A/HRC/23/41 medical treatment. In cases of pregnancy, women may resort to risky illegal abortion to avoid deportation.62 Further, compulsory testing stigmatizes those who are deported based on positive test results. Detention and deportation 34. Receiving States frequently use the public health rationale to detain and deport migrant workers with specific health statuses, such as HIV, Hepatitis C or Hepatitis B. 63 In linking immigration policies with health status, the right to health requirements of confidentiality, counselling and referral are overlooked. 35. To qualify as a public health exception, restrictions must be: provided by law, strictly necessary, for the least possible duration, based on scientific evidence and the least restrictive alternative available. As there are less restrictive, non-custodial alternatives available to detention,64 isolation, rather than detention, must be supported by law and used only when necessary as a measure of last resort, especially in cases of communicable diseases.65 36. Detention centres are often overcrowded, lack basic standards of hygiene, nutritious food and water. They have been described as centres of abuse and violence against migrant workers.66 Long periods of detention and poor living conditions in detention centres facilitate the transmission of communicable diseases and can have a devastating effect on the mental health of migrant workers. 67 Health-care services in some detention centres are reportedly unavailable, difficult to access and of poor quality, which is particularly concerning for migrant workers detained due to health status. 68 Migrant workers living with HIV have faced stigmatization and harassment as a result of lack of confidentiality in detention.69 Where States persist with immigration detention, they should, at the minimum, provide detainees with adequate living conditions, consensual medical check-ups and make quality and confidential physical and mental health facilities available and accessible in a timely manner.70 62 63 64 65 66 67 68 69 70 Human Rights Watch (HRW), Singapore - Maid to Order: Ending Abuses against Migrant Domestic Workers in Singapore, vol. 17, No. 10 (C) (December 2005), p. 92. Sevil Sönmez and others, “Human rights and health disparities for migrant workers in the UAE”, Health and Human Rights, vol. 13, No. 2 (2011); UNAIDS, The impact of HIV-related restrictions on entry, stay and residence: an annotated bibliography (2009), p. 5. A/HRC/13/30, paras. 52-61; Inter-American Court of Human Rights, Vélez Loor v. Panama, judgement of 23 November 2010; A/HRC/20/24, p. 4. WHO, “Guidance on human rights and involuntary detention for XDR-TB control” (2007). International Federation for Human Rights and Suara Rakyat Malaysia, “Undocumented migrants and refugees in Malaysia: Raids, Detention and Discrimination, No. 489/2 (March 2008); HRW, Ukraine - On the Margins: Rights Violations against Migrants and Asylum Seekers at the New Eastern Border of the European Union (November 2005). A/HRC/14/20/Add.4, para. 92; Cathy Zimmerman, Ligia Kiss and Mazeda Hossain, “Migration and Health: A Framework for 21st Century Policy-Making”, PLOS Medicine, vol. 8, No. 5 (May 2011), pp.1-6. HRW, Discrimination, Denial and Deportation, Human Rights Abuses Affecting Migrants Living with HIV, (June 2009). HRW, United States - Chronic Indifference: HIV/AIDS Services for Immigrants Detained by the United States vol. 19, No. 5 (G) (December 2007). General Assembly resolution 43/173, annex, principles 24-25. 11