A/HRC/26/53 25. Although there is still a shortage of information regarding the scale of the violent acts committed against women and girls since the beginning of the crisis, various international and local organizations have identified rape and other forms of sexual violence as the most prevalent of these acts, which are committed by both ex-Seleka and anti-Balaka. The organizations stress that women and girls are particularly vulnerable, and have suffered rape, abduction, sexual slavery and other forms of gender-based violence. In December 2013, medical sources at the Castor hospital in Bangui informed the mission deployed by the Office of the United Nations High Commissioner for Human Rights that they had treated more than nine victims of rape committed by armed groups since 5 December 2013; they added that the actual number of victims was higher. The mission has also received other reports from medical sources and from NGOs indicating that, since December 2013, a clinic in Bossangoa has treated five or six women victims of rape each month. The reports indicate that the actual number of cases is far higher. For safety reasons, many victims have moved and have been unable to access medical care, psychological support and other vital services. Others are reluctant to come forward for fear of reprisals. The situation is particularly serious in the interior of the country where victims have almost no access to health care and basic assistance. Many cases are not reported and the true extent of sexual violence in the Central African Republic is not clear. The scale of this serious crime committed against women and girls must be assessed as a matter of urgency and appropriate measures taken to help the victims and punish the perpetrators. B. Economic, social and cultural rights 26. During her first visit, the Independent Expert found that the education system has not been spared. As they advanced towards Bangui, the ex-Seleka occupied and looted all schools along the way. This is a violation of the right to education, given that the majority of schools were forced to close for several months as a result. During her second visit, she noted that some schools had reopened, at least in Bangui and Bangassou, although the majority of State schools in Bangui and other parts of the country remained closed. 27. There is a real concern that the economic situation, which continues to deteriorate owing to the lack of security, will stifle the limited progress noted in the education system. The continued disturbances and tensions and the hazards associated with the rainy season could reduce freedom of movement even further and prevent the effective resumption of commercial, agricultural and pastoral activities, which are a source of income for the majority of Central Africans. The resulting loss of revenue will greatly limit access to food, basic social services and adequate living conditions; much of the population will therefore descend into poverty and will be dependent on emergency relief and humanitarian assistance. 28. The Minister of Health informed the Independent Expert during her first visit that 80 per cent of health facilities had been destroyed and that only the humanitarian organizations could handle emergencies. In the interior, health centres are looted either by the belligerents or by the local populations. They have neither the health professionals nor the medicines required to provide primary health care. Women give birth in appalling conditions and many die in childbirth. The rate of HIV/AIDS in the country is high. It is said to be higher among girls because of reported rapes. The destruction of health centres and the theft of medical equipment and medicines has eroded and decimated the health system across much of the country. The few health facilities still functioning lack resources and may no longer be able to meet demand. 10 GE.14-03816