A/HRC/40/CRP.1 These challenges are even more marked among displaced youth than among nondisplaced youth. IDP youth have lower levels of labour force participation than urban youth (32 percent as compared to 63 percent of non-displaced youth) in addition to lower levels of education participation.842 This results in higher levels of unemployment among IDP youth with one in four IDP youth not working, nor looking for work, nor in education. This is even more pronounced in relation to women (32 percent of female IDP youth are unemployed as compared to 16 percent of male IDP youth.). 843 5. The Right to Health The Child Act (2008) provides children with the right to health including the right to free basic health care, the provision of which is the responsibility of parents and the government. Children are entitled to free immunization, not to be subjected to discrimination in seeking medical treatment, and not to be deprived of treatment by reason of religious of other beliefs.844 Furthermore, the Transitional Constitution (2011) provides that all levels of government shall promote public health, establish, rehabilitate and develop basic medical and diagnostic institutions and provide free primary health care and emergency services for all citizens.845 Despite these legal guarantees, the availability of health services in South Sudan remains extremely constrained and women and children are among the worst affected by this shortage. Almost one in ten children in South Sudan dies before their fifth birthday, with 60 percent of these deaths occurring in the first year of life. 846 Most of these deaths are preventable with proper health care. In this regard, few children have had their full course of immunizations and as with the general population, access to health care is limited.847 The conflict has resulted in high levels of malnutrition across the country, most acutely seen with respect to children. 848 Over 30 percent of South Sudanese children under the age of five are moderately or severely malnourished (stunted) and there is a Global Acute Malnutrition (GAM) rate of 23 percent and Severe Acute Malnutrition (SAM) rate of 10 percent.849 South Sudanese refugees outside the country also face malnutrition with Global Acute Malnutrition among children under five within acceptable levels (below 5 percent) only in the Central African Republic and reaching up to 19 percent of refugee children in Sudan.850 Children have also suffered high levels of trauma as a result of what they have seen and experienced in the course of the conflict. UNICEF estimates that 900,000 children in South Sudan suffer from psychological distress. 851 Over a quarter of adolescent girls reported considering ending their lives in the past 12 months852 and MSF reported that a number children have attempted to commit suicide in the Malakal PoC camp. 853 One woman told the Commission about how her adolescent son had been shot in the leg by SPLA soldiers during the fighting in Wau in 2017. He was taken to Juba by an NGO for treatment for six months but was so traumatized by the attack that he could no longer speak properly.854 She brought her son with her to meet the Commission. The Government has acknowledged in its National Disability and Inclusion Policy that “[d]espite a high prevalence of mental illnesses there are insufficient services and drugs, World Bank, “Impact of Conflict and Shocks on Poverty: South Sudan Poverty Assessment Survey 2017”, June 2018. World Bank, “Impact of Conflict and Shocks on Poverty: South Sudan Poverty Assessment Survey 2017”, June 2018. 844 Child Act (2008), section 15. 845 Transitional Constitution (2011), Article 31. 846 UNICEF, “South Sudan Health Briefing Note”, August 2018. 847 See above Health section (Section IV(B)(4)); WHO, “Amid insecurity, WHO scaling up routine immunization coverage in South Sudan”, 22 February 2018. 848 Republic of South Sudan, Community Management of Acute Malnutrition CMAM Guidelines, December 2017. 849 UNDP, Human Development Indicators, 2018, http://hdr.undp.org/en/countries/profiles/SSD; Republic of South Sudan, Community Management of Acute Malnutrition CMAM Guidelines, December 2017. 850 UNHCR, South Sudan Regional RRP 2018 Mid-Year Report, June 2018. 851 UNICEF, Childhood under Attack: The Staggering Impact of South Sudan’s Crisis on Children, December 2017. 852 Plan International, “Adolescent Girls in Crisis: Voices from South Sudan”, 2018. 853 MSF, “A mental health legacy that haunts the Malakal Protection of Civilians site”, 19 April 2018. 854 Focus group meeting, Wau PoC, 21 August 2018. 842 843 112