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Short abstract:

I construct a case study of MSF’s work in post-rape medical care to examine how medical-legal documentation of injury is potentially transforming the crisis logics of humanitarian response to include new, if unsettled, expectations that aid workers will provide legally admissible evidence of harm.

Long abstract:

In the 1990s transnational feminist social movements called for humanitarian aid organizations to provide specialized post-rape medical care to survivors of sexual violence during armed conflict and complex humanitarian emergencies. In response, the World Health Organization and United Nations High Commissioner for Refugees issued their first clinical guidelines on post-rape medical care that adapt medical forensic exams for sexual assault (commonly known as “rape kits”) for use with refugees. Importantly, these guidelines recommended medical documentation of injuries and issuance of medical certificates to survivors of sexual violence in order to facilitate prosecution in criminal courts. This new standard of care fundamentally transformed what constituted a human right to health in these settings. However, implementation has been contested. Médecins Sans Frontières (MSF or Doctors Without Borders) is one of the most prominent medical humanitarian aid organizations to routinely issue medical certificates that document violations of international humanitarian law. Its work in this area spans nearly three decades. Drawing on content analysis of published literature and interviews with experts and activists, I construct an historical case study of MSF’s work in post-rape medical care, the establishment of its Legal Department in the 1990s, and its directives to issue medical certificates to patients. Bringing together approaches in medical sociology, sociolegal studies, gender and sexuality studies, and science and technology studies (STS), I examine how medical-legal documentation of injury is potentially transforming the crisis logics of humanitarian response to include new, if unsettled, expectations that aid workers will provide legally admissible evidence of harm.