Sexual and gender-based violence in Myanmar and the gendered impact of its ethnic conflicts in English reduce intimate partner violence and psychosocial and emotional abuse in the refugee community, in part blamed on the lack of opportunities and frustrations in the community.481 B. Ethnic communities in northern Myanmar 221. The impact of sexual and gender-based violence reported to the Mission in Kachin and Shan States is severe, varied and long-lasting. The Mission recorded many women experiencing pain in the vagina and lower abdomen region during sexual intercourse after having been raped.482 It found a case of rape that resulted in death caused by contracting HIV.483 Survivors the Mission spoke to, suffer enduring physical and psychological injuries for which services and assistance are needed. Men who experienced sexual torture in detention also continue to suffer enduring physical and psychological injuries, including bleeding from the anus, loss of cognitive function, loss of emotional control, loss of erectile function and inability to work.484 222. In several cases, women did not have access to medical attention after rape. 485 In one case that the Mission verified, the survivor was treated in a military hospital. The military male-only medical personnel did not examine or treat her genital area.486 These cases demonstrate that a lack of specific medical expertise related to rape exacerbates the effects of sexual violence. Similarly, male survivors also said they had not sought medical assistance due to both the lack of availability and the stigma attached to reporting male rape in their communities and in Myanmar.487 223. Many women and girls who were subjected to sexual and gender-based violence have fled their native village or the country as a result of the ostracism by their communities and authorities.488 “Why didn’t he just kill me, I would rather die than be raped. I should not live with this kind of shame.”489 224. In male-dominated societies of northern Myanmar, women are often held responsible for sexual and gender-based violence inflicted on them.490 One survivor told the Mission that, after she was raped in 2016, she immediately fled Kachin State: “I heard that when women are raped, the victim is always pointed out and everyone knows she was raped. It is very bad in my culture.”491 225. In one case, the mother of a 14 year-old survivor raped by a Tatmadaw soldier in 2014 told the Mission that, after the rape, her daughter did not want to live in the village and fled to China. She said: “before the rape, my daughter was very active and helping the family. After the incident, she was different, she became introverted”.492 481 482 483 484 485 486 487 488 489 490 491 492 Nations Population Fund “One year on Rohingya women and girls seek safety and a chance to heal” (24 August 2018). NM-004, NI-018, United Nations Entity for Gender Equality and the Empowerment of Women,“Rohingya Crisis Response: Bolstering learning livelihoods and Community” (December 2018), p.4. PI-063, PI-068. PI-007. PI-052, PI-055, PI-056. PI-066, PI-067, PI-068, PI-069, QI-098, PI-166. PI-136. PI-052, PI-055, PI-056. PI-146, PI-144, PI-166. PI-136. Gender Profile for Humanitarian Action, and across the Humanitarian-Peace-Development Nexus (Rakhine, Kachin and Northern Shan Myanmar) January 2019. PI-146. PI-144. 51