"Whenever I looked at medical charts, the reference point was always white skin."
Angelina Jolie
Credit: Massimo Insabato/Archivio Massimo Insabato/Mondadori Portfolio, Getty Images

In a June 22nd TIME interview with medical student Malone Mukwende, who is actively trying to reshape the medical industry to be more inclusive, Angelina Jolie discussed with him how her daughter Zahara was treated differently by doctors post-surgery simply because the medical professionals weren't educated enough on how to properly treat people with dark skin tones.

Mukwende, who is currently studying medicine in London, has already published a handbook, Mind the Gap, and an online health platform called Hutano. Both are educational tools for Black and brown people to better educate themselves on various topical health and skin conditions that have only ever been depicted in medical textbooks on white skin. "If we learned [in school] about a particular type of rash or disease that manifests on skin, it would always have white skin as the reference," Mukwende told Jolie. "I would ask 'what does this look like on other skin tones?' just for my own learning. Often people told me that they didn't know. I decided that something needed to be done."

Jolie then told him that she experienced this lack of knowledge when her own daughter went in for surgery. "I have children from different backgrounds, and I know when there was a rash that everybody got, it looked drastically different depending on their skin color," she said. "But whenever I looked at medical charts, the reference point was always white skin."

She continued, "Recently my daughter Zahara, whom I adopted from Ethiopia, had surgery, and afterward a nurse told me to call them if her skin 'turned pink.'"

"Almost the entirety of medicine is taught in that way," Mukwende said. "There's a language and a culture that exists in the medical profession, because it's been done for so many years and because we are still doing it so many years later it doesn't seem like it's a problem. However, like you've just illustrated, that's a very problematic statement for some groups of the population because it's just not going to happen in that way and if you're unaware you probably won't call the doctor."

Mukwende went on to further explain how a lack of knowledge and education in medical professionals who attempt to treat, diagnose, and examine Black and brown people is harmful even outside the realm of skin conditions. He told the story of Victoria Climbié, a little girl who was being abused at home by her great aunt and her boyfriend back in the early 2000s.

"She presented to the hospital, and she had visible injuries on her skin. A doctor concluded that she was suffering from scabies and accepted her guardians' story that she had inflicted the wounds herself by scratching the scars," Mukwende recounted. "Eventually they realized that this was a potential social-services case and a case of neglect."

But it was too late. Climbié ended up dying at the hands of her abusers. "In the report on her death it said she had 128 different injuries. We missed that many different signs on darker skin to be able to identify that this was actually a problem. This is a common problem with bruising and injury in domestic violence and abuse cases."

Of course, Black people and those with dark skin experience discrimination throughout many levels of the healthcare industry, both in the U.S. and abroad. Black women in America are twice as likely to die during pregnancy and/or childbirth than white women, for example. Hopefully, handbooks and resources like Mukwende's will begin to broaden knowledge, diversify medical textbooks and charts, and result in proper care for all people.