A/HRC/12/24 page 11 28. In the European region, the United Nations Economic Commission for Europe Protocol on Water and Health (1999) provides for the protection of human health and well-being, and calls upon States parties to “pursue the aims of … sanitation for everyone within a framework of integrated water-management systems aimed at sustainable use of water resources, ambient water quality which does not endanger human health, and protection of water ecosystems”. 34 29. At the national level, sanitation has also been linked to the right to health. For example, the Constitution of Ecuador links sanitation and the right to health. In Costa Rica, the Constitutional Chamber recently held that the inundation of dwellings, due to the overcharge and lack of maintenance of the sewerage system, and the discharge of wastewater directly in rivers amounted to violations of the constitutional rights to health and to a safe and ecologically balanced environment.35 D. The right to education 30. Lack of access to sanitation can also have serious negative impacts on the enjoyment of the right to education. Each year, 443 million school days are lost due to sickness caused by poor water and sanitation conditions.36 Diseases caused by lack of access to sanitation and drinking water also affect students’ ability to learn. Furthermore, where schools do not have sanitation facilities, children’s exposure to disease is exacerbated, and they may not attend school; where toilets are not sex-segregated, girls often drop out of school, notably at the age of menstruation. 31. The Committee on the Rights of the Child has specifically referred to sanitation in educational settings in its general comment No. 4 (2003) on adolescent health and development, which states that “considering the importance of appropriate education for the current and future health and development of adolescents, as well as for their children, the Committee urges States parties … to … provide well-functioning school and recreational facilities which do not pose health risks to students, including water and sanitation …”37 That Committee has also regularly linked sanitation to education in its concluding observations.38 32. Furthermore, the Special Rapporteur on the right to education has recommended, with regard to school sanitation for girls, that States allocate resources to school infrastructure, 34 Art. 6, para. 1 (b) of the Protocol on Water and Health to the 1992 Convention on the Protection and Use of Transboundary Watercourses and International Lakes, London, (MP.WAT/2000/1. EUR/ICP/EHCO 020205/8Fin). 35 Sala Constitucional, decisions Nos. 11796 of 17 August 2007 and 17007 of 21 November 2007. 36 See the UNDP Human Development Report 2006, p. 6. 37 CRC/GC/2003/4, para. 17. 38 See e.g. CRC/C/TZA/CO/2 (Tanzania), para. 55; CRC/C/MHL/CO/2 (Marshall Islands), para. 62; and CRC/C/KEN/CO/2 (Kenya), para. 57.