A/HRC/39/CRP.2 procurement. Prohibited grounds of discrimination include race, colour, sex, language, religion, or social origin.1170 543. The right to health is to be progressively implemented. Yet, as a party to the ICESCR, CRC, CEDAW and CRPD, Myanmar has an immediate obligation, regardless of resources, to ensure access to health facilities, goods and services on a non-discriminatory basis, especially for vulnerable or marginalized groups. It must also ensure equitable distribution of all health facilities, goods and services.1171 544. The availability of functioning health facilities and services in Rakhine State for all communities is low, with an average of five health workers per 10,000 inhabitants. This is well below the national average of 16 health workers per 10,000 people, and the World Health Organization recommended minimum of 22.8 health workers per 10,000 people. 1172 The Mission notes that all communities in Rakhine State have inadequate access to healthcare, and that under-development and poor transportation make access to healthcare difficult for all, especially those living in remote areas. The Rohingya, however, face additional barriers due to travel restrictions, financial hurdles, cumbersome bureaucratic procedures, and overall discriminatory treatment.1173 Restrictions are often based on official policies and practices. Movement restrictions on access to health 545. Movement restrictions undermine Rohingya access to health services. The Rohingya and Kaman communities face arbitrary and highly cumbersome procedures to travel to hospitals. These are particularly harmful in the case of medical emergencies as they lead to late diagnosis and delays in life-saving treatment. They can result in preventable deaths. For example, one interviewee from northern Rakhine explained that it was easier to access medical treatment by travelling to Bangladesh than to nearby Sittwe hospital. 1174 Another stated: One of my relatives had to go to Yangon to get medical treatment. She tried to get the necessary papers to travel to Yangon but didn’t get them and died at the Sittwe hospital. If Rohingya have a minor sickness it is okay, but if the sickness is serious they can’t get proper treatment.1175 546. In central Rakhine State, the restrictions on freedom of movement imposed after the 2012 violence resulted in Rohingya and Kaman being denied access to their nearest hospitals and clinics. 547. One United Nations official shared an experience about attempts to engage with township authorities and Rakhine community leaders in central Rakhine. When the official tried to challenge township authorities about their failure to ensure that Rohingya could access emergency medical care, the response was that this was a policy matter that needed to be discussed at a higher level. Rakhine community leaders on the other hand justified this approach on various grounds, including the claims that Muslim communities “do not belong to Myanmar” and that their population “needs to be controlled”.1176 548. As a mitigating measure, humanitarian actors have put in place a medical emergency referral system for Rohingya and Kaman patients. This system usually requires a humanitarian actor to liaise with the Rakhine State Health Department to take patients to the Sittwe General Hospital. The process is cumbersome, bureaucratic and slow. The patient may then require hours of travel. 1177 To secure an emergency medical referral, a local township medical officer must first certify the need. The patient, supported by a humanitarian actor, 1170 1171 1172 1173 1174 1175 1176 1177 130 Ibid., paras. 18-19. Ibid., para. 43. Ministry of Health and Sports, Myanmar - 2015-2016 Demographic and Health Survey - Key Findings (2017). See also: Advisory Commission on Rakhine State, Towards a peaceful, fair and prosperous future for the people of Rakhine (August 2017), p. 42. DI-004. DI-013. DM-005. V-047.