Image Use and Consent Policy

What is témoignage and why do we use this word?

Doctors Without Borders/Médecins Sans Frontières (MSF)’s work as an emergency medical organization is guided by the humanitarian principles of impartiality, neutrality and independence. Together with our medical action, we also speak out about the underlying causes of people’s suffering and advocate for change. This speaking out is often referred to in MSF as témoignage, coming from the French verb témoigner, which means ‘to bear witness.’

For MSF, this means a willingness to speak out about what we see, to share what our staff and patients tell us. We bring to the public eye people’s stories about their critical medical needs and exclusion from healthcare in community and in widespread crises, including violent conflict, epidemics, disasters as well as lack of access to necessities like food and clean water.

We share the stories of people we work with and assist through written testimonies, photography, videography and other documenting mediums.

How we use people-oriented images

In general, MSF photography should always show our medical work in action. We always aim to show our patients as dignified human beings, not stereotypes or objects of pity.

We sometimes also use portrait photography when showcasing an MSF healthcare worker, to introduce audiences to our staff, their roles and the specific work they are doing. This helps audiences learn about the different aspects of our work, including hands-on medical work as well as health promotion and logistical support.

How we use crowd images

In some instances, it is difficult to show the magnitude of a crisis without using crowds photos. As well, in instances of mass rescues group shots are taken as they are the only way we can capture these events. We do our best to not create the false image that people are just part of a mass. We focus as much as possible on MSF action and on the situation people are facing.

How we consider distressing images

MSF believes in portraying our patients and the communities we work with in a respectful and dignified manner. This prohibits the use of any imagery that shows a person in significant pain or suffering. Significant pain or suffering can be categorized as anyone who is visibly uncomfortable or afraid, especially without a caregiver in view.

Suffering is an everyday part of humanitarian and medical work. However, medical assistance is often performed behind closed doors, in private. When these practices are made public, the focus of our work at MSF isn’t the suffering, but the process of alleviating that suffering.

Wherever possible, we replace a distressing image with an image of a patient receiving care in a composed, serious and controlled manner.

Why we give context to our images

When an image stands on its own, without any description or context about what it holds, we as viewers bring our own assumptions and biases to the photo. The viewer is forced to draw their own conclusion about what is going on.

Every context is different. If we don’t provide details, we risk lumping every country, every crisis and all emergency response work together. That’s why we always make sure to use photos that are relevant to the text they accompany, and include important details about the photo: what’s going on in this image? Where and when is it happening? Who are the subjects and what is their role? There should never be a question about what we are looking at or why the image is being used.

There will be times when we can’t provide all of these details, especially in ads and videos. In these instances, it is even more important to avoid imagery that can be easily misinterpreted, that can reinforce negative stereotypes or that doesn’t do a good job of capturing the reality of a situation. This is even more true when the imagery is used for fundraising rather than speaking out.

Our consent processes

Before taking an image, the photographer or a communications professional will take time to explain to people why we wish to photograph them, why it is important as part of MSF’s work and how the pictures could be used. As a critical part of that conversation, it is also explained that their decision does not affect in any way the care and medical support they may receive from us.

If they accept, they will either sign a consent form release or be filmed or recorded giving their consent. The consent forms will be uploaded (but kept hidden) on MSF’s internal media database together with the pictures and videos of the people photographed.

Usage rights

All MSF pictures and videos on our internal media database are tagged with specific usage rights ranging from MSF use only to external media or even wire press agencies. Most of the content on our database has been taken by MSF staff.

We don’t sell imagery

We never sell imagery of our projects or patients. MSF does not sell, make money or profit from any picture taken either by MSF staff, hired photographers or agency photographers passing through our project. This includes prints or digital files online. MSF does not sell images as art prints or as a stock photo agency and never will.

Any picture being sold online in any form that features either MSF projects or MSF staff will not be linked with MSF and will not economically profit MSF.

How we capture content

Most of the visual and audio content that is stored and used by MSF is produced by MSF staff. Generally, it is by locally or internationally hired communications staff who will take on the role of photographer, videographer and writer. In some cases, photographers are specifically hired by MSF to visit and document projects. These photographers may be MSF staff or local or international professionals working as freelancers or for agencies.

Where are our photos stored and how are they used?

All MSF photos, including archival images dating back to the beginnings of the organization, are stored in our own media database. This allows all MSF staff to search through content to find what they need. This tool also allows us to regulate who can see and download what but also how the content is being used.

Content older than five years is considered as having expired consent and thus restricted for internal use only and not readily accessible for most staff, it must be requested if needed.

The media database is available to all MSF staff but also, with restrictions, to other people from relevant professional backgrounds or needs. This can include external contractors, staff from other nongovernmental organizations, media and academics. These non-MSF users only have access to recent and pre-approved content.

How do we brief freelance photographers and agencies? How do we control what they do with photos after their assignment?

Our ethical guidelines are given to anyone capturing images or audio of our staff or patients and must be read, understood, agreed to and followed. Photographers, internal or external to MSF, must act in a way that never puts the health and safety of patients or other MSF staff at risk.

Photographers from press agencies (Reuters, AFP, Getty, etc.) are sometimes granted access to our projects or, by the reality of some situations we work in, happen to photograph our work, staff or patients. When allowed in our projects, these independent photographers will be briefed and asked to follow our guidelines. We do not have direct control over the pictures they decide to publish after visiting our projects.

Do subjects in photos have the option to withdraw their consent at a later point?

Yes. It is clearly explained to the people photographed that they always have the possibility to withdraw their consent. The consent form they sign features a slip of paper that they keep, reminding them of the option to withdraw as well as the coordinate of the local MSF office and the person to contact at any time in case they wish to do so. They are also informed that their consent is considered valid for only five years, after which it is considered removed and images will no longer be used for general MSF purposes.

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