A/HRC/29/34 58. During his visit to Azerbaijan in May 2014,20 the Special Rapporteur highlighted the difficulties IDPs encountered in accessing health services due to limited availability and supplies in IDP communities. Limited access to reproductive health services was also raised. During his visit to Ukraine in September 2014,21 the Special Rapporteur learned that IDPs lacked access to essential medicines, which were not available free of charge. Those IDPs requiring urgent medical care or maternal health care and those with chronic health conditions are particularly vulnerable. Congested or cramped living conditions, poor hygiene and sanitation breed and spread diseases. The psychological impact of displacement and proximity to conflict often requires specialist care, rarely available to IDPs. Goal 4: Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all 59. For many children in displacement situations, exclusion from education can be a long-term problem. Particularly in less developed countries, lack of resources, buildings, teachers and education materials may all create barriers to education. Lack of documentation, including birth certificates, may be a factor in States in which students must demonstrate their citizenship or residence in a region to have access to services. Discrimination may also be a factor, with schools and local authorities being reluctant to accept displaced children from different ethnic, linguistic or religious groups. 60. Education also provides routine, normality, a protective function, support and information and can be an important step towards community integration in displacement locations. For IDPs, education may be a low priority in the face of survival needs. Children may contribute economically to displaced communities, which can be another barrier to their schooling. Internally displaced parents may exclude children from school in the belief that they will quickly return to their original homes, only for their displacement to become protracted. Parents may also hesitate to send their children to school in conflict zones which may be targeted for forced recruitment of children. 61. On his visit to Côte d’Ivoire in 2012,22 the Special Rapporteur noted that in some western regions, an estimated 140,000 children had missed out on their education in 2011, due to insecurity and the destruction and pillaging of school buildings. Education was also disrupted in the centre and east of the country, and in Abidjan. He stressed that urgent measures were needed to ensure that children, some of whom had seen their education repeatedly disrupted, were provided with support to resume their education and make up the years of lost schooling. Goal 5: Achieve gender equality and empower all women and girls 62. As women and mothers, poor and frequently from minorities, internally displaced women face multiple and intersectional challenges. Women are frequently separated from men in conflict-related displacement situations, sometimes permanently due to the death of men, or to men joining the armed conflict or being forced to flee the conflict without their families. Women also frequently have the primary responsibility of caring for children and the elderly and are less able to seek employment or income-generating activities. Despite these obstacles, internally displaced women frequently take on family and community leadership roles. 20 21 22 See A/HRC/29/34/Add.1. See A/HRC/29/34/Add.3. See A/HRC/23/44/Add.1, para. 61. 15