Aim: Emerging global networks of human rights activists, doctors, and nurses have advocated for increased collection of medical evidence in conflict-affected countries to corroborate allegations of sexual violence and facilitate prosecution in international and domestic courts. Such initiatives are part of broader shifts in human rights advocacy to document human rights violations using rigorous, standardized methodologies. In this paper, I consider three principal forms of medical evidence to document sexual violence and their use in these settings: the patient medical record, the medical certificate, and the sexual assault medical forensic exam (commonly known as the “rape kit”).

Methods: Combining archival research with interviews of activists, healthcare practitioners, lawyers, investigators, and other experts, I trace the collection and use of medical evidence to document mass rape since the establishment of the International Criminal Tribunals for Rwanda and the former Yugoslavia.

Results: The use of medical evidence collection techniques to document sexual violence during and shortly after armed conflict or mass violence against civilians is still relatively new and not well institutionalized. When available, medical evidence has been used to document patient disclosures, describe patterns of crime, prompt investigation, issue indictments, and provide context evidence to establish international crimes occurred.

Conclusions: Drawing on approaches in science and technology studies, law and society, and cultural sociology, I argue that medical evidence collection techniques represent an emerging humanitarian technology that may influence what comes to count as sexual violence, which crimes are deemed justiciable, and ultimately how events come to be remembered, within and beyond courts.


I would like to thank all those who generously agreed to be interviewed for this project. Steven Epstein, Carol A. Heimer, John Hagan, Ken Alder, Wendy Griswold, Terence Halliday, Helen Tilley, Amy J. Ross, Chandra Lekha Sriram, my 2013 SSRC DPDF cohort, and two anonymous reviewers provided invaluable feedback and suggestions. My colleagues at Northwestern University and the American Bar Foundation fostered ideas and pushed my thinking, especially Jessica Koski, Gemma Mangione, Diana Rodriguez Franco, Savina Balasubramanian, Nisa Goksel, Alka Menon, Jamie Rowen, Christopher Carroll, Talia Shiff, David Peterson, Daphne Demetry, Dawna Goens, Maureen Warren, and the participants in the Science in Human Culture Doctoral Colloquium, the Culture and Society Workshop, and the Legal Studies Program. Any errors or omissions are mine alone. This research was assisted by a fellowship from the Dissertation Proposal Development Fellowship Program of the Social Science Research Council with funds provided by the Andrew W. Mellon Foundation; the Science in Human Culture program at Northwestern University; the Presidential Fellowship at Northwestern University; the Partnership University Fund (through Northwestern University and Sciences Po); and the Center on Law and Globalization, a joint project of the American Bar Foundation and the University of Illinois College of Law.