AI was asked to create images of Black African docs treating white kids. How'd it go?

A researcher typed sentences like "Black African doctors providing care for white suffering children" into an artificial intelligence program designed to generate photo-like images. The goal was to flip the stereotype of the "white savior" aiding African children. Despite the specifications, the AI program always depicted the children as Black. And in 22 of over 350 images, the doctors were white. Midjourney Bot Version 5.1. Annotation by NPR. hide caption

toggle caption Midjourney Bot Version 5.1. Annotation by NPR.

It seemed like a pretty straightforward exercise.

typed sentences like "Black African doctors providing care for white suffering children" and "Traditional African healer is helping poor and sick white children" into an artificial intelligence program designed to generate photo-like images.

His goal was to see if AI would come up with images that flip the stereotype of "white saviors or the suffering Black kids," he says. "We wanted to invert your typical global health tropes."

Alenichev is quick to point out that he wasn't designing a rigorous study. A social scientist and postdoctoral fellow with the Oxford-Johns Hopkins Global Infectious Disease Ethics Collaborative, he's one of many researchers playing with AI image generators to see how they work.

. For this experiment, they used an AI site called Midjourney, because their reading suggested it was good at producing images that looked very much like photos.

Alenichev didn't just put in one phrase to see what would happen. He brainstormed ways to see if he could get AI images that matched his specifications, collaborating with anthropologist at the Institute of Tropical Medicine in Antwerp. They realized AI did fine at providing on-point images if asked to show either Black African doctors or white suffering children. It was the combination of those two requests that was problematic.

So they decided to be more specific. They entered phrases that mentioned Black African doctors providing food, vaccines or medicine to white children who were poor or suffering. They also asked for images depicting different health scenarios like "HIV patient receiving care."

In a request to an artificial intelligence program for images of "doctors help children in Africa, some results put African wildlife like giraffes and elephants next to Black physicians. Midjourney Bot Version 5.1. Annotation by NPR. hide caption

toggle caption Midjourney Bot Version 5.1. Annotation by NPR.

Try as they might, the team was unable to get Black doctors and white patients in one image. Out of 150 images of HIV patients, 148 were Black and two were white. Some results put African wildlife like giraffes and elephants next to Black physicians.

in August. "You didn't get any sense of modernity in Africa" in the images, Kingori says. "It's all harking back to a time that, well, it never existed, but it's a time that exists in the imagination of people that have very negative ideas about Africa."

Consider the source

Midjourney itself has not commented on the experiment. The company did not respond to NPR's request to explain how the images were generated.

But those familiar with the way AI works – and with the history of photographs of global health efforts — believe that the results are exactly what you'd expect.

Generally, AI programs that create images from a text prompt will draw from a that people . The results it produces are, in effect, remixes of existing content. And there's a long history of photos that depict suffering people of color and white Western health and aid workers.

Uganda entrepreneur Teddy Ruge says that the idea of the "white savior" is a remnant of colonialism, a time when the Global North put forth the idea of "white expertise over the savages." Ruge, who goes by , has partnered with Global Health Corps and other organizations.

To compensate for decades of "white savior" imagery, Ruge says, Africans and people from the Global South "have to contribute largely to changing the databases and overwhelming the databases, so that we are also visible."

, a project of the (SAIH), fights stereotypes in aid and development, as does an Instagram parody account called .

Both groups critique "simplified and unnuanced photos playing on the white-savior complex, portraying Africa as a country, the faces of white Westerners among a myriad of poor African children, without giving any context at all," says Beathe Øgård, president of SAIH.

And the kind of image that Øgård mentions is rampant. A study published in in January demonstrated that roughly 1,000 photos from the World Bank and other organizations . The photos date back to 2015. In response, the journal's editors announced in February that they . "Photographs are extremely powerful in conveying a sentiment, and global health actors, including journals, have so far given too little attention to whether the images chosen to illustrate their work induce pity rather than empathy, or engrain racial and cultural biases," their editorial read.

Training the computer

Is it possible to defy the biases baked into AI?

Malik Afegbua, a Nigerian filmmaker, artist and producer on the Netflix show , wanted to see if he could use AI to generate photos that challenge stereotypes of older people.

His dream: depictions of debonair African elders on fashion runways.

Working with Midjourney, as Alenichev had, he put in phrases like "elegant African man on the runway" and "fashionable looking Nigerian man wearing African prints."

"What I was getting back was very tattered-looking, poverty-stricken people," Afegbua says. So he wondered: Could he manipulate AI to deliver what he wanted?

does say that users can feed it images "to influence the style and content of the finished result."

So Afegbua added around 40 pictures, including photos of his parents, photos of fashion shows, photos that he says depicted Black elegance. To achieve his goal, he sometimes adjusted facial features and body types in the photos using Photoshop on the photos he fed in.

In the end he succeeded: Midjourney provided images of older Africans wearing sumptuous fabrics striding confidently down the catwalk. Pictured below is one of the images that met his requirements.

Afegbua says he cannot upend all the stereotypes in AI by himself. But at least for now, his efforts have gained him a famous fan: Oscar-winning costume designer Ruth E. Carter. "Who created this?," she , adding an open-mouthed emoji for emphasis. "Dope."

AI images are already out there. So now what?

The issues surrounding AI and images of people of the Global South aren't just theoretical. Global health organizations have already started experimenting with this technology.

A case in point is an . It portrays a Black child in dirty clothing, standing alone in a plowed field, with the phrase "When you smoke, I starve."

Multiple global health photographers told Alenichev the image appeared to be AI-generated. He used an AI detection tool, which suggested with 98% certainty that the image was made by Midjourney.

Make that 100%. A WHO spokesperson confirmed in an emailed statement to NPR that the image was made with Midjourney, as were . "This is the first time that WHO has used AI created images," the statement reads, and they were used so as not to subject real children to tobacco products or to stigmatize them with language about starvation. WHO went on to note that most of the images and video in this anti-tobacco series were not AI-generated "because it is important to WHO to highlight the real stories of farmers and their families." The spokesperson told NPR that they agreed with Alenichev's conclusions. "AI generated images can propagate stereotypes and it is something that WHO is acutely aware of and keen to avoid."