Somewhere in an undiscovered margin or appendix of our medical textbooks, we will find a sentence or two on a disease called vitiligo. In truth, there are no major medical dangers of the disease, and little is known about its cause or treatment. Vitiligo is a depigmentation process involving destruction of melanocytes. It is probably of autoimmune etiology—ergo, prescribe steroids. There, I just did the literature search for you. The result? Vitiligo is given approximately ten seconds of thought in our medical education.
The only problem with 
relegating this disease to the proverbial sidelines of medical education is that the prevalence of the disease is estimated to be between 0.4 and 2.0 percent of the global population. Don’t worry—I won’t make you readers do the math. Between 29 and 148 million people worldwide are affected.
If vitiligo impacts the lives of this many people and so little is known about it, I’m sure you are asking, “Does vitiligo negatively impact quality of life?” Or in English, “Do people actually care that they have this disease?” Spoiler alert—the disease certainly does, and people certainly do. It has been well documented that some cultures see the depigmented lesions of vitiligo as unclean or contagious. This causes those afflicted with the disease to be shunned, ostracized from their community, and, in some cases, deemed unfit to marry. The psychosocial components of this disease are arguably the most harmful to the patient.
Here in the USA, however, this stigma is not common. Vitiligo is just not a very prominent disease. Even we medical students struggle to remember those two sentences we learned about it. This brings us to the final question: “If not in the USA, where in the world does vitiligo affect quality of life the most?”
And just like that, you know the research question for my scholarly project.
Dr. David Beyda has given students in the Certificate of Distinction in Global Health track a specific mission when it comes to their scholarly projects. We are to identify a major international problem, conduct a systematic review of the literature to learn more about it, and come up with one small solution we can implement. For example, my current plan is to develop an educational program that can be instituted in clinics abroad. This could take the form of a small brochure or flyer to hang in the clinic waiting room. This flyer could include simple information on vitiligo, written in a way that could quickly educate the reader about the cause of the disease. This would hopefully dispel many troublesome misconceptions. Education within communities is the only way to eliminate the stigma that is attached to vitiligo. If even one person learns something about vitiligo and spreads this knowledge to those he or she knows, the impact could multiply exponentially.
In our fourth year, global health students will be required to do one rotation in an international site. The goal is not only to learn about how healthcare is delivered overseas but also to put the results of our scholarly project to action. My project will allow me to determine which regions of the world are affected most by vitiligo. I will discuss with my mentor, Dr. Beyda, which of these locations would be a reasonable destination to travel in my fourth year.
With improved education and societal awareness, the suffering of millions of people can hopefully be mitigated. I hope this goal will one day be reached, and I plan on doing my small part.
Brandon Welbourn is a member of The University of Arizona College of Medicine – Phoenix class of 2018. Prior to attending medical school, he earned degrees in physiology, business administration, and Spanish at The University of Arizona in Tucson, AZ. Brandon is pursuing a Certificate of Distinction in Global Health and has had the opportunity to travel to the Dominican Republic, providing healthcare to those in need. In his spare time, Brandon is an avid sports fan who enjoys playing basketball and spending time with friends and family.