A/HRC/44/48/Add.1 V. Environment 68. The right to the highest attainable standard of physical and mental health includes access to both medical care and the underlying determinants of health, such as safe water, adequate sanitation and a safe environment. In the same vein, article 14 of the Constitution of Ecuador guarantees the right to a healthy and ecologically balanced environment as an integral part of the right to health. However, throughout his visit the Special Rapporteur received numerous allegations and updated information regarding the impacts of the extractive and agricultural industries on the right to health. The Special Rapporteur was concerned about the threats made against human rights defenders who have raised their voices about these cases and will remain vigilant as to their situation. 69. The Special Rapporteur reviewed existing scientific evidence, received personal testimonies and consulted with experts, and was concerned about the high incidence of cancer cases and other diseases disproportionately affecting the populations living in the regions where agriculture and the extractive industries are situated. The examples he was given included the use of pesticides in the banana plantations in Esmeraldas, Santo Domingo, Los Ríos, Guayas, El Oro, Santa Elena and Bolivar; the persistent effects of the extractive industries in Sucumbíos and the risk of similar impacts in other regions as the oil and mining frontier expands; and the worrying situation of numerous Afro-Ecuadorian workers and their families who live and work inside the premises of the Furukawa abaca plantations. 70. The Special Rapporteur was informed that aerial spraying of highly toxic substances to control pests and diseases in large banana monocultures is carried out when workers are present in the hacienda and are thus exposed to the agrochemicals that are spread on the plantations. The particles from the agrochemicals, such as glyphosate and mancozeb, contaminate the air, as well as the water and soil that absorb the chemicals, and are then contained in different plants and products, many of which are for family consumption. Agroindustrial activities involving spraying highly toxic substances have been linked to certain diseases such as leukaemia and skin and stomach cancer, among others. 71. Similarly, pollution caused by extraction projects may also have very negative effects on the population living in the area. When visiting the province of Sucumbíos, the Special Rapporteur witnessed oil spills contaminating the soil and water, as well as several gas pipes (commonly known as mecheros) in populated areas. He was also informed about a register of cancer cases compiled by civil society to demonstrate the impact of the gas pipes on the health of the local population. 72. The Special Rapporteur recommends that the impacts of the extractive and agricultural industries on the right to health in specific areas of the country, where the population is exposed to dangerous chemicals and the water and soil where they live are polluted, be researched and investigated and policies developed to deal with them. 73. Finally, with regard to the Furukawa plantations, the Special Rapporteur had already expressed concern in a joint communication with other special procedure mandate holders that the practices of the Furukawa Company might constitute a system of servitude and forced labour prohibited by the international instruments ratified by Ecuador. 32 He also expressed concern about the physical and mental integrity of persons in particular situations of vulnerability, including children, adolescents, older adults and persons with disabilities as a result of occupational accidents. 33 During the visit, the Special Rapporteur received similar information indicating that those concerns continue to be relevant. He recommends taking the necessary measures to eliminate the exploitation of labour and forced labour at the Furukawa Company and ensure decent living conditions for the people living on the farms, including their access to food and basic services, such as water and sanitation, and non-interference in their access to health and education services. 32 33 16 Available from https://spcommreports.ohchr.org/TMResultsBase/DownLoadPublic CommunicationFile?gId=24480. Ibid.