A/HRC/47/38 distances from health centres, cost, lack of trained providers, long wait times, lack of information and confidentiality and the constraints of a heavy workload. 119 Many of those barriers come into play more acutely in situations of crisis. 58. Land-grabbing and the operations of extractive industries in the rural territories of indigenous peoples and other communities are experienced by women and girls as a crisis, 120 threatening their very survival. They are often targeted for sexual violence, including in the form of sexual exploitation and trafficking, which has been linked to higher incidences of sexually transmitted infections and HIV.121 3. Women and girls with disabilities 59. In crisis responses, the needs of women and girls with disabilities, for example, through reasonable accommodations, such as the installation of ramps and the provision of portable beds and wheelchairs, to ensure their access to sexual and reproductive health goods and services, are often not specifically taken into account.122 Information is often not available in accessible formats, which leads to difficulties in seeking services and communicating with staff.123 Women and girls with disabilities face a higher risk of abuse and violence as result of the breakdown of support systems to which they may previously have had access. 124 Negative stereotypes linked to their sexual and reproductive health status can lead to the further marginalization of their needs and concerns in situations of crisis.125 The sexual and reproductive health needs of women and girls who develop disabilities due to physical and emotional injuries from violence and armed conflict are widely neglected. 126 4. Migrant, refugee and internally displaced women and girls 60. Migrant, refugee and internally displaced women and girls often arrive carrying the traumas of violence, persecution, conflict and poverty. Reception structures and arrangements are often lacking the capacity to respond to their heightened need for sexual and reproductive health services.127 Many live in camps under a persistent threat of violence, including from intimate partners,128 while sexual and reproductive health is typically deemed a taboo topic.129 Cultural and linguistic barriers impede the flow of crucial information.130 Some have recounted traumatic experiences with unplanned and forced pregnancies as “triggering a crisis” in the precarious and dire circumstances of the camps.131 61. Many rely on “transactional sex” to secure their basic material needs, and sex may be demanded of those fleeing a crisis while in transit, 132 increasing the likelihood of unplanned pregnancies and other reproductive health risks for which services are lacking. In some destination countries, migrant women have been put in detention centres, denied basic reproductive health goods and services and subjected to non-consensual and medically unnecessary reproductive health procedures.133 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 16 See www.choiceforyouth.org/assets/Docs/198f89dc19/PositionPaper_CSW_DEF.pdf. Views expressed during the regional consultations. See also submission by Pathways for Women’s Empowerment and Development. See Inter-American Commission on Human Rights, “Indigenous and tribal peoples of the panAmazon region”, 2019; A/HRC/36/46/Add.1; A/HRC/39/17/Add.3; and E/C.19/2013/9. See submission by ASEAN Disability Forum. See submission by Kenya. See submission by Finland. Committee on the Rights of Persons with Disabilities, general comment No. 3 (2016); and submission by the Castan Centre for Human Rights Law. Views expressed during the regional consultations. See submissions by Greece, Pathways for Women’s Empowerment and Development and EKO. See submission by the Feminist Alliance for Rights. Ibid. See submissions by Greece, Pathways for Women’s Empowerment and Development and EKO. Views expressed during the regional consultations. See www.tandfonline.com/doi/full/10.1080/26410397.2020.1822493?src=recsys. See https://spcommreports.ohchr.org/TMResultsBase/DownLoadPublicCommunication File?gId=25835.