Has anyone seen this before? Is it a Photoshop? Kid looks terrified [850x868]

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That's odd

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Not fake. There are many more that have been shared around of Soetoro's actions relating to children, particularly some with Clooney on that boat.

Here's a couple more:

They're all deranged, satan-worshipping, murdering, kike/kike-pet child fuckers and worse.

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If you do fourier analysis on it you can see the arrow was added but the rest of the image looks legit.