations for the patients to be seen, allowing us to get through the numbers of those here to see us in a more efficient manner. There were our typical smattering of epilepsy patients and some MSK (musculoskeletal) pain patients as well as one gentleman who presented with a history and findings concerning for a thoracic cord compression. He would have to obtain an MRI of thoracic spine in Arusha and return next week to see of with the images. The clinical situation didn’t suggest to us anything that would be seen on a CT scan whether it was contrasted or not. Hopefully, he would get this done as he did report to us that he was financially able to cover the cost of the scan, but you never know what he would decide after going home and thinking about it. Without the scan, though, we had little other way to determine what might truly be causing his trouble.
Akash later saw a three month old child whose parents brought the baby in because they were concerned about limb abnormalities and the fact that when they moved the baby’s limbs they hear a cracking noise. On examination, the child was completely missing the proximal upper limbs and there were only several fingers on each of her hands. Additionally, her legs had a significant length discrepancy. On further history, the mother had been on several medications that have been associated with congenital limb abnormalities including chlorpheniramine and doxycycline. It appeared the child had phocomelia, quite likely associated with her medication use during pregnancy.
Things were looking very good for an early departure from clinic, including Kitashu who was planning to travel home into the conservation area this afternoon, when a young child and his mother showed up much to our dismay. It turned out that they had been sitting on the other side of the OPD (outpatient department) and had not checked in with us as they weren’t aware they had to do so. We were already past the time I had told Nish we’d be leaving, but there was no way we were turning this child away from being seen, especially after his mother began to tear up and that was more than any of us could tolerate. Akash agreed to see the child, who had epilepsy, as did his mother, and was seeing us for the very first time. The child also had developmental delay, but the epilepsy appeared to be very likely genetic and primary generalized. Valproic acid was prescribed and the child will follow up in several months.
While Akash was seeing the young boy with epilepsy, the other residents and Phillip ran home to change as we were hoping to hit the road as soon as we were done. Sitting at my desk, a middle aged gentleman who had not yet registered strolled up to my desk to tell me that he had just driven in from Arusha (two hours away) and had been delayed by car trouble. I’m sure that he could see the disappointment on my face as we were already quite late for our departure. When I asked him what his problem was (I could not remember him from March), he told me that he had tingling in his extremities and our prior evaluation had not discovered a cause, but he was really just coming for a refill of his medication as it was working very well and nothing really had changed since the spring. As much as he would have recognized my earlier disappointment, I’m sure he would have noticed the relief in my face when I realized that he was only coming in for the medication. Dr. Anne was more than willing to take care of this as well as giving him an antihypertensive medication as, when he checked in, his pressure was quite high. I ran home to change and Akash followed soon after. We were on our way to the African Galleria at last and had plans for a late lunch and some shopping afterwards as the gallery closed shortly after 5:00 PM.
The drive to the Galleria is probably about 25 minutes as it sits just outside of the village of Manyara that sits on top of the escarpment with the expanse of Lake Manyara and the Rift Valley some 2000 feet below. What was once a tiny storefront is now nearly 40,000 square foot that includes an outdoor restaurant and dining area for safari groups to stop on the way to the Crater or returning, an outdoor art gallery, and a shop that includes virtually any craft that has been made in Africa. Their Makonde carvings are incredible and outside they are working on carving large portions of ebony trees in trees of life, a classic carving of many people intertwined and hollowed out in the center. In the middle of the shop, sits their jewelry, which again is pretty spectacular considering the extensive amount of Tanzanite, Tsavorite and other rare stones they have on hand at all times.
In addition to the opportunity to pick up gifts for those back home, though, the African Galleria now offers a solid menu of food for lunch and early dinner. There was so much that we really couldn’t decide just what to order, so Nish volunteered to order for the table and have us eat family style, sharing all of the dishes. There were two vegetarians among us (Cat and Akash), so he made sure to include enough for them to eat, though the rest of came for the nyamachoma that he had raved about before our arrival. Well, the dishes kept coming and coming and were all amazing. I wish I could remember all the names of the dishes, but for the first course, we had a pumpkin coconut soup that was out of this world. Had they served me a huge bowl of that soup alone for my meal, I would have been totally satisfied and left happy. (I should mention that the homemade soups in Tanzania, especially those while glamping in the Serengeti, are always amazing). The nyamachoma was incredible as was the fried ugali sticks. There were so many other scrumptious dishes that I can’t even remember them all, but leave it to say that when we later left the Galleria after shopping we were all quite full and couldn’t even think of eating anything later that night. We were leaving early in the morning for Tarangire to go on a game drive, and I’m sure that everyone that much better that night with full bellies. Moreover, the entire experience was just perfect – Nish sat with us for the entire meal and made sure to tell us about each of the dishes while the service was just impeccable. There is no question now that the African Galleria should be on everyone’s list of fine dining here in the Karatu district which already has a number of incredible places to dine. Nish has outdone himself.
We ended up shopping until well after the normal close of the shop, but there were other groups there as well which was great to see as it meant that the economy here was on the rebound if even still only a fraction of what it was in the pre-pandemic days. Hopefully, as more are vaccinated here, things will continue to improve. We can only hope. We drove home through the most beautiful countryside one could ever imagine in the waning daylight as the sun slowly set over the distant hills of the nearby Ngorongoro Conservation Area. It’s still hard for me to imagine that I’m here after my 24th trip and I’m sure it’s even harder for those who have come for the first time to experience this truly magical place.