by Rachel Erskine
Amref Health Africa might be the biggest NGO you’ve never heard of. Headquartered in Nairobi, we’ve been around since 1957 and work in 35 African countries. When I joined the organisation’s UK arm in September 2017, I was struck by the breadth and variety of that work.
It’s like that school assembly staple, the parable of the blind-folded men and the elephant: if you asked my counterparts in Ethiopia or South Sudan what Amref does, their answers would bear little resemblance to each other’s, or my own. None of us would be wrong – but you’d need them all to see the truth.
The elephant in the Zoom
I soon came across another elephant; the one everyone avoided in in our bi-monthly video calls. While we had access to thousands of striking photos illustrating the impact of our work, we didn’t always have proof of informed consent from the people who featured. By missing out that stage of the image-making process, we had strayed from the principles that underpin our work. We had made ourselves vulnerable – and rendered much of our beautiful photography unusable.
Recognising the need for change, colleagues from across the organisation undertook a far-reaching review of consent-gathering. Eighteen months later, we’re at the stage of rolling out a new policy and toolkit. This is how we did it…
Assigning responsibility
We started by creating a taskforce from across Canada, Kenya, the Netherlands, Tanzania, and the UK – all with the shared goal of establishing a global policy on image consent and a set of practical tools for implementation. At each stage we took our drafts back to a bigger working group representing every Amref office. Once we had achieved broad agreement as a group, we took it to senior management at global level.
It wasn’t easy – taskforce members were doing full-time jobs in parallel and many are one-person teams. Had we taken a more centralised approach, the work would have been finished much sooner but, as my Canadian colleague pointed out, it wouldn’t have made for such a rich and comprehensive policy.
Involving everyone
Informed consent protects the rights and dignity of those whose stories we have the privilege of sharing. Although the ethical argument is by far the strongest one, it was crucial that everyone understood the potential repercussions (legal, financial, and reputational) when we don’t respect the process. Framed like this, it’s everyone’s business.
We consulted the communities we work with to determine what they thought was reasonable and practical and sought advice from our Legal, HR, and Programmes colleagues, who often find themselves tasked with taking photos.
It wasn’t always easy
This process forced us to have important, and sometimes uncomfortable, conversations. It has revealed other areas that require further attention and work. For example, the new policy needs to be backed up by, and reflected in, our safeguarding and child protection policies; our staff handbook and code of conduct; the contracts we ask freelance photographers to sign; our project feedback mechanisms; the way we’ve configured our online photo library. (All of this work is now underway, with clear deadlines for completion.)
Embracing complexity
Amref has offices in a dozen African countries, and another dozen in Europe and North America. Attitudes and expectations around the act of taking a photo vary from one context to another. Trying to reconcile these was complicated. There were times when conversations threw up more questions than they answered.

The charity sector is still smarting from recent, very public examples of what not to do. Our use of imagery ties into broader conversations about race, representation, and power dynamics; it was important not to shy away from this in our calls with colleagues from all over the world.
In the UK, the public demands increasingly better from NGOs and they’re willing to hold us to account when we fall short.
Letting it take up time and space
This work is important. Developing and implementing a thoughtful, rigorous consent process says a lot about who we want to be as an organisation.
Like many things, it all comes back to relationships: between NGO and community members, between photographer and subject. At Amref, we’re lucky to have strong relationships with the communities we work with; many of them built and maintained over several decades. Whilst these relationships don’t allow us to ever assume consent, they do enable us to have frank and open conversations.
Thinking ahead
Our next step is to develop guidance on the ethical use of imagery. In reality, much of the groundwork for this has already been done. If you’ve already had those conversations by the time the picture is taken and the person is clear on what their image might be used for, where it might appear, how it might be framed and who might see it – you can be reasonably confident that your use of it will align with their wishes. This being so, we do try to ask people for feedback once they’re ready for publication. They can revoke consent at any time.
Zooming out
When it comes to representation – stories, films, photography – it’s not about us. It’s about the people who allow us to share their stories; the people our organisations exist for. Their needs should always come before our own. It’s part of a broader commitment to putting respect for the rights, dignity and preferences of the people we work with above everything else: a principle that guides our project work and should underpin our communications, too.
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Resources we’ve found useful
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Rachel Erskine is Communications Manager at Amref Health Africa UK. The views expressed here are her own and not those of her employer.
www.amrefuk.org / @amref_uk / @erskinerachel