The attention came as a surprise to Chidiebere Ibe, the Nigerian first-year medical student who created the image, and describes it as “just one of my drawings to advocate for diversity in medical illustrations.”
The image started a discussion about a lack of representation in these illustrations — images that are mostly found in textbooks and scientific journals to show medical pathologies and procedures.
Ibe, 25, who is creative director at the Association of Future African Neurosurgeons, has now been invited to have some of his illustrations published in the second edition of a handbook designed to show how a range of conditions appear on dark skin.
“Mind the Gap: A clinical handbook of signs and symptoms in Black and Brown Skin,” was first published in 2020. Co-author Malone Mukwende, a medical student in London, wrote over email that “Chidiebere’s work … unearths some of the biases that exist in medicine in plain sight that we may not be aware of. Representation in healthcare is imperative to ensure that we do not allow implicit biases to cultivate in our heads.”
Ibe, who earned a chemistry degree in Nigeria and is now studying medicine in Ukraine, only began his medical illustrations in 2020. He has already created images depicting anatomy and a range of conditions, such as the skin disorder vitiligo, cold sores, a chest infection and spinal injuries, all in Black people.
Ibe says that a lack of illustrations of skin conditions in Black skin makes it hard for medical students to diagnose them. Mukwende hopes that together they can create “the blueprint for the world” in terms of what diverse medical textbooks should look like and that “Mind the Gap” will be known as “the go-to textbook for representation of a variety of skin tones.”
A “big gap” in representation
Dr. Jenna Lester, an assistant professor in the department of Dermatology at the University of California, San Francisco, describes Ibe’s illustrations as “incredible.”
Lester is director of the university’s Skin of Color program, which provides a space for Black, Asian, Latinx and indigenous people to understand conditions that affect them and become more comfortable seeking care. She says she realized that there was a “big gap” in representation in dermatology back when she was a student, and a lecturer told the class a certain condition would look different in dark skin, but not how the condition would appear. Lester says that she is “grateful” that now “people are actually responding and recognizing it as a big problem and making changes to address it.”
“I think it’s important to increase representation across the board because … who knows what young mind this inspires when they see themselves represented in this way, who might be inspired to go into science or become a physician or nurse or something like that, by seeing themselves depicted in these illustrations?” she adds.
Covid-19 has exposed healthcare disparities
Lester says that “Covid-19 has highlighted a lot of issues of disparities, and that has led us to think about disparities and all the ways that they show up, including in dermatology.”
“It’s not just about the skin conditions,” says Ibe. “It’s just about giving everybody the value that they deserve. Black, White, Asian — let’s all have equal healthcare that we deserve.”
A network of African medical illustrators
Ibe plans to become a pediatric neurosurgeon and is also working on a textbook on birth defects in children, which will be illustrated with Black skin images.
“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,” he says.