The Association of Medical Illustrator’s Diversity Campaign is highlighting the need to feature greater diversity and inclusivity in the illustrations created by our members.

We’ve asked AMI Member Todd Buck to share the process and the final PDF showcasing the illustrations he recently created for Medicine Sans Frontiers. Todd’s art focuses on the need for greater understanding of Neglected Tropical Diseases (NTDs) that are common to various areas around the globe.Todd was contacted by Victoria Russell in the Amsterdam office of Médecins Sans Frontières (MSF), which is the global name for Doctors Without Borders.

The illustrations were for a report about Neglected Tropical Diseases that came out in late January. NTDs included: snakebites, sleeping sickness, chagas disease, visceral and cutaneous leishmaniasis, and noma. Intended audience includes experts in the NTD community and at the World Health Organization, but they also want to educate a general audience about NTDs. The report is to be distributed in both physical and digital format and illustrations will also be used on social media.

MSF was attracted to the diversity of people Todd represents in his illustrations in the Medical Illustration and Animation Sourcebook. As Todd says,

“When I asked if they had any samples of the type and complexity of illustrations they are looking for, they showed me one of my illustrations from my online portfolio.”

Once they signed an agreement, Todd spent several days researching each of the diseases and creating thumbnail sketches of the content and compositions that he thought would tell each story. Victoria’s team consisted of 20 or so physicians and volunteers working in various regions, so their feedback was extensive. “Not much of my initial thumbnail sketches remained, but it became much clearer what I should include and what I should not. Suggestions changed the narrative from cold science to how MSF helps people.” According to Todd, the content evolved several times before sketches were finally approved.

For example:

• They felt it was important to include the vector, but they had no interest in showing the actual parasites in the body.
• They decided to add environment/living conditions since it is an important part of the story. Simply living and working in these environments puts people and communities at risk of certain diseases. For example, dense vegetation and proximity to water in areas like the Congo are breeding habitats for the tsetse fly. Acacia trees are part of the life cycle for the sandfly. Tall grasses are home to several poisonous snake species. Poorly built mud huts in Central and South America can be infested with the triatomine or ‘kissing’ bug that causes Chagas disease.
• MSF also wanted a supportive adult included in each image featuring a pediatric patient as they didn’t want to convey the message that sick children were wandering around alone. “I added an adult hand on the shoulder of these children to show that MSF is there to provide care and comfort, while still maintaining focus on the child and the pathology of the diseases.”
• The Client also opted to switch from a full page vertical format to horizontal so it would be easier to use the illustrations on various social media platforms. This resulted in a complete compositional change to the Illustrations (approx. 16.5” x 11.5 “ @ 300 dpi).
• Todd agreed to keep objects on layers so they can be used individually as well as together. As MSF is one of his favorite charities, he wanted to do what he could to give them the most ‘bang for their Buck’ (pun intended)! This way, they could use the insets of the vector, the environments, the people, and the treatments as needed to fulfill the mission about which he feels such passion.
• He was also asked to show the disease but not at a stage that the pathology is so graphic that no one will want to look at it. MSF’s goal was to have potential donors spend time with the illustrations.

Challenges:

• The deadline was extremely tight as the contract was signed December 12th with the goal of being delivered around January 15th. Todd comments: “I was totally stressed out. I worked on it every single day for 36 days straight, including Christmas and New Year’s!” Luckily the project was over winter break from Todd’s job as a Professor of Illustration at Northern Illinois University.
• Todd feels one of the greatest challenges was in representing patients appropriate to regions of high incidence. MSF provided some reference photos, however, out of respect for the patients, Todd was asked to depict characters without showing any actual patients or providers. ‘None of the people I depicted in this series of illustrations are identifiable. They are cobbled together from many references and even photos of myself in various poses.’
• Depicting the variety of people and cultures across Africa was especially difficult. Todd chuckles as he says “I’m a white dude living in Lombard, Illinois trying to piece together specific physical traits of people in countries I have never visited. I tried using photos a friend took while he was working on his PhD in Africa near Lake Victoria. I had so many references that I thought were fantastic, however, for the image on Visceral Leishmaniasis, the comment came back that the people looked like they were from Central Africa instead of South Sudan.” This re-working the sketches and spending many more hours researching the people of South Sudan.
• Another challenge was in accommodating the opinions of a large team of reviewers. Todd says that Ms. Russell was awesome and able to steer the team when some members wanted him to overwhelm the art with too many visual elements. “Their comments definitely made the illustrations stronger, so I am grateful for their inciteful feedback. After all, it is the workers in the field who know what is going on and what best represents the story for each of these serious diseases.”
• Finally, Todd says “I’d never been asked to paint environments before, so I wasn’t sure how well that part of the illustrations would turn out.” Todd spent loads of time researching the environments of the people who are living with these diseases, in addition to their individual bone structures, hair textures, and skin tones. The result is an amazing series of images that respectfully and accurately depict the people, living conditions and cultures of communities from around the globe.

The AMI Diversity’s Committee would like to thank Todd

... for his work in the depiction of patients and Healthcare providers using models and references of traditionally underrepresented races, cultures, and ethnicities.