International law obliges states to properly investigate all allegations of torture and to punish those responsible. States also need to provide reparations for victims of torture, including fair and adequate compensation, restitution and rehabilitation to the fullest extent possible.

Yet, torture often takes place in secret, and many torture methods are designed to be as painful as possible without leaving physical marks.

A key purpose of documentation is thus to make it impossible for perpetrators to deny their crimes.

One of the major challenges in proving torture, and thus fighting impunity is to obtain sufficient evidence in cases against alleged perpetrators. If there is no proof that torture took place, a climate of impunity can come to exist. In such a climate, perpetrators can continue to torture without risking arrest, prosecution or punishment. The perpetrators need not fear that they will have to face justice systems because of their crimes.

However, through the use of documentation, torture can be proved. Specialised health professionals can, through a careful and thorough examination of physical and psychological sequelae, establish crucial medical findings and evidence that can be communicated to the judiciary and other appropriate bodies.

Where documentation is carried out, it puts pressure on states to fulfill their obligations under international law to fully, promptly, impartially and thoroughly investigate allegations of torture and provide reparation to victims.

However, often the required forensic expertise1 is not available to produce medico-legal reports of sufficient quality or the reports are not taken into account in legal proceedings due to flawed regulations or practice. Other constraints relate to limited awareness among relevant stakeholders, especially at the national level, on the important role that medical documentation can play in establishing evidence, and the frequent intimidation and harassment of victims and professionals involved in trials against alleged perpetrators.

For this reason, the IRCT has, for a number of years, worked to promote the value and use of medical documentation of torture according to the international standards contained in the Istanbul Protocol, the common name for The Manual on the Effective Investigation and Documentation of Torture and Other Cruel, Inhuman and Degrading Treatment or Punishment.

In 2009, the IRCT Secretariat, in collaboration with the Forensic Department of the University of Copenhagen, set up an international focal point for forensic expertise. More than 30 eminent forensic experts from 18 countries have to-date joined the group, who provide support in examining torture victims in cases at the international, regional or national level to establish best practice examples.

Through this International Forensic Experts Group (IFEG), the IRCT has to-date provided support to more than 70 forensic examinations in torture investigations cases. Hundreds of lawyers, doctors and immigration officials, among others, have received training in the use of the Istanbul Protocol to produce medico-legal documentation of torture for use in judicial and administrative systems.

All of this work helps ensure that torture survivors gain access to appropriate medical documentation.