When Black and people of color visit the doctor, they are often are treated differently than white patients. This episode of “What’s up with race” looks at why there are differences in diagnosis and what the consequences are for patients. #What’s up with race
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00:00The misdiagnosis rate was higher when it came to darker skinned patients.
00:05So what's up with race?
00:10White people are still the reference point in medicine, even today.
00:14And this has consequences in clinical practice.
00:18In an emergency, you can see that a patient's lips may have turned blue.
00:22Redness or a rash can be a sign of inflammation.
00:26These parameters can be harder to detect in people with black skin.
00:33When I'm in an emergency room and I can only look for things or symptoms that I was taught,
00:39the consequences could potentially be that I misdiagnosed something,
00:44that I underdiagnosed something.
00:46That means that I probably don't end up making the right decisions when it comes to treatment.
00:52Dr. Efsona Shenkuru wants to change that.
00:57Her field of expertise? Skin of colour dermatology.
01:02When we look at our textbooks that I learned from,
01:05then you do see a representation of lighter skin tones.
01:09The doctor works at the Charité Hospital in Berlin, just like Khalid Sehouli.
01:15He has long been an advocate against racism in medicine.
01:19If you look on the media or even the activities in social media,
01:26but even in the print media, that it's very frequent that they use stereotyping materials.
01:34And this was even with any infection disease.
01:40Diseases such as monkeypox are often shown on black skin.
01:44Even in 2022, when the virus broke out worldwide,
01:49especially in Europe and the US, affecting many white people.
01:53The virus is called monkeypox because it was first discovered in a lab monkey in Denmark.
01:59It can spread to humans, a zoonosis just like the coronavirus.
02:04However, it's not monkeys, but shrews and rodents that are said to be the host animals
02:10and infect other creatures and humans.
02:13Even though the virus originates from West and Central Africa,
02:17it has long since spread worldwide.
02:20Many white people in Europe and the US also fell ill,
02:24but the media showed almost exclusively photos of black people.
02:28According to the World Health Organization,
02:30the word monkeypox can be seen as racist and stigmatizing.
02:35Especially among white people, it seems to produce stereotypical images
02:40that equate monkeys, pox and Africa.
02:43The fact that only others are affected by the disease in the eyes of white people
02:48is a phenomenon known as othering in research.
02:52The WHO now recommends the abbreviation mpox.
02:59We have not to underestimate the power of visibility,
03:04because many of the things we learn are unconscious
03:08and based on pictures and visuality.
03:12Halid Sahouli has gained a lot of experience at the clinic.
03:16He says when patients don't understand German,
03:18this often leads to misunderstandings and discrimination.
03:22And there is often a lack of trained translators.
03:25The result? Too little information, incorrect treatment.
03:30As if it didn't matter if the patients don't understand exactly what it's all about.
03:35I was even invited in many cases to go to translation.
03:41I can speak very weak Moroccan.
03:43That's not Arabic.
03:46But I was invited to patients coming from Iran,
03:51coming from Afghanistan, from Pakistan,
03:54because they believe I can speak all the foreign languages.
03:57And this is something what I mean that is a part
04:02of institutional or organizational racism or discrimination,
04:07because you know this and you accept an inferior access to knowledge.
04:14And this, I think, is unacceptable.
04:17Dermatologist Efsono Shenkuru offers information
04:20privately on social media for people of colour.
04:24And at the clinic, she now also provides consultation for skin of colour dermatology.
04:30We are the first institution who does have a special space
04:35for having patients with undiagnosed skin symptoms.
04:41And what we are really trying to do is just create a space
04:44where those people who approach me can come to and we will just do the work up.
04:49And the goal is to come to a conclusion, to come to a diagnosis.
04:59Thank you.