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Photograph of a camera lense.

A new study by researchers at Oxford Population Health’s Ethox Centre has found that photographers often face ethical and practical challenges when working on global health projects, balancing their clients’ requirements for attention-grabbing imagery with accurate reflections of local communities. The study is published in PLOS Global Public Health.

Global health photographers are often commissioned by non-governmental organisations and agencies to document the pain of others, with a goal to yield donations and attract attention to issues in communities, or to demonstrate empowerment by focusing on images of smiling and healthy people in challenging environments as signifiers of a global health intervention. While photojournalism is often framed as objective, simply by being present photographers interfere with local communities and can face challenging ethical dilemmas.

To better understand how global health photographers operate and obtain consent from subjects, the researchers interviewed 29 photographers reflecting the demographic realities of the field about the moral and practical challenges they face on the job. The authors identified common themes across the anonymised interview transcripts to highlight major issues faced by global health photographers.

In the current global health landscape, organisations often direct photographers to create attention-grabbing marketing images quickly to compete with mainstream advertising. Photographers typically have to work with client-created briefs detailing what images they need to take, and with limited time and resources. In practice, this pushes photographers to increasingly sanitise, sensationalise, or stage scenes to produce the desired image which can misrepresent the realities of local communities, especially in the Global South; photographers often react with resistance.

Arsenii Alenichev, Postdoctoral Fellow at Oxford Population Health and lead author of the study, said ‘Decolonisation of global health and its visual culture will prove impossible without taking the ethical experiences of photographers seriously, especially the local ones. Global health images should not be understood as neutral depictions of interventions ─ they are in fact political agents participating in the formulation of stereotypes about people and entire communities.’

Acquiring ethical consent from subjects is also complicated by power imbalances, language barriers and illiteracy, and misplaced fear or trust in both the photographer and the legal documents subjects are asked to sign. Given these emergent themes, the authors argue that organisations should push for a more photojournalistic approach to the creation of global health images, weighing ethical clarity over potential economic sacrifice.

The authors note that, while their sample of respondents may have been biased towards critical perspectives, this broad overview of tensions will equip other researchers to conduct future studies of more localised, nuanced experiences.