The student who challenged "bias in favor of white people" in medical books

If you call the ambulance service because of a health emergency, you may need to describe the patient's appearance, whether it is pale or if the lips are blue.

But the problem is that some of these symptoms are incompatible with people with darker skin.

This is difficult for the patient.

But what is the situation for medical students when they see the lack of any information or research related to the manifestations of some medical conditions in people with dark skin?

This issue gained importance during the Corona pandemic crisis, as families faced this dilemma during attempts to investigate cases of suspected relatives with Covid 19 disease.

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But when symptoms do not work for black and dark skinned people, the results may lead to lower levels of care, exposing the patient to additional risks.

This is an issue of Maloy Mokwendi's interest.

In his first year as a medical student at St. George's University in the British capital, London, Mukwendi began asking these questions. He wanted to know "what the symptoms look like other than eggs."

He was told that he had to do this research in his own time.

Indeed, Mwquendi started working, but found it difficult to obtain the information necessary to complete his research.

This was not dissuaded, but he went ahead with his research and decided to write a special book on this topic.

"It was of special significance to me at the time, because I realized that I would not be able to help my community or even help myself," he said.

"Even simple things like bruises do not look the same for people with white or black skin. There were other diseases and conditions where I wondered how they would appear in my skin," he added.

He told BBC: "I had no confidence that I would see the symptoms in or with anyone with similar skin and that I would diagnose them accurately, which is strange, especially since I am required to help others recognize this."

In a statement to the BBC, Saint George University stated that "more needs to be done to ensure that medical education and training are more comprehensive", noting that "not all aspects of education and research are included in scientific books."

"All of our students value the clinical education they receive and their interactions with patients, especially with regard to enhancing what they learn through books. Doctors also develop this field through the research they conduct," the statement said.

Creating a special book

Mukwendi continued his own research in his second year in medical school, and found a lack of representation of different ethnicities in the medical books he was using.

"After one year, I still discover unresolved cases," he said.

"It was clear that people do not know anything about the topic and that there may be no vocabulary that can be used to describe symptoms in people with darker complexions," he added.

So 20-year-old Mukwendi applied to his university for a grant to write a booklet (Entitled Beware of the Gap) that aims to help doctors and other health professionals identify the manifestations of diseases for people with dark skin.

It is noteworthy that the University of St. George is located in the region of more than 40 percent of its population hailing from ethnic and racial minorities.

The university says it "strongly supports" joint projects between students and teachers, such as the Mukwendi Handbook, which "deals with gaps in medical education", and projects that ensure "that the training reflects the experiences and needs of all those it serves".

"Bias in favor of white people"

Mukwendi says that "white-skinned bias" in medical textbooks may harm the level of health care that minority members in Britain receive.

It explains that this may lead to a loss of patient confidence in doctors, which may result in errors in diagnosis.

Morgan McIntosh, a specialist in prosthetics, agrees with the view of the student who wrote a medical book explaining the appearance of pathological conditions in people with colored skin. She remembers her experience with a skin disease when she was young, as she had been without a diagnosis for a long time.

And it finally appeared that the disease was eczema.

"My mother noticed that I was scratching my arms a lot until I bleed, and so she took me to the doctor," she said.

But the doctors said they "don't know why." "They gave me traditional Chinese treatment and a few herbs, and they treated me for all symptoms except for eczema," she said.

But Morgan has not given a proper diagnosis for more than a year and a half, after being reviewed by dozens of doctors.

"A black doctor joined the local clinic, and my mother asked to be referred to her. After one interview, she found out why."

The 24-year-old Morgan grew up in a white community in Scotland, but since she was from a multi-ethnic society it was not her focus.

"I have many relatives with different stripes, and my skin is whiter than many of them, so," she said, "until now, when many white doctors have not been able to diagnose a common illness like eczema, I started to know that racism has a role in this issue."

Colonial legacy

Mukwendi hopes that his booklet, after its publication, will become a simple and basic source for physicians' education, and will help change medical education around the world.

"At first I thought the problem was confined to Britain, but after I published my letter, I had responses from Germany, Brazil and New Zealand," he said.

"I think it is strange that these things happen in countries like South Africa, Nigeria and Zimbabwe," he added.

Some doctors in Africa have raised fears of a "white skin bias" in medical books and curricula on the African continent.

They say that this matter, like other forms of inherent racism, reflects the Western medical sector's view of the history of African countries and confirms the colonial influence on educational systems to this day, and the prevailing idea that the principles adopted by British and French medical books and other colonial countries will become the basis despite the lack of Her ideas fit into the population she is supposed to deal with and treat.

How important

For Mukwende, the Corona virus and the "Black Spirits Movement" movement have demonstrated an urgent need for change in aspects of society.

"The world is aware of the existing racial differences, so we must make the necessary changes," he says.

He adds, "It is not correct that medical services be the exclusive domain of a particular group in Britain, while the country is home to a variety of human groups."

"We have to understand the differences between us, and we also have to deal with these differences. Unfortunately, I do not think we are dealing with them optimally," he says.

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