The growth of social media has reduced the world to a “global village” in which images travel fast and far. When they feature vulnerable people, the impact can be disastrous. Starting from a recent controversy involving Médecins Sans Frontières, the authors present a thought-provoking and salutary reflection on an issue that no humanitarian organisation is spared from.
On 25 August 2021, Médecins Sans Frontières (MSF) posted on its website a photo essay by photographer Newsha Tavakolian, a member of the Magnum Photos cooperative, following her visit to a MSF project in the Ituri province of the Democratic Republic of the Congo.[1]Newsha Tavakolian and Sara Kazemimanesh, Ituri, a Glimmer through the Crack, August 2021, https://50years.msf.org/topic/7/gb/ituri-a-glimmer-through-the-crack (this is an edited version of the piece … Continue reading The piece quickly raised concerns inside and outside the organisation for offering up a problematic vision of sexual violence and for including two fully identifiable photographs of a 16-year-old orphaned survivor.[2]David Batty, “Médecins Sans Frontières condemned for ‘profiting from exploitative images’”, The Guardian, 25 May 2022, … Continue reading
In an open letter published on 25 May 2022, photographers, journalists and activists including former and current MSF staff demanded accountability for these images.[3]MSF Child Protection Inquiry, Open letter to the MSF International President and Board, 25 May 2022, https://msfchildprotect.wordpress.com/2022/05/24/letter The letter also revealed that images of identifiable patients in MSF’s care were available for purchase from major online stock libraries, prompting accusations that the organisation was “commission[ing], publish[ing] and allow[ing] the sale of photographs that endanger and exploit vulnerable black people, including children.”
Although MSF subsequently removed photographs of the underaged girl from Tavakolian’s story and pledged a review of its content production guidelines to impose additional restrictions on any content featuring minors,[4]“MSF International President responds to photo ethics concerns”, 25 May 2022, https://www.msf.org/msf-international-president-responds-photo-ethics-concerns the controversy revived old fault lines about the ethics of humanitarian iconography. Among the issues raised are what constitutes a dignified representation of extreme vulnerability and pain, how to reconcile the precautionary principle with respect for the agency of the person depicted and what the cost is of distorting reality to make it more palatable.
Humanitarian action and visual representation
As early as 1981, a seminal piece accused aid agencies of “social pornography” for stripping victims of their dignity and presenting them to Western viewers as helpless objects.[5]Jørgen Lissner, “Merchants of misery”, the New Internationalist, 1 June 1981, https://newint.org/features/1981/06/01/merchants-of-misery The author not only accused those agencies of capitalising on suffering, he also argued that by isolating subjects from their social or historical context, humanitarian imagery perpetuated a racist distortion in the public’s perception of the world.
A few years later, sordid depictions of the Ethiopian famine of 1984-1985 acted as a pivotal event in raising awareness on ethical issues in the representation of humanitarian events, prompting an effort by the non-governmental organisation (NGO) community to formalise regulatory image codes and to get rid of the lens of exoticism or victimhood. By the turn of the 1990s, some humanitarian NGOs started shifting away from depictions of passive suffering to narratives of “resilience” told through more positive imagery. For some, this shift was not only motivated by a concern to avoid representations of death or suffering but also a desire to positively brand their organisation and to display its effectiveness. Efforts to reframe humanitarian imagery thus continued to raise questions about the ethical implications of picturing people in situations of vulnerability.[6]The Action internationale contre la Faim (actual Action Against Hunger) 1994 campaign “Leila 100 F. plus tard” (Leila FRF 100 later) is an example of more “positive imagery”, which was widely … Continue reading
One of the most severe charges made against aid agencies has been that of collusion with media companies. By giving them access to vulnerable populations in their care and sometimes letting them hold the copyright to images taken in the organisation’s name, humanitarian agencies have allegedly contributed to blurring the lines between images produced to deliver a political message and decontextualised photographs turned into commodities.
In the past decade, the rise of social media triggered another shift in terms of how “distant others” are represented. As put by a senior executive in the MSF Communication Department: “Today in the digital age, you are no longer talking to a particular, local cultural reference frame but to many more.” The fact that a same picture, or story, can be seen in different parts of the world and give rise to different interpretations has made it all the more critical to reflect on who these stories are addressed to and with what purpose.
The moral necessity of making suffering visible
The idea that photographs are an effective means to raise collective awareness is so deeply rooted in the sector’s culture that displaying shocking images of human suffering is part of a vow to “tell it as it is” encapsulated in MSF’s conception of témoignage. The concept originates in a commitment to stand by the side of victims and to use MSF’s platform and credibility to help bring their stories to the world. The value of témoignage is therefore based on the moral credibility of being an eyewitness – according to Renaud Dulong’s condition of “personal attestation”.[7]Renaud Dulong, Le Témoin oculaire. Les conditions sociales de l’attestation personnelle, éditions de l’EHESS, 1998.
Additionally, to the extent that representing the pain of others is considered justifiable if it leads to action or when it conveys a strong enough moral message,[8]Philippe Calain, “Ethics and images of suffering bodies in humanitarian medicine”, Social Science & Medicine, vol. 98, December 2013, pp. 278–285, … Continue reading the use of images by humanitarian organisations is anchored in a belief that putting a face to a catastrophic event or situation is effective to humanise suffering patients, to raise funds or to induce political change. In that regard, publishing recognisable faces not only has more impact but is seen as a way to let victims know they are seen and heard, while identity protection practices such as the blurring of faces or the use of silhouette shots is seen as perpetuating stigma and shame.[9]Laure Wolmark, « Portraits sans visages. Des usages photographiques de la honte », Science and Video, n° 2, 2010, https://scienceandvideo.mmsh.fr/2-6
The problem with asserting a moral necessity of making suffering visible is that calling out an injustice to the world is never only about the people affected. Indeed, denouncing others’ suffering reinforces the legitimacy of the person or the organisation doing so, at the risk of benefitting them more than the person whose story is shared. Whether they derive money, visibility or moral authority from circulating pictures of what they see and do, humanitarian organisations are thus inevitably accused of commodifying suffering.
The insufficiencies of the notion of consent
Faced with suspicions of exploitation, image producers may be tempted to stand behind informed consent. If the person wants their story known and their picture shown, why not let them? In Ituri, Tavakolian argued, the 16-year-old heard she was there and travelled to her, determined to give testimony.[10]Tom Seymour, “Magnum photographer defends images of teenage gang rape victim after humanitarian organisation removes them from website”, The Art Newspaper, 20 May 2022, … Continue reading Putting aside the age of the girl, the reality is that obtaining consent is particularly complex when dealing with anyone under extreme distress. Stress hormones can cause a dramatic loss of cognitive abilities and people in shock may lack capacity to provide or withhold consent.[11]Amy Arnsten, “Stress signalling pathways that impair prefrontal cortex structure and function”, Nature Reviews Neuroscience, vol. 10, no. 6, June 2009, pp. 410–422.
This is especially true in a situation where different kinds of power asymmetry are likely to skew the position from which consent is requested. In their research on Yazidi women’s perceptions of journalistic practices in the reporting of Daesh sexual violence, Johanna Foster and Sherizaan Minwalla contend that women shared their stories along “a continuum of choice”, where the pressure they felt from journalists and community leaders was mixed with “a clinging hope” that the world would respond to their suffering.[12]Johanna E. Foster and Sherizaan Minwalla, “Voices of Yazidi women: Perceptions of journalistic practices in the reporting on ISIS sexual violence”, Women’s Studies International Forum, … Continue reading
Speaking about survivors of sexual violence, Nina Berman stresses that “when you’re dealing with women who have decided to put themselves out there as activists, that’s a different story; or if a person is legitimately in a stable place, and feels they can make that decision.”[13]Nina Berman and Samira Shackle, “Visual choices: Covering sexual violence in conflict zones”, Dart Center for Journalism and Trauma, 13 May 2021, … Continue reading She goes on to challenge the suggestion that telling their story and having their picture taken will make survivors feel seen and that being seen is necessarily empowering. Perhaps the bottom line is that consent does not absolve humanitarian organisations (or anyone holding a camera) of their responsibilities. One of them being to understand the expectations behind the act of making one’s suffering visible (and to whom) as well as the potential harms should those expectations not be fulfilled.
The danger of eliciting pity and perpetuating stereotypes
There are many ways in which the commitment to document the realities of suffering and abuse can come into tension with the medical oath to “do no harm”. The retelling of traumatic events can exacerbate symptoms of post-traumatic stress disorder. A victim of direct violence may face retaliation for telling their story. A community’s dignity may be undermined in some way. Humanitarian representations have indeed been criticised for reinforcing colonial relations of power by perpetuating cultural stereotypes about “Third World” dependency.
What is humanising or dehumanising is an especially complex, highly subjective, issue. People have different opinions of what qualifies as offensive or undignified, and trying to portray a reality in a way that accommodates the sensitivities of the public is not devoid of ethical perils.[14]John Taylor, “Problems in photojournalism: realism, the nature of news and the humanitarian narrative”, in Journalism Studies, vol. 1, no. 4 1, 2000, pp. 129–143. Nevertheless, there is no denying that images are part of a system of representation where their meaning is inevitably intertwined with the identity of the person that views them as well as the context in which they are viewed.[15]Roland Bleiker, David Campbell, Emma Hutchison et al., “The visual dehumanisation of refugees”, Australian Journal of Political Science, vol. 48, no. 4, December 2013, pp. 398–416, … Continue reading Depictions of suffering, in particular, are rooted in structures of power, especially when the victim and the viewer belong to socially or culturally distinct groups.[16]Philippe Calain, “Ethics and images of suffering bodies…”, art. cit., p. 279.
The problem here is that not only does looking at parts of the world through a prism of misery entertain racial bias, miserabilist depictions mask, simplify or are oblivious to the root political causes of crises and therefore unlikely to affect real change. At times, pictures and stories can turn personal plights into iconic representations of far more complex and far more political crises. The Madonna of Bentalha by Hocine Zaourar or The Migrant Mother by Dorothea Lange are examples of images which have gradually lost their historical, informative character to become atemporal, dolorist symbols of something other than the experience of the persons in them. Symbolism not only dismisses the unique experience of pain, it doesn’t adequately account for the political circumstances which have caused it. This kind of decontextualisation and depoliticisation of suffering as well as the fact that people are reduced to being representatives of their plight is thus a “double betrayal”.[17]Elizabeth Dauphinée, “The politics of the body in pain: reading the ethics of imagery”, Security Dialogue, vol. 38, no. 2, June 2007, pp. 139–155.
Aestheticising pain
Another ethical issue specific to images is that the beautification of tragedy contributes to exalting the presupposed moral value of pain. While some authors have argued that the presence of beauty in the midst of disaster is a means to challenge usual stereotypes,[18]David Campbell, “Salgado and the Sahel. Documentary photography and the imaging of famine”, in Francois Debrix and Cynthia Weber (eds.), Rituals of Mediation: International Politics and Social … Continue reading others have highlighted the risk of humanitarian photography being used for entertainment purposes because of “the pornographic element of seeing”.[19]Elizabeth Dauphinée, “The politics of the body in pain…”, art. cit., p. 145. There is a general consensus that the only people who should be entitled to watch extreme suffering are those who have the power to alleviate that suffering directly – medical staff treating a patient – or those working to investigate crime. In other words, extreme suffering is not something to be gazed at but to be acted on.
It should also be noted that the problem of aestheticising pain is as much about how images are produced as it is about how they are circulated and consumed. According to Elizabeth Dauphinée, the act of displaying extreme suffering (such as torture), even when intended as defiance, “is not outside of the economy of violence” that causes suffering in the first place. The author highlights that “[t]he ‘ethical use’ of the imagery of torture and other atrocities is always in a state of absolute tension: the bodies in the photographs are still exposed to our gaze in ways that render them abject, nameless and humiliated – even when our goal in the use of that imagery is to oppose their condition”.[20]Idem.
A moral case can therefore be made against the proliferation of photographic realism based on the belief that the image of pain reiterates the humiliation of the one who has suffered it. Hannah Arendt went so far as to argue that extreme suffering cannot be imagined or even understood,[21]Hannah Arendt, The Portable Hannah Arendt, Peter Baehr (ed.), Penguin, 2000. that it is unspeakable and therefore shouldn’t be depicted. But how else are we supposed to bring the unbearable to light?
Moving forward
Pictures have the potential to affect the unconscious frames through which the public understands distant events. They can animate important forms of political and social resistance, but they can also serve as a form of voyeurism where some people watch others, elsewhere, suffer, while reinforcing their distorted perception of the world. In any case, the significance of images, what they are used for, how they are interpreted and what happens to them after they are circulated goes beyond the individual(s) in them.
Considering certain images to be unacceptable is not an injunction to stop taking pictures or to remove the possibility to represent pain entirely. Similarly, addressing the issue of what constitutes dignified portrayal should not be confused with an attempt to please the sensibilities of the audience. Otherwise, humanitarian organisations risk falling into the trap of rejecting one stereotype only to replace it with another. Instead, how to represent suffering without reducing people to their situations deserves a collective, context-based discussion, informed by the viewpoint of the individuals and the communities represented. “There is an ultimate question of how the photographer reads the situation, how the person being photographed reads it and how they interact,” says a former Director of Communication and Fundraising at MSF. The key lies in making sure consent is understood as a process and as something that can be withdrawn, to avoid a situation where something which initially feels empowering or restorative ends up feeling exploitative.
It may also be necessary to redefine how humanitarian organisations collaborate with communications or media agencies. Aid actors have a responsibility to make sure that the photographers and journalists they work with agree on which principles should guide image production. Clear and non-negotiable measures should be taken to protect the privacy of children identified as victims of sexual abuse or exploitation, such as changing their name and obscuring their visual identity.[22]As an immediate action following the reactions to Tavakolian’s story, MSF amended its productions guidelines to reflect that provision, extending it to minors suffering from a highly stigmatised … Continue reading More generally, greater efforts should be made to engage the public based on their cognitive understanding of political injustices rather than on knee-jerk, ephemeral emotional reactions. It may mean “missing out” on some of the visibility and, potentially, some of the funding, but this is a choice that humanitarian organisations can willingly accept to make if it yields more enduring forms of outrage.
The authors are grateful to colleagues working in the communication departments of the various sections of MSF for their detailed comments. This article reflects the views of the authors only and not those of the organisation to which they belong.