A medical student who was trained to identify how conditions appear on white patients, such as lips turning blue, has written a handbook to highlight how symptoms can look on darker skin.
Malone Mukwende, a second-year student at St George’s, University of London, wrote Mind the Gap as guidance for other healthcare professionals to show how conditions manifest on Black and brown people.
Mind the Gap features side-by-side images of illnesses and how they appear on pale skin and dark skin.
Malone’s book comes after British doctors and trainees launched a petition to make medical schools more inclusive of society.
Using the example of Kawasaki disease, a rare condition that mainly affects children under the age of five, the petitioners pointed out that on white skin, this appears as a red blotchy rash but is less easy to spot on Black skin.
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Lead petitioners say delays in diagnosis in dark-skinned people can lead to fatal consequences.
Speaking to the British Medical Journal, Malone said white normativity is teaching students to identify risks and conditions in white people that can be missed in people of colour.
He said: ‘Mind the Gap is a handbook of clinical signs in black and brown skin. Its aim is to teach medical students and other health professionals about the importance of recognising how some conditions can present differently in darker skins.
‘On arrival at medical school, I noticed a lack of teaching about darker skin. We were often taught to look for symptoms, such as rashes, in a way that I knew wouldn’t appear on my own skin.’
In a statement, he added: ‘The booklet addresses many issues that have been further exacerbated during the Covid-19 pandemic, such as families being asked if potential Covid patients are “pale” or if their lips “turned blue”.
‘These are not useful descriptors for a Black patient and, as a result, their care is compromised from the first point of contact.
‘It is essential we begin to educate others so they are aware of such differences and the power of the clinical language we currently use.’
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