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I read with interest the article by Garland. However, I found the picture fronting the article rather disturbing. In the UK taking a photograph of a patient or even a 'part' of a patient warrants the completion if consent forms etc etc. Did the article author obtain permission from the two ladies appearing in the photograph for that particular photograph with them in varying degrees of undress to be published in an international journal? Did the editorial team at the BMJ apply the same consent standards they would have applied if they two young women had been British or indeed white in publishing the picture? As an African, I find myself wondering whether photographs of Africans are vetted using similar standards used to those of white people by the BMJ. Whilst one would not be surprised to see different 'standards' applied to photographic material by the wider media, one would have thought the BMJ would have exercised caution .kn such matters. Reaching this point in itself in 2012 is actually quite disturbing.