A/HRC/42/47 54. It is widely recognized that water and sanitation are key determinants of health and that the human rights to water, sanitation and adequate health are intrinsically linked. Without appropriate facilities for the enjoyment of their rights to water and sanitation, people living and working in public spaces may be at greater risk of experiencing significant negative health outcomes.47 Poor accessibility of water and sanitation in public spaces can exacerbate pre-existing health problems, for instance where the poor design of facilities leads to persons with disabilities being physically injured when trying to use them. Where people lack access to water and sanitation in public spaces, they may also develop mental health problems, as an inability to ensure personal hygiene can lead to negative selfimage and people, particularly those who are homeless and lack alternative sanitation options, regarding themselves as intrinsically dirty. 48 Furthermore, a lack of adequate water and sanitation in public spaces has been shown to potentially affect the ability of those who live and work in public spaces to access health care. For example, a study in Brazil has documented cases where people who are homeless have been refused access to hospitals owing to their appearance, because they have been unable to access sanitation facilities in public spaces.49 55. The inadequate provision of water and sanitation in public spaces can equally impact the enjoyment of the right to work. The right to work applies to all people across every employment sector, including those working informally, and guarantees the rights, inter alia, not to be excluded from work opportunities and to just and favourable conditions of work, in particular to safe working conditions.50 The link between the right to work and the rights to water and sanitation is reflected in the obligations placed on States pursuant to their duty to ensure that everyone experiences just and favourable working conditions, which obviously also applies to people who work in public spaces. In satisfying those obligations, States are required to introduce policies which enable healthy working environments, including by ensuring that workers have access to safe drinking water and adequate sanitation facilities that also meet women’s specific hygiene needs.51 56. The link between a lack of water and sanitation in public spaces and the enjoyment of the right to work can also arise from the negative impact inadequate water and sanitation pose to the health of workers in public spaces, often meaning they have to take time off to recover. In the context of informal and self-employment, being unable to work inevitably leads to a complete loss of earnings over the period of convalescence. 52 Furthermore, a lack of adequate water and sanitation in public spaces may be to the detriment of the right to not be excluded from opportunities by decreasing the prospects of obtaining employment. For people who are homeless, in particular, a lack of places in which to maintain personal hygiene may degrade their appearance, which has been shown to make it more challenging to obtain employment.53 57. As shown throughout the present report, the failure of States to ensure the adequate provision of water and sanitation in public spaces has a particularly negative and often disproportionate impact on women and their enjoyment of a great number of their human rights. Accordingly, a lack of adequate water and sanitation in public spaces may infringe women’s right to non-discrimination. In order to meet their obligations under the Convention on the Elimination of All Forms of Discrimination against Women, States must take a number of steps, including ensuring that they and others do not engage in acts that 47 48 49 50 51 52 53 Ibid. See Christine DeMyers, Chloe Warpinski and Amber Wutich, “Urban water insecurity: a case study of homelessness in Phoenix, Arizona”. See Priscila Neves-Silva, Giselle Isabele Martins and Léo Heller, “‘We only have access as a favor, don’t we?’ The perception of homeless population on the human rights to water and sanitation”, Reports in Public Health, vol. 34, No. 3 (2018). See Committee on Economic, Social and Cultural Rights, general comment No. 23 (2016) on the right to just and favourable conditions of work. Ibid., para. 30. Divya Rajaraman, Sandra M. Travasso and S. Jody Heymann, “A qualitative study of access to sanitation amongst low-income working women in Bangalore, India”, Journal of Water, Sanitation and Hygiene for Development, vol. 3, No. 3 (September 2013). Inner City Law, “No place to go. An audit of the public toilet crisis in Skid Row” (June 2017). 15