maggie you need a bit of knowledge with Photoshop... see my earlier post above
Anybody can do this kind of work - it is at it's roots copy/pasting. There are many tutorial on the web for photoshop (costs $$$) and Gimp (just like PS, but free) and Paint. Worth1000 has both beginner and advanced tutorials.
While it's mainly copy/paste (anyone can do) the hard part is blending it properly and making sure things are proportional... and believable
Check out http://aww.worth1000.com/entries/549546/elephantine
for similar images. Then check the link to tutorials