Redressing Rape in War: A Medico-Legal Approach to Sexual Violence combines the author’s nuanced expertise in law and medicine to address a difficult subject without losing sight of the human realities at its heart. It cares as much as it is careful. It looks beyond shortcut descriptions of conflict-related sexual violence (CRSV) as “rape as a weapon of war”, beyond the victim/survivor dichotomy, and beyond financial compensation as the main form of reparation. It refuses simplification and sensationalism. It quietly manages to be at the same time victim-centred and rigorous, progressive and realistic, clear-eyed and powerful.

In that sense, Sunneva Gilmore’s book offers a major contribution to the growing body of literature on reparations for CRSV that has emerged over the past fifteen years, after a long period of silence.Footnote ¹ Sexual violence in conflict has become an important area of enquiry in the fields of both international criminal justice and transitional justice. Better recognition of its pervasive, endemic nature and the profound harm that it causes has led to debates about how to address it in post-conflict societies, notably through reparations. The need for more research – and less siloed research, Dr Gilmore would argue – on how to remedy the harm resulting from CRSV remains acute, and the negotiation, design and delivery of related reparations all face considerable challenges.

What sets Dr Gilmore’s work apart in this growing field stems from her profile as a researcher and author. She is a medical practitioner, with a background in sexual and reproductive health care, who chose to dedicate a PhD in law to the issue of reparations for CRSV. The title of her book says it all: her work seeks to build bridges between medical and legal approaches, with the ultimate aim of making reparations more effective remedies for victims. Rooted in this background, it is her deliberate and detailed understanding of the harm caused by CRSV that first stands out; then, it is her attention to the intricacies and ramifications of post-conflict reparation measures and their impact on victims.

On top of the author’s practitioner experience and previous engagement as an expert in reparations processes, the book draws on fieldwork conducted in Colombia, Peru and Uganda. These countries were selected to represent three societies at different stages of transiting out of armed conflict. Dr Gilmore carried out a series of semi-structured interviews with ninety-two persons, comprising victims of CRSV (including through victim-organized focus groups), transitional justice actors and health-care professionals. Quotes from these conversations punctuate the book, grounding its analysis in lived experiences. They also add an important long-term perspective – taking place long after the harm occurred, the interviews show its enduring consequences, and what reparations can and cannot achieve when they come after a long delay, as is usually the case. Dr Gilmore’s approach to data collection receives the same thoughtful treatment as the rest of the book. Her introductory chapter explains her interview methodology – including, importantly, her positioning as a researcher and not as a care providerFootnote ² – and offers a detailed account of the limits and problems of data collection on CRSV, beyond the expected under-reporting.

After the first introductory chapter, the book is divided into six substantive chapters. Chapter 2 makes a strong case for the medico-legal approach at the heart of the book, an approach meant “to dissect what counts as adequate and meaningful repair by aligning the articulation of harm with the articulated needs of survivors”.Footnote ³ It is deliberately transdisciplinary, at the intersection of law and medicine. As the author points out, reparations themselves have to be inherently interdisciplinary; both their design and delivery require perspectives beyond the legal field. Dr Gilmore consistently argues throughout for a larger role for medical professionals. This medico-legal approach also allows for a careful unpacking and articulation of concepts that can take on different meanings across the two fields, such as harm, quality of life, vulnerability or rehabilitation.

Harm, precisely, is the central focus of Chapter 3. Dr Gilmore takes great pains to detail the breadth of harm caused by CRSV, including largely overlooked injuries such as those caused to breasts or resulting from strangulation, and the connected psychological harms. She examines the feasibility and limitations of capturing and documenting the harm caused by CRSV through forensic medical examinations. The impact of mandatory reporting by health-care professionals is touched on as well, though quite briefly.

Stigma, and the strategies that victims adopt to mitigate its impact on their lives, is another key concern introduced early and reappearing throughout the book. The harm that stigma causes, so deeply woven into the lived experiences of CRSV victims, receives special attention – including an interesting analysis of stigma itself as a form of violence and power. A section is dedicated to pregnancy, and another to children. The young age at which many of those interviewed were victimized remains one of the most striking and disturbing threads running through the book.

Chapter 4 turns to the impact that these compounded harms have on the identity of victims – or should we rather say survivors? The question of how persons who have suffered CRSV should be identified is closely tied to their (self-)perception and to their experience of seeking justice and/or reparations. The debate has largely coalesced around the two imperfect terms presented above: “victim” and “survivor”. Dr Gilmore is very clear that this is not an abstract debate: the way a person is identified has very real consequences for their access to reparations. This is one reason why she ultimately favours the term “victim”, at least in her own writing.Footnote ⁴ But that identity carries its own risks – of stigmatization, of additional violence, of having to conform with a judicially defined category that constrains and excludes. Recognizing the absence of a one-size-fits-all answer, Dr Gilmore widens the frame to introduce a “patient” identity, aligned with her medico-legal approach and the importance of post-CRSV care.

It is after painting this layered picture of the impact of CRSV that the book comes, at the halfway point, to the history and typology of reparation measures. Chapter 5 defines reparations and their objectives, places reparations for CRSV within the broader context of transitional justice, and surveys the growing body of related jurisprudence and State practice, without forgetting related civil society initiatives. Two concepts are further scrutinized: gender-sensitive reparations and transformative reparations. Without discounting reparations aimed at profoundly changing institutions, Dr Gilmore’s research shows that more immediate, concrete measures (such as education or health-care interventions) often bring more direct benefits to victims.

The next two chapters delve further into what reparations can and cannot do for victims of CRSV, in line with the book’s wider aim. Chapter 6 presents the five main measures of reparations outlined in the 2005 United Nations Basic Principles and Guidelines on the Right to a Remedy and Reparation: restitution, compensation, rehabilitation, measures of satisfaction and guarantees of non-repetition. Dr Gilmore then examines the extent to which these have been deployed in the contexts covered by her fieldwork and can address the needs of victims. She gives particular attention to the two most common measures: compensation and rehabilitation. Unintended effects are also considered. Stigma rears its ugly head again, particularly around compensation, which victims may be chastised for accepting.

The discussion of rehabilitation is especially illuminating, as it draws on a medical definition that understands rehabilitation as a path towards a better quality of life, sense of self, and relation to one’s health and body.Footnote ⁵ The focus on the body is one of the distinctive contributions of the book’s medico-legal approach, one that might very well have received less attention in a more conventional book on CRSV reparations – even though the interviews show that it matters greatly to victims.

It is, then, quite fitting that the final substantive chapter, Chapter 7, introduces its two central concepts – vulnerability and resilience – through the following title: “Vulnerable Bodies: Resilience, Sexual Violence, and the Utility of Reparations”. Vulnerability is introduced as a way to help prioritize the allocation of reparations in post-conflict environments where resources are limited. But there is one recommendation the author immediately nuances: a vulnerability-informed reparation programme, she argues, should be careful to support the resilience, agency and capacity for self-repair that victims will have developed, and not to undermine them. And Dr Gilmore does not lose sight of the broader structural dimensions that create and sustain such vulnerabilities, and that well-designed reparations may also help alleviate, or at least not perpetuate.

Redressing Rape in War is a book that leaves readers with scenes that are difficult to forget, in colours the shades of a bruise: the purple armband given to victims of sexual violence in Colombia, or the blue eyebrows of a woman avoiding her reflection in the mirror. But most importantly, it leaves readers – whether they are health-care practitioners, lawyers, civil society actors or transitional justice officials – with carefully considered recommendations for how reparations can help remedy the harms of CRSV. For such a cautious and nuanced book, there is one conviction that it never doubts: health-care professionals need to be more closely involved with transitional justice processes for CRSV. The operationalization of the medico-legal approach defended in the book puts such professionals in a position of considerable responsibility, and logically, it is to them that some of the author’s concluding recommendations are directed, such as learning to combat stigma, to which they might themselves not be immune. In collaboration with transitional justice professionals, they are uniquely positioned to build a gender-sensitive, trauma-informed response that can work with and within a reparations framework, improving continuity of care and ultimately quality of life for victims and patients.