Twitter | @malone_mk

Medical Student Develops Handbook To Fill Info Gap For Dark Skin Symptoms

When we discuss protests in support of the Black Lives Matter movement, we understand them to be standing against systemic racism and police brutality.

And while those concepts go hand-in-hand, it doesn't fully capture what systemic racism is to boil down its consequences to fatal encounters Black citizens face at the hands of police officers. As has been a mounting concern for years, even the health care systems in which we're all supposed to find help for medical issues can bring about different experiences for patients depending on the color of their skin.

This isn't specifically a reference to how Black patients are treated by medical staff, though there are widespread issues in this area of care as well.

As one medical student has identified and now works to address, this reality can manifest even before the health care providers of tomorrow graduate from medical school.

Ever since 20-year-old Malone Mukwende started classes at St George’s medical school at the University of London, he's found himself asking "But what will it look like on darker skin?”

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As The Washington Post reported, this refers to what medical students are taught when it becomes to examining physical symptoms such as rashes, bruises, and blue lips.

As Mukwende said, "I noticed a lack of teaching about darker skin tones, and how certain symptoms appear differently in those who aren’t white.

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That difference isn't a minor one and neither are the consequences for missing them.

As we can see here, the symptoms of the potentially fatal inflammatory illness known as Kawasaki disease are much subtler in patients with darker skin tones than in white patients.

As The Washington Post reported, this is also true for meningitis, jaundice, eczema, psoriasis, and even skin cancer and COVID-19.

In an interview with CBC, Mukwende identified the knowledge gap surrounding this difference as a factor in both COVID-19 and skin cancer survival rates among Black patients because doctors are only noticing physical symptoms when these diseases are in advanced stages.

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And as he saw before he even began medical school, this knowledge gap can lead to biases that result in a mutual lack of trust between black patients and health care providers.

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As he said, "It became apparent to me long before medical school, because I had heard of instances and stories within members of my own community and the Black community about being misdiagnosed or not being taken seriously by health-care professionals or just mistreatment, really."

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And thus, Mukwende became inspired to create a "universal tool" to bridge this gap.

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As The Washington Post reported, he approached Lecturer Margot Turner about this mission and she helped him apply for a student-staff partnership grant alongside another lecturer named Dr. Peter Tamony.

Before their grant was approved in December of 2010, this team arrived at the idea to create a book entitled Mind the Gap: A Handbook of Clinical Signs in Black and Brown Skin.

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In addition to his already rigorous course load, Mukwende spent hours each week researching this book.

St. George's University of London

As The Washington Post reported, this book will feature images and descriptors of clinical signs of various conditions including the ones outlined above.

It will also advise on language for health care workers to adopt in discussing these conditions.

As Turner said, "It’s really about the words we use. We are looking to decolonize the curriculum and make sure the medical education is reflective of everyone."

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Gathering those photos of symptoms has proved particularly challenging for the team and the British Association of Dermatologists and the U.K.'s National Health Service have contacted Mukwende because they've faced the same issues.

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As The Washington Post reported, it's for this reason that both the book itself and the associated website will exist as a living document to allow input from professionals, medical students and patients.

The team is also encouraging people to send in their own photos to address the scarcity in photos displaying relevant conditions.

As Mukwende told CBC, "Fundamentally, I think it will allow some people to live longer, essentially, because they will be able to be diagnosed correctly in the first place. And this can also go back to increasing the trust in health-care professionals, their confidence in the health-care professionals, too."

h/t: The Washington Post, CBC

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