Sexual and gender-based violence in Myanmar and the gendered impact of its ethnic conflicts in English to sexual and reproductive health care.109 The Mission received reports of women who were raped during the “clearance operations” having to flee to Bangladesh without receiving medical assistance.110 59. The Mission spoke to Rohingya women and girls in the camps in Bangladesh who said receiving medical attention in the camps was a novelty. For most, it was the first time they had access to health facilities. 111 Many Rohingya women also expressed a high level of distrust in the medical care in Rakhine, when they could access it. A refugee recalled, “In our country, people usually don’t go to the hospital because of the high rate of killings of new born babies.”112 Another Rohingya woman from Maungdaw told the Mission that “people were always scared to go to the hospital because they are run by non-Rohingya.”113 Even when people needed to go to the hospital, they stayed home and bought medicine at the pharmacy instead.114 One woman told the Mission she only went for treatment at a clinic in Maungdaw because it was run by a Rohingya doctor.115 It is reported that most hospitals are staffed by non-Rohingya, increasing the level of distrust.116 60. Unsafe abortions are a significant cause of maternal mortality among Rohingya women. Unsafe abortions are reported to be the cause of 15 per cent of all maternal deaths in Rakhine State, compared to the national average of 10 per cent of maternal deaths. 117 Abortion is prohibited under Myanmar’s domestic law, even in cases of rape, except to save the life of the woman.118 Women and girls in northern Myanmar 61. Similar to Rohingya women and girls in Rakhine, ethnic women and girls in Kachin and Shan States119 face many types of gender discrimination, intersecting with other factors such as ethnicity, religion, displacement, poverty, education and health. These factors disproportionately exacerbate their vulnerability during conflict. 62. Decades of protracted armed conflict in Kachin and Shan States, resulting in prolonged displacement, new displacement and repeated displacement, renewed outbreaks of violence and increasingly restricted humanitarian access, have compounded marginalization and vulnerabilities across ethnic communities, especially for women and girls.120 Around 40 per cent of the displaced people in Kachin are located in areas beyond 109 110 111 112 113 114 115 116 117 118 119 120 16 DI-038, DI-002, DI-013, CI-089, DI-013, CI-082. See also, Doctors without borders “Rohingya refugees: Still searching for safety ”( July 31, 2018). UNFPA, Population Council. “Marriage and sexual and reproductive health of Rohingya adolescents and youth in Bangladesh; a qualitative study.” (October 2018), p. 8, 9. EI-074, EI-081, EI-083, EI-090. DI-006, DI-053, NI-014, NI-021, NM-001.The Mission heard from stakeholders that there is improvement on health issues after awareness campaigns launched camps to improve the health of refugees. Trained Rohingya refugees raise awareness on basic health issues such as hygiene for babies and mothers, prenatal care, they refer serious cases to medical staff. DI-053. DI-054. DI-054. DI-009. DI-001, DI-004, CI-073, DI-006, DI-004, DI-009, DI-053, DI-054. Gender Profile for Humanitarian Action, and across the Humanitarian-Peace-Development Nexus (Rakhine, Kachin and Northern Shan Myanmar) p.5. January 2019. The Penal Code of Myanmar, articles 312-316. The peoples of Shan State include the Shan, Pa-O, Intha, Lahu, Lisu, Taungyo, Danu, Ta’ang, Ahka and Jinghpaw (Kachin), Shan-Chinese (Han), Shan-Ni and Kokang. The peoples of Kachin State include the Jinghpaw, Shan, Ruwang, Lisu, Zaiwa, Lawngwaw, Lachyit, Rakhine and Bamar. Many of the ethnic minority groups have substantial numbers of Christians among their members. Some groups are predominantly Christian. Gender Profile for Humanitarian Action, and across the Humanitarian-Peace-Development Nexus (Rakhine, Kachin and Northern Shan Myanmar) January 2019.