The Review has chosen to open this issue with the voices of those who have suffered sexual violence and have been overcoming the multiple ensuing challenges. All have benefited from health care, psychological, psychosocial or material support and/or legal advice provided by the ICRC, the relevant National Red Cross Society or local partners – the non-governmental organization Profamilia in Colombia and the “maisons d’écoute” in the Kivus, the Democratic Republic of the Congo. The testimonies below reflect real, personal – sometimes very intimate – stories of persons who have agreed to share their experience, their trauma, the difficulties they and their loved ones have been facing, the way they have worked to overcome them, as well as their hopes for the future. In order to protect them and their relatives, their testimonies have been anonymized and references to specific locations deleted.

In 2014, the International Committee of the Red Cross (ICRC) undertook a four-year commitment to consolidating and expanding its efforts to address sexual violence in armed conflicts and other situations of violence. In this Q&A, ICRC President Peter Maurer reflects on the complex nature of sexual violence and on some of the specific challenges involved, including identifying victims and assessing and adequately responding to their needs. He emphasizes the need for a proactive, multidisciplinary approach comprised of assistance, protection and prevention efforts, and explains how the ICRC intends to step up its efforts to better respond to and prevent sexual violence in the coming years.

Scholars increasingly document different forms of conflict-related sexual violence, their distinct causes, and their sharply varying deployment by armed organizations. In this paper, I first summarize recent research on this variation, emphasizing findings that contradict or complicate popular beliefs. I then discuss distinct interpretations of the claim that such violence is part of a continuum of violence between peace and war. After analyzing recent research on the internal dynamics of armed organizations, I suggest that widespread rape often occurs as a practice rather than as a strategy. Finally, I advance some principles to guide policy in light of recent research.

Dr Raed Aburabi has been working for the International Committee of the Red Cross (ICRC) for twenty years. He is currently in charge of the health in detention unit at the ICRC's Headquarters in Geneva. As part of his work, he visits countries in which the ICRC operates in order to develop a dialogue with the detaining authorities on improving health services and conditions in places of detention.

Increasing acknowledgement in some quarters that women and girls are not the only victims of sexual violence, and that sexual violence is not the only form of gender-based violence (GBV), has yet to be adequately reflected in policy and practice in the humanitarian world.

Sexual violence is prevalent in contemporary armed conflicts. International humanitarian law and human rights law absolutely prohibit all forms of sexual violence at all times and against anyone; international criminal law moreover provides for the individual criminal responsibility of sexual crimes' perpetrators. These three bodies of law importantly reinforce each other in this field. The discrepancy between the facts on the ground and the law is a matter of concern that cannot be explained by potential legal gaps or uncertainties. What is needed is to find new ways of improving implementation for existing laws at the domestic and international levels.

From 2011 to 2014, the Human Rights Center at the UC Berkeley School of Law conducted qualitative research in Kenya, Liberia, Sierra Leone and Uganda to identify accountability mechanisms and challenges related to sexual violence committed during periods of conflict or political unrest. This article shares two aspects of that research: first, it presents key challenges related to the investigation, prosecution and adjudication of sexual violence committed during and after the periods of recent conflict. Second, it flags the emergence of specialized units tasked with investigating and prosecuting either sexual and gender-based violence or international crimes, noting the operational gap between these institutions. It notes that if not bridged, this gap may impede responses for the intersecting issue of sexual violence committed as an international crime. The article closes with recommendations for a more coordinated response and more accountability at the domestic level.

Sexual violence and rape in armed conflicts are widespread phenomena, with devastating consequences. Over the last thirty years, our understanding of these phenomena has significantly improved. Today humanitarian and health professionals understand better the reality, scale and impact of sexual violence on the personal, physical, social and mental health of individuals and communities. Rape is recognized to have a dehumanizing effect, as much as torture or mass violence. Major efforts are put into providing an effective and ethical response, with respect and sympathy to the survivors. Health and humanitarian assistance contribute to the healing and resilience of survivors and communities. Looking forward, programmes must be centred on the person, promoting their autonomy and dignity, and integrating medical, psychosocial and socio-economical responses.

During the past twelve months, the issue of sexual violence in conflict and emergencies has received an unprecedented amount of attention at the highest political and institutional levels. In 2013, the United Kingdom's Department for International Development (DFID) launched a Call to Action to mobilize donors, UN agencies, non-governmental organizations (NGOs) and other stakeholders on protecting women and girls in humanitarian emergencies, culminating in the high-level event “Protecting Girls and Women in Emergencies” in November 2013. As of August 2014, over forty partners (including governments, United Nations (UN) agencies and NGOs) had made commitments to the Call to Action. Furthermore, in June 2014 the “Global Summit to End Sexual Violence in Conflict”, co-chaired by the UK Foreign Secretary and Angelina Jolie, Special Envoy for the UN High Commissioner for Refugees (UNHCR), gathered 1,700 delegates and 129 country delegations. In his summary, the chair of the Global Summit states: “We must apply the lessons we have learned and move from condemnation to concrete action. We must all live up to the commitments we have made.”1 In September 2014, the United States organized a Call to Action event in New York during the UN General Assembly with the purpose of sharing progress on commitments made in November 2013. It thus seems that efforts to raise awareness about sexual violence in conflict and emergencies and advocate for a much stronger commitment to action are well under way. But is this enough? Is there enough evidence from lessons learned to allow us to increase and improve our response?

Over the past ten years, Médecins Sans Frontières (MSF) has provided medical care to almost 118,000 victims of sexual violence. Integrating related care into MSF general assistance to populations affected by crisis and conflicts has presented a considerable institutional struggle and continues to be a challenge. Tensions regarding the role of MSF in providing care to victims of sexual violence and when facing the multiple challenges inherent in dealing with this crime persist. An overview of MSF's experience and related reflection aims to share with the reader, on the one hand, the complexity of the issue, and on the other, the need to continue fighting for the provision of adequate medical care for victims of sexual violence, which despite the limitations is feasible.

Public understanding of humanitarian emergencies tends to focus on one story and one type of victim. Examples are manifold: amputees in Sierra Leone, victims of kidnapping in Colombia, or victims of chemical weapons in Syria. At times, the aid community, and the media in turn, seizes upon a particular injustice – landmines, female genital mutilation and child soldiers are examples from recent decades – and directs resources and attention its way. Similarly, thematic trends tend to dominate aid discourse, with funding proposals to donors replete with references to the framework du jour. In a related phenomenon highlighted by author and aid worker Fiona Terry, “[w]ords are commandeered to give a new gloss to familiar themes: ‘capacity building’ became ‘empowerment’, which has now become ‘resilience’”. In the Democratic Republic of the Congo (DRC), the conflict has been largely defined by sexual violence, and raped women are its most prominent victims.