By: Laura S. Lorenz, M.Ed. Panel Presentation, American Public Health, 130th Annual Meeting and Exposition, Philadelphia, PA, Nov 2002
Photovoice is community assessment using photographs and narratives. Photovoice puts cameras in the hands of community residents so they can take photographs of their community’s problems and resources, reach policymakers with their point of view, and promote dialogue.
Policymakers in the context of photovoice may include the participants themselves, their families, their friends and neighbors, community groups, elected officials, school teachers, health workers, social workers, community volunteers, municipal, provincial, and national government agencies, and the participants’ peers.
Since 1991, Photovoice projects worldwide have created awareness of local conditions. Photovoice projects in China, Democratic Republic of Congo, New Zealand, Great Britain, South Africa, and the United States have empowered disenfranchised people to act as catalysts for community change.
Photovoice and Youth:
Photovoice allows young people to express themselves with originality and enthusiasm. It contributes to their feelings of self-worth and requires them to take risks. Photovoice provides hands-on opportunities to practice life skills such as action research, photography, writing, marketing, and activism. It gives young people, whose voices are often ignored, a hands-on experience with making a difference in their community.
The benefits of practicing activism. Teenagers start habits that stay with them their entire lives. These habits might be good—physical exercise, for example, or they might be bad—smoking cigarettes. One important habit that young people can develop is the habit of activism. Photovoice participants practice activism when they take photographs of community resources and problems and share their photos with people who make decisions. When young people participate in an activity that benefits their community, they are more likely to vote and to join and lead community organizations when they are adults.
Adolescence and identity. Adolescence is a time for developing identity—a separate sense of self. Photovoice stimulates the development of a civic identity, or sense of self as part of a greater whole, as young people act together in a group to achieve their goals and take photographs of problems and resources in the community from their point of view.
A participatory learning environment. Young people need opportunities to figure things out for themselves. Photovoice provides a participatory learning environment that lets young people learn from each other. In brainstorms, discussion sessions, and photo missions, the participants share their thoughts, insights, and creativity in a way that reinforces an image of themselves as smart and capable people.
Empowerment. Acting in concert with others to put on a final exhibit empowers every person involved. Ideally, a photovoice project leads to follow on actions that result in positive change. However, young people will be empowered by photovoice whether or not change is achieved.
Seeing young people as resources. Young people are often seen as problems to be managed rather than as resources to be supported. With photovoice, youth provide their communities with a valuable perspective on its problems and resources. Their photographs and narratives may open the eyes of adults to problems and resources they see every day but tend to ignore.
Visual literacy. Photovoice promotes learning that is vital to understanding and participating in today’s visual society. In discussing their photographs in photovoice, the participants ask themselves a series of questions that help them learn to read photographic images and identify its messages. Using these questions in a structured setting with invited guests, such as parents and other community decision-makers, participants learn that different people receive different messages from the same picture. They also learn how their written narrative can enhance, reinforce, or clarify the message that they want to convey.
Photovoice as social documentary. Photography has long served as a tool to document social ills and advocate for change. In the 1800s, reformers in industrialized nations used photographs of factory conditions to influence public opinion, improve working conditions, and fight child labor. In the 1930s, photographs of people in poor urban and rural areas wakened the minds and hearts of the entire country and led to social programs to alleviate suffering.
A community voice for youth. Photovoice provides a visual example of young people as activists making a difference in their communities. Photovoice requires youth to reflect on people who make decisions about the types of problems and resources they identify in their photographs. They invite policymakers to participate in program sessions or attend the exhibit. Photovoice gives young people the opportunity to build bridges with decision-makers and create partnerships for community change.
Some Photovoice Lessons Learned
I have led one photovoice project in Lowell, Massachusetts and another in Mdantsane, South Africa. The Lowell project I led as an independent study under my Master of Education studies in Instructional Design at UMASS Boston. The South African project was sponsored by EQUITY Project, a partnership of the US Agency for International Development, the South African Department of Health, and Management Sciences for Health, a nonprofit where I work as a Sr. Writer/Editor and Educator.
In May we put on an exhibit of 50 photographs and narratives in the foyer of City Hall. The Mayor of Lowell brought attention to the project and to one longstanding problem—a broken dance floor at the high school. She took the City Councilors downstairs to view the exhibit and used the evidence of the dance floor photo to get them to approve funding to fix it.
The project received a Girls Inc. National Programs award in 2001. With Strengthening Families funding from the Annie E. Casey Foundation, I am developing a photovoice facilitator’s guide that Girls Incorporated will send out to affiliates nationwide on CD rom in December 2002.
Challenges in Lowell. It was challenging to design and lead a photovoice project for the first time with a group of girls who did not get along very well. They were resentful if any of the cameras differed. They got bored filing their photos. Some kept their notebooks in perfect condition; others lost them. Some had lots of good ideas of things to photograph in the community; others focused on their home, family, and friends. Sometimes they waxed enthusiastic; other times they seemed to barely drag themselves to the session. At times I despaired of reaching our goal, though in the end, we did and with resounding success.
To overcome project challenges, it helped to spend
non-project time with the girls and to communicate openly and honestly with each
one when needed. It was also useful to invite relatives and policymakers to
participate in sessions when we discussed the girls’ photographs and hold the
exhibit in a very public venue (City Hall). Bringing out the concept of point of
view—that we all see things differently and that it is okay for us to have
different perspectives on the same thing was also helpful.
Photovoice in South Africa. In Mdantsane, South Africa, I worked for five weeks with 16 black township youth between the ages of 19 and 32. For the first week, four youth participated in a photovoice leadership training. Together we led the 4-week project, which culminated in an exhibit of 80 photographs and narratives of problems and resources in Mdantsane from their point of view.
Nine of the 16 participants were HIV positive. Some had graduated high school, others left school because they couldn’t pay school fees. Several were single parents, and all were unemployed. Most had never worked in teams or in their community. Two of the leaders had training and experience in leading groups; two had less experience in facilitation, but were HIV+ and respected by their HIV+ peers.
The final exhibit of the EQUITY photovoice project shared a view of hope and challenge in Mdantsane that inspired community dialogue and action. Nurse managers at the local hospital brought a photo of the problem of improperly discarded syringes to the attention of their infection control colleagues. An elected official called the Youth Academy to see how he could help solve the problem of leaking water pipes in the township. The Youth Academy initiated a community newspaper. Several participants started small businesses taking photo ids for local schools, making beaded AIDS pins, providing snacks to local schools, and taking photograph for neighbors, family, and friends.
The problems depicted in the Mdantsane exhibit include young women raped by gangs, lack of trash bins, clinics closed during the day, and family members who reject HIV positive relatives. Their photographs and narratives also shared a positive side of township life--gardens that used to be bushes where criminals hid to attack passers by, and people who start their own businesses and provide services and employment in the community. The participants’ narratives ask the municipality to collaborate with the community to improve roads and schools. Their images and words encourage young people to get tested for HIV if they are pregnant, to use condoms, and to continue to love family members with HIV/AIDS.
The Mdantsane youth did the same activities during their project as the adolescent girls in Lowell, except for several innovations. For example,
· Each participant drew a picture of one Mdantsane problem and one resource and discussed them before we handed out the cameras. This kept us focused on project content, and not on the technology of the cameras.
We incorporated ice breakers and participatory exercises into every session, and two of the more experienced youth leaders led most of these exercises. The exercises kept the level of interest high, made the project more culturally relevant, and taught important concepts, such as persistence and listening.
· We mounted “mini,” or “trial” exhibits on the days that policymakers visited. This promoted fruitful dialogue and helped the participants develop the final exhibit in stages.
Challenges in South Africa. The HIV positive status of more than half the participants was a potential challenge to project success. Young South Africans who are HIV positive tend to isolate themselves from their peers, and are isolated in turn, even by family members. Having two HIV positive leaders helped the HIV positive participants feel comfortable about joining the project. Participatory learning exercises broke down barriers among the participants. They began the project feeling awkward with each other, but ended up with a sense of “togetherness” that is appropriate to their Xhosa culture.
Filing the photographs is a tedious task. Each participant kept a file of all of his or her photographs, numbered by film and exposure. Each leader kept a file of the negatives and photographs for three team members. They enjoyed filing their photos the first time, when the experience was new. By the third time, it seemed like work. It is advisable to use film with only 12 or 15 exposures per roll, to reduce the amount of time they spend on this task.
Many of the Mdantsane participants were concerned about whether they could do a good job of writing their narratives, especially in English, which is a second language for all of them. Discussing their photographs in small groups helped them realize what they wanted to say. Some participants dictated their narratives to others, or wrote them first in Xhosa and had their leader translate for them. They needed little or no assistance in this important task.
Suggestions of Best Practices:
Photovoice is an on-going learning experience. Here are some suggestions of best practices. This list is not comprehensive; rather, it reflects some of my learning to date in researching and leading projects that use this dynamic participatory-learning methodology.
Protect the participants. For example, give them a letter on official letterhead showing they have permission to take photographs. Other examples include: speak with community organizations or leaders and get their support for the project; publish an article about the project so community residents are aware of the activity and its official sanction; and/or have the participants wear t-shirts or badges with a project logo.
Develop a dissemination strategy right from the start. What local newspapers or radio stations might want to publicize the project when it is completed? Where can you hold the exhibit? What are the potential benefits to you, your organization, your school, or your participants from this project—new funding, new community partnerships, enhanced self-esteem, new projects in the future? Answering this last question will help you to determine what types of dissemination activities and outlets are appropriate for your project.
Use film with few exposures. Keeping careful files of all photographs and negatives is a vital project task that the participants must take part in. Using film with fewer exposures makes this task easier and less time consuming. It also gives participants an immediate feeling of success to complete a roll and see their photographs in their notebooks.
Have fun while developing life skills. Incorporate stories, pictures, music, and games into the project. The project does not have to be all work and no play. Build into the project games that develop important life skills, such as persistence and the ability to listen.
Use visual learning techniques. Have the participants draw pictures of something positive and negative about their community before they receive their cameras. This will keep them focused on the project content—problems and resources—and not on the technology of the camera. Use symbols and pictures in the instructional materials.
Respect the participants’ contributions. Type up the results of all brainstorming sessions and give them copies to put in their notebooks. This is very motivating for many participants and helps them to feel respected.
Use SHOWeD. Caroline C. Wang at the University of Michigan, School of Public Health, developed a series of five questions that help to structure discussion of the photographs and bring out solutions to the identified problems. Called SHOWeD, these questions are: What do you see here? What is really happening here? How does this relate to our lives? Why does this situation exist? What can we do about it? These questions keep discussions focused on the image at hand. Answering them helps the participants write their narratives.
Provide leadership opportunities for the participants. Have participants lead or record brainstorming sessions, develop invitation text, and/or design the posters. Involve them in all stages of the project.
Involve policymakers. Invite policymakers, such as parents, social workers, teachers, peers, or elected officials, to attend project sessions and discuss the participants’ photographs. Involving decision-makers creates awareness of different points of view, promotes solutions to identified problems, and contributes to project success.
Protect the community. Before the final exhibit, have on file consent forms signed by all individuals who can be recognized in exhibit photographs. Every photographer must sign a form giving consent to exhibit the photograph. Give veto power over any photograph to the photographer, the photographic subject, the project manager, and the photographer’s guardian in the case of minors. Following these guidelines helps to protect the entire community—the participants, their families, their subjects, and the project’s sponsoring organization—from any possible problems that could arise from the display or use of project images.
Plan for follow-on.Photovoice may generate tremendous enthusiasm among the participants and in the community. It plants a seed of activism and change. In order to grow, the seed must be nurtured. By building discussion of and planning for follow on activities into the project design, you will help the participants direct their energy and enthusiasm into positive action.
Photovoice is an effective, community-based approach to involving community residents in identifying their problems and resources and seeking solutions. Many different types of projects have used the photovoice methodology. Successful audiences have included youth, illiterate women, people with HIV/AIDS, the homeless, and the terminally ill. Some projects last for a few weeks; others last for years. Some focus on developing the participants’ photographic skills; others spend minimal time on such skills and focus instead on content.
On the surface, a photovoice project seems simple. Photovoice—that means giving people cameras, taking pictures of the community, and holding an exhibit. Easy, right? It sounds easy, but in reality this project is complex and challenging. Project leaders have many details to follow up on. The participants have many responsibilities.
At the same time, people from all walks of life and many
different levels of experience are successful with photovoice. By adapting the
methodology to the local context and keeping an eye on the final goal—an
exhibit in a public venue—project leaders and participants will almost
certainly hold a final exhibit, reach policymakers, and encourage dialogue and
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