Forensic medical researchers at iMMO are seeing Laila*, a 32-year-old woman from Eritrea. She claims to have been raped on numerous occasions. The IND has repeatedly denied requests for additional medical examination. In addition to scars, iMMO identifies numerous physical and psychological symptoms. Based on a comprehensive personal assessment, it is concluded that this combination of symptoms has prevented Laila from explaining the reasons for her flight. In the subsequent legal proceedings, the court qualified its decision from April 2025.

During her military service, Laila is subjected to frequent physical punishment by her commanding officers because she is physically not strong enought to carry out her orders. She is transferred to a civilian post to complete her military service. There, she is sexually abused by her supervisor for years. She flees and seeks international protection in the Netherlands.

What is striking about Laila’s case is that no medical examination or assessment took place prior to the initial application and first hearing, and that there are many indications of underlying medical issues. It is not until the follow-up hearing that a medical examination is conducted and a medical assessment is issued. The assessment only mentions limitations regarding “recalling exact dates.” The recommendation is to give Laila more time. It also mentions “headache complaints,” for which the advice is “Take extra breaks if necessary.” The medical examination form lists only a few medical complaints, namely: intrusive memories and mood swings. However, the hearing officer cannot view this form.

When iMMO reviews the case file, it quickly becomes clear that Laila already had medical symptoms during the initial hearing that affect her ability to testify. For example, it can be determined that Laila is unable to distinguish between questions, which leads to inconsistent answers. In addition, during the initial hearing, Laila repeatedly expressed emotionally that she “doesn’t know.” During the follow-up hearing, the immigration officer noted that she was speaking in an increasingly soft voice and became emotionally distressed on several occasions while giving her statement. In the supplementary hearing, all of the aforementioned medical symptoms were evident. Laila was overwhelmed during all of the hearings.

Although the attorney expresses concern about Laila’s medical condition and requests a medical examination on several occasions during the proceedings, the IND does not grant these requests. The attorney requests a forensic medical examination from iMMO.

Within this assessment, the observations can objectively document the nonverbal signs Laila exhibits regarding her distress and medical issues. Shame related to trauma and an inability to maintain chronological order in her narrative are repeatedly documented. A dissociative reaction is also observed.

During the physical examination at iMMO, several scars were found that, in accordance with the Istanbul Protocol, were assessed as consistent and highly consistent. The combination of gynecological symptoms, bladder symptoms, abdominal pain, and sexual symptoms was assessed as highly consistent with the alleged abuse.

The psychological evaluation indicates that the individual in question exhibits symptoms of PTSD, as well as associated anxiety and depressive symptoms, psychosomatic symptoms, and cognitive difficulties. There are feelings of worthlessness and shame, accompanied by a strong tendency to avoid certain situations. These psychological issues are considered typical of the violence described in the account.

Question B is answered based on the review of the case file, the medical history, psychodiagnostic questionnaires, the physical examination, and the observations made during the two days of the evaluation. Based on this comprehensive analysis, it is concluded that the symptoms certainly interfered with the ability to provide a statement.

Read here for the legal follow-up

(* Names are fictitious)