Diversity, Equity and Inclusion in Medicine: Puff PR, or actual action, policy and practice?
A conversation with medical illustrator Kunda Mwape about the transformative power of art in health, healthcare and Global Health by Kimberly J. Soenen | April 21, 2024
("C O N C E N T U S" by Kunda Mwape. Digital painting made exclusively for THE FINE PRINT, April 19, 2024.)
Representation in medicine goes beyond just increasing diversity for the sake of inclusivity. It positively impacts patient outcomes, reduces healthcare disparities, and fosters a more compassionate and effective healthcare system. Embracing diversity and promoting representation in medicine is essential for building a healthier, more equitable world for everyone. But have medical associations, medical institutions and medical schools truly enacted DEI policies that change work and academic cultures? Or, is the trend in support of equality actually a PR game veiled as policy?
Black persons are the lowest paid physicians in the United States of America. Black physicians earn an average annual salary of about 16%, or $50,000, less than their similarly trained physician colleagues. In 1940, only 2.8% of physicians were Black, but 9.7% of the United States population was Black; and by 2018, 5.4% of physicians were Black, but 12.8% of the population was Black. Black men who were physicians represented 1.3% of the physician workforce back in 1900. Black men represented 2.7% of the physician workforce in 1940 and 2.6% in 2018. Black women in medicine face even more access and leverage challenges. Is that progress?
So, the question becomes: What is true diversity, true inclusion and true Health Equity?
Chidiebere Ibe is from the Igbo ethnic group and is a native of Ebonyi State, Nigeria, and was born in Uyo, Akwa Ibom State in Nigeria. He speaks English, Igbo, and Ibibio. After his mother died unexpectedly during a surgery, he became passionate about medicine, especially as it relates to women and children. He began creating medical illustrations by reading anatomy textbooks, watching videos online, and practicing illustrations using hand sketches. Currently, he is a Medical Illustrator, renowned for the creation of the Black Fetus illustration. The illustration of a Black fetus in the womb went viral in 2021 with many people commenting on social media that it was the first time they had seen a depiction of a dark-skinned fetus or pregnant woman.
His frequent artistic collaborator is Kunda Mwape.
Mwape’s illustrations and paintings have accelerated awareness about how the BIPOC body has been entirely ignored in medical textbooks, and across medical school curriculums. I had an email conversation with Mwape specifically about the power of art and how art has changed practices and behaviors across the white-male dominated healthcare-scape globally.
We began our conversation talking about what made Mwape start creating art in the health, healthcare and Public Health space and discussed how art has the power to changes protocols, practices and behaviors across medicine and healthcare.
Soenen: What motivates you as an artist, and why medical illustration and health?
Mwape: Well, art itself has always been a vital part of who I am. I have loved it from the moment I could hold a pencil. Now, I always created art for my eyes only for the larger part of my life. A couple of years ago, I decided to start sharing my work online, and I did not pay too much mind to it. I got a little bit of attention in my country amongst a handful of musicians and people in the entertainment industry. So, my work shifted and began revolving around the local entertainment scene; which it had been doing already for a few years.
On the flip side, I acquired the desire to study medicine pretty early on in my childhood. When I eventually got into med school, particularly in my clinical years, I was exposed to a lot unfortunate truth. I got to see the challenges we face in the health and public health space. It was quite the sobering experience.
On one end, I identified a gross lack of awareness about various medical issues among my people. On the other end, I also came to realize that I too lacked awareness on some minor but significant aspects of certain medical conditions.
A prime example of that is Systemic Lupus Erythematosus (SLE). See, some patients with SLE may present with a butterfly shaped rash on their face called a malar rash. However, all my medical text books only ever depicted this rash on Caucasian skin. I only came to know what a malar rash looks like on black skin after an experienced consultant pointed it out for me.
So given these two backgrounds, I began to wonder if there was a space for me to use my talents to help shed light on some of these disparities in health care. I wondered if there was a part, however small, my artistic talent could play. Around this time, as if it was destiny, I ended up meeting a medical illustrator who appreciated my artworks. He shed more light on what medical illustration entails and that was like the final push that set me down the path I am on.
In a nutshell, I am passionate about art and health care, and through these experiences I realized these two passions can be combined.
Soenen: Have you, or anyone in your family, ever been injured, ill, disabled or challenged because of medical conditions or healthcare status?
Mwape: Yes. My father passed away when I was about two years old and my mother passed away when I was in my first year of medical school. Both of them died because of health issues. I also had a sister, my only sibling, who was a special needs child and had epilepsy. Unfortunately, she passed away when I was in my third year of medical school due to health issues as well. I, on the other hand, have been fortunate enough to not have suffered any major health issues.
Soenen: How do you view your role in medical care education, scientific education and Health Humanities?
Mwape: Well, honestly, I just feel like I am but a small component of a larger system. I actually just completed my medical school and I think, given my artistic proclivities and my medical knowledge, I am in a unique position to help educate and raise awareness in creative ways. I am just one small voice, amongst many others, playing my part in health education.
Soenen: How do you think art impacts health, healthcare and Global Health policy positively in achieving true DEI equality and improving health outcomes?
Mwape: Well, I think it’s multi-factorial. I think raising awareness is a big factor. If people can stop and look at an artwork, an illustration, and have their minds opened to information they never knew, then that could positively influence their health behavior. Other times, the artwork is just so relatable it helps to foster a healthier and more inclusive public health space.
I think art can be very impactful as a companion to educational material used in the health field. Take dermatology for example, medical students would benefit from there being extensive illustrations of dermatological conditions on skins of color. This would have a direct effect on patient diagnosis further down the line, a direct effect on healthcare. So, I think the integration of conscious artwork in medical literature is another factor.
It is also essential to have conversations about some of the health disparities we face. I believe art has the power to jumpstart some of these conversations and influence global health policy.
Soenen: What is the challenge of communicating through art and what are the rewards?
Mwape: For me, the challenge tends to be that I have a lot creative ideas and different painting styles that I would like to try out but I often find myself toning down some of these ideas to create something more “appropriate” for medical illustrations.
The reward for me is twofold. On one hand, the sheer process of creating itself is very rewarding. On the other hand, to have people relate and be enlightened by my work is also very rewarding. A midwife had once reached out to me to let me know she used my illustrations during a class she had with her midwifery students. Things like this are very rewarding for me.
Soenen: Who are your strongest partners for publishing art related to health and health humanities?
Mwape: As of today, my biggest partner has been the acclaimed medical educator, Chidiebere Ibe. However, I am still growing and I hope to establish more partnerships, especially with publishers.
Soenen: Digital tools and social media have made Global Health crises more visibale internationally. We now carry warfare in our palms. How do we make art rise to the top of the noise to transform Global Health Philosophy?
Mwape: I do not know If I can really pin down the exact secret ingredient needed to make art rise to the top of all the noise. However, I think being authentic really helps. Telling real stories with our art is important. Social media can be such a content churning machine which prioritizes whatever the algorithm finds trendy. This does not always favor actual art. However, the people who use social media, they are actual real people, real human beings. They have experiences that only they know about, as well as shared experiences. If we create from an authentic place and tell the stories that matter, eventually our art will land in front of the people who connect with it. Once people start to connect with the art, it often begins to rise above the noise.
Another thing to consider is collaborative work. There are many people who have voices in certain spaces, and they have a greater reach in these places. It is useful to collaborate with such people to get your work out there. It could also be collaborating with artists in different mediums, with professionals in the health field, or with people who are particularly adept at social media. Whatever the case, finding your tribe is very helpful. Finding the right people who have an appreciation for your art and collaborating with these people is very helpful.
I also believe that consistency in the long run also plays a crucial role.
Soenen: How can art shape-shift Public Health policy?
Mwape: It all goes back to conversations. Art can touch people and it can spark much needed conversations. These conversations can grow to influence the decision-making in the Public Health space.
Soenen: What does painting give to you personally and professionally?
Mwape: Painting gives me a means to express myself and my thoughts in the best way I know how. It enables me to offer something to this world. I need to create; it is just part of who I am. If I go a long time without creating, I feel off, like I am missing something. Art is also such a stress reliever for me, as well. Furthermore, it is very satisfying for me to know that painting can be used to create a positive impact in my health space.
Soenen: What do you think the world most needs now to educate people about the universal need for healthcare? What is most pressing healthcare issue in your mind today?
Mwape: I think the scope of what the world needs to educate people about the universal need for healthcare is quite broad, it is multi-faceted. There are certainly many health issues that can be pointed out. From the need to promote better health seeking behavior to the need to raise awareness about often overlooked aspects of healthcare. For me personally, what weights pretty heavy on my mind is the lack of representation of people of color. There is need for more diversity in medical literature. There need to shed light on some of the disparities in healthcare faced by minorities.
Soenen: What does a day in your life look like now?
Mwape: I am currently on vacation, having just finished medical school I am taking time to slow down and rest. I am usually up at 7:00a.m, and I tend to start my day with some light reading. I follow this up with some journaling. I usually have a couple errands to run that take up the rest of my mornings. In the afternoon, I usually take some time to study. I am preparing for my licensure exams later on this year, so I prefer to dedicate a small chunk of time each day to studying. My afternoon tends to be spent on art, usually doing some digital painting studies or working on some illustrations. I usually keep at it till late in the evening. I end the day by winding down and talking to some loved ones.
Soenen: If you could give advice to children and women about the Health Philosophy Transformation happening now, what would you tell them?
Mwape: I would tell them that knowledge is power. They must take a keen interest in learning about health and health related issues that affect them.
Soenen: How else do you engage civically in your community?
Mwape: I do not have anything of the sort coming out this year. However, I am putting in the work behind the scenes. I hope to put out something in the near future.
Soenen: How do you personally define health?
Mwape: Health for me is a holistic term. It is more than merely the physical well-being of an individual. It also encompasses mental and emotional well-being.
Soenen: You have so many lovely complex spices and dishes in your country. What is your favorite food or meal?
Mwape: Pizza.
Soenen: Do you have a favorite band or musician?
Mwape: Coldplay.
Soenen: How do you relax and truly step away from big world and the pressures of modern day?
Mwape: I'm more of a home body. I like to relax at home.
Soenen: Your art is seen by the world internationally thanks to digital tools and online reach. Do you also engage civically in your local community?
Mwape: I love to do volunteer work.
Soenen: What is your wish or vision for health, healthcare and Global Health Philosophy Transformation?
Mwape: My one health wish would be for everyone to come together and hold honest conversations about the state of health in today’s world, and that through these conversations each individual may take it upon themselves to play their part in addressing these health issues. My one wish would be global unity for a common health goal.
Soenen: What would you say to artists and creators out there who might be struggling with the need for a salaried job vs. making their art their full time livelihood and becoming a professional artist?
Mwape: My advice to artists is this: Just create. Keep creating. Do not worry about recognition or numbers. Just keep creating regardless.
Soenen: Thank you for the ongoing work and light Kunda. You have converted your great personal loss into significant change already, and you are just getting started. Thank you.
Mwape: Thank you.
ADDITIONAL RESOURCES
To collect or purchase works of art, book an exhibition or hire Kunda Mwape reach out here
Learn more about Chidiebere Ibe
PR or practice? Research here>
Learn more about the Coalition of Black Men Physicians