45 210. Likewise, the Istanbul Protocol states that the most significant component of a medical evaluation may be the examiner’s assessment of the background information and demeanor of the 204 individual, bearing in mind the cultural context of the woman’s experience. 211. Although these United Nations parameters were published after the acts of torture that have been established in the case at hand, the IACHR notes that the medical reports produced on April 18, 19, and 21, and on May 18, 1993, and the psychological report dated April 26 of that year, lack such essential details as the symptoms reported by Gladys Carol Espinoza during the examinations, her version of how the injuries to her body occurred, and the exact time at which the examinations were carried out (with the exception of the report dated April 18, 1993). The IACHR highlights the fact that the evaluations of April 18 and 21, 1993, and the psychological report of April 26, 1993, were prepared by officers of the National Police of Peru, when the victim was in the custody of agents belonging to the same institution. It also highlights the fact that the psychological report of April 26, 1993, is signed by professionals assigned to a psycho-social section of the DINCOTE, the same police force that had been holding Gladys Carol Espinoza since April 19, 1993, and whose members had been accused by the victim’s next-of-kin. 212. The IACHR also notes that those medical examinations were not aimed at establishing the possible causes of the bodily injuries found on the victim, and that the reports of the April 19 and May 18 examinations do not even contain conclusions or a diagnosis. Although the superficial nature of those examinations prevented more detailed information from being obtained, the descriptions of bruising, hematomas, traumatic brain/skull injury, and recent tearing of the anus provide sufficient elements for the Peruvian authorities to have begun an ex officio criminal investigation. 213. On April 26 and 28, 1993, Mrs. Teodora Gonzales Vda. de Espinoza and the APRODEH organization filed complaints informing the 14th Special Prosecutor’s Office for Terrorism, Supreme Criminal Prosecutor in charge of the special prosecutions unit of the Office of the People’s Defender, and 205 the Attorney General that the victim was being tortured at a DINCOTE facility. During interviews with the expert Carmen Wurst de Landázuri, Gladys Carol Espinoza reported having been visited by two 206 agents of the Public Prosecution Service while she was at the DINCOTE. In spite of these complaints, and of the visit made by representatives of the Public Prosecution Service when Gladys Carol Espinoza was showing visible signs of aggression on her body, the Peruvian authorities did not order the launch of a criminal investigation to examine the facts. 214. In connection with the acts of torture carried out at Yanamayo Prison on August 5, 1999, nineteen days after the incident a surgeon from the National Penitentiary Institute examined Gladys Carol 207 Espinoza and recorded the following diagnosis: “Clinically healthy.” That examination contradicts the conclusions of the report published by the Office of the People’s Defender of Peru on August 25, 1999, which described a series of wounds to sensitive parts of Gladys Carol Espinoza’s body and recommended a criminal investigation be opened against the police officers responsible. 215. The Peruvian State argues that no investigations were opened into the violent acts suffered by Gladys Carol Espinoza on account of the absence of reliable proof to back up the claims. It thus stated that “had reasonable indications of a possible violation […] of humane treatment been 204 United Nations, Manual on Effective Investigation and Documentation of Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (Istanbul Protocol), 2001, para. 227. 205 Annex 16 (a): Complaint filed by Mrs. Teodora Gonzales Vda. de Espinoza with the 14th Special Prosecutor’s Office for Terrorism, stamped received on April 26, 1993; (b) Complaint filed by the APRODEH organization with the Supreme Criminal Prosecutor in charge of the special prosecutions unit of the Office of the People’s Defender, stamped received on April 28 1993; (c) Complaint filed by the APRODEH organization with the Attorney General, stamped received on April 28 1993. 206 Annex 17: Psychological report by Dr. Carmen Wurst Calle de Landázuri of October 8, 2008, based on interviews with Gladys Carol Espinoza at Chorrillos Women’s Maximum Security Prison, p. 5; 207 Annex 24: Report No. 143-99-INPE/DRAP-EPY-MIN, August 24, 1999.