Chidiebere Ibe’s Black fetus illustration will be published
Ibe reignites the conversation of the lack of skin of colour representation in medicine and innovates solutions to combat it.

Has this ever happened to you? While changing, or maybe walking by a mirror, you catch a glimpse of something on your body that wasn’t there yesterday. You take note of it or just ignore it and move on with your day. A few days later, you wonder, why is it still there? Has it gotten bigger? The discovery of this new spot, or mole, or rash sends you running to Dr. Google for your worries to be assuaged with results saying, “it’s a blackhead, it’ll fade in a few days” or “that’s just a pen mark.” 

Sometimes, the problem is more serious and the explanations are not so readily available. This was the situation I found myself in when a recent scare sent me looking for the symptoms of psoriasis and melanomas. Slightly hypochondriac-esque? Perhaps. But my frantic Web MD-ing was put off by the fact that the majority of what I found wasn’t helpful to me at all. As an Indo-Caribbean individual with dark skin, how exactly was I supposed to see the telltale signs of “redness” on the skin? 

This minor example seems harmless enough (it turned out to just be eczema), but the problems I had with finding information for darker skin are representative of a much larger issue. In the medical field, the issue of underrepresentation in textbooks, instruction, and medicine itself has been an ongoing issue for decades. Thankfully, some are making strides to close this gap. 

Chidiebere Ibe, a medical student in Nigeria, whose illustrations went viral in December, is going to have his illustration published in a book—the second edition of Mind the Gap: A clinical handbook of signs and symptoms in Black and Brown Skin. Ibe’s illustration of a black fetus garnered much attention online, with many people observing the fact that they had never seen a darker-skinned pregnant woman or fetus depicted in a medical illustration before. This drew focus to the ever-present issue of the lack of representation in medical illustrations. 

According to the Association of Medical Illustrations, this is something they have been trying to combat. “[A] stark majority of the most circulated illustrations that are actively used by medical schools and healthcare professionals to this day include depictions of mostly white, male, able-bodied figures,” they said in a press release. Not only this, but the majority of those accepted to the small medical illustration programs are typically from a privileged minority. 

This is what Ibe is trying to challenge with his illustrations. “The whole purpose was to keep talking about what I’m passionate about—equity in healthcare—and also to show the beauty of Black people,” he explains. “We don’t only need more representation like [white, male, able-bodied figures]—we need more people willing to create representation like this.”

The problem with the lack of representation isn’t just a social issue. In many handbooks and classrooms, medical students are often told that certain conditions will present differently on darker skin, but they are not always told how. How exactly are medical professionals expected to diagnose and treat certain conditions in skin of colour without even knowing what to look for? If someone is scared and looking for answers online, how will they find anything? 

These issues are more than skin deep. A study in 2018 found higher rates of mortality in Black Americans, with an excess of over 74,000 deaths per year. The rates of mortality were higher in some cities than others, with links to income inequality levels. Beyond the issue of representation in medical illustrations, it’s also about equality in healthcare. 

More recently, studies have found that pulse oximeters used to test the oxygen level in the blood, and crucial in Covid-19 care, do not work as effectively on darker skin.

Ibe recognizes this larger issue. “It’s not just about the skin conditions. It’s just about giving everybody the value that they deserve. Black, white, Asian—let’s all have equal healthcare that we deserve.” 

Ibe has created many more images, depicting various skin conditions and health issues on Black skin, and plans to illustrate a textbook on birth defects in children, with conditions depicted on Black skin. He says, “I want it to be a norm that whenever a person searches online for a particular skin condition, a particular health challenge, that the first pop-ups are Black illustrations or are illustrations of people of color.” 

Hopefully the next time I, or someone else with skin of colour run to Dr. Google, we will be comforted by the representation of our skin and bodies in medicine, no matter how big or small the issue. 

Staff Writer (Volume 48 & 49) — Hema is currently in her final year, finishing a double major in Linguistics and French Language Teaching and Learning. She previously served as a Staff Writer for Volume 48 of The Medium. Her favourite part of writing is the opportunity to research new topics, speak to new people, and make her voice heard, and she hopes that her articles can spark this interest in other students. In her spare time, you can find her in bed reading with a cup of coffee (and she's always looking for more book recommendations!).


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