A/HRC/41/47 67. By the same token, responses to the question about protection by work legislation during treatment in the case of physical impairments and disability evinced a low awareness of rights, with 31.6 per cent affirmative answers, 30 per cent negative replies, and as many as 38.4 per cent of responders affirming that they did not know. Concomitantly, the same question applied to mothers of children affected by leprosy, asking whether work legislation allows them to care for their children affected by leprosy during treatment, received 29.4 per cent positive replies and 29.4 per cent negative answers, while 41.2 per cent did not know the answer. 68. In turn, when asked if women affected by leprosy-related disabilities have access to social security benefits, 56.4 per cent of the respondents replied yes, 25.7 per cent no and 17.9 per cent did not know, which is an encouraging indicator. However, the question on which impairments are recognized by State policies and administrations as disability highlighted a knowledge gap and low awareness of leprosy’s characteristics among State policymakers and workers that fails to acknowledge non-visible physical impairments as falling under the umbrella of disability rights. 69. With regard to social protection of children affected by leprosy, the responses to the question whether there are any measures in place for protecting the rights of children affected by leprosy-related disabilities were mainly “don’t know”. Accordingly, the responses to the question on the existence of measures in place to ensure that children affected by leprosy-related disabilities can proceed with their studies with reasonable accommodation evinced low awareness of rights as well as deficient access to enshrined international human rights, with 35.6 per cent of the responses being affirmative, 34.5 per cent negative and 29.9 per cent answering “don’t know”. 70. With respect to health care, the majority of responses pointed to the existence of a health system in place that provides medical care for leprosy. The main gaps, according to the responses received, occur due to the inability of the system to address extra-institutional barriers to the right to the highest attainable standard of health and also to provide complementary care, especially after bacteriological cure. Many responses also pointed to practices of medical pluralism and ongoing recourse to traditional healers to treat leprosy with religious healing and exorcising, among other practices. When asked to choose from among several barriers to access to health services, those most frequently chosen were the lack of health facilities near the home and lack of financial resources. 71. Finally, participation was also assessed, and collected data point to very low participation of women affected by leprosy, and even less by children affected by leprosy, in health services and settings, outreach activities, organizations of persons affected by leprosy and NGOs, as well as in the design, target-setting, prioritization, delivery or monitoring of local/regional/national planning for leprosy. 72. Lack of access by persons affected by leprosy and their family members to substantive equality is a result of the structural violence imposed upon this group that keeps the group enclosed in a spiral of disadvantage. Structural violence reflects the systematic restrictions that impair people who occupy the bottom rungs of society from meeting their basic needs and that may even cause harm in a way that leads to deprivation and denial of fundamental human rights. This is even more the case of women and children affected by leprosy who, due to the intersection of leprosy with gender and age, experience widespread and systemic structural violence. the right to the highest attainable standard of health of the Committee on Economic, Social and Cultural Rights. 13