A/HRC/44/46/Add.2 Federal Court in 2017, Federal Prosecutor’s Office vs. State of Amazonas Government, Institute of Artistic and National Heritage and the Federal Government.34 72. During her visit, the Special Rapporteur heard testimonies from these separated children, who are now adults deeply marked by a traumatic childhood. One of them told the Special Rapporteur, “I was taken away from my mother as a baby and they put me in the preventorium. There was a shoe store there, for the boys to learn something. When I was 7, the shoemaker said that I was a cute girl, so he would be my father. I was happy because I missed my parents a lot. The shoemaker then made me sit on his lap and started to grope my body. I felt uncomfortable, but he told me to be quiet and he made me smell shoe glue, which made me feel dizzy. He raped me. They toyed with my life.” These persons have received no reparation for the damages they suffered owing to the compulsory isolation of their biological parents and the abuse and violence they suffered within State facilities. 73. These separated children suffered abuses and violence from birth, which severely compromised their psychological, physical and social development. The State is thus fully responsible for their current situation as persons living with psychosocial disabilities and without access to a minimum standard of living. The Special Rapporteur calls upon the State to enforce guideline No. 4 of the principles and guidelines for the elimination of discrimination against persons affected by leprosy and their family members, and the Basic Principles and Guidelines on the Right to a Remedy and Reparation for Victims of Gross Violations of International Human Rights Law and Serious Violations of International Humanitarian Law. There is an urgent need for a complex reparation programme (see A/69/518) that encompasses material and symbolic reparations, guarantees of nonrecurrence, a memorialization process, and rights of access to information and rehabilitation, given the ageing of this population. VI. Conclusions and recommendations A. Conclusions 74. During the last decades of the twentieth century, Brazil led the way in the elimination of discrimination against persons affected by Hansen’s disease and their family members. Key for such a pioneering role has been the rights-based Constitution, the high level of expertise about Hansen’s disease among health researchers in the country, and a sturdy organization of persons affected by the disease, which attests to their resilience and civic engagement in public affairs. The Brazilian normative and institutional framework is qualified to protect, promote and fulfil the rights of persons affected by Hansen’s disease and their family members. Of particular relevance are laws that combat discriminatory language and compensate for past damage with a permanent and special measure based on material reparation. 75. Notwithstanding de jure equality, de facto discrimination endures in institutionalized practices and interpersonal social relations. Structural barriers act as powerful social determinants of the incidence of Hansen’s disease in the country, heightened by the regional and local autonomy in resource administration in this quasi-continental and highly diverse country. Mechanisms that can ensure accountability, accessible channels for addressing complaints to relevant authorities, effective access to justice and strengthening of already existing participatory collegiate bodies are key to ensure equitable access to health, social protection and interrelated rights. 76. Moreover, groups that are already in vulnerable situations are disproportionately affected by stigmatization on the grounds of Hansen’s disease. The Special Rapporteur identified gender, age and disability as categories that continue to intersect with discrimination related to Hansen’s disease, generating restrictions on the enjoyment of the rights to non-discrimination, equality, health, education, decent work, accessibility, reasonable accommodation and support, full inclusion and independent living in the community, and freedom from want and violence. Such 34 16 See www.mpf.mp.br/am/sala-de-imprensa/docs/acp-hanseniase.