A/68/297 A. Marginalized communities 38. Communities excluded from social, political and economic institutions are often marginalized and inhabit areas marked by weak infrastructure and poor governance, such as urban slums, ghettos and border areas. The impact of conflict may further devastate underlying determinants, such as food and housing, and disproportionately increase the vulnerability of marginalized communities to ill-health. This vulnerability is heightened during conflict when health resources are inappropriately and inequitably distributed prior to and after conflict. 39. Unaffordable health-care services, high taxes and confiscation of essential supplies by parties to the conflict increase the vulnerability of marginalized communities. 46 Accessibility may further be hindered due to lack of linguistic and culturally appropriate health services and information. Failure to recognize the different needs of marginalized communities may deter them from accessing health care, as well as contribute to a profound sense of isolation and disempowerment. 40. The health needs of certain groups are often overlooked in conflict due to limited or suspended services. Older persons are more at risk in conflict due to poor mobility and are less able to travel to health facilities. They may be unable to carry heavy packages of food or containers of water, and often live without family support, which renders them vulnerable to higher levels of malnutrition and disease. 47 Similarly, persons with disabilities, often abandoned by families fleeing conflict, may face greater health and safety risks. 48 Many facilities are unable to provide children with disabilities with the treatment and care suited to their physical developmental needs, hampering their ability to enjoy their right to health. 49 B. Displaced communities 41. Conflicts often result in displacement of people, within States and across borders. Displaced persons may be deprived of the same rights and underlying determinants as host communities. 50 A large number of displaced persons may be forced to migrate to relief camps that are characterized by dilapidated and overcrowded conditions where basic services are inadequate, contributing to the spread of communicable diseases. Displaced persons may also be forced to migrate to urban slums, which renders them susceptible to vulnerabilities arising not only from a lack of capacity and resources, but also from the unwillingness of the State to address their needs. 42. Moreover, displaced persons are particularly vulnerable when their legal status prevents them from accessing health facilities, goods and services and availing __________________ 46 47 48 49 50 13-42297 Minority Rights Group (MRG), Uganda: The Marginalization of Minorities (London, MRG International, 2001), p. 17. Unni Karunakara and others, “Ending neglect of older people in the response to humanitarian emergencies”, PLOS Medicine, vol. 9, No. 12 (December 2012), pp. 1-3. HRW, As If We Weren’t Human: Discrimination and Violence against Women with Disabilities in Northern Uganda (New York, 2010), p. 29. Tami Tamashiro, “Impact of conflict on children’s health and disability”, paper commissioned for the Education for All Global Monitoring Report 2011, The Hidden Crisis: Armed Conflict and Education (Paris, United Nations Educational, Scientific and Cultural Organization, 2011). IRC, “Syria: a regional crisis”, 2013, p. 12. 13/24