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Magazine uses graphic images to tell story of NEED


The photographs are graphic--of a child with a cleft lip and palate, of twin boys with cataracts that stopped them from seeing, of a man whose tumor weighed over 6 ½ pounds deforming his face.

In its premiere 2006 winter issue, the humanitarian magazine NEED was faced with a dilemma on how to use the images taken by volunteer photo journalist Scott Harrison. The photos featured the patients from the West African city of Cotonou, Benin that the Mercy ship Anastasis's medical personnel volunteers treated.

These patients had disorders--often tumors--that were slowly disfiguring their faces and making it almost impossible to live. One patient contemplated suicide; another was ostracized from his village.

The NEED staff had to figure out how to show the pictures with sensitivity, dignity and humanity, but also to tell the story at the same time, according to Stephanie Kinnunen, the editor in chief and co-founder of NEED.

"We had to figure out how not to exploit [the patients'] suffering," she said. "We decided to try and find what was relevant, what was personal and unique to each person. We wanted to capture the little pieces of each person's story."

Since the photos are so graphic, the NEED staff knew that the words underneath the photos would have to be short, telling paragraphs, which wouldn't take their readers long to comprehend, according to Kinnunen.

"We wanted to share who the people were before their surgeries and how their lives improved after their surgeries rather than focusing on just what was going on medically with them," Kinnunen said.

The NEED staff talked to Harrison about his experiences to get the unique part about each person shown in their photos, according to Kinnunen.

According to Harrison's blog, there are many happy endings. He wrote, "One man who
lived for more than a decade on the fringe of society, the man once monstrously deformed and rejected was now the instant and unlikely celebrity. It was truly something to see."

The NEED staff also had to decide how they were going to layout the images in a way that their readers wouldn't be blindsided by them and still get the message the staff was trying to send that hope is being brought by people who are doing humanitarian efforts all over the world.

"We knew the photos were graphic and that they might disturb some people," Kinnunen said. "We wanted to warn people so we put a disclaimer at the beginning in red."

This is an ethical problem that many journalists and editors face when graphic images come into play.

Almost all publications have restrictions to their usage of graphic images, according to Mark Anfinson, an attorney for the Minnesota Newspaper association.

"Though almost none of [the publications] have them written down," Anfinson said. "The key is the level of detail [the images go into]--what is the graphic image of and what the image is being used for. "

Anfinson said that the usage of the images differs from context to context. "What might be alright for one magazine may not be ok with another."

For example, what might be considered acceptable for an adult magazine wouldn't be for a children's magazine, according to Anfinson.

There are other situations about when to use graphic images that apply to all publications.
"By and large, most publications don't show dead bodies," Anfinson said.

According to the RTNDA's ethical guidelines for graphic content, before making an ethical decision on whether or not to use a graphic image, a journalist or editor should have a discussion of the pros and cons with a diverse group in your organization. A journalist should be asked if he or she was willing to include non-journalist at the discussion since they are more likely to be representative to your audience.

Kelly McBride, the ethical leader for the Poynter Institute, said there are different questions that should be asked before using the images. Some of them are: "What harm can come to the people in the photos? What alternatives are there to using the photos?

Would you publish these photos in your local community?"

According to the News release from the Society of Professional Journalists (SPJ) called, "Danish Cartoon Coverage Should Be Guided by SPJ Code of Ethics," "Journalists should: treat sources, subjects and colleagues as human beings deserving respect, and tell the story of the diversity and the magnitude of the human experience boldly ..."
In a case study dealing with the Danish cartoons conducted by the SPJ called, "Offensive Images," it is recommended that journalists look at who, what and how the images will affect the readers.

Journalists should look at different principals, according to the SPJ case study. The should ask the questions, "Is it freedom of expression? Or is it unnecessary provocation? Is there an acceptable middle ground between showing the blunt truth and minimizing the harm of insult?"

Whatever is decided the case study said, "It's important to have a serious discussion and a good reason for [the] decision."

In a round-table discussion, the NEED staff did just that. They went through the pro and cons of different layouts to see what seemed to be the least offensive, most compelling and which photos worked the best to express the story behind them, according to Kinnunen.

They ultimately decided that the only way to show the images would be with them together.

With stories that broach such a touchy subject, the purpose of the images has to be clear, Kinnunen said.

"We like to present the problem and the solution side-by-side," she said. "We want the images to show the beauty of the story."

For the first two pages are in spread form. The spread is solid black with two, white words, "Before" and " After" printed only once, dominating the pages. "Viewing Advisory," printed in small, red words indicated to the only other text on the left side, a message stating that the following graphic images were of disorders that if left untreated could become life threatening. There are no pictures to be seen.

This gave readers a warning that graphic images are coming up. The warning was a key issue that the NEED staff wanted to express, Kinnunen said.

The Poynter Online article called, "APME Survey: Readers Balance Compassion with Privacy when considering Disturbing Images," says that when dealing with graphic images, journalists use the "cereal test," which asks the simple question: "Would I want my family to see this photo at the breakfast table tomorrow morning?"

While media outlets are moving toward the trend of printing graphic images, according to the Poynter article, the key to deciding if a photo should be printed is to have healthy process for deciding which photos to use, how many photos should be used, where they are going run and what other contextual information is provided to the reader."

The best way to figure out if you should use the graphic images is to talk to your colleagues, and rely on their experiences with images, as well as your own, to make your decision, according to Anfinson.

The use of graphic images leads to both positive and negative reactions from readers. There will always be someone who will be unhappy, according to Anfinson.

Anfinson said the best way to deal with a negative reaction "is to explain why they publication used their photos. They are going to have a reason for publishing the photos.
It is important to explain their reasoning."

NEED's process was effective. The reader response to the article was flavorful, according to Kinnunen.

"We would hear about people donating to organizations who have never donated before," Kinnunen said in an excited voice. "Mercy also said there was a rise in doctor and nurses volunteering for their organization after the issue can out."

The Mercy Ship organization was pleased about the NEED article, according to Pauline Rick, director of Mercy Ships' public relations.

"We are very happy that NEED magazine would profile the Mercy Ships. We are always trying to raise awareness about the work that we do in Africa to bring hope and healing to the poor," Rick said.