A/HRC/31/35 have an obligation to ensure that all migrants have equal access to preventive, curative and palliative health services, regardless of their legal status and documentation. 38 33. In addition to basic access to health care, specific challenges to migrants’ right to health while in countries of transit include the management of chronic conditions, such as diabetes and cardiovascular disease, and addressing psychosocial and mental health problems. Many migrants undergo traumatic experiences relating to their journey, including imprisonment and physical and psychological violence, which necessitate mental health care.39 Without access to adequate services, migrants are likely to self-medicate or rely on informal medical interventions to address their health problems. 34. The specific health needs of migrant women and girls, particularly in relation to their sexual and reproductive health and rights, frequently remain unmet. Where medical services are provided to migrants in transit, they may not include consultations with gynaecologists or sexual and reproductive health services and specialized care for survivors of sexual violence. 2. Inadequate living conditions 35. In a report on sub-Saharan African migrants in transit in Morocco, it was noted that almost half of the medical problems diagnosed were diseases closely related to poor living conditions.40 While in transit, migrants may be compelled to live in precarious conditions, such as in forests, fields, abandoned houses, train stations or other public spaces, with no sanitary facilities and limited access to safe food and water sources. Improvements to those places are often prevented and access to homeless shelters may be denied. Migrants who manage to rent accommodation are often forced to live in crowded, unsanitary and unsafe conditions, because they are unable to rent accommodation legally or because they lack the financial means to do so. 36. The International Covenant on Economic, Social and Cultural Rights recognizes “the right of everyone to an adequate standard of living for himself and his family, including adequate food, clothing and housing, and to the continuous improvement of living conditions” (art. 11 (1)) and the Convention on the Rights of the Child recognizes the right of every child to a standard of living adequate for the child’s mental, spiritual, moral and social development (art. 27). States should adopt measures to prevent and sanction discrimination against all migrants that undermines their right to an adequate standard of living, and should avoid the marginalization and social exclusion of migrants in an irregular situation, including because of the location of their accommodation.41 38 39 40 41 10 See the Committee’s general comment No. 14 (2000) on the right to the highest attainable standard of health, para. 34. A survey of 1,102 men, women and youth who were receiving post-trafficking assistance services found that symptoms associated with depression were reported by 59.7 per cent of participants; symptoms associated with post-traumatic stress disorder were reported by 35.6 per cent of participants and 41.9 per cent met the symptom criteria for an anxiety disorder. See Cathy Zimmerman and others, Health and human trafficking in the Greater Mekong Subregion: Findings from a survey of men women and children in Thailand, Cambodia and Viet Nam (International Organization for Migration and London School of Hygiene and Tropical Medicine, 2014), p. 6. See Doctors Without Borders, Violence, Vulnerability and Migration: Trapped at the Gates of Europe (see footnote 32), p. 9. OHCHR, The Economic, Social and Cultural Rights of Migrants in an Irregular Situation (New York and Geneva, 2014), p. 78.