A/HRC/42/21 were very afraid of being killed and nearly one third believed that they could be murdered within the next twelve months.51 27. In most States, these injuries occur in low-income, urban areas that already suffer from inadequate access to public health services. The added burden from high numbers of gunshot injuries further strains available health-care resources and degrades them over time, thereby entrenching the deprivation of these communities in a vicious cycle that negatively impacts their right to health. In Cape Town, South Africa, for example, firearm injuries are overburdening orthopaedic health-care resources, such as material consumables, physical beds and non-material labour. An average orthopaedic firearm wound case uses at least 5 per cent of the total available emergency theatre time per day, which various surgical disciplines must share.52 28. In underserved rural areas, firearm violence among civilians impacts the right to health by impeding access to health services and sources of water. In the North Rift region of Kenya, for example, where cattle rustling and generalized banditry by armed civilians is common, individuals are often unable to access the limited health-care services for any purpose. Many clinics and health facilities have closed altogether and vaccination programmes are unable to reach children. Moreover, very few qualified health professionals are willing to travel to and work in the North Rift region, due to insecurity. In addition, rural communities are often unable to access water sources, such as boreholes, because they are either inaccessible or have been destroyed as a result of insecurity. Water and irrigation projects are frequently abandoned or delayed due to ongoing firearm violence. 53 29. The right to education is the primary vehicle by which economically and socially marginalized adults and children can lift themselves out of poverty and obtain the means to participate fully in their communities. In this regard, education has a vital role in empowering women and girls, protecting children from exploitative and hazardous labour and sexual exploitation, promoting human rights and democracy, protecting the environment and controlling population growth. While the right to education entails progressive realization, States parties to the International Covenant on Economic, Social and Cultural Rights should take deliberate, concrete and targeted steps towards the full realization of this right.54 30. Civilian acquisition, possession and use of firearms can have a substantial impact on the right to education. In Latin America and the Caribbean, the use of firearms in schools and the threat thereof is a growing challenge to the security of children and educators, which results in reduced access to education. 55 In Rio de Janeiro, Brazil, for example, shootouts between rival gangs or between gangs and police forced the closure of between 20 and 30 schools or day care centres per day in 2017, resulting in 6,000 to 7,000 children being sent home per day.56 31. Armed cattle-raiding among civilians from pastoralist communities also has a negative impact on the right to education. Customarily, these cattle raids were carried out with traditional weapons, or none, keeping violence at low levels. However, increased access to small arms has made the raids more violent. Indeed, Kalashnikov-pattern assault rifles such as the AK-47 are now the weapon most commonly used by cattle raiders in East Africa and the Horn of Africa.57 The resulting upsurge in insecurity from cattle-raiding has worsened the provision of quality education in a number of countries, including, for 51 52 53 54 55 56 57 See the contribution of the Sur File on Firearms. C. Martin et al., “The burden of gunshot injuries on orthopaedic health-care resources in South Africa”, South African Medical Journal, vol. 107, No. 7 (July 2017). See the contribution of the Kenya National Commission on Human Rights. Committee on Economic, Social and Cultural Rights, general comment No. 13 (1999) on the right to education. United Nations Regional Centre for Peace, Disarmament and Development in Latin America and the Caribbean, “Preventing firearms proliferation and armed violence in educational centres of Latin America and the Caribbean”, working paper (2011), pp. 6–7. Associated Press, “Schools caught in crossfire in violent Rio de Janeiro slums”, 13 April 2017. Control Arms, “How to use the Arms Trade Treaty to address armed violence in pastoralist communities”, March 2017, pp. 3 and 6. 7