A/HRC/42/44/Add.1 forcibly evicted from an informal settlement in San Ferdinando, Calabria, and in April, the informal settlement of Borgo Mezzanone was dismantled. Migrants housed in informal settlements regularly die in fires: in the tent city set up by the authorities of San Ferdinando, a young man from Senegal died in March 2019 and another man died in a fire in Borgo Mezzanone in April. 64. Secondly, informal settlements are practical for the caporali, as they are generally located close to the fields and they often recruit workers there. Thirdly, many workers cannot afford to rent an apartment while living on less than the minimum wage. 65. Seasonality as such should not necessarily prevent migrant workers from gaining access to decent housing, although seasonality is often used as an explanation for not putting in place more permanent housing structures. 66. Serious racial discrimination, particularly against migrants from sub-Saharan Africa, also prevents workers from getting access to decent housing. They live in abysmal conditions in informal settlements that are geographically isolated, creating a troubling segregation between them and the local population. In the informal settlements visited by the Special Rapporteur, migrant workers were living in hazardous makeshift shelters with no electricity, water, waste removal or sanitation facilities and had no social protection. The settlements are reportedly controlled by organized crime networks, owing to a complete absence of State authorities. In most such settlements, the majority are young men and about 10 per cent are women who engage in prostitution – a business which is also controlled by criminal groups. 67. Regardless of their status, migrants are entitled to public health care under article 32 of the Constitution. In practice, however, accessing health care is often difficult for migrants, owing to a number of issues, including administrative barriers, overly bureaucratic procedures, a lack of information or marginalization and precarious living conditions. A “sanitary card” is needed to obtain medical assistance but a local residence is required to obtain one, which is difficult for many workers, particularly those working on a seasonal basis. Without a sanitary card, even migrants with a regular residence permit can get access to health services only in an emergency. 68. Laws and regulations concerning the attribution of a local residence permit and exemption from payment for medicines and examinations are not correctly implemented by the local health authorities in many cases. Practices can vary by region and by city, thus arbitrarily excluding many migrants from the regular health-care system. 69. The precarious living and working conditions have a significant impact on the physical and mental health of migrant workers, as they face a continuous battle for survival. Furthermore, the presence of large informal settlements and the conditions found there risk fuelling social tensions, which may increase racism and xenophobia. Incidents such as the killing of the Malian migrant worker, Soumaila Sacko, in Rosarno, Calabria, in June 2018 and the alleged use of air rifles to shoot Indian workers in Latina could escalate unless attention is paid to addressing social integration and ending the impunity of perpetrators. 70. In places such as Latina, migrants live in ordinary houses within the local community, but they remain marginalized and discriminated against, often by being charged excessive amounts of rent for their housing. Connection between migration status and vulnerability to labour exploitation 71. During her visit, the Special Rapporteur witnessed migration policies having a direct impact on the vulnerability of migrants to exploitation, forced labour and slavery. 72. Labour exploitation is a long-standing issue in Italy, regardless of migration flows. In agriculture, however, the numbers of migrant workers employed have increased, while entry permits have been drastically reduced over the last decade. Currently, about one third of the estimated 1 million agricultural workers are migrants. The shortage in the number of available workers has increasingly been met by workers with regular residence permits from European Union and non-European Union countries, irregular migrants and asylum seekers. 11