A/HRC/23/41 centres, with a requirement that 51 per cent of governing board members be from the community.114 Domestic work 54. Women make up a significant proportion of the estimated 52.6 million migrant domestic workers worldwide.115 Domestic work provides economic and social independence for migrant women, accounting for 7.5 per cent of women‟s wage employment globally.116 It is, however, largely undervalued and confined to the hidden informal economy of the home, reinforcing gender disparities in accessing underlying determinants of health, including decent work conditions. 117 55. Discrimination and prejudice based on gender, ethnicity and socio-economic status intersect, causing chronic stress and making migrant domestic workers a highly vulnerable and marginalized group.118 Owing to their vulnerability, isolation and dependence, migrant domestic workers experience a range of violations 119 which negate their enjoyment of the right to health and its underlying determinants. Violations include food and sleep deprivation, denial of medical treatment, squalid living conditions, non-payment of wages, excessive work hours (increasing the risk of accidents) and psychological, physical and sexual abuse.120 Cardiovascular, endocrine, skin, musculoskeletal, and psychological conditions have also been documented among migrant domestic workers, with worst cases resulting in death, including suicide.121 56. Migrant domestic workers are frequently excluded or inadequately covered by the receiving State‟s labour laws and social protections, including health insurance. 122 Sponsorship systems, debt, language barriers, fear of arrest, detention or deportation and a lack of effective recourse for violations interact to varying degrees in different receiving States to facilitate the systematic exploitation and abuse of domestic workers. 123 The situation of some migrant domestic workers has even been described as “modern-day slavery”.124 In order to fulfil the right to health, States are obligated to address the particular 114 115 116 117 118 119 120 121 122 123 124 Candace Kugel and Edward Zuroweste, “The State of Health Care Services for Mobile Poor Populations: History, Current Status and Future Challenges”, Journal of Health Care for the Poor and Underserved, vol. 21, No. 2 (May 2010), pp. 421-429. ILO, Domestic workers across the world: Global and regional statistics and the extent of legal protection (2013), p. 39. Ibid., p. 2. CMW, general comment No. 1, paras. 25-26. E/CN.4/2004/76, para. 26; Maria Theresa Ujano-Batangan, Women and Migration: The Mental Health Nexus: A research on Individual and Structural Determinants of Stress and Mental Health Problems of Filipino Women Migrant Domestic Workers (Quezon City, ACHIEVE, 2011), p. 32. CMW, general comment No. 1, para. 7. E/CN.4/2004/76, paras. 25-35; A/HRC/14/30, para. 30; CARAM Asia, Reality Check: Rights & Legislation for Migrant Domestic Workers Across Asia (2011); ILO, “Decent work for domestic workers”, Report IV (1) (August 2010); HRW, Singapore - Maid to Order, pp. 35-36 (see footnote 62). Sevil Sönmez and others, “Human rights and health disparities”, p. 6 (see footnote 63); OHCHR, “Saudi Arabia: UN experts outraged at beheading of a Sri Lankan domestic worker”, Press release (11 January 2013), available from http://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=12922&LangID=E. ILO, Domestic workers across the world (see footnote 115); Committee on the Protection of the Rights of all Migrant Workers and Members of Their Families, general comment No. 1, paras. 18-24. CMW, general comment No. 1, para. 7. Sevil Sönmez and others, “Human rights and health disparities”, p. 3 (see footnote 63); Nisha Varia, ““Sweeping Changes?” A Review of Recent Reforms on Protections for Migrant Domestic Workers 17